Cold in children

Introduction to pediatric cold Children with colds, also known as acute upper respiratory infections (acuteupperrespiratory infections), are the most common diseases in children, mainly invading the nose, nasopharynx and pharynx. They can also be collectively referred to as upper respiratory tract infections. Nasopharyngeal infections often have complications involving adjacent organs such as the larynx, trachea, lungs, mouth, sinuses, middle ear, eyes, and cervical lymph nodes. Sometimes the symptoms of the primary disease of the nasopharynx have improved or disappeared, and its complications may be prolonged or aggravated. Therefore, the clinical features of upper respiratory tract infection and its complications must be comprehensively observed and analyzed for early diagnosis and early treatment. Improve the efficacy, must not be considered as a daily illness and rash treatment. basic knowledge Sickness ratio: 5% Susceptible people: infants and young children Mode of infection: respiratory transmission Complications: laryngitis Abscess around the tonsils Pneumonia

Pediatric cold cause

Virus infection (45%):

80% to 90% of the colds are caused by viruses, and there are more than 200 kinds of viruses that can cause colds; 10% to 20% of the colds are caused by bacteria. Infants under the age of 1 are more likely to have a cold because the immune system is not yet mature.

The immune system is immature (20%):

The child's nasal cavity is narrow, the mucous membrane is tender, the mucosal gland is insufficiently secreted, it is dry, and it is poorly adapted and resistant to the external environment, and is prone to inflammation. Premature infants, children with congenital defects or diseases, such as cardiopulmonary insufficiency, especially those with congenital immune diseases, may have a cold when they take care of a slight mistake.

Improper feeding (20%):

A survey of 157 parents on the Children's Nutrition Knowledge Survey showed that only 10.2% of people know about general parenting nutrition. Due to the rapid growth of children, children who are artificially fed due to lack of breast milk, as well as children who are overly pampered, partial eclipse, or anorexia, may cause different levels of iron deficiency, calcium deficiency or insufficient intake of vitamins and protein. . Nutrients such as iron, zinc and protein play an important role in the synthesis of various globulins of the immune system and in promoting the maturation and differentiation of immune cells, affecting the resistance of the child's body. The body lacks vitamin A, causing the cilia of the respiratory epithelial cells to decrease and disappear, the gland loses its normal function, the lysozyme and secreted immune antibodies are significantly reduced, and the barrier function is reduced, which may lead to infection. Insufficient calcium intake can cause rickets in children, resulting in low resistance and vulnerability to viral and bacterial infections. Low calcium can cause the ciliary movement of the airway epithelial cells to weaken, making the secretions of the respiratory tract difficult to discharge. These are the causes of the cold.

Poor surrounding environment (5%):

Some children have poor family room conditions, dark and humid; some indoor temperatures are too much or too low; some families like to close the doors and windows all day long, the air is not circulating; some family members like to smoke, plus the same room fire, smoke pollution serious. Poor environment, turbid air, and great harm to the respiratory tract are important causes of colds. Some parents dress too much or too little for their children. The result is not sweating or cold, it is easy to induce a cold.

Lack of outdoor exercise (10%):

Due to objective conditions or insufficient attention, many children lack outdoor activities. For example, in the northern part of China and in the cold season, children spend most of their time indoors, and rarely have the opportunity to be outdoors. Some parents love children and keep their children in air-conditioned rooms. Once these children are cold, they can't adapt and are prone to colds.

Pediatric cold prevention

prevention

1. Active exercise: It is very important to use physical factors to exercise physique. For example, frequent window sleep, outdoor activities, etc. are all positive methods. As long as they are consistent and often carried out, they can enhance physical fitness and prevent upper respiratory tract infection.

2, talk about hygiene, to avoid the cause of the disease: clothes too much or too little, room temperature is too high or too low, sudden changes in the weather, environmental pollution and passive smoking, etc., are the cause of upper respiratory tract infection, should pay attention to prevention.

3, to avoid cross-infection: wash hands after contact with sick children, if necessary, wear gowns, isolation not only protects neighboring children, but also reduces complications in sick children, can be performed in general care institutions and hospitals, adult patients in the family Avoid contact with healthy children. The ward should be ventilated, maintain proper temperature, disinfect the bed of discharged patients and keep clean empty beds, so that you can receive new patients at any time. If conditions permit, you can use UV to irradiate the ward and contaminated areas for disinfection. The pathogens are all scattered.

