Approach to Common Pediatric Upper Respiratory Tract Infections
Journal of Comprehensive Pediatrics
; 13(Supplement 1):32-33, 2022.
Article
in English
| EMBASE | ID: covidwho-2058676
ABSTRACT
Upper respiratory tract infection (URI) is one of the most frequent diseases observed at centers for pediatric care and results in significant morbidity worldwide. URI is the most common cause in children treated against acute respiratory infection. The difficulty found by clinicians in establishing the differential and etiologic diagnosis of URIs and the occasionally indiscriminate use of antimicrobial drugs. URIs range from the common, cold-typically a mild, self-limited, catarrhal syndrome of the nasopharynx to life-threatening illnesses such as epiglottitis. Viruses account for most URIs. Appropriate management in these cases may consist of reassurance, education, and instructions for symptomatic home treatment. Diagnostic tests for specific agents are helpful when targeted URI therapy depends on the results. Bacterial primary infection or superinfection may require targeted therapy. The upper respiratory tract includes the sinuses, nasal passages, pharynx, and larynx, gateways to the trachea, bronchi, and pulmonary alveolar spaces. Rhinitis, pharyngitis, sinusitis, epiglottitis, laryngitis, and tracheitis are specific manifestations of URIs. Most URIs are viral in origin. Typical viral agents that cause URIs include the Rhinoviruses, Coronaviruses, Adenoviruses, and Coxsackieviruses. In the emergency department, attention should be paid to the patient's vital signs, including temperature, heart rate, respiratory rate, blood pressure, and oxygen saturation (if obtained). Neonates are obligate nose breathers and may be at greater risk for respiratory distress;hence practitioners should auscultate the lungs for adequate aeration and assess breathing quality. The cardiovascular examination should assess adequate distal perfusion and an appropriate-for-age heart rate. Finally, dehydration can be a complication of any viral illness, and therefore, an assessment of hydration should be a part of the initial evaluation. Tests of nasopharyngeal specimens for specific pathogens are helpful when targeted therapy depends on the results (e.g., group A streptococcal infection, gonococcus, pertussis). Specific bacterial or viral testing is also warranted in other selected situations, such as when patients are immunocompromised, during inevitable outbreaks, or provide specific therapy to contacts. Symptombased therapy represents the mainstay of URI treatment in immunocompetent adults. Antimicrobial or antiviral therapy is appropriate in selected patients.
Infection; Upper Respiratory; Adenoviridae; adult; aeration; antiviral therapy; attention; blood pressure; breathing; breathing rate; bronchus; child; common cold; complication; conference abstract; Coronavirinae; dehydration; diagnosis; diagnostic test accuracy study; education; emergency ward; Enterovirus; epiglottitis; group A streptococcal infection; heart rate; home care; human; hydration; laryngitis; larynx; lung alveolus; molecularly targeted therapy; morbidity; nasopharynx; Neisseria; newborn; nonhuman; nose; oxygen saturation; pediatrics; perfusion; pertussis; pharyngitis; pharynx; physician; primary infection; reassurance; respiratory distress; respiratory tract infection; Rhinovirus; risk assessment; sinusitis; superinfection; tracheitis; upper respiratory tract infection; vital sign; antiinfective agent
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Collection:
Databases of international organizations
Database:
EMBASE
Language:
English
Journal:
Journal of Comprehensive Pediatrics
Year:
2022
Document Type:
Article
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