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Pedes Pneumonia

The document discusses the assessment and management of acute respiratory conditions in children, particularly focusing on croup and pneumonia. It outlines symptoms, differential diagnoses, and treatment options for various respiratory infections, emphasizing the importance of monitoring respiratory distress and oxygen saturation levels. Additionally, it highlights the bacterial etiology of pneumonia and the need for appropriate antibiotic therapy based on the causative organisms.

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Saquib Jan2
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18 views4 pages

Pedes Pneumonia

The document discusses the assessment and management of acute respiratory conditions in children, particularly focusing on croup and pneumonia. It outlines symptoms, differential diagnoses, and treatment options for various respiratory infections, emphasizing the importance of monitoring respiratory distress and oxygen saturation levels. Additionally, it highlights the bacterial etiology of pneumonia and the need for appropriate antibiotic therapy based on the causative organisms.

Uploaded by

Saquib Jan2
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF or read online on Scribd
J 15.3: Assessment of severity of acute | Qi _Méneral appearance Happy, feeds well interested in surroundings Stridor Intable Sidor on coughing, no stridor A art be agitated Respiratory distress No distress Oxygen saturation >92% in room ait ) 392% in So © 2and 3, influenza virus, adenovirus and rhinovirus. Bacterial etiology or bacterial superinfection is unusual. In infectious croup, the onset of the illness is more gradual Usually there is a mild cold for a few days before the child the abstraction increases, the stridor becomes more marked and the suj prasternal, and sternal recession with respiration become manifest. See Chapter 14; Fig. 14.14. Child with actité Taryngotracheobronchitis I ye assessed for severity of illness on Basis of general appearance, ‘stridor and respiratory distress (Table 15:3) 8 5 . 2 2 laryngotracheobronchitis Cierats Stridor al rest; gets worse when Tachypnea and chgst retractions develops a brassy cough and_mild inspiratory Stridor AS © (audible with or without stethoscope), Oxygen ‘saturation eee) - Tat comforted by parents Restless, agitated or altered sensor YP gitated or orium Sridor at rest and worsens on agitation we Marked tachypnea with chest retractions (92% in room air, may be cyanosed — _ room ai Bacterial: In over 40-60% of the cases, common bacteria cause pneumonia. In first 2 months, the Fclude_gram-negative bacteria such jositive OF and 6 Tween 3 months and 3 years, common bacteria include S. pneumoniae, H, ju luenae and st i Aftey Frage, common bacterial pathogens include pneumococcrand. ‘Gram negative organisms cause jonia in early infancy, mised states severe malnutrition and ‘Atypical organisms: Chlamydia and Mycoplasma spp me) caine commuunity-acquired pneumonia in adults ané children ae ae ) ‘Spasmodic Croup, ‘ children: : : : = YC occursin children between the age of Land we) Pneumocystis firovectt: This organism causes BRENTON: © There may not be preceding cory7a. The child wakes up" immunocompro! y i st fing with brassy *) Fungi “Histoplasmosis and coccidioidomyeosis may OS cough and noisy breathins “The symptoms improve ws ithin pneumoni in immun uildren. Ffeerhour. The ilinessmay recuron s cee te te The 9 Miscellaneous causes include ascariasis (Loefflr | course is generally ‘benign and patients recover completely syndrome), aspiration of food, oily nose drugs, kerose’ ‘The cause Sunknown, ‘umiification oftheroom inwhich’ a ‘ersensitivity pneumonitis. The etiology rema! seisunknown, Humil the child is nursed is all thatis necessary. y ———e——— Differential Diagnosis The syndromes of croup should be. rg ner pnd alsg from the croup associated Wit" ‘dightheria in which ame fs seen on laryngosc or occasional) Rarely the croup may result om angigneUrotic es A re aaharngea! “abscess Corre respiratory obstruction, Aspiration. ofa foreie” TES important cause of obstruction. It may be rarely confused: with wheezing. 