This document discusses acute respiratory diseases in children. It covers the etiology, transmission, clinical signs, and treatment of acute respiratory diseases. The main points are:
1. Acute respiratory diseases are caused by viruses, bacteria, and other infectious agents. They commonly cause symptoms like cough, runny nose, and fever.
2. Viruses spread through the air or contact. Children under 3 are most susceptible due to lack of prior immunity.
3. Treatment focuses on relieving symptoms like fever. Paracetamol and ibuprofen are generally safe and effective antipyretics. More severe cases may require anticonvulsants or lytic mixtures.
The document discusses epiglottitis, which is inflammation of the epiglottis. The epiglottis is a flap of cartilage in the throat that prevents food from entering the trachea and lungs. Epiglottitis is often caused by bacteria like H. influenzae type B and can block airflow to the lungs, making it potentially life-threatening. Symptoms include fever, drooling, difficulty swallowing, and anxiety. Diagnosis involves laryngoscopy and x-rays. Treatment secures the airway through intubation and provides IV antibiotics and fluids. Prevention involves Hib vaccination for children and general hygiene practices.
The Global Initiative for Asthma (GINA) is an independent organization established by the WHO and NHLBI in 1993 to increase awareness of asthma and improve asthma prevention and management through coordinated global efforts. GINA publishes annual evidence-based strategy reports that provide practical guidance on asthma diagnosis and treatment that can be adapted for local health systems. The 2022 report includes updates to the diagnostic approach for patients taking controller treatment and emphasizes using low-dose ICS-formoterol as reliever therapy to reduce exacerbation risk compared to SABA relievers.
Acute bronchitis is an inflammation of the air passages in the lungs that is usually caused by a viral infection such as a cold or the flu. It causes coughing and other breathing problems that typically last around two weeks. While it is usually not a serious illness, it can sometimes be caused by bacterial infections or pollution. Diagnosis involves examining symptoms and listening to the lungs for abnormal sounds. Treatment focuses on relieving symptoms through rest, fluids, medication, and avoiding irritants. Complications are rare in otherwise healthy children.
Respiratory disorders are the most common illnesses affecting children. They account for half of pediatric primary care visits and one-third of hospital admissions. The most frequent respiratory infections in children are caused by viruses like RSV. Bacterial pathogens like Streptococcus pneumoniae also commonly cause pneumonia. Conditions range from mild upper respiratory infections to serious illnesses like bronchiolitis and pneumonia that occasionally require hospitalization. Proper management depends on the specific pathogen, age of the child, and severity of symptoms.
to differentiate b/w wheezing and stridor....lead to know to make clinical dx for asthma, croup, laryngomalacia, epiglottis...there many noisy breathing....our focus wheezing n stridor....
Croup is a common respiratory illness in young children caused by viruses such as parainfluenza. It causes barking cough, hoarseness, and stridor. Symptoms typically worsen at night. Diagnosis is clinical based on symptoms and appearance of the steeple sign on chest x-ray. Treatment involves corticosteroids which reduce symptoms, and nebulized epinephrine for more severe cases. Most children recover without complications, though a small percentage require hospitalization for respiratory support.
The document discusses respiratory infections in children, including upper respiratory tract infections like sinusitis, pharyngitis, and ear infections, as well as lower respiratory tract infections like pneumonia and bronchiolitis. It describes the anatomy of the upper and lower respiratory tract, signs and symptoms of different infections, common causative agents, and treatment approaches.
Sinusitis is inflammation of the paranasal sinuses that can be acute or chronic. Acute sinusitis lasts less than 4 weeks and is usually caused by a viral infection leading to secondary bacterial infection when the sinus defenses are breached. It can be caused by infections, swimming/bathing, trauma, or general diseases. The osteomeatal complex is an important drainage site that when blocked can cause bacterial sinusitis. Treatment involves antibiotics, nasal decongestants, antihistamines, and anti-inflammatories while surgery is rarely needed and complications are common.
The document discusses epiglottitis, which is inflammation of the epiglottis. The epiglottis is a flap of cartilage in the throat that prevents food from entering the trachea and lungs. Epiglottitis is often caused by bacteria like H. influenzae type B and can block airflow to the lungs, making it potentially life-threatening. Symptoms include fever, drooling, difficulty swallowing, and anxiety. Diagnosis involves laryngoscopy and x-rays. Treatment secures the airway through intubation and provides IV antibiotics and fluids. Prevention involves Hib vaccination for children and general hygiene practices.
The Global Initiative for Asthma (GINA) is an independent organization established by the WHO and NHLBI in 1993 to increase awareness of asthma and improve asthma prevention and management through coordinated global efforts. GINA publishes annual evidence-based strategy reports that provide practical guidance on asthma diagnosis and treatment that can be adapted for local health systems. The 2022 report includes updates to the diagnostic approach for patients taking controller treatment and emphasizes using low-dose ICS-formoterol as reliever therapy to reduce exacerbation risk compared to SABA relievers.
Acute bronchitis is an inflammation of the air passages in the lungs that is usually caused by a viral infection such as a cold or the flu. It causes coughing and other breathing problems that typically last around two weeks. While it is usually not a serious illness, it can sometimes be caused by bacterial infections or pollution. Diagnosis involves examining symptoms and listening to the lungs for abnormal sounds. Treatment focuses on relieving symptoms through rest, fluids, medication, and avoiding irritants. Complications are rare in otherwise healthy children.
Respiratory disorders are the most common illnesses affecting children. They account for half of pediatric primary care visits and one-third of hospital admissions. The most frequent respiratory infections in children are caused by viruses like RSV. Bacterial pathogens like Streptococcus pneumoniae also commonly cause pneumonia. Conditions range from mild upper respiratory infections to serious illnesses like bronchiolitis and pneumonia that occasionally require hospitalization. Proper management depends on the specific pathogen, age of the child, and severity of symptoms.
to differentiate b/w wheezing and stridor....lead to know to make clinical dx for asthma, croup, laryngomalacia, epiglottis...there many noisy breathing....our focus wheezing n stridor....
Croup is a common respiratory illness in young children caused by viruses such as parainfluenza. It causes barking cough, hoarseness, and stridor. Symptoms typically worsen at night. Diagnosis is clinical based on symptoms and appearance of the steeple sign on chest x-ray. Treatment involves corticosteroids which reduce symptoms, and nebulized epinephrine for more severe cases. Most children recover without complications, though a small percentage require hospitalization for respiratory support.
The document discusses respiratory infections in children, including upper respiratory tract infections like sinusitis, pharyngitis, and ear infections, as well as lower respiratory tract infections like pneumonia and bronchiolitis. It describes the anatomy of the upper and lower respiratory tract, signs and symptoms of different infections, common causative agents, and treatment approaches.
Sinusitis is inflammation of the paranasal sinuses that can be acute or chronic. Acute sinusitis lasts less than 4 weeks and is usually caused by a viral infection leading to secondary bacterial infection when the sinus defenses are breached. It can be caused by infections, swimming/bathing, trauma, or general diseases. The osteomeatal complex is an important drainage site that when blocked can cause bacterial sinusitis. Treatment involves antibiotics, nasal decongestants, antihistamines, and anti-inflammatories while surgery is rarely needed and complications are common.
This document discusses various acute respiratory infections that can occur in children, including common cold, sinusitis, otitis media, tonsillitis, croup, and epiglottitis. It provides clinical descriptions of each condition and recommendations for diagnosis and management according to IMNCI (Integrated Management of Neonatal and Childhood Illness) guidelines. Several case scenarios are presented and classified according to IMNCI protocols. Key signs and treatments are outlined for different ear, throat and breathing problems that may present in children.
