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 5. 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) 6. 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). 7. 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 8. How we can help 1) vaccination 2)early diagnosis + rx 3) improve nutrition 4) safer environment 9. 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 10. 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 TABLESPOON NON-IODINIZED TABLE SALT A PINCH OF BAKING SODA