小儿呼吸疾病(英文)课件

小儿呼吸疾病（英文ppt）小儿呼吸疾病（英文ppt）1Introduction

HighMorbidityRate

HighMortalityRateEachyear,respiratoryinfectiondiseasescauseabout15milliondeathsamongchildrenyoungerthanage5yearthroughtheworld.Pediatricpulmonaryinfectionaccountsforabout63.89%ofallhospitalizationsofchildren,inwhich44.6percentarepneumonia.IntroductionHighMorbidityRaCricoidcartilageUpperrespiratorytract

nose,paranasalsinuses,pharynx,eustachiantube,epiglottis,larynxLowerrespiratorytract:

trachea,bronchi,bronchioles,alveolus

AnatomyCricoidcartilageUpperrespiraAnatomyUpperrespiratorytract

ShortNasalpassages,nasolacrimalductandeustachiantubeSignificance:Thesecharactersmakenasalcavityeasytobecomehyperemia,edema,andcongestionwhichwillinduceinfection.Localinfectioncanspreadtonearbyorgansandtissueseasilyandcausedyspnea,hoarsenessandapnea.NasalmucosaIssoftMorevascular

NasalcavityisshortandnarrowAnatomyUpperrespiratorytraAnatomyNarrowedairwaySoftmucousmenbraneMorevascularSofterandmorecompliant

Clinicalsignificance:Easytobecomehyperemia,edema,andcongestionwhichwillinduceinfectionComplication:PulmonaryemphysemaandatelectasisLowerrespiratorytractAnatomyNarrowedairwayClinicPhysiologyTheyoungerthechildThequickerthefrequencyThelessregulartherhythmVitalcapacity(VC)

TidalvolumeTotallungcapacity(TLC)

Respiratoryfrequencyandrhythm：Therespiratoryfrequencyisinverselyrelatedtoage

.⑴neonate:40～50bpm；6～12mo:30-35bpm；

1-3

yr:25～30bpm；4～9yr:20-25

bpm；

8-14

yr:18～20bpm。(2)Someyounginfantspresentwithirregularrhythmorapneaduetoimmaturerespiratorycenter.SmallPhysiologyTheyoungerthechil大家学习辛苦了，还是要坚持继续保持安静大家学习辛苦了，还是要坚持继续保持安静ImmuneSystem

LowlevelofsIgA,IgGonRespiratoryMucosa

LowlevelofTh1functionImmuneSystemAcuteUpperRespiratoryTractInfection

“Commoncold”

AcuteUpperRespiratoryInfectionAcuteUpperRespiratoryTractIntroduction80-90%proportionofvisittoclinic.spreadtonearbyorgansandtissues(otitismedia,conjunctivitis,lymphadenitis,lymphadenitisandpneumonia)Bronchialasthma,nephritis,myocarditis,measlesandpertussismayalsofollowAURIIntroduction80-90%proportio90%ofAURIarecausedbyviralinfectionEtiology

RhinovirusEchovirusCoxsackievirusParainfluenzaInfluenzaAdenovirusRSV(RespiratorySyncytialVirus)90%ofAURIarecausedbyPneumococcusMoraxellecatarrhalis

HaemophilusinfluenzaeStaphylococcusaureusBacteriaPneumococcusHaemophilusinflueMycoplasmaChlamydiaOtherMicroorganismsOthersOthersMildsymptom

Nasalcongestion,rhinorrhea,sneezing,sorethroatSeveresymptom

Highfever,convulsion,anorexia,frequencycoughClinicalManifestation

MildsymptomClinicalManifestaSymptomsofURIinchildrenofdifferentagesSymptomsofURIinchildrenofThepharynxisredRetropharyngealfolliculosisErythematousenlargedtonsilsEnlargedlymphnodesEnterovirusillnessesmaybeassociatedwithawidevarietyofskinrashesPhysicalSign

PhysicalSignHerpanginaCoxsackievirusAMostoftenoccursinsummerandautumnMoreoftenininfants（0-3yrofage）Characterizedbysuddenonsetoffever,sorethroatanddysphagiaCharacteristiclesions,presentontheposteriorpharynx,arediscretevesiclesandulcersDurationofillnessisusually7days