The document defines a wheeze as a high-pitched sound caused by narrowed airways, discusses the differential diagnosis and symptoms of conditions that can cause wheezing like bronchiolitis, asthma, and pneumonia. It also provides details on the pathogenesis, diagnosis, treatment and prevention of bronchiolitis in infants, noting that the mainstay of treatment is supportive care while reserving medications for severe cases.
This document discusses pneumonia in children. It defines pneumonia and describes different types including lobar, bronchopneumonia, and interstitial pneumonia. The pathogens causing pneumonia vary by a child's age. Clinical manifestations depend on age with neonates showing subtle signs and older children showing fever, cough, and difficulty breathing. Investigations may include blood tests, chest x-rays, and culture of respiratory samples. Treatment depends on severity but usually involves antibiotics, oxygen, and hospitalization for severe or complicated cases. World Health Organization guidelines recommend oral amoxicillin for non-severe cases and injectable antibiotics for severe or non-responding cases.
Croup is an inflammation of the larynx and trachea most commonly caused by parainfluenza virus. It presents with inspiratory stridor, barking cough, and hoarseness in children ages 6 months to 3 years. The Westley Croup Score is used to evaluate severity, and treatment depends on score but may include dexamethasone, nebulized epinephrine, and hospitalization for severe cases. Differential diagnoses include epiglottitis, bacterial tracheitis, retropharyngeal abscess, and foreign body aspiration.
This document discusses upper airway obstruction, including its location, signs and symptoms, causes, and types. The upper airway extends from the nose or mouth to the main carina. Common causes of obstruction include infections, tumors, and trauma. Signs include noisy breathing, dyspnea, and hypoxemia. Obstructions can be fixed or variable. Fixed obstructions do not change size during breathing and result in flattened flow-volume loops. Variable obstructions change size during breathing, most commonly seen in vocal cord paralysis. Proper diagnosis relies on patient history and examination of flow-volume loops.
This document discusses diseases of the middle ear, including acute suppurative otitis media and chronic suppurative otitis media. It describes the pathology, clinical presentation, investigations and treatment options for these conditions. Acute suppurative otitis media typically presents with otalgia, otorrhea and deafness, and is usually treated with antibiotics. Chronic suppurative otitis media can be the safe/tubotympanic type or dangerous/atticoantral type, with the former confined to the middle ear cleft and carrying less risk.
This document describes a case of croup in a 20-month-old male who presented to the emergency department with a cough. He developed rhinorrhea, fever, hoarse cry, and worsening barking cough over the past two days. On examination, he had inspiratory stridor, clear mucus, injected pharynx, and subcostal retractions. He was treated with nebulized racemic epinephrine and dexamethasone, which resolved his symptoms. The document then provides an overview of croup including definitions, etiology, pathophysiology, epidemiology, clinical presentation, diagnosis, and differential diagnosis.
This document discusses classifications of allergic rhinitis proposed by various groups from 1985 to 2001. It describes classifications based on etiology (allergic vs non-allergic), chronicity (seasonal vs perennial), and severity (intermittent vs persistent). The ARIA classification from 2001 divides rhinitis into intermittent or persistent, and further by severity as mild or moderate-severe based on sleep disturbance and impairment. Topical corticosteroids are highlighted as the most potent and effective treatment for moderate-severe persistent allergic rhinitis.
- Pneumonia is a major cause of death in children under 5 years old worldwide, though mortality has decreased with interventions.
- It is usually caused by viruses in young children and bacteria in older children, though over 50% of cases the pathogen is not identified.
- Clinical features include fever, cough, rapid breathing and in severe cases cyanosis and respiratory fatigue. Diagnosis is usually by chest x-ray but cannot differentiate between bacterial and viral pneumonia.
- Treatment involves antibiotics, oxygen and supportive care. The choice of antibiotic depends on the child's age and illness severity. Most children can be managed at home but some require hospital admission.
This document discusses childhood asthma, including its classification, epidemiology, etiology, pathogenesis, clinical features, complications, management, prognosis, and prevention. It provides case scenarios to demonstrate the diagnosis of asthma in children. Key points include that asthma is a chronic inflammatory condition of the airways causing episodic obstruction, it has a prevalence of 20% in Pakistani children, and is diagnosed based on a history of recurrent or intermittent respiratory symptoms and signs of bronchial obstruction on examination. Asthma is managed by avoiding triggers, using quick-relief and preventive medications, and treating exacerbations.
This document defines and discusses croup, a respiratory condition typically affecting children ages 3 months to 5 years. Croup is usually triggered by a viral infection of the upper airways, with symptoms including a barking cough, stridor, and difficulty breathing that worsens at night. While most cases are viral in nature, some bacterial causes are also noted. Diagnosis is usually clinical based on symptoms, though imaging may show narrowing of the trachea. Treatment focuses on supportive care, hydration, oxygen, steroids, and epinephrine to ease symptoms. Croup is generally self-limiting, with symptoms improving within a week.
This document discusses acute bronchitis, including its etiology, clinical features, diagnosis, investigations, management, and prevention. It begins by classifying a 4-year-old child presenting with cough and fever according to IMNCI guidelines. The child's symptoms and examination findings lead to a likely diagnosis of acute bronchitis. Acute bronchitis can be caused by viral, bacterial, or air pollution factors and presents with runny nose, cough, wheeze, and fever. It is diagnosed clinically and through examination of the chest and type of cough. Management involves supportive care, bronchodilators, antipyretics, cough suppressants, and antibiotics for bacterial infections. Prevention includes vaccinations, good nutrition, hand
This document discusses paediatric asthma, including its various types, pathophysiology, clinical features, diagnosis, investigations, management, and assessment in children. It describes how asthma is common in infancy and can be transient early wheezing or persist into childhood. The diagnosis is made based on a history of recurrent wheezing and reversible airflow obstruction. Investigations include assessing symptoms, triggers, lung function tests, and ruling out other conditions. Management involves reliever medications for acute symptoms and controller medications like inhaled corticosteroids to prevent exacerbations. Assessment of asthma in children evaluates severity, control, and monitors for growth, lung function, and appropriate treatment use.
Pertussis, or whooping cough, is a highly contagious bacterial disease caused by Bordetella pertussis. It is characterized by severe coughing spells that can end with a "whooping" sound when breathing in. While most severe in infants under 1 year old, it is very contagious and spreads through coughs or sneezes. Treatment focuses on limiting coughing fits through antibiotics and supportive care, with vaccination providing the best prevention against this potentially serious disease.
This document discusses atypical pneumonia caused by Mycoplasma pneumoniae and Chlamydia trachomatis. M. pneumoniae causes tracheobronchitis and pneumonia in up to 20% of pneumonia cases. It has no cell wall and is resistant to beta-lactam antibiotics. C. trachomatis is a common sexually transmitted infection and can cause pneumonia in 10-20% of infants born to untreated mothers. C. trachomatis pneumonia presents without fever in infants 1-3 months old and is diagnosed through cultures or PCR from nasopharyngeal specimens. Both are treated with macrolides like azithromycin or erythromycin.
Escherichia coli species are components of the
Normal animal and human colonic flora;
Flora of a variety of environmental habitats, including long-term care facilities (LTCFs) and hospitals.
E.coli are the cause of most nosocomial infections.
