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Bronchitis

mixture of wheeze & coarse crackles
different to chronic bronchitis of adults
1. main sx in children
  1. cough
    1. persists about 2 weeks
    2. lasts > 2 weeks
      1. pertussis
      2. Mycoplasma infections
  2. fever
2. No evidence of speeding recovery
  1. Abx
  2. Cough suppressants
  3. Expectorants
Whooping cough (pertussis)
1. highly contagious resp infection
2. causative pathogen
  1. Bordetella pertussis
3. epidemics
  1. every 3-4 mths
4. Clinical features
  1. initially coryza
    1. 1 week
    2. ff by
      1. characteristic paroxysmal or spasmodic cough
        followed by
        characteristic inspiratory whoop (paroxysmal phase)
        may be absent in infants
        apnoea a key feature in infants
        spasms worse @ night
        often -> vomiting
        vigorous coughing often followed by
        epistaxis & subconjunctival haemorrhages
  2. during a paroxysm
    1. child goes red or blue in face
    2. mucus flows from nose & mouth
  3. paroxysmal phase
    1. 3-6 weeks duration
  4. convalescent phase
    1. sx gradually decrease
      1. but may persist for many months
5. complications
  1. uncommon
    1. pneumonia
    2. convulsions
    3. bronchiectasis
  2. mortality
    1. significant
      1. esp in infants
        those who haven't completed primary vaccination @ 4mths esp vulnerable
6. Mx
  1. infants & young children
    1. severe spasms of cough or cyanotic attacks
      1. admit to hospital
        isolate from other children
  2. Ix
    1. culture of org on per-nasal swab
    2. blood count
      1. characteristic lymphocytosis (> 15 x 10^9)
  3. Rx
    1. Abx
      1. erythromycin
        decreases sx only if started during catarrhal phase
        prophylaxis for close contacts
    2. vaccination of unvaccinated infant contacts
      1. reduces risk of developing pertussis
      2. reduces severity of disease in those affected
      3. doesn't guarantee protection

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Bronchitis

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	Created by v.djabatey almost 11 years ago