2 suggested Reading + Patrocheilou A, Tanou.K, Kalampouta E, et al Vit! os Diagnosis and a treatment algorithm. Pediatr Pulmonol 20144942129. a Pheumonia = Preumonia my lobar Tabular pneumonia, bronch aa f Sue Pree pathologically, there imation of the inters wih ee inflammatory ceo Etiology = 27s pneumoniajcaussaebs-BSY, inllucnzn “ 3 Vea ono Ys ay be espouse orabout te of ee — Preurnococoul PReUMONIG Unknown in one-third of the cases of pneumonia. oii cirica Features = | Risk factors.for pneumonia include low birth weigh wistoy vitamin A deficiency, lack of breastfeedit” jive smoking, (@rge fan fly history <' | bronchitis, advanced birt onder crowding, voungageai! pollution, Onsct of peunonia ee beiaiousstarins aoe eee pantory tractinfection or maybeacute wit | Naber dyapnen a rer dyapnea and grunting respiration. Respisto® rate is always increased. larly, pneumonia " phoumonia may present with sympto! 5 of J te sbaominal emergen ene) Fete! ppaitt from the pleura. pical_pnewmonia may somssin* be associated with meningismus ‘and_convulsions. O° ae ie Thee i faring of ale pst, relzacton ob lower chest and aiecsal paces Siete ‘spaces, Signs of consolidation care observed in lobar pneumonia. | ie a? hy’ Respiration, infections dv to) Steptcsecs poe tiansmitted by droplets and are more common in months, Overcrowdlin and dims bossa | oops ese infection wi pocumesosse | Pathology: Bacteria multiply in the alveoli and 2 Hiflammatory exadate is formed. Scattered areaS.2 aa stoatace which coalescearound thebronchia™ a ier become labs or lobatin distribution, Pathological Clinical features: The illness usually follows upper avs: on esa ansTon whedandgy espta bat nfo, paauans Erased fepatizatin before the final stage of resolution Sara rc Tesveathe usual fextonesoLpncumonia Clinical features: Incubation period @1 to 3 dapy The (_bégeufling respirationpthe child has fever andl anorexia, is ‘gstisabuupLuvith headache, chills, coughandhigh fever, (Ts "yanosis may be present. PrORTeSSION Geghisntall-dcvbumay beasoctedwiththicknityP#iCaympomend signs sani Sometimes pulmonary Chldmay developsbactpaeTsteae ieee infection may be complicated by disseminated disease, Le Sealine Respaton ape rr involvement of more than two anatomically different sites. See here ma egnuntng chest ifcatyin TS may mane as measicabscsss in joints Boe, Ssangedgma estes sina aay "ws rencailiun, Resumail obey x ieee carer seplatorsndbroshualbmaliimayte. Diegoss: The diagnos ofS Gephyococe PRSTED ee SS ee Gauge Sy © pc nam eS Soa oss Fee sino pitas a ee ,, amination, Xray findings of lobar consolida SOP PES Cpropneumatioa}ind + (fig 15: and leukocytosis Bacteriological confirmation s > dificult sputum may be examined by Gram stain and calture. Blood culture may be pastive in S10 of ones, These pncumalosels pts WTR ymplOMaTCcysts for several weeks, Often Bemnstationofpelysecchardeantgeninurineandbiooa 2 lNi-watled asymptomatic ests 2) Saainciveinvesigation but doesnot ave suffcemts1phylococs con be grown rom the Blood. 4 ecicy for confinming pneunieacel PRRAIEt|_Tieamen The cd shouldbe immediately hospitalized ‘Fayaso be posiigeTnchilgren with colanzaon in throat. and isolated to prevent thesprend ofrsistant staphvlococci Tratment{Penellin G 50000 units/kg/day is gsan '18e other paisots. Fever contoled with antipyretics ineavenously or inkamectlay individ acs aTijdraion is majniained by inavenous fd. Oxygen G5 patients allergic to peniciln altemative agents 4dministered to relieve the dyspnea and cyanosis ag chloramphenical gr cephalosporins (ceftriaxone, + Empye {and the pus sent forcultureand casino) Thelater oul Begier wi cutionascross SnSTvly fo anlbioues) Appropriate antibiotic therapy Servi topeniTinmay occur Incommuniteswithhigh © carried out using coamoxjclav or ceftriaxone with reales enccofsigniicntpenclinessionce igherdoses cgscllin thepabent dies not gapandsoon, vancomycin igiiath but soon tke Soni es logon supports sling Suppwtates wsuling T= dsinage of empyema may helps prevention of pet feural =e sini. ‘lpm ple mjrabsceses oe REN, reTaon ie aR pase or urokinase eum foie which ere and discharge Fisica ‘er contents i 1 Dareineyistcasthe | PC reesionafplawat hens aaa See ‘Ti¥bronchioies collapse during expiration and, therefore, ) ‘@mo@hilus Pneumonia «y- 4 —— SS Gee, thes ao Si eisai at nasopharynxand spreads PRET may Tr and they may tate sie oor SETA Oeheting lina maalaganddeappeaagwin infections ae muld and cular mmumiy Genre + Period of few weeks to months. Staphylococcal abscesses ‘serious illness after the early months of life. .