acute resp illness in childrens

1. Title
Respiratory tract infections
in childrens

2. Etiologies
strep.pneumonia
- most common < 2yo
Mycoplasma pneumonia
> 5yo
Chlamydophila pneumoniae
> 5yo

3. Respiratory syncitial virus
( commonest)
adenovrus
Parainfluenza virus
Influenza virus

4. Common complaints
1) cough
2) running nose
3) fever
4) wheezing

7. WHO severity criteria
1) RR ( tachypnoe)
D1OL – 2Mo : > 60 bpm
2Mo – 2yo : > 50bpm
> 2yo : > 40 bpm
> 3yo : can occur with absence of tahypnoe
2) chest recessions :
Lower chest recessions : pneumonia ( severe)
Intercostal recessions : ddx bronchiolitis
Others :
- inability to eat
- audible stridor @ rest/calm/ sleep
- not active
- cough > 30days ( further assessmnt TRO PTB / chronic
infections)

10. Sepsis?1.hypo/ hyperthermia
2. poor feeding
3. poor weight gain
4. lethargy
5. hypotonia
6. pallor
7. mottled skin
8. irritability
9. jaundice
10.vomiting
11.ileus
12.pseudoparalysis
13. apnea / tachypnoea
14. cardiovascular signs
15.hemorrhagic diasthesis
16. sclerema.
Septicemic shock and death
often occur within 12 hours
of the first sign of illness
(Anwer et al, 2000, level 8).

11. Bacteria / Virus?
Bacteria Virus
●high fever > 39'c
● rapid onset
●Tachypnoe
●Recessions
●Sob in older children
●mild symptoms
● low grade 'c
● rapid onset
● Wheeze
●+-tachypnoe
Empirical antibiotic (outpatient)
I) below 5yo
-Amoxycillin
-Amoxycillin clavulanate
± macrolides
ii) above 5yo
-Macrolides
Antibiotic not indicated

12. How we can help
1) vaccination
2)early diagnosis + rx
3) improve nutrition
4) safer environment

14. Management
Mild symptoms of lower resp tract ( likely
viral) : Grade B abx )need not to use)
Clinically not well , febrile < t > 39) and with
tachyonoe or difficulty breathing (resp
distress ) → likely bacteril pneumonias →
warrant empirical abx
1) amoxicillin ( recommended for < 5yo)
2) macrolides ( > 5yo )
Hospitilized 3) peniillin / macrolides/
cefuroxime+ macrolides

15. How to make your own saline
Normal saline solution is salt mixed with water. It is
callednormal because it is a strength (0.9% saline) that is
similar to tears, blood, and other body fluids. It is also
called isotonic saline. Normal saline solution is soothing.
Other kinds of saline solutions (hypertonic or hypotonic)
may cause irritation.
1 CUP
CLEAN WATER
½ TABLESPOON
NON-IODINIZED
TABLE SALT
A PINCH OF
BAKING SODA