Transcript Respiratory Tract Infection

Respiratory tract infectious
Respiratory tract infectious
Upper
Common cold
Pharyngitis
Laryngitis
Acute otitis media
Acute sinusitis
Lower
Bronchitis
Bronchiolitis
Pneumonia
Upper respiratory tract infection
• Etiology:
Viruses: e.g rhinoviruses, adenoviruses, RSV,
enteroviruses, EBV,
Bacteria: e.g Streptococcus. Pnumococcus,
Hemophilus influezna,moraxella catarrhalis
Fungi: e.g Candida albicans,
Common cold -coryza
• Viral ethiology
• Clear or mucopurulent nasal discharge or
nasal blockage
• Fever may occur
• Other symptoms : tiredness , headache,
• Treatment : paracetamol, ibupropfen,
Pharyngitis
Symtoms: Throat pain, Fever
Physical exam: Inflammed,red pharynx ,
lymph nodes can be enlarged
Etiology: 2/3 viral, 1/3 bacterial
Viral
Bacterial
drops of dew- like
accompanying coryza
pharynx distinctly red
coryza
lymph nodes slightly
enlarged or not enlarged
lymph nodes prominently
enlarged and tender
Laboratory test
Usually low CRP,WBC,
Lymphocyte in Blood
film
High CRP,
WBC low or high
Neutrophil granulocyte
Viral
Bacterial
Tonsilitis
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Fever
red and/or swollen tonsils
white or yellow patches on the tonsils
tender, stiff, and/or swollen neck(swollen lymph
nodes)
painful or difficult swallowing
Sore throat
Abdominal pain , vomiting
Antibiotic should be given (penicillin, macrolid)
Tonsilitis
Mononucleosis(glandular fever)
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fever
tonsilitis (sometimes causing airway narrowing)
prominent lymphadenopathy (Neron’s neck)
hepatosplemomegaly
a maculopapullar rash
no positive reaction to antibiotic
most commonly contracted by adolescents and
young adults ages
• Etiology: mostly EBV
Mononucleosis
Scarlet fever
• acute, bacterial, rash disease of childhood
• caused by β hemolytic streptoccoccus, group
B
• incubation period 1-7 days ( average-3 days)
acute onset, fever,vomiting, abdominal pain,
• pharyngitis , tonsilitis
• rash appears on 1 or 2 day- macular ,punctate
intensively red
• characteristic location on face- paleness
around mouth, spreading downwords
Scarlet fever
• characteristic tongue ( white strawberry
tongue→ red strawberry tongue
• haemorrhagic lesions in articular fossae (
Pastia lines)
• Desquamation begins after a week from face
to limbs
Acute infection of the middle ear
• fever , pain in ear, irritation, loss of
appetite
• examination of tympanic membrane: loss
of normal light reflection, bulging, red
membrane
acute infection of the middle ear
Complications:
• mastoiditis
• meningitis
Reccurent ear infection may cause chronic
secretory otitis media( glue ear), leading
to hearing loss
Sinusitis
• Sinusitis is inflammation of the paranasal
sinuses Most cases are due to a viral infection
• Pain, swelling, tendreness over a cheek, nasal
blockage, headache
• Treatment: antibiotics, histamine blockers,
decongestants,
Laryngitis
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Symptoms
Hoarseness or no voice at all
Dry, sore burning, throat
Coughing, barking cough
stridor
Difficulty swallowing
Sensation of swelling in the area of the larynx
Cold or flu-like symptoms
Swollen lymph nodes
Fever
Difficulty breathing (mostly in children)
Difficulty eating
Increased production of saliva in mouth
Comparison of clinical features of subglottic
laryngitis and epiglottitis
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Onset
Subglottic
laryngitis
over days
Preceding coryza
Cough
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severe, barking
Epiglottitis
over hours
slight or absent
Ablity to swallow
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Drooling saliva
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Appearence
Fever
unwell
<38,5
Stridor
Voice,cry
toxic, very ill
>38,5
harsh, rasping soft,whispering
hoarse
Reluctant to speak
Treatment of suglottic laryngitis
Nebulised steroids and 0,9 % NaClsaline
