Recurrent upper respiratory tract infection

Introduction Repeated respiratory infection in children refers to infants under the age of 3 who have repeated respiratory infections for more than 7 times per year or lower respiratory tract infections for more than 3 times. The scope of being a weak child is the object of health care management for child health workers.

Cause

(1) Children are born with poor physical fitness, such as low birth weight infants, premature infants, twin fetuses, multiple fetuses and deformed children.

(2) Pediatric problems due to production, such as suffocation caused by dystocia and aspiration pneumonia.

(3) Infected diseases such as neonatal sepsis, neonatal pneumonia, enteritis, etc. due to illness in the neonatal period.

(4) Due to improper feeding during infancy, such as lack of maternal milk or insufficient mother milk, artificial feeding is unreasonable, causing indigestion from a small age, disharmony between the spleen and stomach, resulting in malnutrition. Or due to calcium deficiency, iron deficiency, zinc deficiency, etc. caused by rickets, iron deficiency anemia.

(5) Due to the physiological and anatomical features of infants and young children, for example, the development of the respiratory tract and digestive tract is not mature enough, the immune organs are not well developed, and there is not enough disease resistance, so it is very susceptible to infection.

(6) Due to environmental factors, such as sudden changes in the weather, cold and hot, the child's tolerance to cold and heat is very poor, and he does not add clothes in time to cause a cold.

(7) Due to air pollution. Children live in cities, the atmosphere is often polluted by the exhaust of cars, and they live in smoking households. The air is contaminated by cigarettes, which makes children under passive smoking conditions, and is susceptible to coughing and infection due to low respiratory immune function. Another type of pollution is that children live with adults or children with colds or bronchitis, and the bacteria are directly inhaled by the air to cause cross-infection. In particular, direct supervision of children is more likely to cause infection in children when they have respiratory diseases.

(8) Due to poor management. In early childhood, children can wear their own clothes, and in areas with large indoor and outdoor temperature differences, they should pay attention to wearing clothes unreasonably. Children with a large amount of activity sweat more, but also add water in a timely manner, dry the sweat, do not let the sweat dry on its own temperature, so that it is easy to get sick. In addition, each child's physique is different, some are afraid of heat, some are afraid of cold, some like to drink cold water, some like to drink hot water, with the child's physique, strengthen management at any time, so as not to get sick.

(9) Due to psychological factors. Children's changing environment is also likely to cause discomfort and illness. For example, children who are new to the park are prone to get sick, or change the babysitter, and there are also emotional tensions caused by children who are snoring, and can also cause illness. Therefore, it is also very important to create a happy family atmosphere for your child.

an examination

Related inspection

Respiratory syncytial virus antibody lung ventilation imaging host-mediated test bacteria metabolism test for carbohydrates bacterial identification enzyme test

1, physical examination

According to the history, prevalence, symptoms and signs of nasopharynx inflammation, combined with peripheral blood and chest X-ray examination can make a clinical diagnosis.

2, blood white blood cell count and classification; white blood cells are low, early neutrophils slightly increased. The total number of white blood cells and neutrophils in the combined bacterial infection can be increased.

3, chest X-ray examination to rule out lung disease.

4, for bacterial culture and virus isolation, or viral serology, immunofluorescence, enzyme-linked immunosorbent assay, hemagglutination inhibition test, etc., can determine the cause of diagnosis.

Differential diagnosis

1, the common cold type

Also known as acute rhinitis or upper respiratory tract catarrh, cold, the onset of the disease occurs in the winter and spring season; local nasopharynx symptoms are heavier, such as nasal congestion, runny nose, sneezing, sore throat, etc., systemic symptoms are light or no; Visible nasal mucosa congestion, edema, secretions, mild congestion of the pharynx; blood routine white blood cell count is low or normal, lymphocyte ratio is increased; virus isolation in adults mostly rhinovirus, children mostly respiratory syncytial virus. Generally self-healing in 5-7 days.

2, influenza

Influenza is referred to as flu. The disease is acute, infectious, and the symptoms are variability. It is mainly caused by systemic poisoning and mild respiratory symptoms. Have chills, high fever (39-40 degrees), general malaise, low back pain, fatigue, headache, dizziness, sneezing, stuffy nose, runny nose, sore throat, dry cough, less sputum. The examination showed severe illness, weak and weak, facial flushing, congestion and edema of the nasopharynx, and a small amount of wet rales or wheezing sounds in the lower part of the lungs. Leukopenia is reduced and lymphocytes are relatively increased. If the secondary bacterial infection can have yellow purulent sputum, rust sputum, blood stasis, chest pain, total white blood cells, neutrophils, the course of 3-5 days.

3, pharyngitis type

The onset season occurs in the winter and spring seasons; pharyngeal inflammation is the main cause, which may have pharyngeal discomfort, itching, burning sensation, sore throat, etc., may be accompanied by fever, fatigue, etc.; the examination has obvious congestion and edema of the pharynx. Submandibular lymph nodes are swollen and tender; blood routine white blood cell counts can be normal or decreased, lymphocyte ratio is increased; virus isolation is mostly adenovirus, parainfluenza virus and respiratory syncytial virus.

4, herpes angina type

The onset season is mostly in the summer, common in children, occasionally in adults; the degree of sore throat is heavier, more often accompanied by fever, the course of disease is about 1 week; there are pharyngeal congestion, phlegm, pharyngeal and tonsil surface with grayish white herpes and ulcers. Surrounded by red blush; virus isolation is mostly Coxsackie virus A.

5, pharyngeal conjunctival heat type

The onset season often occurs in the summer, spread in swimming, more common in children; there are sore throat, photophobia, tearing, itchy eyes, fever and other symptoms, the course of disease is about 4-6 days; the pharyngeal cavity and the combined membrane are obviously hyperemia and other signs; The blood routine white blood cell count is normal or decreased, and the proportion of lymphocytes is increased; the virus is mostly isolated from adenovirus and coxsackie virus. The criteria for diagnosis of repeated respiratory infection in children are: 0-2 years old, 7 times of upper respiratory tract infection and 3 times of lower respiratory tract infection per year; 3-5 years old, 6 times of upper respiratory tract infection and 2 times of lower respiratory tract infection; 6-14 At the age of 5, upper respiratory tract infections occur 5 times a year, and lower respiratory tract infections occur twice.

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