Paraconia in children
Parakoklysh in children is an infection of bacterial origin, which has an acute course and similarity with whooping cough. It is possible for an adult and a child to transfer paracoids, the incidence of the disease in a baby up to a year is not high. Given active prophylaxis by the planned introduction of DTP, pertussis infection is more common. Specific vaccine against paracoliticosis is absent. For paracutaneous infection, the periodicity in the flow is characteristic, which is a difference from whooping cough. Suffer from this infection are those who are vaccinated against whooping cough and those who have had it.
reasons parakoklyusha children
Pathogen parakoklyusha Bordetella parapertussis is representative of a class Betaproteobacteria. This gram-negative microbe is in the form of an ovoid bacillus of relatively large size. Cocci are located more often alone, the bordetelles are immobile. Is a hemophilic bacterium, a strict anaerobic. There are three exotoxins( pertussis, tracheal and dermonecrotoxin).Paracoloca wands have tropism to the ciliary epithelium of the respiratory tract.
The causative agent of paraculation is similar in pathogenicity to a pertussis wand. They are ill children visiting nurseries, gardens, schools. The source of infection is a sick child with the course of the disease without symptoms, or a bacteriocarrier( there are no clinical manifestations).
Parakoklyush spreads through the air. With sputum particles, excreted by coughing paracocephalic pathogen upon inhalation, falls on the mucous of an uninfected child.
The development of paraculation in children is greatly facilitated by:
- a large number of people in the room;
- rare airing or complete absence;
- dry, warm air, conducive to the drying out of mucous airways, which leads to a loss of its protective properties;
- chronic pathology of the nasopharyngeal organs, reducing local immunity;
- neurological abnormalities.
Getting on the mucosa, the pathogen begins to actively divide into the ciliated epithelium of the airways. With current flicker cilia exciter parakoklyusha falls into the lower parts of the lung( bronchi and lower third-order, bronchioles, alveoli).
Under the influence of tracheal exotoxin, the mucosal epithelium undergoes necrosis, resulting in irritation of the cough receptors. A continuous stream of pulse signals is created at the center of the cough, which is located in the medulla oblongata, where a stable focus of excitation is finally formed. This is the basis of the attacks of a characteristic cough.
There is no contamination of the paraculation into the blood. But secondary microbial flora can become involved, which causes complications.
parakoklyusha Symptoms in children
Parakoklyush may be typical, then the symptoms of the disease is similar to the specific manifestations of pertussis, but parakoklyushe the disease much easier. If the disease is erased, then the paraconiae in children passes under the mask of a lung of acute respiratory disease, accompanied by an unproductive cough. With transient( transitory) bacteriocarrier, there are no signs of suffering.
The incubation period takes two weeks. At this point, there are no obvious symptoms.
Then comes the prodromal period, it lasts about 5 days. Manifest small signs of catarrh: from the nose unpronounced transparent discharge, a mild redness of the throat area, a rare unproductive cough. The state of health of children suffering from parakkolushem remains satisfactory, the temperature is within the permissible value.
Then, with a certain type of disease course( erased or typical), the next period begins - manifestations of clinical symptoms.
Parakoklyush in children, in the form of cough syndrome occurs as:
- whooping form when, after a brief quiet period of prodrome, there is an attack characteristic cough accompanied by severe facial flushing, swelling of the superficial veins, protruding outward language, reprises( episodes noisy exhalation at the end of spasticCoughing, on inhalation), occasionally ending with a rapid vomiting. Unlike pertussis cough, seizures of spasmodic coughing occur rarely and are shorter in duration. In infants, such an attack of coughing can provoke a short-term stop of breathing, which is accompanied by oxygen starvation.
- With erased flow, the cough syndrome proceeds as tracheal or tracheobronchial - episodes of nauseous cough, with scant sputum. The diagnosis can be verified only after a specific examination.
Degrees of severity with paracutosis in children give off light and medium. Criteria determining severity:
- degree of severity of oxygenation deficiency in an attack;
- duration and frequency of coughing attacks;
- presence of vomiting;
- how the child feels between seizures;
- hemogram indicators.
Parakoklysh in a child is complicated rarely. Complications( bronchitis, otitis, pneumonia), if they arise, are caused by the layering of the secondary pathogenic flora or exacerbation of existing diseases.
After the child has transferred paracussis, life-long immunity is formed.
Although the symptoms of paraculation in children occurring typically are specific, yet the episode of spasmodic cough is sometimes regarded as a symptom of another disease. There are several main nosologies with a similar clinic:
- Pertussis. With it, the course of the disease, during a spasmodic cough, is more severe, often frequent seizures lead to a disturbed state of health. The catarrhal period proceeds more vividly.
- ARVI, with the phenomena of tracheitis, tracheobronchitis. With acute respiratory viral infections, catarrhal manifestations are marked, significantly worsen the child's condition, an intoxication syndrome is expressed, there is almost always a fever.
- Phenomena of bronchial obstruction of allergic genesis. Here it is necessary to take into account allergic anamnesis, to establish a link between the episode of cough and allergen.
