Bronchitis in children. Acute upper respiratory tract

infections

Prof. Pavlyshyn H.A., MD, PhD

Why it’s important to know?

• Respiratory illnesses are common in children under 5 years of age. Most children will develop three to eight colds or respiratory illnesses a year. This number may even be higher in children who attend day care or are exposed to tobacco smoke.

• Most cases are mild, but about one-third of all hospitalizations in this age group are due to respiratory problems, including asthma and pneumonia.

Anatomical characteristics of respiratory system

The upper respiratory tract

The lower respiratory

tract

Acute upper respiratory tractinfections

• Upper respiratory tract infection (URI) is a nonspecific term used to describe acute infections involving

• the nose, • paranasal sinuses, • pharynx, • larynx, • trachea, • and bronchi.

Rhinitis is a nonspecific term that covers infections, allergies, and other disorders whose common feature is the location of their symptoms.

In rhinitis, the mucous membranes become infected or irritated, producing a discharge, congestion, and swelling

of the tissues.

Forms of rhinitis

• rhinoviruses,• adenoviruses, • RSV• Coxsackie's viruses.

allergic rhinitis

(hay fever)

nonallergic rhinitis (common

cold)•pollen•dust mites•mold•animal dander

Clinical manifestations: – fever, – rhinorrhea, –sore throat, –cough–similar cases in the family

Complications:

»acute otitis media,

»pharyngitis,

»sinusitis,

»conjunctivitis,

»pneumonia,

»adenitis.

Treatment (Symptomatic) :fever antipyretics

nasal obstruction

decongestants

rhinorrhea antihistamines

saline nasal drops/solution

Prevention• Chemoprophylaxis or immunoprophylaxis is

generally not available for the common cold.

•Immunization or chemoprophylaxis against influenza may be useful for prevention of colds caused by this pathogen; however, influenza is responsible for only a small proportion of all colds. •Vitamin C and echinacea do not prevent the common cold.•Interrupting the chain involved in the spread of virus by direct contact may prevent colds.•In the hospital setting, prevention of transmission of respiratory viruses has been achieved by personnel wearing protective face shields to prevent hand-to-eye or hand-to-nose contact. •Prevention of the spread of viruses by direct contact can be most readily accomplished by good hand washing by the infected individual and/or the susceptible contact.

Sore Throat - any of various inflammations of the tonsils, pharynx, or larynx characterized by pain in swallowing.• Pharyngitispredominantly inflammation of the

oropharynx, but not the tonsils.

Pharyngitis

Tonsillitis

• Tonsillitis when the tonsils are particularly affected.

Tonsillitis

Laryngitis• Laryngitis• few signs of infection visible but the patient complains of

soreness lower down the throat often with a hoarse voice.

Causes

• Viral (70-80%)

• Group A beta-haemolytic streptococcus (20-30%)

Symptoms

• Sore throat• Pain on swallowing• Fever• Headache• Malaise• Hoarseness if laryngeal involvement

Objective Signs• Redness of the pharynx and tonsils• Presence of exudate

•Note! Streptococcal sore throat is impossible to diagnose on clinical grounds alone.

Objective Signs Redness of the pharynx and

tonsils

Objective Signs Enlarged tonsils

Objective Signs Swollen tender neck glands.

Management

• Sore throat (pharyngitis, tonsillitis, laryngitis) is usually a self-limiting illness

• symptomatic treatment

• antibiotic.

Acute Bronchitis

• Bronchitis is an acute inflammation of the air passages within the lungs.

Bronchitis Causes

• Several viruses ( including influenza A and B)

• bacteria ( Mycoplasma pneumoniae)

• inhalation of irritating fumes or dust, chemical solvents and smoke,

• weakened immune systems

Prevention

Symptoms• Cough with expectoration• Mild breathlessness• Fatigue / Body pain Symptoms which can precede

or follow :

»Sore throat, »Sinusitis headache»Wheeze

COMPLICATIONS

• chronic bronchitis, • pneumonia, • asthma,• bronchiecstasis

Chronic bronchitis

Pneumonia

Bronchial asthma

bronchiecstasis

Non-medication remedies for acute bronchitis

include:• drinking lots of fluids - this makes

mucus easier to get rid of

• using a cool or warm moist-air humidifier to help thin the mucus blocking the air passages

MANAGEMENT• Antibiotics are normally only prescribed if a

bacterium is the cause. • If a virus is the problem, the infection will

generally go away by itself.

Children should never take ASA* (acetylsalicylic acid) for a viral

infection of the respiratory tract. •Control the cough expectorants, bronchodilators ( help open up the airways).

•Control the fever symptoms antipyretics