Acute Respiratory Ailments in Pediatric Age Group and Role of CRP in Diagnosis and Management

Das, Chandra Shekhar

Respiratory diseases account for nearly 25% of all pediatric consultations. Acute respiratory infections (ARI) in infant, children, and adolescent age group are common incidence in India and worldwide. ARI need special care and knowledge from physicians to diagnose the exact pathology. It is sometimes very challenging to cure. In the intrauterine (fetal) life, gaseous exchange of oxygen and carbon-di-oxide does not occur in lungs as the placenta helps in exchange process. After birth hypoxia, temperature fluctuations, hypercapnia, and sensitivities of chemoreceptor play important role in breathing. With increasing age, there is expansion in lung volume, multiplication of alveoli and vessels for better and improved lung ventilation. The patients can be presented with cough (irritation of pharynx, larynx, trachea, bronchi, and pleura), rattling (due to excessive secretion in trachea-bronchial pathway), wheezing (audible whistling sound), stridor (upper respiratory obstruction by hoarseness, retraction of chest), tachypnea (abnormally rapid respiration), and dyspnea (difficult breathing). As the children cannot expectorate smoothly, there are always higher chances of lower respiratory tract infections like bronchiolitis, pneumonia, lung abscess, etc. These infections have to be diagnosed properly with blood investigations: pulmonary functions test (PFT), bronchoscopy, and imaging (X-ray or CT scan) techniques. Arterial blood gas analysis with supportive and definitive line of management is always crucial. Serial estimation of C-reactive protein (CRP) can guide the true recovery or deteriorating phases of infections in cumulative disease conditions apart from viable signs and symptoms.