Pneumonia in children can be caused by viral or bacterial infections that lead to lung inflammation and fluid-filled alveoli. It is a common cause of death in children under 5 years old. Common bacteria that cause pneumonia include Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus. Clinically, pneumonia can be diagnosed by symptoms like fast breathing, chest indrawing, and coarse lung sounds. Chest x-rays can reveal lung infiltrates. Treatment involves antibiotics, oxygen, and managing symptoms. Vaccines help prevent acute respiratory infections that can lead to pneumonia.
1. A 54-year-old male presented with acute epiglottitis, which was diagnosed based on flexible laryngoscopy findings of a swollen epiglottis.
2. He was admitted and started on IV antibiotics and steroids. However, he collapsed and died shortly after admission.
3. Acute epiglottitis leads to swelling of the epiglottis and surrounding structures, which can cause rapid airway obstruction. Without treatment, it can progress to a life-threatening emergency.
Bronchitis and bronchiolitis are acute infections of the bronchial tubes. Bronchitis typically affects larger airways while bronchiolitis primarily impacts smaller airways called bronchioles. The most common cause is viral infection, especially respiratory syncytial virus. Clinical features include cough, wheezing, difficulty breathing. Treatment focuses on supportive care like hydration and oxygen supplementation. Severe cases requiring hospitalization involve respiratory distress, apnea or hypoxemia.
This document provides information about influenza viruses and influenza. It discusses the family of influenza viruses (Orthomyxoviridae), which includes influenza A, B, and C viruses. It describes the structure of influenza viruses and the antigenic shifts that occur. It also summarizes the pathogenesis of influenza, including transmission, replication in the body, symptoms, and potential complications. The document outlines influenza's epidemiology, seasonal patterns, pandemics, and global impact. It discusses diagnosis of influenza as well as prevention through vaccination and treatment with antiviral drugs.
The document discusses Myxoviruses, which are RNA viruses that infect the respiratory mucosa. It specifically focuses on Orthomyxoviruses like influenza virus and Paramyxoviruses such as parainfluenza virus, respiratory syncytial virus, measles virus, and mumps virus. It provides details on the structure, transmission, pathogenesis, diagnosis, and treatment of these important respiratory viruses.
This document discusses various acute respiratory infections that can occur in children, including common cold, sinusitis, otitis media, tonsillitis, croup, and epiglottitis. It provides clinical descriptions of each condition and recommendations for diagnosis and management according to IMNCI (Integrated Management of Neonatal and Childhood Illness) guidelines. Several case scenarios are presented and classified according to IMNCI protocols. Key signs and treatments are outlined for different ear, throat and breathing problems that may present in children.
The document defines a wheeze as a high-pitched sound caused by narrowed airways, discusses the differential diagnosis and symptoms of conditions that can cause wheezing like bronchiolitis, asthma, and pneumonia. It also provides details on the pathogenesis, diagnosis, treatment and prevention of bronchiolitis in infants, noting that the mainstay of treatment is supportive care while reserving medications for severe cases.
This document discusses pneumonia in children. It defines pneumonia and describes different types including lobar, bronchopneumonia, and interstitial pneumonia. The pathogens causing pneumonia vary by a child's age. Clinical manifestations depend on age with neonates showing subtle signs and older children showing fever, cough, and difficulty breathing. Investigations may include blood tests, chest x-rays, and culture of respiratory samples. Treatment depends on severity but usually involves antibiotics, oxygen, and hospitalization for severe or complicated cases. World Health Organization guidelines recommend oral amoxicillin for non-severe cases and injectable antibiotics for severe or non-responding cases.
Croup is an inflammation of the larynx and trachea most commonly caused by parainfluenza virus. It presents with inspiratory stridor, barking cough, and hoarseness in children ages 6 months to 3 years. The Westley Croup Score is used to evaluate severity, and treatment depends on score but may include dexamethasone, nebulized epinephrine, and hospitalization for severe cases. Differential diagnoses include epiglottitis, bacterial tracheitis, retropharyngeal abscess, and foreign body aspiration.
This document discusses upper airway obstruction, including its location, signs and symptoms, causes, and types. The upper airway extends from the nose or mouth to the main carina. Common causes of obstruction include infections, tumors, and trauma. Signs include noisy breathing, dyspnea, and hypoxemia. Obstructions can be fixed or variable. Fixed obstructions do not change size during breathing and result in flattened flow-volume loops. Variable obstructions change size during breathing, most commonly seen in vocal cord paralysis. Proper diagnosis relies on patient history and examination of flow-volume loops.
This document discusses diseases of the middle ear, including acute suppurative otitis media and chronic suppurative otitis media. It describes the pathology, clinical presentation, investigations and treatment options for these conditions. Acute suppurative otitis media typically presents with otalgia, otorrhea and deafness, and is usually treated with antibiotics. Chronic suppurative otitis media can be the safe/tubotympanic type or dangerous/atticoantral type, with the former confined to the middle ear cleft and carrying less risk.
This document describes a case of croup in a 20-month-old male who presented to the emergency department with a cough. He developed rhinorrhea, fever, hoarse cry, and worsening barking cough over the past two days. On examination, he had inspiratory stridor, clear mucus, injected pharynx, and subcostal retractions. He was treated with nebulized racemic epinephrine and dexamethasone, which resolved his symptoms. The document then provides an overview of croup including definitions, etiology, pathophysiology, epidemiology, clinical presentation, diagnosis, and differential diagnosis.
This document discusses classifications of allergic rhinitis proposed by various groups from 1985 to 2001. It describes classifications based on etiology (allergic vs non-allergic), chronicity (seasonal vs perennial), and severity (intermittent vs persistent). The ARIA classification from 2001 divides rhinitis into intermittent or persistent, and further by severity as mild or moderate-severe based on sleep disturbance and impairment. Topical corticosteroids are highlighted as the most potent and effective treatment for moderate-severe persistent allergic rhinitis.
- Pneumonia is a major cause of death in children under 5 years old worldwide, though mortality has decreased with interventions.
- It is usually caused by viruses in young children and bacteria in older children, though over 50% of cases the pathogen is not identified.
- Clinical features include fever, cough, rapid breathing and in severe cases cyanosis and respiratory fatigue. Diagnosis is usually by chest x-ray but cannot differentiate between bacterial and viral pneumonia.
- Treatment involves antibiotics, oxygen and supportive care. The choice of antibiotic depends on the child's age and illness severity. Most children can be managed at home but some require hospital admission.
This document discusses childhood asthma, including its classification, epidemiology, etiology, pathogenesis, clinical features, complications, management, prognosis, and prevention. It provides case scenarios to demonstrate the diagnosis of asthma in children. Key points include that asthma is a chronic inflammatory condition of the airways causing episodic obstruction, it has a prevalence of 20% in Pakistani children, and is diagnosed based on a history of recurrent or intermittent respiratory symptoms and signs of bronchial obstruction on examination. Asthma is managed by avoiding triggers, using quick-relief and preventive medications, and treating exacerbations.
This document defines and discusses croup, a respiratory condition typically affecting children ages 3 months to 5 years. Croup is usually triggered by a viral infection of the upper airways, with symptoms including a barking cough, stridor, and difficulty breathing that worsens at night. While most cases are viral in nature, some bacterial causes are also noted. Diagnosis is usually clinical based on symptoms, though imaging may show narrowing of the trachea. Treatment focuses on supportive care, hydration, oxygen, steroids, and epinephrine to ease symptoms. Croup is generally self-limiting, with symptoms improving within a week.
