Pediatric Recurrent Respiratory Tract Infections

What Are Respiratory Tract Infections?

Infections involving parts of the respiratory tract, including the sinus, airways, lungs, or throat, are referred to as respiratory tract infections. Respiratory tract infections can affect the upper and lower respiratory tract. The common cold, laryngitis (inflammation of the larynx or the voice box), tonsillitis (inflammation of the tonsils), acute rhinitis (inflammation of the mucus membrane lining the nose), and acute otitis media (middle ear infection) are examples of upper respiratory tract infections. Acute bronchitis (inflammation of bronchial tubules’ lining), bronchiolitis (inflammation of small airways), pneumonia (inflammation of air sacs), and tracheitis (inflammation of the trachea or the windpipe) are examples of lower respiratory tract infections. Respiratory tract infections are commonly treated with the help of antibiotics.

What Are Pediatric Recurrent Respiratory Tract Infections?

Pediatric recurrent respiratory tract infections are repeatedly occurring infections of the upper or lower respiratory tract in children. One of the most common causes of pediatric visits and hospitalizations is recurrent respiratory tract infections. Children frequently have respiratory infections, which mostly affect the upper airways, and their recurrence presents a difficult problem for pediatricians. Infections must happen at least two weeks apart from one another and be accompanied by a time of no symptoms in between for them to be deemed as recurrent infections. Although recurrent respiratory tract infections are quite common in kids, they can occasionally be a symptom of a more serious illness, such as primary immunodeficiency syndromes or congenital disabilities of the lungs. Therefore, it is crucial to differentiate between kids with easily treatable causes for their symptoms and kids with severe underlying conditions.

Are Pediatric Recurrent Respiratory Tract Infections Common?

• Around six percent of children under the age of six are believed to have recurring respiratory tract infections, according to epidemiological studies. Recurrent respiratory infections are prevalent, affecting ten to 15 % of children.

• Up to 25% of children under one year of age and 18 % of children between the ages of one and four get respiratory tract infections in developed nations.

• Clinically, most children experience recurrent upper respiratory tract infections, but in ten to 30 % of cases, the lower respiratory tract is also impacted.

• Recurrent respiratory tract infections are prevalent among preschoolers and are typically caused by unfavorable environmental factors, such as early socialization and immune system immaturity.

What Are the Symptoms of Pediatric Recurrent Respiratory Tract Infections?

Symptoms of recurrent respiratory infections include-

• Runny nose.

• Sore throat.

• Pain in the throat.

• Nasal congestion.

• Swelling in the tonsils.

• Enlarged lymph nodes of the neck.

• Cough.

• Dyspnea or shortness of breath.

• Tachypnea or rapid breathing.

• Bluish discoloration of the skin or cyanosis.

• Wheezing (whistling sound while breathing).

• Retraction of the chest.

• The child may act fussy or cranky.

• Fatigue and tiredness.

• Loss of appetite or refusal to eat properly.

• Weight loss.

Risk Factors for Pediatric Recurrent Respiratory Tract Infections

There are a plethora of risk factors that can be attributed to the increased incidence of recurrent respiratory tract infections in children.

• Age: Children under five years are at a higher risk of developing recurrent respiratory infections due to their immature immune systems.

• Exposure: Increasing contact with infectious agents during the initial years of life, particularly when the child attends preschool with other kids.

• Sex: Males are more prone to these infections as compared to females.

• Social Environment: Children who go to daycare and have a big family are exposed to air pollution or parental smoking.

• Inadequate Breastfeeding: The risk of recurrent respiratory tract infections rises due to the lack of maternal antibodies derived during nursing.

• pets: Having pets at home.

• Climate: Winter months and cold climate.

• Family History: Family history of atopic diseases.

• Low Birth Weight: Babies born with low weight.

• Malnutrition: Malnutrition and low socioeconomic status.

• No Vaccination: Lack of vaccines will lead to recurrent infections.

• Gastroesophageal Refux Disorders: History of gastroesophageal reflux may lead to recurrent respiratory infections.

• Physical Activity: Excess physical workout.

What Causes Pediatric Recurrent Respiratory Tract Infections?

Children's respiratory infections typically result from an imbalance between exposure to infectious diseases and the body's ability to fight the infection. The causes include the following:

• Microorganisms: Children with recurrent respiratory infections are most frequently infected with viruses and bacteria. Rhinoviruses, influenza viruses, and respiratory syncytial viruses are common viruses. Hemophilus influenza, Streptococcus pneumoniae, Mycoplasma pneumonia, and Streptococcus pyogenes are a few common bacterial infections.

• Underlying Causes: Recurrent respiratory infections are widespread in children, and they are frequently caused by an immune system that is not yet completely developed, as well as risk factors. The underlying causes are further classified into anatomic abnormalities, functional abnormalities, secondary immunosuppression, and primary immunodeficiency disorders.

Complications of Pediatric Recurrent Respiratory Tract Infections

Recurring infections can cause complications, but they can also negatively affect kids and their families. Common complications of pediatric recurrent respiratory infections are as follows:

• Bronchiectasis: A form of chronic obstructive pulmonary disease or COPD marked by enlarged airways and increased mucus production. The incidence of bronchiectasis is rising in the United States.

• Antibiotic Resistance: Children who frequently get respiratory infections also need to take antibiotics. Recent research has shown that taking antibiotics can harm the gut flora and even raise the risk of developing colon cancer. Antibiotic resistance can also develop as a result of repeated antibiotic use.

• Asthma: Children with recurrent respiratory tract infections are also at a higher risk for asthma due to the infections. Moreover, in children who already have asthma, recurrent respiratory tract infections can trigger an asthma attack.

How Are Pediatric Recurrent Respiratory Tract Infections Diagnosed?

Pediatric recurrent respiratory tract infections can be diagnosed in the following ways:

• Medical History: A thorough history is the most crucial step in evaluating a patient for recurrent respiratory tract infections. This should describe prior infections, including their severity and any treatments employed. Additionally, detailed family history is also important.

• Physical Examination: The child’s height and weight should be checked. The head and neck should be inspected to check for the presence of enlargement in the tonsils and adenoids. Nasal polyps or septum, if present, should be checked. The chest should be inspected for changes and abnormalities.

• Blood Examinations: A complete blood count is performed to check white blood cells, red blood cells, or platelets. It is important to check the levels of serum immunoglobulin.

• Imaging Tests: If a congenital problem is suspected or to assess the severity of an infection or sequelae like bronchiectasis, X-ray, computed tomography (CT), and magnetic resonance imaging (MRI) may be performed.

How Are Pediatric Recurrent Respiratory Tract Infections Treated?

• The underlying cause of the infection determines the treatment of recurrent respiratory infections.

• Vaccinations against primary and secondary infections should also be maintained; they are safe and effective even for the majority of kids who suffer from immunodeficiency diseases.

• The use of antibiotics is necessary when secondary infections develop.

• Treatment options for kids with immunodeficiency disorders may include immunoglobulin.

Conclusion

Pediatric recurrent respiratory tract infections are prevalent infections affecting young children. They can affect upper and lower respiratory tracts and can occur due to bacterial infections, viral infections, immune deficiency, etc. It is estimated that two million children die yearly from recurrent respiratory tract infections. Therefore, recurrent infections should be treated to limit the risk of long-term lung damage. Moreover, potential underlying causes should be examined to prevent further complications. These infections have a good prognosis.