TwoSpecialTypesHerpanginaTwoSpecialTypesOccurstypicallywithtype3,7adenovirusMostoftenoccursinspringandsummerChildren（>3yr）moreoftenaffectedFeaturesinclude:Ahightemperaturethatlasts4–5days,pharyngitis,conjunctivitis,cervicallymphadenopathy,andrhinitis.Durationofillnessisusually1-2weeksPharyngoconjunctivalFeverOccurstypicallywithtype3,7OtitismediaCervicallymphadenitisBronchitisPneumoniaSepticemiaComplicationViralInfection

→ViralMyocarditisViralEncephalitisBacterialInfections（streptococcus))

→AcuteNephritis

RheumaticFeverOtitismediaComplicationViralDiagnosisSymptomssighsDiagnosisSymptomsThedifferentialdiagnosisoftheURlincludesotheracuteinfectiousdisease.Inpatientwithfebrileconvulsion,centralnervoussystemInfectionsshouldalsoconsidered.Patientswithabdominalpainmayhaveacuteabdomen.

DifferentialdiagnosisThedifferentialdiagnosisofDifferenceBetweenMesentericLymphadenitisandAcuteappendicitisDifferenceBetweenMesentericProphylaxisIncreaseoutdooractivities.Improvephysicalfitness.Enhanceimmunityfunction.Patientsincollectiveinstitutionsshouldbeisolated.ProphylaxisIncreaseoutdooGeneraltreatment

Etiologicaltreatment

Anti-virus：Ribavirin

AvoidtheabuseofantibioticsSymptomatictreatment

SeverenasalobstructionIrritability-restlessnessHighfeverPharyngealportionulcerConjunctivitisTreatmentGeneraltreatmentTreatmentUpperrespiratoryinfectionisthemostcommondiseaseinchildhood,mostofwhicharecausedbyviralinfections.Theseverityofclinicalmanifestationsisrelatedtoageofthepatients.Infantspresentmildlocalsymptomsandseveresystemicsymptoms,whileolderchildrenpresentonthecontrary.Astuffy,congestednosemayexistininfantsyoungerthan3monthsofage.Treatmentforthecommoncoldshouldbemainlysymptomatic.Antibioticsshouldnotbeusedunlessinthoseyoung,infantpatientswhicharesuspectedtocomplicatebacterialinfections.SummaryUpperrespiratoryinfectioniAcutebronchitisisinflammationofthetracheobronchialepithelium.Tracheaisusuallyinvolved，soacutebronchitisisalsocalled‘acutetracheobronchitis’.Acutebronchitisiscommonlysecondarytoanacuteviralinfection,orjustonemanifestationofacuteinfectiousdisease.

AcuteBronchitisAcutebronchitisisinflammatiInfectiousfactors：viral,bacterialorotherpathogeninfectionsCharactersofrespiratorytractofinfants:Themucousbecomeedemaandhyperemiawhichmakethebronchusnarrowerwheninflammation.Otherfactors：immunodeficiency,nutritionaldiseases,specificbodyconstitution.EtiologyInfectiousfactors：viral,bactClinicalManifestation

BeginsasanURICoughisasignificantsigns

nonproductivecough→productiveThesystemicsymptomsisusuallysevereininfantsincludingfever,vomitinganddiarrheaMedicalexamination：RespiratoryrudenessDiffuseorscatteredralesNodyspneaCXR:maybenormal

orthickeninglungmarkingsClinicalManifestationBegins

Acutebronchitisisaninflammationofthemajorconductingairwayswithinthelungwhichcausedbyviralorbacteria,andismostoftenininfants.Coughisthemostsignificantclinicalmanifestation.Fever,vomitinganddiarrheaarefrequentininfants.Respiratorysoundsareroughandscatteredralesareheardonauscultation.

Radiographicexaminationofthechestmayshowamildincreaseinbronchovascularmarkings.

Antibioticsareindicatedifabacterialinfectionoftheairwayissuspectedorproven.Corticosteroidsarerecommendedinseverecases.Summary

AcutebronchitisisPneumoniaisaninflammationoftheparenchymaofthelungs.

