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Literature review on bronchiolitis
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What age group is most often affected by Bronchiolitis/RSV?
Respiratory Syncytial Virus (RSV) has been known as a major cause of acute lower respiratory tract infection in children. According to new estimate, the annual death of infection from RSV is 66000 to 199000 in children under five years of age. More than three million children in this age group also get hospitalized due to RSV. RSV can affect anyone, including the elderly, however the burden is more in the youngest who experience highest rates of emergency department and hospitalization related to RSV infection (Heikkinen et al., 2015).
How is RSV transmitted?
RSV infection spread through droplets. RSV can spread when an infected person cough or sneeze. It can also spread through the
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Major symptoms of bronchiolitis include coughing, wheezing and poor nutrition. Approximately 20 percent of children develop bronchiolitis during their first year of life. Among them two to three percent of children require hospitalization during their first year of life. Respiratory syncytial virus is the most common cause of bronchiolitis, especially epidemics in winter season. In most studies it accounts for 60 to 80 percent of the bronchiolitis cases in children below 12 months of age. It is important to prevent nosocomial spread of RSV from children with bronchiolitis. RSV can survive up to seven hours on surface and can transmit directly or indirectly by touch. Hand decontamination with antimicrobial soap or alcohol based hand rubs are important before and after patient contact, and after contact with possible decontaminated objects (Oymar et al., 2014). Other prevention measures include, wash your hand at least 20 seconds, keep your hands off your face, avoid close contact with infected people, cover your cough and sneeze, clean and disinfect surfaces, and stay home when you are sick. (Centers for Disease Control and Prevention,
The presented case is of a patient named R.S. who has a smoking history of many years, which can be directly tied to his development of chronic bronchitis, a chronic obstructive pulmonary disease (COPD) specified as Type B. It is estimated that in 90% of chronic bronchitis or “blue bloaters”, cigarette smoking is the major cause. Chronic bronchitis involves persistent and irreversible airway obstruction, due to the constant inflammation of the bronchial mucosa, leading to hypertrophy and hyperplasia of bronchial glands. The latter exposes the individual to higher risks of bacterial infections; often colonization of organisms such as Streptococcus or Staphyloccocus pneumoniae can be exhibited. This is due to the lost or impaired function of mucociliary clearance action which results from the replacement of certain sections of ciliated columnar epithelium by squamous cells in the bronchi. (Copstead &Banasik, 546-547)
R.S. has chronic bronchitis. According to the UC San Francisco Medical Center “Chronic bronchitis is a common type of chronic obstructive pulmonary disease (COPD) in which the air passages in the lungs — the bronchi — are repeatedly inflamed, leading to scarring of the bronchi walls. As a result, excessive amounts of sticky mucus are produced and fill the bronchial tubes, which become thickened, impeding normal airflow through the lungs.” (Chronic Bronchitis 2015) There are many things that can be observed as clinical findings. R.S. will have a chronic cough that has lasted from 3 months to two years or more, and a lot of sputum. The sputum is due to
Ventilator Associated Pneumonia (VAP) is a very common hospital acquired infection, especially in pediatric intensive care units, ranking as the second most common (Foglia, Meier, & Elward, 2007). It is defined as pneumonia that develops 48 hours or more after mechanical ventilation begins. A VAP is diagnosed when new or increase infiltrate shows on chest radiograph and two or more of the following, a fever of >38.3C, leukocytosis of >12x10 9 /mL, and purulent tracheobronchial secretions (Koenig & Truwit, 2006). VAP occurs when the lower respiratory tract that is sterile is introduced microorganisms are introduced to the lower respiratory tract and parenchyma of the lung by aspiration of secretions, migration of aerodigestive tract, or by contaminated equipment or medications (Amanullah & Posner, 2013). VAP occurs in approximately 22.7% of patients who are receiving mechanical ventilation in PICUs (Tablan, Anderson, Besser, Bridges, & Hajjeh, 2004). The outcomes of VAP are not beneficial for the patient or healthcare organization. VAP adds to increase healthcare cost per episode of between $30,000 and $40,000 (Foglia et al., 2007) (Craven & Hjalmarson, 2010). This infection is also associated with increase length of stay, morbidity and high crude mortality rates of 20-50% (Foglia et al., 2007)(Craven & Hjalmarson, 2010). Currently, the PICU has implemented all of the parts of the VARI bundle except the daily discussion of readiness to extubate. The VARI bundle currently includes, head of the bed greater then or equal to 30 degrees, use oral antiseptic (chlorhexidine) each morning, mouth care every 2 hours, etc. In the PICU at children’s, the rates for VAP have decreased since the implementation of safety ro...
