上海交通大学医学院儿科学临床医学五年制课件 儿童呼吸系统感染性疾病.pptVIP

Infection Diseases of Respiratory System in Children 上海交通大学医学院附属新华医院儿科 鲍一笑 Introduction High Morbidity Rate High Mortality Rate Anatomy Short Nasal passages, nasolacrimal duct and eustachian tube Anatomy Narrowed airway Soft mucous menbrane More vascular Softer and more compliant Physiology The younger the child The quicker the frequency The less regular the rhythm Immune System Low level of sIgA , IgG on Respiratory Mucosa Low level of Th1 function Introduction 80-90% proportion of visit to clinic. spread to nearby organs and tissues (otitis media, conjunctivitis, lymphadenitis, lymphadenitis and pneumonia) Bronchial asthma, nephritis, myocarditis, measles and pertussis may also follow AURI Physical Sign The pharynx is red Retropharyngeal folliculosis Erythematous enlarged tonsils Enlarged lymph nodes Enterovirus illnesses may be associated with a wide variety of skin rashes Two Special Types Herpangina Coxsackievirus A Most often occurs in summer and autumn More often in infants（0-3 yr of age） Characterized by sudden onset of fever, sore throat and dysphagia Characteristic lesions, present on the posterior pharynx, are discrete vesicles and ulcers Duration of illness is usually 7 days Pharyngoconjunctival Fever Occurs typically with type 3,7 adenovirus Most often occurs in spring and summer Children （3 yr ） more often affected Features include: A high temperature that lasts 4–5 days, pharyngitis, conjunctivitis, cervical lymphadenopathy, and rhinitis. Duration of illness is usually 1-2 weeks Complication Otitis media Cervical lymphadenitis Bronchitis Pneumonia Septicemia Diagnosis Treatment General treatment Etiological treatment Anti-virus：Ribavirin Avoid the abuse of antibiotics Symptomatic treatment Severe nasal obstruction Irritability-restlessness High fever Pharyngeal portion ulcer Conjunctivitis Summary Upper respiratory infection