1. Respiratory tract infectious
Katarzyna Stankiewicz-Sojka

2. Respiratory tract infectious
Upper Lower
common cold-coryza Bronchitis
pharyngitis Bronchiolatis
laryngitis Pneumonia
acute otitis media
acute sinusitis

3. 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,

4. Common cold -coryza Viral ethiology
Clear or mucopurulent nasal discharge or nasal blockage
fever may occur
Other symptoms : tiredness , headache,
Treatment : paracetamol, ibupropfen,

5. Pharyngitis Symtoms: Throat pain, Fever
Physical exam: Inflammed,red pharynx , lymph nodes can be enlarged
Etiology: 2/3 viral, 1/3 bacterial

6. Viral Bacterial drops of dew- like pharynx distinctly red
accompanying coryza
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

7. Viral

8. Bacterial

9. Tonsilitis 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)

10. Tonsilitis

11. Mononucleosis(glandular 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

12. Mononucleosis

13. 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

14. 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

18. 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

20. acute infection of the middle ear
Complications:
mastoiditis
meningitis
Reccurent ear infection may cause chronic secretory otitis media( glue ear), leading to hearing loss

23. 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,

26. Laryngitis 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

28. Comparison of clinical features of subglottic laryngitis and epiglottitis
Onset
over days
over hours
Preceding coryza + -
Cough
severe, barking
slight or absent
Ablity to swallow
Drooling saliva
Appearence
unwell
toxic, very ill
Fever
<38,5
>38,5
Stridor
harsh, rasping
soft,whispering
Voice,cry
hoarse
Reluctant to speak

29. Treatment of suglottic laryngitis
Nebulised steroids and 0,9 % NaClsaline
Systemic steroids
Oxygen therapy
Usually no antibiotics are needed
Etiology: mostly viral or allergens

30. Epiglottic laryngitis
Etiology: Haemophilus influenzae HIB,
rare after HIB vaccinations
Treatment of epiglottitis
In intensive care unit
Intubation
Antibiotic (cephalosporin II, III generation)

31. LTRI
Bronchitis (acute, obturative)
Bronchiolitis
Pneumonia

32. 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

33. Symtoms of bronchitis non-productive cough productive cough
dyspnoe (due to obturation)
fever
vomiting
wheezing
dry rale
coarse rattling

34. 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)

36. Broncholitis Etiology:
viruses (RS virus, Parainfluenzae, Influenzae, Adenovirus)
One of the most danger LRTI due to lifethreatening respiratory insufficiency

37. Bronchiolitis
Typical childhood infection
Most often in infancy
Cough,expiratory dyspnoe, fever
Involvment of bronchioli
Respiratory insufficinecy
Wheezing , crackles

38. Bronchiolatis Oxygen therapy,
Bronchodilators- Berodual, Ventolin, Atrovent
Steroids-nebulized and/or systemic
Nebulized epinephrine
Nebulized hypertonic saline (3%)

39. dyspnoe Sternal, subcostal and intercostal recession Nasal flaring
Hyperinflation of chest
(sternum prominent, liver displaced downward)
Dyscoordination of chest and abdomen movment

42. 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.

43. 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

44. 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

45. 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

46. Pneumonia tachypnoea, nasal flaring chest indrawing
crackles over the affected area
dullness on percussion,
decreased breath sounds
bronchial breathing

47. Pneumonia-diagnosis
chest x ray- segmental involvement,diffuse peribronchiolar densities,effusion
blood tests- e.g. blood cell count, CRP,
sputum culture
pulse oximetry

50. Treatment 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

51. Pneumonia Complications: most common: abscesses, empyema
less common: peritonitis, pericarditis,