This document discusses acute bronchitis, including its etiology, clinical features, diagnosis, investigations, management, and prevention. It begins by classifying a 4-year-old child presenting with cough and fever according to IMNCI guidelines. The child's symptoms and examination findings lead to a likely diagnosis of acute bronchitis. Acute bronchitis can be caused by viral, bacterial, or air pollution factors and presents with runny nose, cough, wheeze, and fever. It is diagnosed clinically and through examination of the chest and type of cough. Management involves supportive care, bronchodilators, antipyretics, cough suppressants, and antibiotics for bacterial infections. Prevention includes vaccinations, good nutrition, hand
This document discusses paediatric asthma, including its various types, pathophysiology, clinical features, diagnosis, investigations, management, and assessment in children. It describes how asthma is common in infancy and can be transient early wheezing or persist into childhood. The diagnosis is made based on a history of recurrent wheezing and reversible airflow obstruction. Investigations include assessing symptoms, triggers, lung function tests, and ruling out other conditions. Management involves reliever medications for acute symptoms and controller medications like inhaled corticosteroids to prevent exacerbations. Assessment of asthma in children evaluates severity, control, and monitors for growth, lung function, and appropriate treatment use.
Pertussis, or whooping cough, is a highly contagious bacterial disease caused by Bordetella pertussis. It is characterized by severe coughing spells that can end with a "whooping" sound when breathing in. While most severe in infants under 1 year old, it is very contagious and spreads through coughs or sneezes. Treatment focuses on limiting coughing fits through antibiotics and supportive care, with vaccination providing the best prevention against this potentially serious disease.
This document discusses atypical pneumonia caused by Mycoplasma pneumoniae and Chlamydia trachomatis. M. pneumoniae causes tracheobronchitis and pneumonia in up to 20% of pneumonia cases. It has no cell wall and is resistant to beta-lactam antibiotics. C. trachomatis is a common sexually transmitted infection and can cause pneumonia in 10-20% of infants born to untreated mothers. C. trachomatis pneumonia presents without fever in infants 1-3 months old and is diagnosed through cultures or PCR from nasopharyngeal specimens. Both are treated with macrolides like azithromycin or erythromycin.
Escherichia coli species are components of the
Normal animal and human colonic flora;
Flora of a variety of environmental habitats, including long-term care facilities (LTCFs) and hospitals.
E.coli are the cause of most nosocomial infections.
Pneumonia in children can be caused by viral or bacterial infections that lead to lung inflammation and fluid-filled alveoli. It is a common cause of death in children under 5 years old. Common bacteria that cause pneumonia include Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus. Clinically, pneumonia can be diagnosed by symptoms like fast breathing, chest indrawing, and coarse lung sounds. Chest x-rays can reveal lung infiltrates. Treatment involves antibiotics, oxygen, and managing symptoms. Vaccines help prevent acute respiratory infections that can lead to pneumonia.
1. A 54-year-old male presented with acute epiglottitis, which was diagnosed based on flexible laryngoscopy findings of a swollen epiglottis.
2. He was admitted and started on IV antibiotics and steroids. However, he collapsed and died shortly after admission.
3. Acute epiglottitis leads to swelling of the epiglottis and surrounding structures, which can cause rapid airway obstruction. Without treatment, it can progress to a life-threatening emergency.
Bronchitis and bronchiolitis are acute infections of the bronchial tubes. Bronchitis typically affects larger airways while bronchiolitis primarily impacts smaller airways called bronchioles. The most common cause is viral infection, especially respiratory syncytial virus. Clinical features include cough, wheezing, difficulty breathing. Treatment focuses on supportive care like hydration and oxygen supplementation. Severe cases requiring hospitalization involve respiratory distress, apnea or hypoxemia.
This document provides information about influenza viruses and influenza. It discusses the family of influenza viruses (Orthomyxoviridae), which includes influenza A, B, and C viruses. It describes the structure of influenza viruses and the antigenic shifts that occur. It also summarizes the pathogenesis of influenza, including transmission, replication in the body, symptoms, and potential complications. The document outlines influenza's epidemiology, seasonal patterns, pandemics, and global impact. It discusses diagnosis of influenza as well as prevention through vaccination and treatment with antiviral drugs.
The document discusses Myxoviruses, which are RNA viruses that infect the respiratory mucosa. It specifically focuses on Orthomyxoviruses like influenza virus and Paramyxoviruses such as parainfluenza virus, respiratory syncytial virus, measles virus, and mumps virus. It provides details on the structure, transmission, pathogenesis, diagnosis, and treatment of these important respiratory viruses.
The document discusses various upper respiratory infections including the common cold, influenza, pharyngitis, and sinusitis. It describes the epidemiology, clinical presentation, causative agents, and treatment for each condition. The respiratory tract's defenses against infection are also outlined. The common cold is usually viral in origin and self-limiting, while influenza can be caused by different virus subtypes and sometimes causes pneumonia. Pharyngitis may be due to viruses or Group A Streptococcus bacteria. Sinusitis is classified by duration and can be caused by various bacteria.
This document provides information about rhinosinusitis and allergic rhinitis. It defines rhinosinusitis as inflammation of the nose and paranasal sinuses that can be acute, lasting less than 4 weeks, or chronic, lasting more than 12 weeks. Allergic rhinitis involves inflammation of the nasal mucosa due to IgE-mediated reactions to allergens. Diagnosis involves taking a history, physical exam, and allergy tests like skin prick tests. Management focuses on allergen avoidance, pharmacotherapy including antihistamines, and immunotherapy for long-term treatment.
Paramyxo virus Classification Symptoms and Lab diagnosis Neeraj Sharma
Paramyxovirus includes viruses like RSV and parainfluenza that cause respiratory tract infections in infants and children. Measles and mumps are among the most contagious childhood diseases. RSV and parainfluenza are limited to the respiratory tract, while measles and mumps can disseminate throughout the body. Paramyxoviruses have an envelope, nucleocapsid containing RNA, and glycoproteins like the fusion protein. They replicate in the cytoplasm and include important pathogens like RSV, parainfluenza, mumps, and measles viruses.
Parasitic infection and immunomodulation: A possible explanation for the hygi...Apollo Hospitals
This document discusses the hygiene hypothesis in autoimmune and allergic disease. It proposes that reduced incidence of parasitic infections in developed countries due to improved sanitation may be linked to increased rates of autoimmune and allergic diseases. Parasitic infections induce regulatory immune responses that help the parasites survive while also reducing inflammation. Specific parasite molecules modulate the immune system by suppressing Th1 and Th17 responses and inducing Th2 and regulatory T cell responses. Understanding these immunomodulatory mechanisms could help develop new treatments for inflammatory and allergic conditions.
This document summarizes an article on allergic rhinitis (AR). It describes AR as a chronic condition caused by immunoglobulin E reactions to inhaled allergens. AR involves nasal inflammation driven by type 2 immune cells and is often comorbid with asthma and conjunctivitis. The prevalence of AR is high in developed countries and increasing in developing countries. Risk factors include genetic predisposition and exposure to indoor and outdoor allergens. AR impairs quality of life and causes substantial economic costs. Diagnosis is based on medical history and examination, with additional allergen tests in some cases. Available treatments include allergen avoidance, pharmacotherapy, and immunotherapy.
The document discusses immunity to fungal infections. It notes that fungi can cause diseases through either a lack of immune recognition or overactivation of the inflammatory response. The immune system uses pattern recognition receptors and innate immune cells like phagocytes to recognize and respond to fungal pathogens. Both resistance mechanisms that limit fungal growth and tolerance mechanisms that limit host damage are important for maintaining immune homeostasis during fungal infections.
