URTI is defined as an inflammation of the structures of respiratory tract above larynx like nose, sinuses and phanynx.
Children are more pron to get infections then adults.
A large number of different micro organisms, chiefly the viruses like rhinovirus, parainfluenza virus, adenovirus, etc. and the bacteria like streptococcus pyogenes, staphylococcus, haemophilusinfluenza,etc. are capable of causing inflammation of upper respiratory tract
INFECTIONS OF UPPER RESPIRATORY TRACT IN CHILDREN INCLUDE:-
- Allergic rhinitis
- Sinusitis
- Nasopharyngitis or common cold
- Pharyngitis
- Nasal polyp
- Adenoids
Nasopharyngitis or common cold:
It is an inflammatory infectious syndrome caused by many different viruses mainly by rhinovirus. Its symptoms are due to release of inflammatory mediators which generally doesn’t cause damage to nasal epithelium.
Pathology includes oedema & vasodilatation of submucosa. mononeuclear cells will be polyneuclear, superficial epithelial cells separate & may slough.
Sinusitis
Sinusitis is inflammation of the mucous membrane that lines the paranasal sinuses.
Types:
- Acute sinusitis- may lasts up to 4 weeks
- Subacute sinusitis- lasts between 4 and 12 weeks
- Chronic sinusitis- symptoms lasts up to more than 12 weeks.
Mostly sinusitis precipitated by an earlier upper respiratory tract infection.
- Sinusitis due to virus
-inflamed sinuses usually filled with clear exudates. - Sinusitis due to bacteria
-thickened sinus membrane
-sinuses filled with pus or mucopurulent exudations
-smear of secretion reveals neutrophils - Sinusitis due to allergic reaction
-Smear of secretion reveals eosinophils.
Pharyngitis:
Pharyngitis is an inflammation of the pharynx- the back of the thoat. It is mainly caused by betahaemolytic streptococcus.
Types:
- Viral pharyngitis
-usually the inflammation is slight, but occasionally inflammation may be sever and small ulcers may form on the soft palate & posterior pharyngeal wall.
-Exudates on lymphoid follicles of palate & tonsils.
-Cervical lymphnodes- enlarge, firm & may or may not tender.
-predominance of polymorphnuclear cells. - Streptococcal pharyngitis:
-Tonsillar involvement is usually seen. Enlargment & diffuse redness of tonsils & tonsillar pillars are common.
-Pharyngeal erythema and exudation on tonsils.
-Anterior cervical lymphadenopathy and lymph nodes are more tender than viral pharyngitis.
-Patatchial mottling of soft palate.
Allergic rhinitis:
It is an allergic inflammation of the nasal airways.
When an individual with a sensitized immune system inhale the allergens like pollens, dust, animal dander, etc. It will trigger the production of antibody IgE, which binds to the mast cells & basophils contain histamine.
Adenoiditis:
Adenoids are the parts of lymphoid tissues that circles the pharynx. Frequent exposure to infectious agent may produce hypertrophy of the adenoids. So, there is obstruction of air passage that leads to mouth breathing and snoring.
Nasal polyp:
Nasal polyp is a benign pedunculated tumors formed from edematous and chronically inflamed nasal mucosa. Cystic fibrosis is the most common cause of nasal polyposis. Glistening, gray, grape like masses squeezed between the nasal turbinate & septum. Prolonged pressure of polyps may widen the bridge of the nose & erode adjacent osseous structure.
Allergic rhinitis:
It is an allergic inflammation of the nasal airways.
When an individual with a sensitized immune system inhale the allergens like pollens, dust, animal dander, etc. It will trigger the production of antibody IgE, which binds to the mast cells &basophils contain histamine.
MANAGEMENT:
Management depends upon the underlying cause. The most important thing that parents can do for a child with upper respiratory tract infection is to provide healthy habits, avoidance of unwanted pollutions, plenty of sleep, loving and caring environment.
According to Homoeopathic point of view
Acute upper respiratory tract infection in children require similimum constitutional medicine, to get similimum medicine we have to erect portrait of patient.
In paediatric case taking, when we try to find the basic innate characteristics we have to take case thoroughly, and few points are as follows:
- Age/sex
- Physical constitution
- Fundamental cause (i.e. miasm)
- Mental character
- Intellectual character
- Mode of living
- Social and domestic relation, behavior
