ACUTE RESPIRATORY INFECTIONS in Children

DEFINITION ARI

ARI stands for Acute Respiratory Tract Infection. This term was adapted from the term Acute Respiratory Infections (ARI). The term includes three elements, namely respiratory infections, respiratory tract and acute, with the following meaning:
a. Infection is the entry of germs or microorganisms into the human body and multiply, causing symptoms of illness.
b. Respiratory tract is an organ starting from the nose to the alveoli and its adnexa organs such as the sinuses, middle ear cavity and pleura. ARI anatomically include upper respiratory tract, lower respiratory tract (including lung tissue) and respiratory organs adnexa. With these restrictions, including lung tissue in the respiratory tract (respiratory tract).
c. Acute infection is an infection that lasts up to 14 days. Limit of 14 days was taken to indicate an acute process even for a few diseases that can be classified in the ARI process may take more than 14 days.


CLASSIFICATION

Upper respiratory tract consists of air from the nostrils to the vocal cords in the larynx, including the paranasal sinuses and middle ear. lower respiratory tract includes the continuation of the airways from epiglotis, bronchioli and trachea to the alveoli.
ARI classified by the location of the infection is an acute upper respiratory tract infection and acute lower respiratory infections. ARI is consists of rhinitis, pharyngitis, tonsillitis, rhinosinusitis and otitis media, lower respiratory infection, while consisting of epiglottis, croup (laringotracheobronchitis), bronchitis, bronchiolitis, and pneumonia.

ARI Eradication Program (P2 ARI) ARI classify as follows:
• Severe pneumonia: characterized clinically by chest indrawing.
• Pneumonia: characterized clinically by rapid breathing.
• Not Pneumonia: marked clinically by cough colds, can be accompanied by fever, without pulling into the chest wall, without a quick breath. Rinofaringitis, pharyngitis and tonsillitis are not classified as pneumonia.

Based on the investigation can be made a classification of respiratory disease. This classification is distinguished for age groups under two months and for age group 2 months to 5 years. For age groups less than two months there are two classifications of disease are:
• Pneumonia: rapid breathing limit for the age group less than two months ie 60 times per minute or greater.
• No pneumonia: cough common cold, if not found signs of a strong attraction of lower chest wall or rapid breathing.

For age group 2 months to 5 years there are three classifications of disease are:
• severe pneumonia: when accompanied by shortness of breath that is the attraction of lower chest wall into at the time the child took a breath (when the child should be examined in a calm state of NO crying or straining).
• Pneumonia: when accompanied by rapid breathing. Limit fast breathing is for ages 2-12 months was 50 beats per minute or more and for ages 1-4 years old is 40 times per minute or more.
• No pneumonia: cough common cold, if not found the bottom of the pull of the chest wall and there is no fast breathing



CLINICAL MANIFESTATIONS

In general, a respiratory disease began with complaints and symptoms are mild. In the course of the disease symptoms may be more severe and if the weight can fall in a state of respiratory failure and possibly death. When you are in the treatment of respiratory failure is needed is more complicated, but nevertheless still high mortality, it should be attempted so that the light does not become more severe and who had weight quickly helped by the right not to fall in respiratory failure.

Danger signs can be seen based on clinical signs and laboratory signs.
A. Clinical signs
• In the respiratory system are: takipneu, irregular breathing (apnea), thorak wall retraction, nostril breathing, cyanosis, weak or missing breath sounds, grunting and wheezing expiratoir.
• In cardial systems are: tachycardia, bradikardi, hypertension, hypotension and cardiac arrest.
• In the cerebral system are: restless, easily aroused, headache, confusion, papil weir, convulsions and coma.
• In general it is: tired and sweating a lot.
B. Laboratory signs
• hypoxemia,
• hipercapneu and
• acidosis (metabolic or respiratory)

Danger signs in children age groups 2 months up to five years is: unable to drink, convulsions, decreased consciousness, stridor and malnutrition, while the danger signs in children age group less than two months are: less able to drink (drinking decreased ability ampai less than half the usual volume of drink), seizures, decreased consciousness, stridor, wheezing, fever and cold.


ETIOLOGY

ARI can be caused by viruses, bacteria or Riketsia, while often a complication of bacterial infections caused by respiratory viruses, especially if any epidemic or pandemia. Respiratory viruses is a common cause of respiratory infection. Up to now been known for more than 100 types of virus causing respiratory infection. Another group of viruses are Miksovirus, adenovirus, Coronavirus, Picornavirus, mycoplasma, herpesvirus. Bacteria cause among others of the genus Streptococcus, staphylococcus, Pneumococcal, Hemofilus, Bordetella and Corynebacterium.