Croup: Croup is another common airway inflammation caused by virus that can affect the trachea, larynx and possibility the bronchi (Murray, Sidani, & Zoorob, 2011) thus causing infection in the upper respiratory tract. Murray et al. describes it as the most common illness in children under the age of 6 to 36 months and cause for cough mostly when a child cries; acute stridor and hoarseness in febrile children (Murray et al., 2011). It can be a life-threatening situation in the life of the young infant and the family. Croup symptoms exhibit as hoarseness, barking cough, inspiratory stridor, and respiratory distress. I chose this diagnosis as my first preference because when I read the mother’s subjective report it matches that of croup symptoms: a barking cough, no fever, severe at night and when the baby cries, fatigue due to excessiveness of the tears, pain due to inflames and swollen of the airway. Murray et al., led us to understand that the etiologies of this viral causing agent can be traced to the parainfluenza viruses, type 1. (2011). This virus is commonly spread through contact or droplet secretion.
My disease is Streptococcal pneumonia or pneumonia is caused by the pathogen Streptococcus pneumoniae. Streptococcus pneumoniae is present in human’s normal flora, which normally doesn’t cause any problems or diseases. Sometimes though when the numbers get too low it can cause diseases or upper respiratory tract problems or infections (Todar, 2008-2012). Pneumonia caused by this pathogen has four stages. The first one is where the lungs fill with fluid. The second stage causes neutrophils and red blood cells to come to the area which are attracted by the pathogen. The third stage has the neutrophils stuffed into the alveoli in the lungs causing little bacteria to be left over. The fourth stage of this disease the remaining residue in the lungs are take out by the macrophages. Aside from these steps pneumonia follows, if the disease should persist further, it can get into the blood causing a systemic reaction resulting in the whole body being affected (Ballough). Some signs and symptoms of this disease are, “fever, malaise, cough, pleuritic chest pain, purulent or blood-tinged sputum” (Henry, 2013). Streptococcal pneumonia is spread through person-to-person contact through aerosol droplets affecting the respiratory tract causing it to get into the human body (Henry, 2013).
There are not many ways for a person to contract valley fever. One way to contract valley fever is inhaling the fungus that causes it or Coccidioides immitis. It can also be contracted through cuts on the body. Valley fever can not be contracted from other people. The infection is not contagious. There are some factors that can cause certain people to have a greater risk of getting the infection though. For example certain races, pregnant women, people with weakened immune systems and older aged people have a greater risk.
It began with infection mainly in the blood vessels of the human skin and mouth, resulting in different kinds of symptoms that turn into serious stages. It was spread by physical contact with human skin and mostly affected children and adults. This disease was so outrageous that it led to a vast number of deaths in New England colonies. Also, smallpox virus is transmitted through airborne infection from the oral, nasal mucus of the infected person. But mostly was spread from close contact or contaminated material of the infected person.
Chronic bronchitis is a disorder that causes inflammation to the airway, mainly the bronchial tubules. It produces a chronic cough that lasts three consecutive months for more than two successive years (Vijayan,2013). Chronic Bronchitis is a member of the COPD family and is prominently seen in cigarette smokers. Other factors such as air pollutants, Asbestos, and working in coal mines contributes to inflammation. Once the irritant comes in contact with the mucosa of the bronchi it alters the composition causing hyperplasia of the glands and producing excessive sputum (Viayan,2013). Goblet cells also enlarge to contribute to the excessive secretion of sputum. This effects the cilia that carry out the mechanism of trapping foreign bodies to allow it to be expelled in the sputum, which are now damaged by the irritant making it impossible for the person to clear their airway. Since the mechanism of airway clearance is ineffective, the secretion builds up a thickened wall of the bronchioles causing constriction and increasing the work of breathing. The excessive build up of mucous could set up pneumonia. The alveoli are also damaged enabling the macrophages to eliminate bacteria putting the patient at risk for acquiring an infection.
