Acute Infections

Croup. This is a viral infection, caught by inhaling droplets which have been coughed up or sneezed out by someone with the infection. It causes swelling in the relatively small upper airways (windpipe and the voice-box) of children, usually less than 3 years old. Symptoms start with a slight cold and fever, but soon develop into a barking cough, increasing breathlessness or noisy breathing, called stridor. Although it is usually a relatively mild, short-lived illness, occasionally, if the inflammation blocks the airway, the baby can become very ill.

Epiglottitis; this is a medical emergency that may result in death if not treated quickly. The epiglottis is a flap of tissue that sits at the base of the tongue, keeping food from going into windpipe, during swallowing. When it gets infected and inflamed it can swell to obstruct and close off the windpipe. Unless treated promptly, this may be fatal. Since the introduction of the Haemophilus Influenza (HIB) immunisation programme, epiglottitis has rarely been seen.

Diphtheria; caused by a bacterium (bug) called Corynebacterium diphtheria, it can cause upper airways obstruction. However, since routine vaccination, diphtheria is very rare in the U.K.

Acute Viral Bronchiolitis (see BLF pamphlet or website for more). This is inflammation and obstruction of the smallest airways in the lung, the bronchioles. It is caused by a number of different viruses in the first year of life. Huge numbers of infants are affected every winter, most of whom only develop mild symptoms and get better without treatment. However, about 20,000 babies, mainly younger than 6 months old, need hospital admission with cough, noisy breathing (wheezing) and difficulty breathing.

Viral wheezing (preschool); Chest infection involving the small airways (bronchi)

Respiratory syncytial virus (RSV). (see BLF pamphlet or website for more). This is one of the most common viruses causing bronchiolitis, particularly in premature babies and young children.

Whooping cough. This is an infection with Bordetella pertussis bacteria. It produces severe coughing (often lasting for weeks). There are bouts of coughing, which often end with vomiting, and whoops on breathing in. In babies it can be a very serious problem; it occasionally causes apnoeas.

Pneumonias (also see adult diseases). Pneumonia is an inflammation in the gas-exchanging air sacs (alveoli) in the lung caused by various bugs, including viruses and bacteria. The most common bacteria, affecting children is Streptococcus pneumoniae. Pneumonia is an illness which comes on suddenly, often following a viral infection, such as a cold. A high fever, cough, breathlessness and sometimes pleurisy – a sharp chest pain on breathing in – may occur. It is generally responds well to antibiotics.

Lung abscess; this may occur in a previously healthy child. However children particularly at risk are those with chronic lung disease, such as cystic fibrosis, or those with repeated aspiration of stomach contents, especially if they have some congenital abnormality of their nervous system.. The symptoms are similar to those in pneumonia.

Lung disease due to parasites. Infection with parasites is known as infestation. Parasitic infestations are a worldwide problem. So, children who have travelled to areas where the problem is common, may come back to the UK with an infestation. Organisms causing lung problems are either Protozoa (malarial and amoebic parasites) or worms (Ascaris, Toxocara, Schistosoma, Echinococcus or Hydatid). To diagnose the problem it is important to get a history of travel in an area where the parasite is common. Symptoms include fever, chills, cough sometimes with bloody phlegm, breathlessness or chest pain. Accurate diagnosis is crucial as special antibiotics are necessary to treat these parasites.