pediatric infectious obstructive airway diseases n.
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Pediatric Infectious Obstructive Airway Diseases. Fred Hill, MA, RRT. Obstructive Airways Diseases of Children. Epiglottitis Croup Bronchiolitis. Epiglottitis: Etiology and Incidence. Acute inflammation and edema of supraglottic structures

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Presentation Transcript
obstructive airways diseases of children
Obstructive Airways Diseases of Children
  • Epiglottitis
  • Croup
  • Bronchiolitis
epiglottitis etiology and incidence
Epiglottitis: Etiology and Incidence
  • Acute inflammation and edema of supraglottic structures
  • Causative agent - most often Haemophilus influenzae type B
  • Typically affects children ages 2 to 6 years
epiglottitis clinical presentation
Epiglottitis: Clinical Presentation
  • Acute onset: Upper airway obstruction and fever
  • Lethargic or agitated
  • Child sits upright
  • May be drooling
  • Toxic appearance
  • Temperature > 38 C
epiglottitis diagnosis
Epiglottitis: Diagnosis
  • Lateral neck X-ray: “thumb sign”
epiglottitis treatment
Epiglottitis: Treatment
  • Intubation
  • Antibiotics: ampicillin and chloramphenicol
croup etiology and incidence
Croup: Etiology and Incidence
  • More correctly: Laryngotracheobronchitis
  • Inflammation and edema of subglottic structures
  • Viral in origin: Parainfluenzae types I & II, RSV, others. Occasionally, Mycoplasma pneumoniae
  • Children: 6 months to 3 years
croup clinical presentation history
Croup: Clinical Presentation & History
  • Common cold precedes LTB by 1-3 days
  • Low grade fever
  • Barking cough (worse at night)
  • Stridor, hoarseness
  • Retractions, tachypnea
  • Recovery period: 2 to 6 days
croup diagnosis
Croup: Diagnosis
  • Lateral or AP X-ray of the neck: “steeple sign”
bronchiolitis etiology and incidence
Bronchiolitis: Etiology and Incidence
  • Lower airways: inflammation, edema, secretions
  • Transmission: contact with infected secretions
  • Prevalent in fall and winter
  • Viral: RSV and parainfluenzae viruses, others
  • Children <2 years
bronchiolitis clinical presentation history
Bronchiolitis: Clinical Presentation & History
  • Preceded by common cold, upper RTI
  • Congested cough
  • Wheezing, perhaps wet crackles
  • Tachypnea
  • Hyperinflation
  • Low grade fever
bronchiolitis diagnosis
Bronchiolitis: Diagnosis
  • Chest X-ray:
    • Hyperinflation
    • Peribronchial thickening
    • Patchy consolidation
    • Sternal bowing
bronchiolitis treatment
Bronchiolitis: Treatment
  • Most often mild form, doesn’t require hospitalization, primarily supportive
  • Hospitalization
    • Supplemental O2 for hypoxemia
      • Sp O2 <92%, Pa O2 <70 mm Hg
    • Mechanical ventilation
    • Ribavirin (Virazole): now controversial