Hot dogs are most comon causes of fatal aspiration

History: onset coughing w/out prodrome, gagging, and or choking

Physical: cough, unilateral wheeze, recurrent pneumonia, hemoptysis, dyspnea, cyanosis, horaseness

Diagnostic: inspiratory and expiroatory xray show hyperexpansion

Croup

Laryngotracheobronchitis

Parainfluenza Virus Loves Croup!!!

A viral infection which causes inflammationo f larynx, treachea, and bronchi

Peak age 3mo-3yo (6mo-5yo) Fall and Winter

S&S: uri prodrome, rhinits for 3-4 days, low grade fever, sore throat. Rapid onset or barky (seal) cough, stridor, hoarseness, fever variable, symptoms worse at night or with agitation

Physical: inspiratory stirdor, brassy-barky cough, dyspenia, low grade fever (can be high),

Mgmt: Humidifcation w/cool mist

Dexamethasone .6-1mg/kg IM or PO x1

xray shows Steeple sign

Febrile cough illness lasting less than 3 weeks with ronchi and referred breath sounds. Peaks midwinter

Cough is hallmark symptom: dry, harsh & brassy becomes productive

No evdience to support use of cough suppressants or bronchodilators.

Loves RSV

Hx: of Uri symptoms. low grade fever up to 102, some infants just go apnea.

wheezing is the most prominent physical finding. spleen may be palpable due to hyperinflation.

• Viral 80% of cases ie) RSV, parainfluenza, influenza
• Neonates: group B strep
• 1-3 months: S. Aureus, strep pnuemoniae
• 4mo-4yo: S pneumonia
• 5 years: S pneumoniae, mycoplasma
• S.pneumonia is the leading cause of bacterial in all groups except newborn and causes lobar pneumonia
• S. Aureus presents with empyema, abscess, and pneumotocele.
• Tachypnea is key finding, expiratory grunting, fever, neck or chest pain (upper lobe), abdominal pain (lower lobe). wheezing (viral).
• Bacterial Abrupt onset of fever, chills, cough, and chest pain.
• Rales/crackles, diminished breath sounds.
• x-ray
• Mgmt: hospatlize birth to 3 week old, out patient 4mo-5 year old

• Autosomal recessive disorder. Most comon fatal disorder affecting caucasian population.
• S&S: Extremely viscid meconium with delayed passage, poor grwoth, recurrent and chronic respt infections, large, bulky-foul smelling greasy stools. frequent flatuence or abdominal pain, chronic cough, recurrent or persistant wheezing. salty-tasting skin. distal small bowel obstruction.
• Physical: nasal polyps, FTT, rectal prolapse, Digital clubbing
• Diganostic: sweat chloride >60 mmol/L
• Role of PCP: annual influenza vaccine more liberal use of abx

Bronchopulmonary Dysplasia

(BPD)

Infants <1000g at birth and <28 w

Leading cause of chronic lung disease in infants

Acute resp distress first week of life

Airway hyper-responsivness

IgE mediated response

viral respirtory infection most common cause of exacerbation

Physical: diffuse wheezes initally heard at end of expirtory phase with decrased air flow and prolonged expirtory  phase. allergic shiners dennies lines, nasal polyps (concider cf), atopic dermatitis, barrel chest (chronic hyperinflation)

Dignostic: Pulmonary Function Tests-->Spiromety gold standard in diagnosing children older than 4-5 yo