—= in The Tungs may erode thé” Tg may tie nt the GEMSTUD GAINS. livin ete: The onset the decal with PARA Tpyenainachidboon eyes masotulyaed ines ees asa it FG Rarryalvays steph ylococcal in etiology act synengistically with FL nfunang £ = s 8 e 2 3 § z g a — ae The child has moderate fever, dyspnea, gounting pharyngeal congestion, cervical imphadenopathy and a and retraction of the lower intercostal spaces. _few crepitations. Extrapulmonary manifestations include splcadora of 1 eerste paasmania shi remolytic anemia bacteremia, pericacTis, empyema, meningitis and Xray findings aremor extensive han gested by he polyarthritis. physical findings. Poorly defined hazy or fluffy exudates Treatiment/H. infttenzae pneumonia is est twated with Tadiate from the hilar regio Enfargement of The Mir cefotaxime (100-mg/ke/day) or ceffiasaRe (50-75 mp/ para pleural ff ction here RETRO g/day) intravenously for (iva — SOT mp/ Fe TaRraes involve one lobe, usually thelower | 3 —— Diagnosis: Wig difficult to distinguish Mucoplasay | ae pneumonia from viral or rickettsial pneumonia. The | 7 leukocyte count is usually noua. Cold agglutinins ‘Streptococcal Preumonia’ Streptococcal infection of the lungs by Hanuly be sreptocace! is usually secondary tormegpes, are elevated-in 1/3 to 3/4 of the patents. Mycoplasma Chjskenpox inlugnza or whooping congh. Group B pneumoniae i ecm the pharm ed | StopocncusisantmporantcauseoTrespiatorySRTESIn sputum. The diagnosis made capidls by demanstan 4 5 nefyborns, Pathe logically, enue Tea ‘causes Tear SRuTROn! ia, of gM it ule stage, Which may at times be hemorrhagic. Tracheobronchial More recently diagnosis is confirmed:by polymerase chain wR Shr uberaiel Lumph nodes ave enlarged reaction on eee ay Soualent pleut aTasion is a en G frequently associated. a 8 he ¥ “ (erythromycin, azithromycin of, smyein) or ¥& Clorcat featores: The onset is abrupt with foes tetragyeline for 7 to 10 days. a 5 ayspnea, rapid respiration blood sealed sputu A a nex Bry Signs of bronchopne Pneumonia cue fo Grom Negative Organims © 3 Tess pronounced, as the pathology isusuallyinkerstitl. The etiological agents are Ec, Klbstle and ido = Complications: Thin serosanguineous or purulent ‘These organisms affect st ren ( for empyema sa usual complicalion. Pulmonary suppuration children withmalnutifon and poor immunity. Pseudomor patients with cystic flbmasis a 2 SSE guenr When pneumatocelgs agg pasen} the may colonize ainvays of condition mimics See focoscal pneumonia. cee ase recurrent pulmgnary exacerbations. Sis mental involvement, Clinical features: Onset-is gradual and assumes lit | “itfuse peribronchial densities Oran effusion. j threatening proportigns during its course. Signs; | SI ec im ampiclin iM mmg/kg/day , consolidation areuminins) particular inf Treatment: Peni el Ge tiven for 7-10 days. The € Constitutional symptoms aremore prominent C+ | SSpanwe is gradual but recovery is generally complete." ratory distress | a Empyema is sate by closed drajnage with indwelling. Diagnosis: Radios jcal signs are extensive ina form. | igfemostaltwbe 2 massive consolidation Klebsiella pcre m= = - a Pexnertanniooieeumone Feibrents Ineavenous ustlonasnitdigenertion ¥X The etiological agent is Mycoplasma'pneumonine; other ~ cephalosporin cefotaxime or ceftriaxone, 75-100 mgs pathogens include Chlamydia and Legionella spp It cccurs day) with or without aman eis recommended Peapuiemicschiefirinthe winter months. Chidcen living. for 10to14 days, Incase of suspected Pseudomonas infection Oe are pronets devslop g cade crbopanem may betiedragaT TOR. | Oc oMiapiana uncommon aes” SET — Teeth cof euuiy iogh sPetn So sit re Veieuron

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