Mostcasesofpneumoniaarecausedbymicroorgnanisms,butthereareseveralnoninfectiouscauses,whichincludeaspirationoffoodorgastricacid,foreignbodiesandsoon.AcutePneumoniaPneumoniaisaninflammationoSeasonofonset

AgeofonsetMorbidityrateMortalityrateEpidemiologySeasonofonsetEpidemiologyClassifiedaccordingtotheinfectingorganism:Viralpneumonia,bacterialPneumonia,mycoplasmaPneumonia.ClassifiedaccordingtoPathology:Bronchopneumonia,lobarpneumonia,interstitialpneumonia.Classifiedaccordingtodurationofdisease:Acutepneumonia(<1mo),persistentpneumonia(1-3mo)andchronicpneumonia(>3mo).Classifiedaccordingtoseverityofdisease:Mildpneumoniaandseverepneumonia.CategoryClassifiedaccordingtotheinBacteriaStreptococcuspneumoniae,Haemophilusinfluenzae,Staphylococcusaureus,

Escherichiacoli,PseudomonaspyocyaneaVirusesRespiratorySyncytialViruses,adenovirus,influenza,parainfluenzaothersIncidencerateofChlamydiapneumoniaeandMycoplasmapneumoniaeareincreasingrecentyears.EtiologyBacteriaStreptococcuspneumoniAgeMoreoftenininfantsDiseaseEnvironmentMalnutrition,Congenitalheartdisease,Immunodeficiencydiseasewetness,stuffinessandcrowding.

InducementPatientswiththefollowingproblemsareparticularlypredisposedtothisdisease:AgeMoreoftenininfantsDiseaHyperemia,edemaandinflammatoryinfiltrationoflungtissuesAlveolarexudatePatchyInflammationfocus,andconsolidationAtelectasisandemphysemaoflungPathologyHyperemia,edemaandinflammatfevercoughtachypneaRalesfoursymptomsClinicalManifestionPneumoniafevercoughtachypneaRalesfoursyApartfromthegeneralfeaturesofbronchopneumonia,severepneumoniaalsopresentwithsystemictoxicsymptomsinrespiratorysystemcirculatorysystemnervoussystemdigestivesystemSeverePneumoniaApartfromthegeneralfeatureCirculatorysystemMyocarditis,heartfailureMicrocirculationdisturbanceDigestivesystemGastrointestinaldysfunction,enteroplegiaAlimentarytracthemorrhageNervoussystemIntracranialhypertensionEncephaledemaWater-ElectrolyteBalanceMixedacidosis,dehydrationHyponatremiaExtrapulmoanrypresentations

CirculatorysystemMyocarditis,

Suddenlyonsetoftachypnea,R>60bpm,increased

pulmonaryrales.

Tachycardiathatcannotbeexplainedbyhighfeverortachypnea,HR>180bpmIrritabilityandcyanosisGalloprhythmordullheartsound,distensionofjugularveinandenlargedcardiac

Increasedliverwithtenderness,>1.5cm.

Oliguriaoranuriathatpresentwithedemaofeyelidorlowerextremities.MyocardialfailureSuddenlyonsetoftachypnea,EmpyemaofpleuraPurulentpneumothoraxBullaeoflung

SepticemiaPurulentpericarditis

ComplicationComplicationPeripheralbloodexamination

Whitecellcount

CRP(C-reactiveprotein)NitrobluetetrazoliumtestEtiologicalexamination

Bacteriologicalexamination：BacterialcultureVirologicalexamination：ViralisolationExamination

ofmycoplasma：

Specificimmunityexamination

LaboratoryExaminationPeripheralbloodexaminationLLobularpneumonia(Bronchopneumonia)Pathogen

Streptococcuspneumoniae

HaemophilusinfluenzaePathology

Pathologicalchangessuchashyperemiaandedema

ofbronchiolarwall,exudationofpulmonarylobule,andbronchiolarobstructionarescattered

surroundbronchus.Clinicalmanifestation

Hyperpyrexia,cough,tachypneaanddyspneaMorecommonininfants,agedpeopleandweakpeopleLobularpneumonia(BronchopneIncreaselungmarkingsDiffusebilateralPatchyinfiltratesandconsolidationscatteredthroughoutbothlungsAtelectasis,hyperinflation,bullaeoflung

andpyothoraxChestradiographicfindingsinbronchopneumoniaIncreaselungmarkingsDiffuseChestradiographicfindingsinbronchopneumoniaFrontalviews

