Often ill children - causes, symptoms, diagnosis and treatment
Often ill children - The category of children exposed to high levels of acute respiratory diseases as a result of transient, correctable violations in the protective systems of the body. The group of sickly children included, carrying more than 4-6 ARI episodes per year, which can occur in different clinical forms. Often ill children should be examined by a pediatrician, ENT doctor, allergist-immunologist; diagnostic algorithm includes: KLA, seeding from the mucous of the nose and throat, infection detection by PCR, allergotesty, immunogram study, X-ray paranasal sinuses and chest. Often ill children in need of readjustment of foci of chronic infection, etiopathogenic therapy of acute respiratory disease, vaccination and prevention of non-specific.
Often ill children
rhinitis, nasopharyngitis, sinusitis, tonsillitis, laryngotracheitis, bronchitis, pneumonia and others.). In pediatrics, the term "often ill children" is used to describe a group of clinical supervision and reflects mainly the multiplicity and severity of infectious diseases. Sometimes the notion of "long-term and often ill children" (CHDBD) for emphasizing the protracted nature of respiratory infections in this group of children. In Western countries, in relation to these patients used the term "children with recurrent acute respiratory infections." According to epidemiological data, often ill children make up 15-40% of the total number of children.
. Intrauterine infections, asphyxia, hypoxic-ischemic encephalopathy, prematurity, etc. Infants may experience malnutrition, rickets, anemia, vitamin deficiencies, goiter; at an early age joined helminth infections and chronic infections nosoglotki- adenoids, rhinitis, sinusitis, otitis, pharyngitis, and so forth.
Disruption of the already imperfect adaptation mechanisms may contribute to early child transfer to artificial feeding, environmental deprivation, poor child care, passive smoking, irrational use of medicines (antipyretics, antibiotics, etc.), Allergic stress. Often ill children often have limfatiko-hypoplastic anomaly of the constitution (diathesis). Sometimes a seemingly normal developing child goes into the category of sickly children after beginning to attend pre-school establishments, due to a high level of contact with sources of infection.
Activators of repeated infections in frequently ill children in most cases are the viruses (influenza and parainfluenza, respiratory syncytial, adenoviruses), atypical bacteria (pathogens chlamydia and mycoplasma), bacteria (Haemophilus influenzae, Staphylococcus, Streptococcus, marokselly, pneumococci, and others.).
SARS. This respiratory infections in frequently ill children can take the form of destruction of upper respiratory tract (adenoiditis, tonsillitis, sinusitis), upper respiratory tract (rhinitis, nasopharyngitis, laryngotracheitis et al.), Lower respiratory tract infections (bronchitis, bronchiolitis, pneumonia). We often ill children have a tendency to long and complicated infections. In the structure of complications they dominated sinusitis, purulent otitis, asthma, pneumonia, pyelonephritis, glomerulonephritis, rheumatic fever.
Frequent infectious disease leads to disruption of mental and physical development of children, development of vegetative-vascular dystonia, limited social contacts with peers, poor academic performance. Quite often in sickly children have aborted and visual-spatial visualization ability, delayed speech development, fine motor skills violation.
pediatrician, child otolaryngologist, children's allergist-immunologist, pediatric pulmonology.
Since half of sickly children are chronic diseases of upper respiratory tract, is necessary to conduct rhinoscopy, pharyngoscope, otoscopy, ultrasound sinuses to assess the state of the adenoids, tonsils, sinuses, ear drums
In order to identify atopy run allergotesty determined content of total and allergen-specific immunoglobulin E (IgE). Advantageously study immune status indicators including levels of IgA, IgG, IgM.
To evaluate the nasal mucous microbiocenosis in sickly children shall be required bacteriological culture from the throat and nose. For detection of viral and atypical pathogens (RS-virus, mycoplasma, chlamydia, cytomegalovirus, HSV types 1 and 2) smears and washes were investigated by PCR.
Of the additional laboratory tests are often ill children held blood count, urinalysis, stool for bacteria overgrowth, screening for helminthiasis and giardiasis. Diagnostics is complemented by performing X-ray of the nasopharynx and sinuses, chest radiography, ERF.
general massage, breathing exercises and physical therapy. In chronic ENT-pathology conducted local treatment - oral saline lavage of the nose, throat gargle, wash lacunae of tonsils, physiotherapy (UVR tonsils, inhalation, microwave, UHF, laser to regional lymph nodes); on the testimony - moxibustion nasopharyngeal mucosa, adenotomy, tonsillectomy etc.
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The incidence of periods of respiratory infection is often ill children assigned etiopathogenetic treatment: anti-inflammatory (fenspirid), antiviral (interferon alpha, umifenovir, rimantadine), local or systemic antibiotic therapy (amoxicillin, amoxicillin-clavulanate, cefixime, etc).
To stimulate the nonspecific factors of protection are often ill children shown receiving the bacterial lysates. It is necessary to conduct correction of the intestinal microflora using probiotics and prebiotics. It does not rule out the possibility of observation of sickly children homeopath.
The assignment of a child to a group of sickly children does not preclude the carrying out of preventive inoculations, and, on the other hand, it is the basis for an elaborate individual vaccination. Thus, the frequent incidence of respiratory infections is the main indication for vaccination of children against influenza. Mandatory and optional vaccinations are often ill children should be carried out during periods of clinical well-being; In this case, the risk of post-vaccination complications not exceed the average.
Often ill children: prevention
Unfortunately, completely prevent the incidence of acute respiratory disease of children is not possible, however, able to reduce the adult incidence and severity of the disease. Since pregnancy planning is necessary to lead a healthy lifestyle, to avoid exposure to adverse factors during gestation; after birth - to carry out breastfeeding. With regard to sickly children should not be neglected immunoprophylaxis and nonspecific prevention of respiratory diseases, timely treatment of opportunistic infections.
The number of repeated episodes of acute respiratory infections per year in frequently ill children depends not only on the correct treatment, but, to a greater extent from the way of life in times of clinical well-being. Planning and compliance with rehabilitation and recovery activities prolongs remission, reduction in the frequency and severity of episodes of acute respiratory disease.