.
Acute respiratory
infection (ARI)
Dr. Raad Al-samarraee
Respiratory tract infection (RTI) :
refers to any of a number of infectious
diseases involving the respiratory tract. An
infection of this type is further classified as an
upper respiratory tract infection (URI or URTI)
, which starts at sinuses and ends at vocal
chords, or a
lower respiratory tract infection
(LRI or LRTI)
, which starts at vocal chords and
ends at lungs.
Acute respiratory infection
(ARI)
Upper Respiratory Tract Infections:
URIs are the most common infectious
diseases. They include rhinitis (common cold),
sinusitis, ear infections, acute pharyngitis or
tonsillopharyngitis, epiglottitis, and laryngitis—of
which ear infections and pharyngitis cause the
more severe complications (deafness and acute
rheumatic fever, respectively).
The vast majority of URIs have a viral
etiology. Because most URIs are self-
limiting, their complications are more
important than the infections.
Acute
viral
infections
predispose
children to bacterial infections of the
sinuses and middle ear, and aspiration of
infected secretions and cells can result in
LRIs.
Acute Pharyngitis
Acute pharyngitis is caused by viruses in more
than 70 percent of cases in young children. Mild
pharyngeal redness and swelling and tonsil
enlargement are typical.
Streptococcal infection is rare in children
under five and more common in older children.
Acute pharyngitis in conjunction with the
development of a membrane on the throat is
nearly
always
caused
by
Corynebacterium
diphtheriae in developing countries.
Acute Ear Infection
Acute ear infection occurs with up to 30 percent
of URIs. In developing countries with inadequate
medical care, it may lead to perforated eardrums
and chronic ear discharge in later childhood and
ultimately to hearing impairment or deafness.
Chronic ear infection following repeated
episodes of acute ear infection is common in
developing countries. The associated hearing
loss may be disabling and may affect learning.
Repeated ear infections may lead to mastoiditis,
which in turn may spread infection to the
meninges.
Lower Respiratory Tract Infection:
Pneumonia
Both bacteria and viruses can cause pneumonia.
Bacterial
pneumonia
is
often
caused
by
Streptococcus pneumoniae (pneumococcus) or
Haemophilus influenzae, mostly type b, and
occasionally by Staphylococcus aureus or other
streptococci.
Bronchiolitis
Bronchiolitis occurs predominantly in the first
year of life and with decreasing frequency in the
second and third years. The clinical features are
rapid breathing and lower chest wall indrawing,
fever in one-third of cases, and wheezing.
RSV
s are the main cause of bronchiolitis
worldwide and can cause up to 70 or 80 percent
of LRIs. Other viruses that cause bronchiolitis
include parainfluenza virus type 3 and influenza
viruses.
Causes of acute respiratory infection
Causes of upper respiratory infection:
acute pharyngitis
acute ear infection
common cold
Causes of lower respiratory infection:
bronchitis
pneumonia
bronchiolitis
Symptoms of acute respiratory infection:
The symptoms you experience will be different if
it’s a lower or upper respiratory infection.
Symptoms can include:
congestion, either in the nasal sinuses or lungs
runny nose
cough
sore throat
body aches
fatigue
Call your doctor if you experience:
a fever over 103˚F (39˚C) and chills
difficulty breathing
dizziness
loss of consciousness
Case Management
WHO
clinical
guidelines
for
ARI
case
management use two key clinical signs:
- respiratory rate, to distinguish children with
pneumonia from those without, and
- lower chest wall indrawing, to identify severe
pneumonia requiring referral and hospital
admission.
Children with audible stridor when calm and
at rest or such danger signs of severe disease as
inability to feed also require referral.
Children without these signs are classified as
having an ARI but not pneumonia. Children
showing only rapid breathing are treated for
pneumonia with outpatient antibiotic therapy.
Children who have a cough for more than 30
days are referred for further assessment of
tuberculosis and other chronic infections
.
Preventing acute respiratory infection
Most causes of an acute respiratory infection
aren’t treatable. Therefore, prevention is the best
method toward off harmful respiratory infections.
1.Vaccination:
Getting the MMR (measles, mumps, and rubella)
and pertussis vaccine will substantially lower your
risk of getting a respiratory infection. You may also
benefit
from
influenza
vaccination
and
pneumovax.
2.Practice good hygiene:
- Wash hands frequently, especially after you’ve
been in a public place.
- Always sneeze into a tissue, it will prevent you
from spreading infectious diseases.
- Avoid touching face, especially eyes and
mouth, to prevent introducing germs into your
system.