The upper respiratory tract includes structures like the sinuses, nasal passages, and larynx. Upper respiratory tract infections (URIs) range from mild illnesses like the common cold to more severe infections. Viruses cause most URIs, though some bacterial infections may require treatment. Common manifestations of URIs include rhinitis, sinusitis, pharyngitis, laryngitis, and others resulting from inflammation in different areas of the upper respiratory tract. URIs spread through person-to-person contact and begin when viruses or bacteria are able to bypass the body's defenses in the nose and throat and multiply in the upper respiratory mucosa.
This document provides information about influenza (flu) for 5th year medical students. It describes the epidemiology and pathophysiology of flu, which is caused by influenza viruses A, B, or C. Flu causes respiratory illness and can sometimes lead to death. The document discusses flu outbreaks, transmission, symptoms, complications, diagnosis, treatment, prevention through vaccination, and high-risk groups for flu. Pandemics occur when a new flu virus emerges globally. Seasonal flu is responsible for annual epidemics typically in winter months in temperate regions.
Evaluation And Management Of Upper Respiratory Tract Infections In Children Dawood Al nasser
Evaluation And Management Of Upper Respiratory Tract Infections In Children
This presentation offers helpful comparison tables, please note that some recommendation might have changed since preparation and publication of this material.
The document discusses communicable diseases and provides details about some specific diseases. It begins with an introduction to communicable diseases, noting they can be spread through various means like contact with bodily fluids or insects. It then defines communicable disease and provides data on the top causes of child deaths globally. The document goes on to provide more details on specific diseases like tetanus, leprosy, and sexually transmitted diseases, including definitions, transmission methods, symptoms, classifications, diagnosis, treatment, and control/prevention efforts.
This document provides information on measles (rubeola), including its definition, epidemiology, pathogenesis, clinical manifestations, complications, diagnosis, treatment, vaccination, and prophylaxis. It describes measles as a highly contagious viral disease characterized by fever and rash. Key points include that measles virus is transmitted via respiratory droplets; the vaccine is live attenuated measles virus that provides 95% protection with two recommended doses at 12-15 months and 4-6 years of age.
The document discusses various diseases and vaccines. It provides information on monkeypox transmission between wild animals in the US in 2003. It also summarizes the distribution of monkeypox cases across several midwestern and central US states. The document then discusses signs and symptoms of disease, protective immune responses, phases of vaccine development including preclinical and clinical trials, bacterial toxins, Vibrio cholerae pathogenesis and treatment, tetanus and diphtheria causative bacteria and diseases, polysaccharide encapsulated bacteria, meningococcal disease and treatment, conjugate vaccines for H. influenzae, S. pneumoniae and N. meningitidis, and combination vaccines.
This document discusses immunity to parasitic and fungal infections. It begins by defining parasites and fungi, and outlines the immune response mechanisms against them. For parasites, it describes innate immune responses like phagocytosis and complement activation. The adaptive response involves TH1/TH2 cytokines and antibodies. Parasites evade immunity through mechanisms like antigenic variation and inhibiting immune factors. Fungal immunity involves phagocytosis and TH1/TH17 cell-mediated responses. Diagnosis of mycotic infections requires microscopy, culturing, and serological tests.
Mumps is an infection of the salivary glands caused by the mumps virus, which is transmitted through respiratory droplets. It mainly affects the parotid glands located below and in front of the ears, causing swelling. Common symptoms include fever, pain when chewing or swallowing, and swelling of the parotid glands. Complications can include meningitis, orchitis, and deafness. Treatment focuses on relieving symptoms, and vaccination provides effective prevention against mumps infection.
The document summarizes key information about the Orthomyxoviridae family of viruses, which includes the influenza viruses that cause flu in humans and other animals. It describes the structure and components of influenza virions, how the viruses replicate and spread infection in the host, symptoms and potential complications, methods of diagnosis, host immune response, and approaches for prevention and treatment, including annual flu vaccines tailored to predicted circulating strains and antiviral drugs that can reduce severity of infection.
Upper respiratory infections in childrenKhaled Saad
Upper respiratory infections are very common in children and are usually caused by viruses. The most frequent types are the common cold, acute pharyngitis (sore throat), sinusitis, and ear infections. Cough associated with an upper respiratory infection can last 1-3 weeks on average and 10% of children may still be coughing after 4 weeks. Recurrent infections are also common in children due to their developing immune systems. Accurate diagnosis of conditions like sinusitis and ear infections can be challenging but is important for guiding appropriate treatment.
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Rickets is a disease characterized by impaired bone formation and growth due to abnormalities in calcium and phosphorus metabolism. It is caused by vitamin D deficiency or impaired vitamin D activity. Symptoms include skeletal deformities, muscular weakness, and growth retardation. Treatment involves correcting the underlying vitamin D or calcium-phosphorus deficiency through supplementation and increased sunlight exposure.
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2. Plan of the lecturePlan of the lecture
1. Etiology of ARD
2. Transmission mechanism in ARD
3. Hyperthermic syndrome
4. Toxic syndrome
5. Stridor
6. Clinical signs of ARD
7. Therapy in ARD
3. ARDARD is etiologically heterogeneous group ofis etiologically heterogeneous group of
infectious diseases with similar epidemiologicinfectious diseases with similar epidemiologic
and clinic characteristics.and clinic characteristics.
Typical clinical picture of ARD is characterized by respiratory tract
mucous membranes inflammation with secret excessive production
and activation of respiratory tract epithelium protective reactions and
further secretion excess removal
There are upper ARD – all affected structures upper vocal cord
( rhinitis, sinusitis, pharyngitis, tonsillitis, otitis) and ARD of lower
respiratory tract – inflammation of structures lower vocal cord
( laryngitis, tracheitis, bronchitis, pneumonia)
More frequent morbidity on ARD is find among children of first 3
y.o. ARD is more frequent in cities than in rural population and in
industry developed regions with air pollutions. Toddlers and
preschools are affected more frequently.
4. Etiology of ARDEtiology of ARD
respiratory viruses
enteroviruses
coronaviruses
bacteria
atypical microorganisms like Chlamidia,
Mycoplasma, Pneumocystis
fungus
5.
6. As a rule ARD course isn’t severe andAs a rule ARD course isn’t severe and
rarely produce complications, butrarely produce complications, but
sometimes it can initialize anothersometimes it can initialize another
pathologies.pathologies.
Among respiratory viral diseases theAmong respiratory viral diseases the
most severe course is in influenza ormost severe course is in influenza or
adenoviral infections, RS viruses oradenoviral infections, RS viruses or
parainfluenza type 3. It’s quite commonlyparainfluenza type 3. It’s quite commonly
accompanied by bacterial infection thataccompanied by bacterial infection that
worsen condition and prognosis for life.worsen condition and prognosis for life.
7. Transmission mechanism in ARDTransmission mechanism in ARD
Air way. Viruses has significantly minor sizes of
particles than microbes so they can stay longer in
aerozol, combined with mucus particles
discharged by affected person in surrounding air
during the sneezing or coughing. These particles
can spread for long distances.
Contact way (through dirty hands or by infected
subjects as it can be in adenoviruses) also play its
epidemiological role in infectious process,
especially among children. In the case of bacterial
ARD contact way is predominant.
8. Susceptibility for ARD infection is universal, but is moreSusceptibility for ARD infection is universal, but is more
prominent in age of 6 mo to 3 y.o. It can be explained byprominent in age of 6 mo to 3 y.o. It can be explained by
absence of previous contact with these microorganisms andabsence of previous contact with these microorganisms and
absence of active immunity. Growing children get this immunityabsence of active immunity. Growing children get this immunity
and lower their morbidity.and lower their morbidity.
