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Upper and Lower Respiratory Infections in Children - Types, Symptoms, Diagnosis, and Treatment

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Upper and Lower Respiratory Infections in Children - Types, Symptoms, Diagnosis, and Treatment

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Severe or acute respiratory infections are harmful, especially in children. Read the article to learn more about children's severe or acute respiratory infections.

Written by

Dr. Saberitha

Medically reviewed by

Dr. Sajeev Kumar

Published At July 12, 2022
Reviewed AtJanuary 9, 2023

Introduction

The infection that affects normal breathing is called acute respiratory infection. This infection involves both the upper and lower respiratory tract. The upper respiratory tract comprises the nose, the pharynx, and the larynx. The lower respiratory tract comprises the airways, alveoli, and lungs. Lower respiratory tract infections affect both the lungs to a great extent.

Upper Respiratory Infection

The most common disease of upper respiratory tract infection is cold. Other diseases in the upper respiratory tract infection are sinusitis, pharyngitis, and ear infection.

What Are the Common Symptoms Present in Upper Respiratory Infection in Children?

Various symptoms corresponding to acute respiratory illness in children are as follows;

1. Sore Throat (Pharyngitis): Sore throat is the most common symptom of acute respiratory infection. The child faces difficulties like the burning sensation while swallowing and a coarse feeling in the throat. The tonsils appear red, swollen, and tender.

2. Nose Block: Cold and sinus infections cause inflammation in the nose. The disease affects the respiratory tract and causes mucus discharge in the nose. In acute respiratory infection, the nasal block lasts for around seven to ten days.

3. Sinus Infection (Sinusitis): The common cold affects the sinus region in children. The sinus area affected by the infection is tender.

4. Congestion: The mucus buildup in the lungs and nose of the children causes congestion in the lungs and nose.

5. Cough: The children affected by the acute respiratory infection have a cough lasting three weeks. Mostly, the cough is relieved after two weeks. However, consider visiting a pediatrician if the cough continues for more than three weeks.

5. Fever: The temperature rises to 102°F in children.

6. Ear Infections: The bacterial infection spreads to the middle ear and causes ear infections.

Pharyngitis

It is defined as the inflammation of the food pipe (pharynx). The virus and bacteria that cause sore throat in children are streptococci, measles, influenza virus, and adenovirus.

What Are the Various Symptoms of Pharyngitis?

  • Cold - Sneezing along with a runny nose is the first symptom to appear due to the influenza viral infection. It causes the common cold.

  • Fever - Children have fever and chills in the extremities like feet and palms. The lymph node appears swollen due to the infection.

  • Loss of appetite - The child will refuse to eat due to the pain in the throat during swallowing.

  • Fatigue - The children become restless and tired during the day. The child has a headache and body ache due to the infection.

  • Nausea - The child has an unpleasant taste in the mouth. It gives a feeling of nausea. Red or white patches appear on the throat region because of the inflammation.

What Are the Diagnostic Methods for Pharyngitis?

Culture Test: The secretion from the throat is collected using a cotton swab. It is used to detect the presence of streptococcus. If the result is positive, then the child must be provided with the necessary treatment.

Blood Test: The complete blood count test is used to detect the type of infection. Blood is collected from the arm to test the presence of mononucleosis.

What Is the Treatment for Pharyngitis?

Antibiotics are used to treat bacterial infections like sore throat and pharyngitis. Penicillin is the most commonly used medicine. The antibiotics course takes one week.

Sinusitis

Sinusitis is an inflammation in the air cavities of the face and nasal passages. The air cavities are present in the cheeks, foreheads, and near the nose.

What Are the Symptoms of Sinusitis?

1. Stiff Nose - The mucus builds up in the sinus cavity and causes a stuffy nose. Later it turns out to be a cough.

2. Fatigue - Children with weak immune systems are prone to infection and get tired shortly.

3. Fever and Headache - Headache occurs due to the pressure in the air cavity (sinus). The infection causes a fever of more than 102° F.

How Is Sinusitis Diagnosed in Children?

  1. X-Ray - Normal X-rays are used to diagnose abnormal changes in air cavities (sinus).

  2. CT (Computed Tomography)-Scan - CT scans are used for more detailed images. It gives a clearer picture of the area affected by a sinus infection.

  3. Culture Test - Children have mucus discharge from the nasal passages. This discharge is collected in a swab for lab tests.

What Is the Treatment for Sinus Infection?

  • The infection is due to an allergy. So antihistamines are used to reduce the allergic condition.

  • Antibiotics are prescribed by the medical professional for three to five days.

Lower Respiratory Infection

The lower respiratory tract comprises the lungs and the alveoli. The alveoli help the lungs to deliver oxygen to all parts of the body. Therefore, any infection in the lower respiratory tract affects the lungs and causes bronchiolitis and pneumonia.

Bronchiolitis

Bronchiolitis is the most common lower respiratory tract infection in children. The inflammation in the bronchioles causes bronchiolitis.

What Are the Symptoms of Bronchiolitis?