:Patchyinfiltratesandconsolidationattheinnerzoneandmiddlezoneofbilaterallowerlobes,withorwithouthyperinflationChestradiographicfindingsinSegmentalatelectasisFrontalviews

:Itisasegmentalatelectasisattherightsuperiorlobe.Thetransversafissureisdisplacedtowardtheairlesslobe.Thereisasectorhighdensityshadowwiththeapextowardthehilumoflung.Thediaphragmiselevatedandthemediastinumisshiftedtothesideofinvolvement.SegmentalatelectasisFrontalvLobarpneumoniaPathogen:mailystreptococcuspneumoniaePathology:inflammtioninfiltratesthroughoutawholelobeorsegmentofthelung.

Mainclinicalmanifestation:Morecommoninadolescence,rareinyoungchildren.Hyperpyrexia,cough,andrustysputumX-rayfindingsChangeafterchangesofclinicalsymptoms.LobarpneumoniaPathogen:mailyLobarpneumoniaatmiddlelobeofrightlungFrontalviews

:Aconsolidationwithinthetransversefissureandobliquefissurecanbeseenatthemiddlelobeofrightlung,Lobarpneumoniaatmiddlelobeviraldisease,RSV(85%).aged2-6months.airwayobstructionisduetopathologicalchangesincludeswellinganddistensionofbronchioles,

secretionsblockage.Bronchiolitisviraldisease,RSV(85%).Broexpiratorywheezingtachypnea,nasalflaringCyanosisfineralesemphysemaThedurationofillnessis4~7daysClinicalManifestationexpiratorywheezingClinicalMaHyperexpansioniscommonlypresentPeribronchialcuffingIncreasedinterstitialmarkings

PatchyinfiltratesChestradiographicfindingsHyperexpansioniscommonlypreFrontalviewsofCXR:Ground-glassopacityDecreasedlungmarkingsPatchyinfiltratesininnnerandmiddlezoneAcquiredhyperinflationRSVPneumoniaFrontalviewsofCXR:RSVPneumEscherichiacoliisthemostcommonpathogeninneonate.Inyounginfants>1week,mainlypathogenarestaphylococcusaureusandhemolyticstreptococcus.

Somepatientsmaypresentonlywithsignsofgeneralizedtoxicity.Patientuausllypresentnocoughorfever.Ralesareseldomheardonausculation.

Clinicalmanifestationmaybemilk-resistant,drowsiness,lowresponse,andtachypnea.Cyanosis,foamingatmouth,noddingrespirationorapneamaypresentinseverecases.Respiratorysignsisrare.PneumoniaofnewbornEscherichiacoliisthemostcChestX-rayFrontalviews

:Thereispatchyshadowsandinfiltratesatrightlungfield.ChestX-rayFrontalviews:Adenoviruspneumonia

Type3,7adenovirusYoungchildren（6mo-2yr）aremoreoftenaffectedAcuteonsetofhighfever,toxicsymptomsandpaleface.Sometimespresentwithcardiacdysfunctionandsymptomofnervoussystem

Severecough,dyspneaandwheezing

Respiratorysignssuchasfineralesoccurafter3-4daysPatchyinfiltratesandconsolidationwithhyperinflation.AdenoviruspneumoniaType3,7AdenoviruspneumoniaFrontalviews:Chestradiographsrevealsdiffuseinterstitialandpatchyalveolarinfiltrates,peribronchialthickening,andfocalconsolidationthroughoutbothlungfield.AdenoviruspneumoniaFrontalviStaphylococcalpneumonia