Postinfective specific immunity has its own peculiaritiesPostinfective specific immunity has its own peculiarities
depending on etiology of disease. Influenza or vaccinationdepending on etiology of disease. Influenza or vaccination
develop lifelong immunity but viral drift (i.e. not significantdevelop lifelong immunity but viral drift (i.e. not significant
antigen changes) raise susceptibility of population andantigen changes) raise susceptibility of population and
seasonal morbidity sometimes even epidemic. Influenza virusseasonal morbidity sometimes even epidemic. Influenza virus
A except drift capable for spontaneous mutations andA except drift capable for spontaneous mutations and
recombination of RNA fragments (so called antigen shift). Duerecombination of RNA fragments (so called antigen shift). Due
to this pandemia can appear periodically (once per 10-40to this pandemia can appear periodically (once per 10-40
years), when all world population can be affected by theseyears), when all world population can be affected by these
pathogenes.pathogenes.
9.
10.
11. The total viral serotypes count is about 180 andThe total viral serotypes count is about 180 and
they cause respiratory tract affection in 95 %they cause respiratory tract affection in 95 %
Immune-diffusion reaction is used to reveal as well antigens and
antibodies (IgM, IgG) in viral infections. This method is helpful in
detection bacteria toxicity
Reactions of passive or nondirect hemagglutination (i.e.RPGA,
RNGA) are performed with using of erythrocytes, surfaces of which
absorb antigens or antibodies.
Immune-enzyme analysis (IEA) used specific antibodies conjugated
with enzymes that help to detect specific antigens.
Radio-immune method (RIM) is based on usage of radioisotopic
mark of antigens or antibodies.
Polymerase Chain reaction (PCR) help to reveal specific sites of
genetic information in RNA and DNA in assay. This method is
highly sensible and quite fast ( about 3 hours) and is helpful in first
hours of diseases to give all proper information about pathogen, its
replicative activity and foresee course and outcome of disease.
12. All viruses produce very similar clinicalAll viruses produce very similar clinical
picture – catarhhal events, running nose,picture – catarhhal events, running nose,
cough and hyperthermia. But somecough and hyperthermia. But some
peculiarities exist in various virusespeculiarities exist in various viruses
diseases. For instance:diseases. For instance: adenovirusesadenoviruses cancan
cause tonsillitis (frequently with thin coatingcause tonsillitis (frequently with thin coating
on tonsils), produce lymphadenopathy,on tonsils), produce lymphadenopathy,
prolonged course of intoxication and fever.prolonged course of intoxication and fever.
EnterovirusesEnteroviruses can produce herpangina.can produce herpangina.
ParainfluenzaParainfluenza viruses are the mostviruses are the most
frequent reason of laryngitis and stridor infrequent reason of laryngitis and stridor in
children.children. RSRS viruses produce obstructiveviruses produce obstructive
bronchitis or bronchiolitis in infants.bronchitis or bronchiolitis in infants.
13. Viral infection affect ciliary
epithelium, suppress topical
immunity of mucous membranes and
predispose to microbial inoculation.
Very important defending of
respiratory tract mucous membranes
is mucociliar clearance mechanism
that remove sputum from bronchi.
Another defending mechanism is
cough. It is helpful to remove
sputum and particles from
respiratory tract
respiratory tract is protected by
immune system.
14. Except mechanical defending mechanism, respiratory tract isExcept mechanical defending mechanism, respiratory tract is
protected by immune systemprotected by immune system..
lysozyme ( split mucopolysaccharides and
mucopeptides of bacterial wall)
transferrin ( band iron ions, necessary for
syderophylic microbes growth)
fibronectin ( prevent microbe adhesion to
membranes)
interferon ( has antiviral activity)
secretory IgA that perform primary
defending of mucous membranes. It
neutralize viruses and their toxins,
opsonize bacteria (prepare to
phagocytosis) and prevent penetration of
allergen through membranes.
15. Neonates after birth are defended by adequateNeonates after birth are defended by adequate
immune response. Besides this they are protected byimmune response. Besides this they are protected by
mother’s Ig for 3 mo. But infants has peculiarities ofmother’s Ig for 3 mo. But infants has peculiarities of
immune system.immune system.
Polynuclear neutrophils are able to performPolynuclear neutrophils are able to perform
phagocytosis but their mobilization is 2-3 times lowerphagocytosis but their mobilization is 2-3 times lower
than in adults.than in adults.
Cytotoxic activity of NK is significantly lower than inCytotoxic activity of NK is significantly lower than in
adults.adults.
Production of IgM is the same as in adults butProduction of IgM is the same as in adults but
secretion of IgA and IgG and reach the proper level issecretion of IgA and IgG and reach the proper level is
only at 5-7 years old.only at 5-7 years old.
Interferon secretion is 10 times less than in adults.Interferon secretion is 10 times less than in adults.
Deficiency of IL-2 predispose to Th-2 type of answerDeficiency of IL-2 predispose to Th-2 type of answer
and efficient Th-1 way of defending as Th-2 induceand efficient Th-1 way of defending as Th-2 induce
secretion of IgE and predispose to atopy.secretion of IgE and predispose to atopy.
16. Fever is the protective- accommodate reaction ofFever is the protective- accommodate reaction of
organism caused by pathologic agents andorganism caused by pathologic agents and
characterized by remodeling of thermoregulationcharacterized by remodeling of thermoregulation
process with elevation of body T and stimulation ofprocess with elevation of body T and stimulation of
natural organism reactivitynatural organism reactivity
Subfebrile fever (37,2-37,8C)
Low febrile (37,8-39 C)
High febrile (38,1-40 C)
Hyperthermic excessive (more than 41 C)
17. Types of feverTypes of fever
“Pink fever” or moderate hyperemia of skin. Skin
is moist and hot by sensation, child’s behavior is
normal ( heat emission correlates with heat
production)
“Pale fever” – chill, paleness of skin, cool foots
and hands, condition of child is disturbed ( heat
emission isn’t equivalent to heat production due to
impairment of peripheral microvasculature).
18. Indications for antipyreticIndications for antipyretic
medicationsmedications
1. For children without anaemnestic problems
- if body T more than 39C
- manifested myalgias
- manifested head ache
2. For children with convulsions in anamnesis
- if body T more than 38,0 C
3. For children with pathology of heart and lungs
- if body T more than 38,5 C
4. For children of first 3 mo old
- if body T more than 38,0 C
19. Risk group for complicationsRisk group for complications
due to feverdue to fever
Children less than 2 mo old with T> 38,0 C
Children with febrile seizures in anamnesis
Children with CNS diseases
Children with chronic pathology of cardio-vascular
system
Children with inherited metabolic disorders
Risk group patients need to get antipyretics
even for subfebrile temperature!
20. Hyperthermic syndrome isHyperthermic syndrome is
pathologic type of fever whenpathologic type of fever when
fast raising of body T isfast raising of body T is
accompanied withaccompanied with
microvasculature metabolicmicrovasculature metabolic
impairment and progressiveimpairment and progressive
dysfunction of essential organsdysfunction of essential organs
21. Main signs of hyperthermiaMain signs of hyperthermia
condition:condition:
Stable elevation of body T more than 40C within
3-6 hours in newborns and more than 6 hours in
infants
Motley, grey-lilic, “marmour” skin discoloration
Cold extremities despite fever
Hemodynamic impairment
Inadequate child’s behavior – flaccidity,
drowsiness or irritation
22. Medication choice in fever areMedication choice in fever are
Paracetamol
Ibufen
Antifebrile action of antipyretics is based on
supression of prostoglandin synthesis
predominantly of cyclooxygenase (COG-1 and 2)
Ibufen blocks COG in CNS in inflammative site
( antipyretic and antiinflammative effect)
Paracetamol inhibit prostoglandine synthesis
predominantly in CNS ( antipyretic and analgetic
effect).