Coughing and wheezing with a runny nose are the common symptoms. The infants also experience middle ear infections.

What Is the Risk Factor for Bronchiolitis?

For babies younger than 12 weeks old, systemic diseases like heart and lung disease are at increased risk for bronchiolitis. Immunocompromised children exposed to smoke are at increased risk for bronchiolitis.

What Are the Signs and Symptoms of Bronchiolitis?

  • The child appears lethargic and refuses to eat or drink.

  • The child has difficulty in breathing.

  • A gentle sound is heard when the child breathes.

  • The lips and nails in the fingers turn blue.

Vaccine for Bronchiolitis:

There is no specific vaccine for bronchiolitis. However, a flu shot for children older than six months can protect them from respiratory tract infection.

Pneumonia

Streptococcus pneumonia causes pneumonia in children under five years of age.

What Are the Risk Factors for Pneumonia?

  • Children with wheezing or asthma are more likely to be affected by pneumonia.

  • It affects children with a weak immune system.

  • Smoking during pregnancy affects the child with pneumonia after birth.

What Are the Symptoms of Pneumonia?

  1. The child has pain along with the mucus discharged while coughing.

  2. The child looks tired and has a loss of appetite.

  3. Vomiting and diarrhea cause dehydration in children.

  4. The body temperature increases, causing fever and chills.

How Is Pneumonia Diagnosed?

Blood Test - The arterial blood test detects the amount of carbon dioxide and oxygen in the blood.

Sputum Test - The sample is collected when the child coughs up mucus. It helps in diagnosing the infection.

X-Ray - It helps to diagnose the presence of mucus in the chest area.

How Is Pneumonia Treated?

  1. The child should get plenty of rest along with IV (intravenous) fluids.

  2. Acetaminophen is used to treat fever.

  3. Oxygen therapy is provided for the child to enhance breathing.

What Are the Vaccines to Prevent Pneumonia?

Vaccine limits the severity of pneumococcal infections in children. Pneumococcal vaccines protect children against disease transmission. The vaccine is scheduled for sixth, tenth and fourteenth weeks in infants and at one year of age.

Respiratory Syncytial Virus

The most common virus that infects children under two years of age is the respiratory syncytial virus (RSV). This virus is contagious and affects the respiratory tract in children. Primarily the infection causes a cold. In severe cases, the infection results in pneumonia in children. The inflammation in the airways causes bronchiolitis.

Symptoms of RSV Infection:

The infection causes common symptoms like cold, running nose, and cough. These symptoms usually last for around two weeks. However, the parent should seek help from a pediatrician if the symptoms in children turn worse. The severe symptoms include:

  • A whistling sound is heard when the child breathes. It indicates the presence of mucus in the lungs. The mucus expelled during cough appears yellowish-green.

  • The child faces difficulty in breathing and remains inactive.

  • The child refuses to drink milk during breastfeeding and bottle-feeding.

  • The child shows signs of dry skin. They lack tears while crying and refuse to pass urine even after six hours.

  • The parent must take the baby to a pediatrician if the baby has a blue tint on the lips or fingernails.

What Are the Causes and Risk Factors for RSV Infection?

The mode of spread of the respiratory syncytial virus is through the air during direct contact with children, cough, and sneezing.

The Risk Factors for the Infections Include:

  1. Premature babies are more prone to the respiratory syncytial virus.

  2. Children with other systemic diseases like heart and lung disease.

  3. Children with weak immune systems.

  4. Just born babies (eight to ten weeks old).

How Is RSV Diagnosed?

The doctor examines the children with various tests and physical examinations.

Blood and Urine Tests - This test determines the level of dehydration and observes any bacterial infection.

X-Rays - Chest X-rays are used to detect the presence of pneumonia.

Swab Test - The mucus is collected using the swab from the nose and mouth for the test to detect the infection.

How to Prevent RSV Infection in Children?

The parent should avoid kissing the baby if they have any cold symptoms. Keep the baby away from the family members affected by the cold. Do not take your baby to crowded places.

Keep the place around the baby clean and disinfected. Always wash your hands before touching the baby.

What Are the Treatments for RSV Infection?

  1. The doctor advises medications to open the airways. Palivizumab is used to protect high-risk babies from RSV infection. Acetaminophen is used to reduce fever in children.

  2. Oxygen therapy is given for children who face difficulty in breathing.

  3. The doctors prescribe IV (intravenous) fluids to compensate for dehydration in children.

What Are the Home Remedies for RSV Infection?

  1. Clean the nasal discharge with saline.

  2. Use a vaporizer to make breathing easier in children.

  3. Ensure that the baby gets enough fluid every day to avoid dehydration.

Conclusion

Acute respiratory infections are difficult to treat in children. It is better to take preventive measures to avoid the spread of infection. Vaccinating the child with appropriate vaccines at the right age can lower the risk of acute respiratory infection. Try to implement good hygiene in day-to-day life to avoid infection. Children are more prone to germ attacks. Wash the hands with proper disinfectant before touching the children. Nourish the children with Vitamin C. Vitamin C is proven to be effective against acute or severe respiratory infections.

