Lower respiratory tract infection
The lower respiratory tract infection are the infection consisting of
the trachea (wind pipe), bronchial tubes, the bronchioles, and the
lungs, including the bronchitis and pneumonia. According to The World
Health Report 2004 – Changing History(1), in 2002 lower respiratory
track infection were still the leading cause of deaths among all
infectious diseases, and accounted for 3.9 million deaths worldwide and
6.9% of all deaths that year.
Bronchitis is defined as a condition of an inflammation of the
mucous membranes of the bronchi, the larger and medium-sized airways
that carry airflow from the trachea into the lung parenchyma(7). Most
cases of Bronchitis are as a result of recurrent injure to the airways
caused by inhaled irritants and cigarette smoking(6).
D. Diagnosis and tests
In the study to assess the practicability of a new algorithm in
decreasing the rate of incorrect diagnoses and inappropriate antibiotic
usage in pediatric Acute Respiratory Tract Infection (ARTI), by Shahid
Beheshti University of Medical Sciences, indicated that upper
Respiratory Tract Infection, Lower Respiratory Tract Infection, and
undifferentiated ARTI accounted for 82%, 14.5%, and 3.5% of 1 209 cases,
respectively. Antibiotics were prescribed in 33%; for: Common cold,
4.1%; Sinusitis, 85.7%; Otitis media, 96.9%; Pharyngotonsillitis, 63.3%;
Croup, 6.5%; Bronchitis, 15.6%; Pertussis-like syndrome, 82.1%;
Bronchitis, 4.1%; and Pneumonia, 50%. Implementation of the ARTIs
algorithm is practicable and can help to reduce diagnostic errors and
rate of antibiotic prescription in children with ARTIs(32). It is
diffiucult in diffentiation between common cold and acute brochtitis in
the early of the diseases. If your doctor suspected that you have
brochitis, after recording the family history and a complete physical examination, the test which your doctor order may include
1. Chest X ray
The aim of the test is to exclude other conditions, such as bronchiectasis, which can mimic the disease clinically.
2. Sputum culture
The purpose of the test is to check for the presence of bacteria in sputum produced when you cough.
3. Pulmonary function test
In the study to evaluate the correlation of 6MWT and spirometric
parameters in stable COPD with different severities. 6MWT data assessed
included three variables: the 6-minute walk distance (6MWD), 6-minute
walk work (6MWORK), and pulse oxygen desaturation rate (SPO(2)%), found
that 6MWT correlated with the spirometric parameters in severe and very
severe COPD patients. 6MWT may be used to monitor changes of pulmonary
function in these patients(33).
Some studies suggested that Children with high pulmonary
function would have lower risks on the development of bronchitis and
asthma. The protective effect of high pulmonary function would be
modified by traffic-related air pollution exposure(34).
According to the study by Dr. Albert RH. at the Hartford Hospital,
Hartford,at in the differentiation of acute bronchitis, Cough is the
most common symptom bringing patients to the primary care physician’s
office, and acute bronchitis is usually the diagnosis in these patients.
Acute bronchitis should be differentiated from other common diagnoses,
such as pneumonia and asthma, because these conditions may need specific
therapies not indicated for bronchitis. Symptoms of bronchitis
typically last about three weeks. The presence or absence of colored
(e.g., green) sputum does not reliably differentiate between bacterial
and viral lower respiratory tract infections. Viruses are responsible
for more than 90 percent of acute bronchitis infections(35).
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Sources
(1) http://www.who.int/whr/2004/en/
(6) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC130746/
(7) http://www.lung.org/lung-disease/bronchitis-chronic/understanding-chronic-bronchitis.html
(33) http://www.ncbi.nlm.nih.gov/pubmed/22932179
(34) http://www.ncbi.nlm.nih.gov/pubmed/21680243
(35) http://www.ncbi.nlm.nih.gov/pubmed/21121518
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