MorecommoninneonateandinfantsPresentasuddenonsetandprogressquicklySignsinclude:rashes,

severe

toxicsymptoms,digestivesymptoms,convulsionandshockSignsvarywithstageofdiseaseConsolidationoflungisobviousChestX-rayrevealsinfiltrates,abscessandbullaeoflungStaphylococcalpneumoniaAbscessoflungFrontalviews:MultipleroundhighdensityshadowinbothsidesAbscessoflungFrontalviews:PyopneumothoraxPyopneumothoraxEncapsulatedpleuraleffusionEncapsulatedpleuraleffusionPulmonaryBullaFemale，7day，hyperpyrexiaandnocryingCXR:multiplegiantair-containingcavityPulmonaryBullaFemale，7day，hyCommoncauseofsymptomaticpneumoniainolderchildrenFever,drycougharecommonsymptomsExtrapulmonarycomplicationssometimesoccurChestradiographsareuntypical,usuallydemonstrateinterstitialorbronchopneumonicinfiltrates

MycoplasmapneumoniaCommoncauseofsymptomaticpnInterstitialinfiltratesinMycoplasmapneumonia

A5-year-oldboycomplainoffeverandcough.MPantibody(+)FrontalviewsofCXR:IncreasedlungmarkingsDiffusepatchyinfiltratesVolumelossoflowerlobesofbilaterallungEnlargedhilarshadowInterstitialinfiltratesinM

Peakageofonset

Clinicalmanifestation

Laboratoryexamination

X-rayexamination

OthersDiagnosisPeakageofonsetDiagnosisAcutebronchitisPulmonarytuberculosisForeignbodyinbronchusDifferentialDiagnosisAcutebronchitisDifferentialDNursingandsupportingtherapySymptomatictreatment：

OxygensupplyConscioussedation

Pyretolysis

CoughsuppressantsEliminatesputumAntimicrobialtherapyTreatmentofcomplicationEnhanceimmunityfunctionphysicaltreatmentTreatmentNursingandsupportingtherapyPrincipleofantibiotictreatment:

SensitiveEarlytreatmentSufficiencyDrugcombinationAntimicrobialtreatmentPrincipleofantibiotictreatmAntibiotictreatmentAntibiotictreatmentAntiviraltreatmentThereisnoidealdruginantiviraltherapy.Ribovirininterferon(IFN)HumanImmunoglobulinTraditionalchinesedrugtherapyYuxingcao,DoublecoptisAntiviraltreatmentThereisn

Severetoxicsymptomthatincludeshock,

ultrahyperpyrexiaandtoxicencephacopathy

IncreasedsecretionsandbronchialspasmComplicatedwithpleuraleffusion

inearlyperiodIndicationof

Systemiccorticosteroids

SeveretoxicsymptomthatincHeartfailure：

cardiotonic,sedativediuresisandoxygensupplyRespiratoryFailure：

suctioning,oxygensupply

intubationandartificialrespiratorToxicencephacopathy：

anti-infection,oxygensupplY,correctacidosisTreatmentofseverepneumoniaHeartfailure：TreatmentofsevFever,cough,tachypneaandfineralesarefourmajorsymptomsofpneumonia.Besides,severepneumoniapresentcirculatory,neurologicalanddigestivesymptomsDiagnosismainlydependsonclinicalmanifestationsandX-rayexamination.Accordingtothecharacteristicsofclinicalsymptoms,signsandauxiliaryexamination,weclassifydifferenttypeandseverity.

Treatmentshouldemphasizecomprehensivetreatment.Choosedifferentantibioticsaccordingtodifferentpathogens.Payattentiontotheimportanceofnursing,supportingtherapy,andsymptomatictherapy.SummaryFever,cough,tachypneaandfi小儿呼吸疾病（英文ppt）小儿呼吸疾病（英文ppt）72Introduction

HighMorbidityRate

HighMortalityRateEachyear,respiratoryinfectiondiseasescauseabout15milliondeathsamongchildrenyoungerthanage5yearthroughtheworld.Pediatricpulmonaryinfectionaccountsforabout63.89%ofallhospitalizationsofchildren,inwhich44.6percentarepneumonia.IntroductionHighMorbidityRaCricoidcartilageUpperrespiratorytract

nose,paranasalsinuses,pharynx,eustachiantube,epiglottis,larynxLowerrespiratorytract:

trachea,bronchi,bronchioles,alveolus

AnatomyCricoidcartilageUpperrespiraAnatomyUpperrespiratorytract

ShortNasalpassages,nasolacrimalductandeustachiantubeSignificance:Thesecharactersmakenasalcavityeasytobecomehyperemia,edema,andcongestionwhichwillinduceinfection.Localinfectioncanspreadtonearbyorgansandtissueseasilyandcausedyspnea,hoarsenessandapnea.NasalmucosaIssoftMorevascular

