Paediatric respiratory infection: Difference between revisions
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Ear infection. Again, mega common. If any child has a fever, the tympanic membranes must be examined, since it may be bright red. Generally, the pain will go away with some paracetemol and the child will be better in a couple of days. | Ear infection. Again, mega common. If any child has a fever, the tympanic membranes must be examined, since it may be bright red. Generally, the pain will go away with some paracetemol and the child will be better in a couple of days. | ||
Sometimes, recurrent episodes leads to chronic secretory otitis media, which is the main cause of conductive hearing loss in children. Insertion of ventilation tubes called grommets to prevent hearing loss is currently under debate; it is probably not very useful. | Sometimes, recurrent episodes leads to chronic secretory otitis media, which is the main cause of conductive hearing loss in children. Insertion of ventilation tubes called grommets to prevent hearing loss is currently under debate; it is probably not very useful. | ||
===Epiglottitis=== | |||
This one is, thanks to the Hib [[vaccine]], rare in the UK. Since the Haemophilus influenzae type b infection is systemic, the child will have a fever, and clearly be ill. They will have a rapidly increasing respiratory distress, with body posture to maximise airways, and a sore throat that prevents the child from talking. | |||
The very first thing you must do is contact the anaesthetist. Do not go anywhere near their throat, because you may force the airway to close; the anaesthetist needs to be on hand to intubate. If the airway closes they can die, but if you protect it, they should respond to [[antibiotics]] and make a full recovery. | |||
===Bronchi and bronchioles=== | ===Bronchi and bronchioles=== | ||
===Lungs=== | ===Lungs=== | ||
===Chronic=== | ===Chronic=== | ||
Revision as of 15:05, 12 September 2008
Upper airways
Snotty little kids, whinging away...
Having a cold and a sore throat is pretty much the definition of childhood, so you will see a lot of these. Usually a cold is a rhinovirus, sore throat an adenovirus. There’s no point in treating with antibiotics cos they won’t work. If they have a fever, give them some paracetemol. That’s about it.
The sore throat may be caused by streptococcal infection in school age kids. The pharynx will be inflamed. Tell them to get over it.
Tonsillitis
Inflamation of the tonsils. Look for an ‘exudate’ (spots of pus on it). Usually caused by strep, or its viral. Generally the child with the bacterial infection will be more ill. That said, antibiotics are usually given, even though only about a third of the them are non viral. When screening for rheumatic fever, its worth asking about episodes of tonsillitis. In patients with recurrent episodes, tonsillectomies are common, since taking it out stops the itis.
Acute otitis media
Ear infection. Again, mega common. If any child has a fever, the tympanic membranes must be examined, since it may be bright red. Generally, the pain will go away with some paracetemol and the child will be better in a couple of days. Sometimes, recurrent episodes leads to chronic secretory otitis media, which is the main cause of conductive hearing loss in children. Insertion of ventilation tubes called grommets to prevent hearing loss is currently under debate; it is probably not very useful.
Epiglottitis
This one is, thanks to the Hib vaccine, rare in the UK. Since the Haemophilus influenzae type b infection is systemic, the child will have a fever, and clearly be ill. They will have a rapidly increasing respiratory distress, with body posture to maximise airways, and a sore throat that prevents the child from talking. The very first thing you must do is contact the anaesthetist. Do not go anywhere near their throat, because you may force the airway to close; the anaesthetist needs to be on hand to intubate. If the airway closes they can die, but if you protect it, they should respond to antibiotics and make a full recovery.