4, drug prevention: card slow Shu, infant 5ml, children 10ml oral, 3 times a day, 3 to 6 months for a course of treatment, L-tetrazole, 2.5mg (kg · d), 2 days a week, 3 The month is a course of treatment. The traditional Chinese medicine Astragalus membranaceus is 6~9g daily for 2~3 months. The above drugs can improve the body's cellular and humoral immune function. Repeated upper respiratory tract infection can reduce the number of recurrences after application. Pediatrics of Beijing Friendship Hospital used traditional Chinese medicine. Adding flavor Yupingfeng powder (formula: raw scutellaria 9g, Atractylodes 6g, windproof 3g, raw oyster 9g, dried tangerine peel 6g, yam 9g, research into fine) 2 times a day, each time 3g oral, through 3 years observation, think this drug It seems to weaken the immunity of children and reduce the incidence of repeated respiratory infections.

5, vaccination: Recently, the application of attenuated virus vaccine, by intranasal drip and / or aerosol inhalation, can stimulate the production of secretory IgA antibodies in the nasal cavity and upper respiratory tract mucosa, thereby enhancing the respiratory tract's defense ability against infection, a large number Research work indicates that secretory IgA is more effective against respiratory infections than any serum antibody, and because of the large number of enteroviruses and rhinoviruses, vaccine prevention is possible.

Pediatric cold complications Complications laryngitis around the tonsils pneumonia

Acute infection of the upper respiratory tract can cause many complications if not treated in time, especially in infants and young children. Complications can be divided into three categories:

1, infection from the nose, the pharynx spread to nearby organs, more common are acute conjunctivitis, sinusitis, stomatitis, laryngitis, middle ear and cervical lymphadenitis, other such as posterior pharyngeal abscess, tonsil abscess, Osteomyelitis, bronchitis and pneumonia are also not uncommon.

2, the pathogen spread through the blood circulation to the whole body, bacterial infection and sepsis can lead to purulent lesions, such as subcutaneous abscess, empyema, pericarditis, peritonitis, arthritis, osteomyelitis, meningitis, brain abscess and urinary tract infections, etc. .

3, due to the infection has an allergic effect on the body, can occur rheumatic fever, nephritis, myocarditis, hepatitis, purpura, rheumatoid disease and other connective tissue diseases.

Children with cold symptoms Common symptoms Runny nose, children with nasal congestion, tonsils, inflammation, children, fever, red spots, low fever, nasal congestion, high fever, high fever, chills, weakness, sore throat

1. Incubation period

Mostly 2 to 3 days or a little longer.

2, mild

Only nasal symptoms, such as nasal discharge, nasal congestion, sneezing, etc., can also be used for tears, micro-cough or pharyngeal discomfort, can be naturally healed within 3 to 4 days, such as infection, involving the nasopharynx and pharynx, often have fever, pharynx Pain, tonsillitis and lymphatic tissue congestion and hyperplasia in the posterior pharyngeal wall, sometimes the lymph nodes may be slightly enlarged, and the fever may last for 2 to 3 days to 1 week, which may cause vomiting and diarrhea in infants and young children.

3, severe

Body temperature can reach 39 ~ 40 ° C or high, accompanied by cold feeling, headache, general weakness, loss of appetite, sleep disorders, etc., soon due to redness, herpes and ulcers, called herpes pharyngitis, sometimes redness Obviously, the tonsils appear, follicular purulent exudate, sore throat and systemic symptoms are added, nasopharyngeal secretions change from thin to thick, submandibular lymph nodes are significantly enlarged, tenderness is also obvious, such as inflammation and sinus , middle ear or trachea, other symptoms occur, systemic symptoms are also more serious, more serious symptoms, should pay attention to febrile seizures and acute abdominal pain, and other diseases for differential diagnosis, acute upper respiratory tract infection caused by febrile seizures are mostly found in infants Infants, several times after onset from 1 to 2 days after onset, acute abdominal pain is sometimes very intense, mostly around the umbilicus, no tenderness, often early, mostly temporary, may be related to intestinal peristalsis, but also sustainable Sometimes it is similar to the symptoms of appendicitis, mostly due to acute mesenteric lymphadenitis.

4, acute tonsillitis

It is part of acute pharyngitis, and its course and complications are the same as acute pharyngitis. Therefore, it can be used as a disease alone or in pharyngitis. It is caused by viruses, sometimes white spotted exudate on the surface of tonsils, and soft palate. And small ulcers can be seen in the posterior pharyngeal wall, bilateral buccal mucosa congestion accompanied by scattered bleeding, but the mucosa is smooth, can be identified with measles, caused by streptococcus, generally more than 2 years old children, the systemic symptoms are more, Have high fever, cold feeling, vomiting, headache, abdominal pain, etc., later sore throat or light or heavy, difficulty swallowing, tonsil diffuse redness, or follicular purulent exudate, patients with red tongue, or have Thick moss, if not treated in time, prone to complications, mainly sinusitis, otitis media and lymphadenitis.