NasalcavityisshortandnarrowAnatomyUpperrespiratorytraAnatomyNarrowedairwaySoftmucousmenbraneMorevascularSofterandmorecompliant

Clinicalsignificance:Easytobecomehyperemia,edema,andcongestionwhichwillinduceinfectionComplication:PulmonaryemphysemaandatelectasisLowerrespiratorytractAnatomyNarrowedairwayClinicPhysiologyTheyoungerthechildThequickerthefrequencyThelessregulartherhythmVitalcapacity(VC)

TidalvolumeTotallungcapacity(TLC)

Respiratoryfrequencyandrhythm：Therespiratoryfrequencyisinverselyrelatedtoage

.⑴neonate:40～50bpm；6～12mo:30-35bpm；

1-3

yr:25～30bpm；4～9yr:20-25

bpm；

8-14

yr:18～20bpm。(2)Someyounginfantspresentwithirregularrhythmorapneaduetoimmaturerespiratorycenter.SmallPhysiologyTheyoungerthechil大家学习辛苦了，还是要坚持继续保持安静大家学习辛苦了，还是要坚持继续保持安静ImmuneSystem

LowlevelofsIgA,IgGonRespiratoryMucosa

LowlevelofTh1functionImmuneSystemAcuteUpperRespiratoryTractInfection

“Commoncold”

AcuteUpperRespiratoryInfectionAcuteUpperRespiratoryTractIntroduction80-90%proportionofvisittoclinic.spreadtonearbyorgansandtissues(otitismedia,conjunctivitis,lymphadenitis,lymphadenitisandpneumonia)Bronchialasthma,nephritis,myocarditis,measlesandpertussismayalsofollowAURIIntroduction80-90%proportio90%ofAURIarecausedbyviralinfectionEtiology

RhinovirusEchovirusCoxsackievirusParainfluenzaInfluenzaAdenovirusRSV(RespiratorySyncytialVirus)90%ofAURIarecausedbyPneumococcusMoraxellecatarrhalis

HaemophilusinfluenzaeStaphylococcusaureusBacteriaPneumococcusHaemophilusinflueMycoplasmaChlamydiaOtherMicroorganismsOthersOthersMildsymptom

Nasalcongestion,rhinorrhea,sneezing,sorethroatSeveresymptom

Highfever,convulsion,anorexia,frequencycoughClinicalManifestation

MildsymptomClinicalManifestaSymptomsofURIinchildrenofdifferentagesSymptomsofURIinchildrenofThepharynxisredRetropharyngealfolliculosisErythematousenlargedtonsilsEnlargedlymphnodesEnterovirusillnessesmaybeassociatedwithawidevarietyofskinrashesPhysicalSign

PhysicalSignHerpanginaCoxsackievirusAMostoftenoccursinsummerandautumnMoreoftenininfants（0-3yrofage）Characterizedbysuddenonsetoffever,sorethroatanddysphagiaCharacteristiclesions,presentontheposteriorpharynx,arediscretevesiclesandulcersDurationofillnessisusually7days

TwoSpecialTypesHerpanginaTwoSpecialTypesOccurstypicallywithtype3,7adenovirusMostoftenoccursinspringandsummerChildren（>3yr）moreoftenaffectedFeaturesinclude:Ahightemperaturethatlasts4–5days,pharyngitis,conjunctivitis,cervicallymphadenopathy,andrhinitis.Durationofillnessisusually1-2weeksPharyngoconjunctivalFeverOccurstypicallywithtype3,7OtitismediaCervicallymphadenitisBronchitisPneumoniaSepticemiaComplicationViralInfection

→ViralMyocarditisViralEncephalitisBacterialInfections（streptococcus))

→AcuteNephritis

RheumaticFeverOtitismediaComplicationViralDiagnosisSymptomssighsDiagnosisSymptomsThedifferentialdiagnosisoftheURlincludesotheracuteinfectiousdisease.Inpatientwithfebrileconvulsion,centralnervoussystemInfectionsshouldalsoconsidered.Patientswithabdominalpainmayhaveacuteabdomen.