23. ParacetamolParacetamol is the most safeis the most safe
antipyretic drug. It’s dosage isantipyretic drug. It’s dosage is
10-15 mg/kg tid or 4 times /day10-15 mg/kg tid or 4 times /day..
Daily dosage mustn’t exceed 60mg/kg.Daily dosage mustn’t exceed 60mg/kg.
Sirup forms of paracetamol start itsSirup forms of paracetamol start its
effect after 30-60 min after admission;effect after 30-60 min after admission;
In suppositories – effect is realized 2-3In suppositories – effect is realized 2-3
hours later. They are convenient forhours later. They are convenient for
night time.night time.
Ibuprofen dosage isIbuprofen dosage is 5-10 mg/kg5-10 mg/kg tid.tid.
24. Lytic mixture is prescribed only forLytic mixture is prescribed only for
hyperthermia condition and “pale”hyperthermia condition and “pale”
fever IMfever IM
Analgini 50% sol 0,1-0,2 ml/10 kg
Diprasini 2,5% sol. (Pipolfeni) 0,01 ml/kg
for infants 0,1-0,15 ml/per year for
children more 1 year old
Papaverini hydrochloridi 2% sol – 0,1-
0,2 ml for infants 0,2 ml/per year for elder
children
25. If child has generalizedIf child has generalized
convulsions it’s necessaryconvulsions it’s necessary
Turn him to one side
Band his head backward for more easy breathing
Don’t open mouth by force because you can
harm his teeth and produce aspiration
Inject anticonvulsants
If convulsions were eliminated but fever is still
present give patient paracetamol
If both convulsions and fever continue inject
lytic mixture IM
26. To relief convulsions prescribeTo relief convulsions prescribe
parenterallyparenterally
Diazepam (Seduxen, Relanium) 0,5% sol (5 mg
in 1 ml) Dosage – 0,3-0,5 mg/kg ( max 0,6 mg/kg
for every 8 hours) IM, IV
If this medication not effective Sodium
oxybutirate 20% sol with 5% glucose 50-
100mg/kg IV.
Phenobarbital (5 mg/kg/per day) per os – can’t
produce fast saturation and is recommended for
prolonged treatment.
27. Toxic syndrome –(Toxic syndrome –(acute infectious toxicosis,acute infectious toxicosis,
neurotoxicosis, toxic encephalopathy) is typical forneurotoxicosis, toxic encephalopathy) is typical for
initial period and has several phases.initial period and has several phases.
Transforming of one phase into another can beTransforming of one phase into another can be
seen if child don’t get proper treatment.seen if child don’t get proper treatment.
Initial phaseInitial phase Child is apathic, refuse feeding, don’tChild is apathic, refuse feeding, don’t
smile, sometimes is irritated, pale with bluishsmile, sometimes is irritated, pale with bluish
discoloration under the eyes. His sleeping isdiscoloration under the eyes. His sleeping is
disturbed, regurgitation or even vomiting candisturbed, regurgitation or even vomiting can
appear. Tachycardia isn’t correlated with T,appear. Tachycardia isn’t correlated with T,
muscle dystonia, contractility of muscle groups,muscle dystonia, contractility of muscle groups,
not stable nystagmus can be find.not stable nystagmus can be find.
28. Irritative phaseIrritative phase Nocturnal agitation, painful crying, fastNocturnal agitation, painful crying, fast
raising of T, tachypnoe and tachycardia, elevation of BPraising of T, tachypnoe and tachycardia, elevation of BP
are common signs of second stage Neurologicare common signs of second stage Neurologic
symptoms appear like tremor and seizures, meningismsymptoms appear like tremor and seizures, meningism
symptoms.symptoms.
Hypotonic phaseHypotonic phase Irritation subsides by adynamiaIrritation subsides by adynamia
sopor, decreasing of BP muffled heart sound,sopor, decreasing of BP muffled heart sound,
depressed respiration, tonic convulsions with apnoe.depressed respiration, tonic convulsions with apnoe.
Deep coma phaseDeep coma phase Child is slightly react or don’t toChild is slightly react or don’t to
pain, T decreased. Respiration become aperiodic,pain, T decreased. Respiration become aperiodic,
hasping type respiration, bradycardia. Skin becomeshasping type respiration, bradycardia. Skin becomes
grayish with marmoreal discoloration due to vasculargrayish with marmoreal discoloration due to vascular
picture, hemorrhagic rash can appear, DIC syndromepicture, hemorrhagic rash can appear, DIC syndrome
can produce bleeding. Child can die without propercan produce bleeding. Child can die without proper
emergency aid.emergency aid.
29. Typical for toxicosis changes ( edema,Typical for toxicosis changes ( edema,
stasis, hemorrhages, acute dystrophy andstasis, hemorrhages, acute dystrophy and
alteration) will more visible in systems andalteration) will more visible in systems and
organs impaired beforehand. Dominatingorgans impaired beforehand. Dominating
syndrome like encephalopathic, cardiacsyndrome like encephalopathic, cardiac
hemorrhagic, kidney failure, respiratoryhemorrhagic, kidney failure, respiratory
distress syndrome will be developed in locusdistress syndrome will be developed in locus
minoris. Such conditions as lost ofminoris. Such conditions as lost of
conscience, prolonged convulsions, signs ofconscience, prolonged convulsions, signs of
brain hypoxia, cardiac failure, hemorrhagicbrain hypoxia, cardiac failure, hemorrhagic
syndrome, kidney failure need emergencysyndrome, kidney failure need emergency
treatment.treatment.
30. Toxicosis treatmentToxicosis treatment
Droperidol ( adrenolytic, neuroleptic
analgetic anticonvulsant and antiemetic
effects) 0,1 mg/kg ( 0,3-0,5 ml of 0,25%
sol)
Dopamine ( epinephrine antagonist) –
dilate vessels, bronchi, stimulate heart
contractility without tachycardia only IV 3-
5 mcg/kg per min by lineomat.
31. Neuro-vegetative protection is performedNeuro-vegetative protection is performed
taking into account such rules:taking into account such rules:
Lytic mixture is injected immediately in irritation
period of hyperthermia syndrome
If there are signs of circulary failure (hypotonia,
shoc) adrenomimetics are used in twice less
dosage with IV infusions
Duration of neuro-vegetative blockage must be
minimal
If there are signs of suprarenal gland failure
glucocorticoids parenterally must be prescribed in
daily dosage 10mng/kg equivalent to prednisone.
32. Typical symptoms of stridorTypical symptoms of stridor
Voice mutation
Noisy, hoarse breathing
Tachypnoe
Obstructive, difficult inspiration ( in 1 degree)
In the case of croup progression ( 2 degree)
accessory muscle of chest and neck involvement,
jugular retractions, tachycardia, cyanosis.
33. Stridor degreesStridor degrees
I ( compensation) is characterised with inspiration difficulties
with jugular retractions. These symptoms are visible during
physical or emotional loadings. Voice is hoarse.