5, blood elephant

Viral infection is generally low or in the normal range of white blood cells, but the percentage of white blood cells and neutrophils can be higher in the early stage; the total number of white blood cells is increased in bacterial infections, and the severe cases can be reduced sometimes, but the percentage of neutrophils is still increased.

6, the course of disease

In mild cases, the fever time varies from 1 to 2 days to 5 to 6 days, but the heavier ones can reach 1 to 2 weeks of high fever. Even for a long period of low fever, for several weeks, it takes a long time since the lesions are not cleared. get well.

Pediatric cold check

Physical examination

Carefully perform a full body check to rule out other diseases. Observation of the whole pharynx, including tonsils, soft palate and posterior pharyngeal wall, such as tonsil and pharyngeal mucosa red and swollen, bacterial and viral infections are possible, when there are purulent secretions on the tonsils, should consider streptococcal infection. If there is a large membranous exudate on the tonsil or beyond the tonsil, the diphtheria should be carefully excluded. The bacteria are usually examined by a pharyngeal smear and cultured if necessary. If there is a hemorrhagic rash at the same time as acute pharyngitis, sepsis and meningitis must be excluded. The severity of the difference can be very large. Generally, the older children are lighter, and the infants and young children are more severe.

If the child has a cold, parents should not only summarize the experience, strengthen life care, and protect themselves from infection. They should also take the children to the hospital to check the humoral immune function IgA, IgG, IgM, cellular immune function E, rosette and test blood zinc. Trace elements such as copper.

Diagnosis and diagnosis of pediatric cold

diagnosis

1. Epidemic situation: Understanding the prevalence of local diseases is helpful for diagnosis and differential diagnosis. When suffering from an acute upper respiratory tract infection, not only the symptoms are similar, but also the complications are similar. Some common acute infectious diseases, such as young children. Acute rash, measles, scarlet fever, epidemic cerebrospinal meningitis, etc., the symptoms are similar to upper respiratory tract infections at the onset, so local prevalence should be noted for identification.

2, physical examination: careful physical examination to exclude other diseases, observation of the whole pharynx, including tonsils, soft palate and posterior pharyngeal wall, such as tonsil and pharyngeal mucosa red and swollen, bacterial and viral infections are possible; Streptococcal infection should be considered when there is purulent secretion on the tonsil. For example, if there is a large membranous exudate on the tonsil or beyond the tonsil, diphtheria should be carefully excluded. Generally, the bacteria should be examined by pharyngeal smear and cultured if necessary. Such as acute pharyngitis, as well as hemorrhagic rash, you must rule out sepsis and meningitis, the degree of severity can vary greatly, generally older children are lighter, more severe in infants and young children.

Differential diagnosis

1, identification with the flu: the flu has a clear epidemiological history, many systemic symptoms such as high fever, limb pain, headache, etc., may have a state of exhaustion, general nasal, pharyngeal symptoms such as nasal secretions and cough, etc., the symptoms of systemic poisoning are light.

2, identification with digestive diseases: upper respiratory infections in infants and young children, often have gastrointestinal symptoms, such as vomiting, abdominal pain, diarrhea, etc., can be misdiagnosed as primary gastrointestinal disease.

3, with allergic rhinitis identification: some "cold" children with systemic symptoms are not heavy, often sneezing, clear sputum, pale edema of the nasal mucosa, you should consider allergic rhinitis, in the nose smear examination, see Eosinophilia can help diagnose the disease, which is more common in preschool and school-age children.

4. Identification from blood: high fever, low white blood cell count, should consider common acute viral upper respiratory tract infection, and exclude influenza, measles, malaria, typhoid, tuberculosis, etc. according to local epidemics and exposure history of children. When the white blood cells continue to increase, bacterial infection is generally considered, but it can be as high as 15×109L in the early stage of viral infection, but rarely exceeds 75% in neutrophils. When white blood cells are particularly high, bacterial pneumonia must be excluded. Mononucleosis and whooping cough, acute pharyngitis with rash, systemic lymphadenopathy and hepatosplenomegaly should be checked for abnormal lymphocytes except for infectious mononucleosis.

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