DifferentialdiagnosisThedifferentialdiagnosisofDifferenceBetweenMesentericLymphadenitisandAcuteappendicitisDifferenceBetweenMesentericProphylaxisIncreaseoutdooractivities.Improvephysicalfitness.Enhanceimmunityfunction.Patientsincollectiveinstitutionsshouldbeisolated.ProphylaxisIncreaseoutdooGeneraltreatment

Etiologicaltreatment

Anti-virus：Ribavirin

AvoidtheabuseofantibioticsSymptomatictreatment

SeverenasalobstructionIrritability-restlessnessHighfeverPharyngealportionulcerConjunctivitisTreatmentGeneraltreatmentTreatmentUpperrespiratoryinfectionisthemostcommondiseaseinchildhood,mostofwhicharecausedbyviralinfections.Theseverityofclinicalmanifestationsisrelatedtoageofthepatients.Infantspresentmildlocalsymptomsandseveresystemicsymptoms,whileolderchildrenpresentonthecontrary.Astuffy,congestednosemayexistininfantsyoungerthan3monthsofage.Treatmentforthecommoncoldshouldbemainlysymptomatic.Antibioticsshouldnotbeusedunlessinthoseyoung,infantpatientswhicharesuspectedtocomplicatebacterialinfections.SummaryUpperrespiratoryinfectioniAcutebronchitisisinflammationofthetracheobronchialepithelium.Tracheaisusuallyinvolved，soacutebronchitisisalsocalled‘acutetracheobronchitis’.Acutebronchitisiscommonlysecondarytoanacuteviralinfection,orjustonemanifestationofacuteinfectiousdisease.

AcuteBronchitisAcutebronchitisisinflammatiInfectiousfactors：viral,bacterialorotherpathogeninfectionsCharactersofrespiratorytractofinfants:Themucousbecomeedemaandhyperemiawhichmakethebronchusnarrowerwheninflammation.Otherfactors：immunodeficiency,nutritionaldiseases,specificbodyconstitution.EtiologyInfectiousfactors：viral,bactClinicalManifestation

BeginsasanURICoughisasignificantsigns

nonproductivecough→productiveThesystemicsymptomsisusuallysevereininfantsincludingfever,vomitinganddiarrheaMedicalexamination：RespiratoryrudenessDiffuseorscatteredralesNodyspneaCXR:maybenormal

orthickeninglungmarkingsClinicalManifestationBegins

Acutebronchitisisaninflammationofthemajorconductingairwayswithinthelungwhichcausedbyviralorbacteria,andismostoftenininfants.Coughisthemostsignificantclinicalmanifestation.Fever,vomitinganddiarrheaarefrequentininfants.Respiratorysoundsareroughandscatteredralesareheardonauscultation.

Radiographicexaminationofthechestmayshowamildincreaseinbronchovascularmarkings.

Antibioticsareindicatedifabacterialinfectionoftheairwayissuspectedorproven.Corticosteroidsarerecommendedinseverecases.Summary

AcutebronchitisisPneumoniaisaninflammationoftheparenchymaofthelungs.

Mostcasesofpneumoniaarecausedbymicroorgnanisms,butthereareseveralnoninfectiouscauses,whichincludeaspirationoffoodorgastricacid,foreignbodiesandsoon.AcutePneumoniaPneumoniaisaninflammationoSeasonofonset

AgeofonsetMorbidityrateMortalityrateEpidemiologySeasonofonsetEpidemiologyClassifiedaccordingtotheinfectingorganism:Viralpneumonia,bacterialPneumonia,mycoplasmaPneumonia.ClassifiedaccordingtoPathology:Bronchopneumonia,lobarpneumonia,interstitialpneumonia.Classifiedaccordingtodurationofdisease:Acutepneumonia(<1mo),persistentpneumonia(1-3mo)andchronicpneumonia(>3mo).Classif