- Foreign body in airways. Episode of a reprise with cyanosis, almost immediately passes, and with obstruction by a foreign body, the condition quickly becomes extremely difficult.
Diagnosis of paraculation in children
There are a number of diagnostic signs of paraculation in a child, namely:
- direct contact with a patient;
- staged and gradual course of the disease;
- absence of fever;
- the condition of the child without deterioration;
- prolonged non-productive cough;
- attacks of a spasmodic convulsive cough.
For the accurate diagnosis use the following specific diagnostics:
- Bacteriological analysis for paracottus - perform the culture of the causative agent of paraculation of the provided material( mucous discharge of the nasopharynx, sputum).Then the pure culture is sown to nutrient specific media. Less often use the method of "cough thrusts".The culture of bacterial microorganisms, which was grown on a medium, is determined by the totality of its characteristics( cultural, biochemical, antigenic).
- Paracottis analysis with serological reactions. It is performed by the complement fixation reaction( RSK), agglutination( RA), passive hemagglutination( RPHA) reaction. The use of these reactions is justified if the culture of the pathogen has not been analyzed, in order to establish a reliable diagnosis in retrospect.
Paracolitic antibodies are found in the serum, after 3 weeks of disease. Confirmation of a reliable diagnosis is possible with the progression of antibody titers in sera, which are analyzed with a two-week interval. In children under the age of 2, paracolitic analysis, by examining serological responses, may be negative.
Serological reactions should be performed with diagnosticums( para-pertussis and pertussis), because there is cross-immunity between the two diseases.
The non-specific methods for diagnosis of paraculation in children include a detailed general clinical hemogram. For parakoklyusha typical increase of leukocytes with increased lymphocytes, or isolated increase in lymphocytes, while the value of ESR does not go beyond the permissible limits.
Radiography as a method of instrumental diagnosis is rarely used. On the surveyed images of the chest, the pattern of the lungs is strengthened, the compaction of the walls of the bronchi is determined.
Treatment of paraculation in children
Given the ease of the course of the disease, paracussis, the therapy is carried out at home, under the supervision of the district doctor. They are sent to the hospital for children under the age of one year or with complications.
In case of paracottis, the purpose of antimicrobial antibacterial drugs is unreasonable. For the treatment of paracutosis manifestations, the child uses symptomatic remedies and the following regimens:
- Sparing, limiting mobile games, psychoemotional stresses, excessive irritants, so as not to provoke a cough.
- Nutrition high-grade, easily assimilated, enriched with vitamins, microelements. After vomiting is shown докармливание and допаивание in small portions.
- Aerotherapy, which implies constant airing. At episodes of a convulsive cough accompanied by cyanosis, the grant of 40% of oxygen by a free stream, by means of a mask, 3 times a day.
The preparations of desensitizing, antihistamine action - Suprastin, Erius, Zirtek, Fenistil, Tavegil, etc. are shown.
- Sedative sedatives - Motherwort, Valerian. When overexcited, often cough, appoint Relanium, at a dose of 0.3 mg / kg per day in pricks, at bedtime.
- Antitussive drugs blocking the center of cough( Codeine, Sinekod, Stoptussin, Kodelak, Libeksin).
- Preparations that improve the state of the pulmonary surfactant system( Lazolvan, Bromhexin).
- Rarely prescribed glucocorticoids used by inhalation( budesonide).
- Drugs that help to level out the negative effects of hypoxia, improving blood flow( Trental, Vinpocetine).
- Folk remedies( decoction of fennel, decoctions of dogrose, lungworts).
Paralysis prophylaxis in children
Prevention of this disease is as follows:
- Quarantine measures. Isolation of the child up to a year for 25 days from the onset of the disease. Quarantine measures are not applied to those who directly contacted the sick person. The exception is children of the first year, who are constantly observed for 2 weeks, since the last contact with the sick. Disinfection is not necessary, washing the floors every day and constant airing is enough.
- Places of large crowding of children( nurseries, gardens, schools) should be regularly provided with fresh and cool air, through regular through ventilation or permanent microventilations. It is necessary to comply with the thermal regime.
- Carrying out a complex of measures that can strengthen the immune forces. Providing a rational, balanced diet, taking vitamin and mineral complexes. Regular performance of basic physical exercises, hardening.
- Detection, diagnosis and sanitation of sources of chronic infection( adenoiditis, tonsillitis, caries, etc.).
Paracoeclus in children in the structure of morbidity is rare, has a light course, a characteristic specific clinical picture, is not complicated in diagnosis and can be easily treated conservatively. But considering the likelihood of joining complications that pose a serious danger to infants, the problem of preventing paracismus incidence remains relevant for children's doctors. To minimize the possibility of infection, it is timely to carry out preventive measures that can strengthen the body's natural immune defense, which will hinder the development of the disease. If the infection has occurred, then it is strictly forbidden to engage in self-medication, especially with regard to the uncontrolled use of antitussive drugs. Only responsible implementation of the recommendations and prescriptions of the doctor, guarantees a smooth course of paraculation in a child with a minimal risk of complications.