Pathogens are a type of microorganism that spreads viral and bacterial diseases. These diseases when present in human blood and body fluids are known as blood borne pathogens, and can spread from one person to another. (Worcester polytechnic institute) The most serious types of blood borne diseases are the hepatitis B virus (HBV) and hepatitis C virus (HCV), which can cause liver damage; and HIV (human immunodeficiency virus), which is responsible for causing AIDS (acquired immune deficiency syndrome). The blood borne pathogens can be spread when the blood or body fluids (semen, vaginal fluid, breast milk, and amniotic fluid) of an infected individual comes into contact with mucous membranes or an open sore or cut on the skin of another person. Mucus membranes are located in the eyes, nose, mouth, and other areas as well. ("Bloodborne pathogens: MedlinePlus Medical Encyclopedia") Two of the most common ways that pathogens are transmitted is through the exchange of fluids during sexual intercourse or by sharing infected IV needles. (Worcester polytechnic institute)
The patient may suffer from additional symptoms, such as chest discomfort, fever, and aching, that are characteristic of these diseases. WHOOPING COUGH is a form of severe bronchitis caused by the bacterium Hemophilus pertussis. Treatment of a pure viral infection is directed toward the relief of symptoms, but frequently secondary infections by bacteria complicate the condition. In such a case the patient's sputum may turn from white to yellow (purulent, or pus containing), and treatment with various antibiotics is recommended. Acute chemical bronchitis may be caused by the inhalation of irritating fumes, such as smoke, chlorine, ammonia, and ozone.
Liam is a previously healthy boy who has experienced rhinorrhoea, intermittent cough, and poor feeding for the past four days. His positive result of nasopharyngeal aspirate for Respiratory Syncytial Virus (RSV) indicates that Liam has acute bronchiolitis which is a viral infection (Glasper & Richardson, 2010). “Bronchiolitis is the commonest reason for admission to hospital in the first 6 months of life. It describes a clinical syndrome of cough tachypnoea, feeding difficulties and inspiratory crackles on chest auscultation” (Fitzgerald, 2011, p.160). Bronchiolitis can cause respiratory distress and desaturation (91% in the room air) to Liam due to airway blockage; therefore the infant appears to have nasal flaring, intercostal and subcostal retractions, and tachypnoea (54 breathes/min) during breathing (Glasper & Richardson, 2010). Tachycardia (152 beats/min) could occur due to hypoxemia and compensatory mechanism for low blood pressure (74/46mmHg) (Fitzgerald, 2011; Glasper & Richardson, 2010). Moreover, Liam has fever and conjunctiva injection which could be a result of infection, as evidenced by high temperature (38.6°C) and bilateral tympanic membra...
Viruses can be transmitted in many ways. Being in contact with an infected person will most likely transfer the virus. One can also obtain the virus through swallowing, inhaling, and unsafe sex. Poor hygiene and eating habits usually increase the risk of catching a viral infection. Contracting a viral infection is followed by adverse s...
Since the cold is very contagious practically no one is safe, at least completely. Children are the most susceptible to the common cold, because they don't have a strong immune system to get rid of the virus. Children also ten...
Of course, the tiny air droplets from coughing or nose blowing are the main carriers of the respiratory viruses. So, it can spread the disease to other persons.
Recent research shows that, there are three major means by which infections can be transmitted and they include direct transmission, indirect transmission and airborne transmission (Hinman,Wasserheit and Kamb,1995). Direct transmission occurs when the physical contact between an infected person and s susceptible person takes place (division of public health, 2011). An example is a health care worker who attends to an Ebola patient, without gloves, gown and mask plus forget to wash his or her hand with soap and hot water and or a person having flu without the use of mask or washes his hand after sneezing easily passes the infection to the other through hand shake or surface touch, living the bacteria there for another vulnerable person to also touch if the surface is not disinfected with bleach. Studies makes it clear that, the spreads takes effect when disease-causing microorganisms pass from the infected person to the healthy person through direct physical contact such as touching of blood, body fluids, contact with oral secretion, bites kissing, contact with body lesions and even sexual contact. However, measles and chicken pox are said to be conditions spread by direct