Systemic steroids
Oxygen therapy
Usually no antibiotics are needed
Etiology: mostly viral or allergens
Epiglottic laryngitis
Etiology: Haemophilus influenzae HIB,
rare after HIB vaccinations
Treatment of epiglottitis
• In intensive care unit
• Intubation
• Antibiotic (cephalosporin II, III generation)
LTRI
• Bronchitis (acute, obturative)
• Bronchiolitis
• Pneumonia
Bronchitis
• Bronchitis is inflammation of the mucous
membranes of the bronchi
• Etiology:
• Viruses ( Parainfluenzae, Adenovirus, RS-virus,
Rhinovirus)
• Bacteria (Haemophilus influenzae,
Streptococcus pneumoniae, Staphylococcus
aureus)
• Atopy
Symtoms of bronchitis
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non-productive cough
productive cough
dyspnoe (due to obturation)
fever
vomiting
wheezing
dry rale
coarse rattling
Treatment
mucolitycs (eg cysteine derivates, Ambroksol)
bronchodilating drugs- Beta Agonist, Ipratropii
bromidum
Steroids
Antibiotics- mainly used in newborns and small
chlildren when bacterial infection is suspected
(eg Amoxicilline, Cephalosporin antibiotics I, II
generation- Cefalotin, Cefuroxim)
Broncholitis
Etiology:
• viruses (RS virus, Parainfluenzae, Influenzae,
Adenovirus)
One of the most danger LRTI due to
lifethreatening respiratory insufficiency
Bronchiolitis
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Typical childhood infection
Most often in infancy
Cough,expiratory dyspnoe, fever
Involvment of bronchioli
Respiratory insufficinecy
Wheezing , crackles
Bronchiolatis
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Oxygen therapy,
Bronchodilators- Berodual, Ventolin, Atrovent
Steroids-nebulized and/or systemic
Nebulized epinephrine
Nebulized hypertonic saline (3%)
dyspnoe
• Sternal, subcostal and intercostal recession
• Nasal flaring
• Hyperinflation of chest
(sternum prominent, liver displaced
downward)
• Dyscoordination of chest and abdomen
movment
Pneumonia
• Pneumonia is an inflammation of the lungs. It
is a serious infection in which air sacs in the
lungs fill with pus and other liquid.
• Pneumonia may be lobar or bronchial
• Pneumonia is most common in winter and
spring.
• About 10 to 15 percent of children with a
respiratory infection have pneumonia.
Pneumonia
• The pathogens causing pneumonia vary
according to the child's age:
• Newborn - organisms from the mother's genital
tract, particularly group B streptococcus, but also
Gram-negative enterococci
Pneumonia
• Infants and young children -mostly
respiratory viruses, particularly RSV, are most
common, but olso bacterial infections include
Streptococcus pneumoniae or Haemophilus
influenzae. Bordetella pertussis and
Chlamydia trachomatis can also cause
pneumonia at this age. An infrequent but
serious cause is Staphylococcus aureus
• Children over 5 years - Mycoplasma
pneumoniae, Streptococcus pneumoniae and
Chlamydia pneumoniae are the main causes.
• At all ages Mycobacterium tuberculosis
should be considered
Pneumonia-symptoms:
• fever and cough are the first to develop
• persistent cough that may last three to four
weeks
• severe cough that may produce some mucus
• chest or stomach pain
• decrease in appetite
• chills
• breathing fast or hard
• vomiting
• headache
• not feeling well
Pneumonia
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tachypnoea,
nasal flaring
chest indrawing
crackles over the affected area
dullness on percussion,
decreased breath sounds
bronchial breathing
Pneumonia-diagnosis
• chest x ray- segmental involvement,diffuse
peribronchiolar densities,effusion
• blood tests- e.g. blood cell count, CRP,
• sputum culture
• pulse oximetry
Treatment
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antibiotics
Increased fluid intake
oxygen therapy
frequent suctioning of your child's nose and
mouth (to help get rid of thick secretions)
• medication for cough
• sometimes bronchdilators
Pneumonia
Complications:
• most common: abscesses, empyema
• less common: peritonitis, pericarditis,