II ( subcompensation) – dyspnea at rest. Accessory musculature
is involved during inspiration, noisy breathing. Child is irritated,
pale, has perioral cyanosis tachycardia. PaCO2 is N PaO2 is
decreased
III ( decompensation) –hoarse, noisy breathing, retractions of all
chest spaces, acrocyanosis, paleness, sweatning. Child is flaccid,
periodically irritated. Cardiac sound is muffled, tachycardia,
PaO2 is decreased ( to 70 mm Hg and more); Pa CO2 is elevated
( to 60 mmHg and more)
IV ( asphyxia) – together with respiratory failure cardiovascular
failure and brain edema is developed. It leads to coma and
respiration arrest
34. Treatment of stridor (only inTreatment of stridor (only in
hospital!)hospital!)
I degree
-Fresh air access, oxygen therapy, warm bath for legs
and hands, adequate basic drinking, decongestants for
nose Physiologic solution, hydrocortisone inhalations
II degree
-Listed above +prednisone IM or IV 2-5 mg/kg,
constant oxygen therapy
-Berodual, salbutamol inhalations through nebuliser or
bebihaler
-Expectorants
III degree
-Listed above +prednisone 5-10 mg/kg per day, naso-
tracheal intubation ( or tracheostomy)
35. Indications for invasiveIndications for invasive
treatmenttreatment
Growing respiratory failure
Pulse deficiency
Heart borders dilation, decreasing of
oxygen saturation despite of treatment
and high levels of PaCO2.
36. Clinical peculiarities and signsClinical peculiarities and signs
of ARDof ARD
Rhinitis can be isolated or combined symptom in
ARD
Clinical signs: sneezing, rhinorrhea (nasal mucus
discharges), impaired nasal breathing (can be
essential in breast feeding abnormality in infants).
Mucus run-off by pharynx and can produce cough,
especially at night. Cough is stimulated by
dryness of mucous because of respiration through
mouth. If nasal discharges prolonged more than
10-14 days it’s indicative for sinusitis
37. Rhinitis treatment isRhinitis treatment is
symptomatic:symptomatic:
Nasal lavage with physiological solution
Decongestants ( xylomethazoline,
nafazoline, oxymetazoline) in spray or
drops (precaution concentration of solution
mustn’t exceed 0.01% for infants; 0.02%
for toddlers and 0.05% for preschools – 2-4
times per day not more than 5 days.
38. Pharyngitis -Pharyngitis - mucous layer inflammationmucous layer inflammation
of pharynx. It is frequently combined withof pharynx. It is frequently combined with
rhinitis and is called nasopharyngitis – therhinitis and is called nasopharyngitis – the
most frequent syndrome in ARD.most frequent syndrome in ARD.
Symptoms: sudden tickling feeling in theSymptoms: sudden tickling feeling in the
throat dryness, thore throat whilethroat dryness, thore throat while
swallowing or taking meals. Commonswallowing or taking meals. Common
condition is usually normal or slightlycondition is usually normal or slightly
impaired, body T can be elevated or not.impaired, body T can be elevated or not.
Prognosis is good. Recovery usually in 5-Prognosis is good. Recovery usually in 5-
7 days.7 days.
39. Pharyngitis treatmentPharyngitis treatment
Proper feeding
Gargling by antiseptic phytosolutions
Sea salt solutions inhalations
Lysozym in tablets
Topical analgetics and antiseptic drugs in elder
children ( Sebedin, Strepsils, Septolete,)
Topical antibiotic bacteriostatic drug – nasal
aerosol Fusafunzhine (Bioparox). It can stop
spreading of microbe agents and prevent
contamination of sinuses and ears.
40. Etiotropic therapy in ARDEtiotropic therapy in ARD
For influenza treatment (especially A2) – Remantadin
may be prescribed (antiviral action is due to inhibition of
specific virus reproduction on the early stages before RNA
transcription). Dosages: 1,5 mg/kg daily bid. Treatment
course 5 days, Medication can be prescribed only to
patients more than 3 y.o.
For children more than 1 y.o. remantadin is prescribed in
mixture with alginatum –ALGIREM _ 0,2 % sirup.
Dosage for 1-3 y.o. -15 ml; 1 day- tid, 2-3 day 0bid, 4 day
–once per day.
RNA-za, DNA-za
41. Etiotropic therapy in ARDEtiotropic therapy in ARD
Arbidol –interferon inductor. Dosages 6-12 y.o.0,1, 12 y.o. –
older -0,2 4 times per day. Treatment duration 3 days. In cases
with complications – 5 days, then 1 intake/per week for 4 weeks.
Anaferon contain purified antibodies for interferon –γ of
humans. Drug stimulate humoral and cell response, raise
antibodies production including IgA, activates T-effectors, T-
helpers function, normalize its ratio.
Ribavirin (nucleotide analogue of guanozine)- is used in RS
viral bronchitis, bronchiolities in severe cases. Dosage 20
mg/kg/daily in form of aerosol through inhaler. In USA
monoclonal antibodies to RS viral F-protein used and it help
rapidly decrease virus quantity in respiratory tract. Inhibitors of
neraminidase (Zanamivir –Relenca) – inhalations 20 mg bid,
Ozeltamivir –Tamiflu ) 2 mg/kg bid are allowed for children of
5 y/o/ and elder These medications shorten fever and all
symptoms duration for 24-36 hours. They can prevent flu
development.
42. Etiotropic therapy in ARDEtiotropic therapy in ARD
Interferones –are proteins that are synthesized by leucocytes
and have properties of cytokines (native leucocyte interferone,
recombinant interferone –reaferon, toleron). Antiviral activity is
due to cell resistance or viral inoculation. Interferons bind to
specific sites on cell membrane, change its properties, stimulate
specific enzymes, block viral RNA replication. Besides these
Interferons activates macrophages and NK-cells.
For influenza and ARD treatment leucocyte interferone (1000
IU) can be used. It is used intranasaly in dosage 2 ml.
Recombinant interferon ( Reaferon, Roferon) is more active (10
000 IU/ml) and is prescribed at the first signs of ARD
intranasaly 3-4 drops every 15-20 min for 3-4 hours, then 4-5
times per day within 3-4 days.
43. Etiotropic therapy in ARDEtiotropic therapy in ARD
Combined medication (Viferone – Reaferone +Vit E and
VitC) is produced in form of rectal suppositorium with cacao
butter. It can recirculate for long time, decreasing of its
concentration is seen only 12 hours later. Dosages 150 000-
500000 IU bid for 5 days. In cases of Chlamidium or
Mycoplasma infection one can use 2-3 treatment courses with
5 days intervals. The only contraindication is intolerance of
cacao butter.
Cycloferone and Neovir (Cridanimod) –are specific
substancies that stimulate endogene synthesis of Interferone.
Elevation of Interferone titer is 60-80 U/ml 2-4 hours after
medication intake. Dosage of Cycloferone is 6 mg/kg once pr
day parenterally for 2 days.
The same activity has another interferone inductors – Poludan
and Amixin (Teloron).
44. Indications for antibiotics inIndications for antibiotics in
ARDARD
Recurrent otitis in anamnesis
Children of first 6 mo with severe protein-energy
malnutrition, rickets, inherited malformations etc.
With clinical signs of immunodeficiency
In case of complications ( purulent otitis, purulent
lymphadenitis, paratonsilar abscess)
Streptococcal (typeA) tonsillitis
Anaerobe tonsillitis
Acute middle otitis
Sinusitis
Respiratory Chlamidiosis, Mycoplasmosis
Bacterial pneumonia.