Upper Respiratory Tract Infections in Children Flashcards
What are the clinical features of tonsillitis/pharyngitis?
Sore throat (usually severe), difficulty swallowing (dysphagia).
Fever, swollen tonsils with or without exudates (white patches).
Anterior cervical lymphadenopathy (swollen lymph nodes).
Possible headache and malaise.
Can be caused by Streptococcus pyogenes, viruses (e.g., EBV).
What are the typical symptoms of the common cold?
Runny nose (rhinorrhea), sneezing, nasal congestion, and cough.
Mild sore throat and headache.
Low-grade fever (especially in children).
Fatigue and mild malaise.
Most commonly caused by rhinovirus; also coronavirus, adenovirus.
What are the clinical features of glandular fever (infectious mononucleosis) caused by EBV?
Fever, severe sore throat, swollen tonsils with white exudate.
Posterior cervical lymphadenopathy (swollen lymph nodes).
Fatigue and splenomegaly.
Rash may appear, especially after taking ampicillin.
Hepatomegaly in some cases.
Diagnosed by heterophile antibody test or EBV serology.
What are the symptoms of otitis media?
Ear pain (otalgia), hearing loss, a feeling of fullness or pressure in the ear.
In children, symptoms may include irritability, poor feeding, and fever.
Can lead to eardrum perforation or mastoiditis in severe cases.
Common organisms: Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis.
What are the clinical features of sinusitis?
Nasal congestion and purulent nasal discharge.
Facial pain or pressure, especially when bending forward.
Headache, fever, fatigue.
Cough, worse at night.
Most cases are viral, but bacterial causes include Streptococcus pneumoniae, Haemophilus influenzae.
What are the common bacterial and viral organisms causing upper respiratory infections?
Bacterial Causes:
Streptococcus pyogenes (causes tonsillitis and pharyngitis).
Streptococcus pneumoniae (causes otitis media and sinusitis).
Haemophilus influenzae (causes otitis media and sinusitis).
Moraxella catarrhalis (causes otitis media).
Viral Causes:
Rhinovirus (causes the common cold).
Adenovirus (causes pharyngitis and tonsillitis).
Parainfluenza virus (causes croup and upper respiratory infections).
Influenza virus (causes flu with sore throat and respiratory symptoms).
Epstein-Barr Virus (EBV) (causes glandular fever/infectious mononucleosis).
What is the role of supportive therapy in the management of upper respiratory infections?
Hydration: Ensures adequate fluid balance and helps to loosen mucus.
Rest: Supports the body’s immune response.
Pain and fever management:
Use of paracetamol or ibuprofen for pain relief and reducing fever.
Saltwater gargles: Can help soothe a sore throat.
Cough suppressants (e.g., dextromethorphan) or expectorants (e.g., guaifenesin) for symptom management.
Decongestants (e.g., pseudoephedrine) for nasal congestion, but use only short-term.
When are antimicrobial therapies used in upper respiratory infections?
Bacterial infections (e.g., Streptococcus pyogenes causing tonsillitis or pharyngitis):
Penicillin or amoxicillin for Strep throat.
Otitis media or sinusitis with confirmed bacterial infection:
Amoxicillin or amoxicillin-clavulanate.
Influenza:
Oseltamivir (Tamiflu) can be used within 48 hours of symptom onset to reduce the severity of symptoms.
EBV: No specific antiviral treatment; supportive care is the main approach.
