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Respiratory Infections - Coggle Diagram

- - - - RSV
      - Influenza
      - Adenovirus
      - Parainfluenza
    - - Neborns
        
        GBS
        
        E. coli
        
        Klebsiella
        
        Enterobactericeae
      - 1-3 months
        
        Chlamydia trachomatis
      - Preschool
        
        Strep pneumoniae
        
        H. influenza b
        
        Staph aureus
        
        GAS
        
        M. catarrhalis
        
        Pseudomonas
      - School
        
        Mycoplasma pneumoniae
        
        Chlamydia
        
        Strep Pneumoniae
  - - - Tachypnea
      - Hypoxemia
      - Increased WOB
      - Apnea
      - Altered mental status
    - - Difficulty feeding
      - Restlessness or fussiness
    - - Pleuritic chest pain
      - Abdominal pain refered from lower lobes
      - Ruchal rigidity referred from upper lobes
  - - - Crackles
      - Decreased breath sounds
      - Bronchial breath sounds
      - Bronchophony
      - Tactile fremitus
      - Dullness to percussion
      - Wheezing caused by atypicall bacteria and viruses
      - Pleural effusion signs
        
        Chest pain with splinting
        
        Dullness to percussion
        
        Distant breath sounds
        
        Pleural friction rub
  - - - O2<92%
      - Recurrent apnoea
      - Grunting
      - Inability to maintain adequate fluid/feed intake
  - - - O2 if hypoxic
      - Analgesia
      - IV fluid to correct dehydration and maintain adequate hydration and Na+ balance
  - - - Refer to paeds specialist
    - - Amoxicillin
      - Penicillin alternative
        
        Clarithromycin
        
        Doxycycline (12-17yrs)
    - - Co-amoxiclav with ( if atypical pathogen suspected) Clarithromycin
      - Penicillin alternative
        
        Consult microbiologist
  - - - CO-amoxiclav if influenza in addition to pneumonia
      - Abx treatment not required in children <2yrs with mild CAP
    - - Co-amoxiclav for sever disease in all age groups initially
      - Dual therapy with a macrolide when atypical pathogen suspected
  - - - Follow up after discharge until complete recovery and near normal x-ray
    - - Consider radiology
- - - - High fever over 39
      - Persistently focal crackles
    - - Older infants with persistent wheeze without crackles
      - Recurrent epidosodic wheeze
      - Personal / fhx of atopy
  - - - Respiratory distress or feding difficulties due to secretions
      - Apnoea even if there are no obvious secretions
    - - High flow O2
        
        CPAP
        
        NIV
        
        Mechanical ventilation
    - - Abx
      - Hypertonic saline
      - Adrenaline, salbutamol, ipratropium bromide (nebulised), corticosteroids
      - Chest physio
  - - - Monoclonal antibody
      - Multiple IM injections
- - - - Steeple sign
  - - - Oral or nebulised steroid
    - - Nebulised adrenaline
      - Oral steroid
    - - Further adrenaline. Consider admisison / transfer
- - - - Strep pneumoniae / group b streps
      - Haemophilus influenza
      - Bordetella pertussis
      - Mycoplasma
    - - RSV
      - Rhinovirus
      - Parainfluenza
      - Influenza
      - Metapneumovirus
      - Adenovirus
  - - - Commenst infection of childhoos
    - - None
    - - Supportative:
      - Fever relief
      - Frequent fluids
      - Nasal obstruction relief
      - Avoidance of tobacco smoke
      - Abx NOT for viral
  - - - Usually due to viruses
        Adeno
        Entero
        Rhino
    - - Aetiology
        
        Viral : EBV
        
        Bacterial : GABHS
      - Clinical features
        
        Fever
        
        Diffues redness of tonsils and pharyngeal exudate
        
        Tender / enlarged anterior cervical lymph nodes
      - Investigations
        
        Throat swab
        
        Rapid antigen testing
      - Management
        
        Supportitive / symptomatic
        
        Abx if bacteria - GABHS 10 day penicillin
  - - - Most common reason for GP/ED visits in children 6-12 months
    - - Viral
      - Bacterial
    - - Bacterial : Amoxicillin ( Macrolide if allergic)
        
        Shorten duration of pain but does not reduce hearing loss
    - - Exam of TM
    - - OM wuth Effusion
        
        Usually asymptomatic
        
        May cause speech and learning difficulties with hearing loss
        
        Deacreased hearing
- - - - Epiglottiitis
      - Bacterial tracheitis
      - Retropharyngeal abcess
      - Infectious mononucleosis - Measles
      - Diphtheria
    - - FB
      - Anaphylaxis