Frequently Asked Questions

1.

What Is the Most Frequent Lower Respiratory Infection Among Children?

The most frequent causes of viral lower respiratory tract infections in newborns and young children are respiratory syncytial and influenza viruses. Other lower respiratory infections include bronchitis, bronchiolitis, and pneumonia.

2.

What Are the 4 Infections of the Lower Respiratory System?

Lower respiratory tract infection (LRTI) includes 
- Acute bronchitis.
- Acute exacerbation of bronchiectasis.
- Pneumonia.
- Acute exacerbations of chronic bronchitis (AECB).

3.

Does the Cough Affect the Upper or Lower Respiratory System?

A cough can affect both the upper and lower respiratory systems. It depends on the underlying cause. Upper respiratory infections typically result in a dry, hacking cough, while lower respiratory issues can lead to a productive, mucus-producing cough.

4.

What Lower Respiratory Conditions Affect Children?

The flu, viral bronchiolitis, and pneumonia are some of the more typical lower respiratory tract infections in newborns and young children. Children who are coughing and breathing quickly can be diagnosed with acute lower respiratory tract infections using the respiratory rate as a valuable clinical indicator.

5.

What Antibiotic Is Most Effective for Lower Respiratory Infections?

The first-choice antibiotics are Tetracycline and Amoxicillin. Newer macrolides such as Azithromycin, Roxithromycin, or Clarithromycin are good alternatives in the event of hypersensitivity.

6.

What Is the Primary URTI Treatment?

 
Amoxicillin (50 mg/kg/day for 10 days) is the first-line treatment for urinary tract infections. Symptoms of urinary tract infections may be moderate and treatable at home, or they may go away without medical intervention. However, some infections might produce more serious symptoms or problems that require professional treatment.

7.

Is Azithromycin Good for Upper Respiratory Infections?

Azithromycin is used to treat several community-acquired infections, including those that affect the genitourinary system, the respiratory system, and skin tissues. The first dose of Azithromycin begins to work almost immediately. Oral Azithromycin normally takes 2 to 3 hours to reach peak concentration in your body, so the effects may not be apparent straight away.

8.

What Are the Signs of a Lower Respiratory Infection?

The signs of a lower respiratory infection include
- Congestion or runny nose.
- Dry cough.
- Sore throat.
- Low-grade fever.
- Mild headache.

9.

What Are the Signs of Pediatric Respiratory Failure?

The signs of pediatric respiratory failure include
- Increased breathing rate.
- Increased heart rate. 
- Nose flaring. 
- Sweating
- Color changes. 
- Grunting. 
- Retractions. 
- Wheezing.

10.

What Cough Medicine Can I Use if I Have an Upper Respiratory Infection?

Dextromethorphan can relieve coughs caused by upper respiratory tract infections in adults alone, at least for a short time following administration. Dextromethorphan should not be taken by anyone who has chronic obstructive pulmonary disease (COPD),or asthma.

11.

What Is the Best Bronchiolitis Treatment?

Bronchitis has no specific vaccines or medications. Bronchitis cannot be treated with antibiotics or anti-cold medications. Most instances can be treated at home and resolved on their own. The child must consume plenty of fluids to avoid dehydration.

12.

What Is Bronchiolitis and How Is It Treated?

Bronchiolitis is a prevalent lung infection in newborns and young children caused by a virus. It enlarges the tiny airways of the lung and irritates them while also causing edema and mucus buildup. For bronchiolitis, there are no specific vaccines or therapies. The majority of bronchiolitis illnesses can be treated at home and resolved on their own.

13.

Is Bronchiolitis a Serious Condition?

Bronchiolitis is a common chest illness that primarily affects infants and toddlers under the age of two. It is typically minor and manageable at home, but it can also be serious. Bronchiolitis is distinct from bronchitis, which causes a cough with a lot of mucus and can affect people of all ages.

14.

Can Bronchiolitis Cause Lung Damage?

Bronchiolitis can affect both adults and children. Inflammation of the bronchioles can produce an oxygen blockage in the airways, resulting in symptoms such as coughing or difficulty breathing. Although most cases of bronchiolitis are minor, severe ones can lead to lung failure.

15.

Is Steam Effective for Bronchiolitis?

Steam inhalation or cool mist therapy is often used to treat acute bronchiolitis. It is believed that humidified air, inhaled as steam or misted, will benefit the patient by reducing respiratory distress symptoms and thinning down respiratory tract secretions.

16.

Is Bronchiolitis Treatable With Antibiotics?

Bronchiolitis does not have any vaccines or targeted treatments available. Antibiotics are not typically prescribed for bronchiolitis, unless there are concerns about potential complications like secondary bacterial pneumonia or respiratory failure. The condition usually resolves on its own and can be managed at home.
Dr. Sajeev Kumar
Dr. Sajeev Kumar

Pediatrics

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