I. Definition: Recurrent respiratory tract infection is a clinical condition in which the number of upper and lower respiratory tract infections occurring within one year is frequent and beyond the normal range.
Second, the criteria for determining recurrent respiratory tract infections in children.
Recurrent respiratory tract infection is divided into two categories: recurrent upper respiratory tract infection and recurrent lower respiratory tract infection, and recurrent lower respiratory tract infection can be divided into recurrent tracheobronchitis and recurrent pneumonia
(1) The interval between two infections is at least 7 days.
(2) If the number of upper respiratory tract infections is not enough, the number of upper and lower respiratory tract infections can be added together, and vice versa. However, if the recurrent infections are predominantly lower respiratory tract, they should be defined as recurrent lower respiratory tract infections.
(3) The number of determinations must be observed continuously for 1 year.
(4) Recurrent pneumonia means repeated pneumonia ≥ 2 times in 1 year, pneumonia must be confirmed by pulmonary signs and imaging, and pneumonia signs and imaging changes should completely disappear in the interval between two pneumonia diagnoses.
Third, the etiology of recurrent upper respiratory tract infections
Infants and preschoolers with recurrent upper respiratory tract infections are mostly associated with improper care, initial admission to child care institutions, lack of exercise, relocation, passive inhalation of fumes, environmental pollution, micronutrient deficiencies or other nutrients that do not match well; some of them are related to chronic nasopharyngeal lesions, such as rhinitis, sinusitis, tonsillar hypertrophy, adenoid hypertrophy, chronic tonsillitis etc.
Fourth, the etiology of recurrent tracheobronchitis
The reason for this is that it is not a good idea to have a good idea of what to expect. Most of them are also caused by pathogenic microorganisms, and a few are related to primary immune deficiency and airway malformation. Some children have chronic sinusitis-bronchitis syndrome.
V. Etiology of recurrent pneumonia
1, primary immunodeficiency diseases: including primary antibody deficiency diseases, cellular immunodeficiency diseases, combined immunodeficiency diseases, complement deficiency diseases, phagocytosis deficiency diseases, and other primary immunodeficiency diseases.
2. Congenital abnormalities in lung parenchyma and pulmonary vascular development: Children with congenital abnormalities in lung parenchyma development, such as pulmonary isolation disease and pulmonary cyst, are prone to recurrent pneumonia or chronic pneumonia. Abnormal pulmonary vascular development leads to pulmonary stasis or ischemia, which is prone to co-infection and causes recurrent pneumonia.
3. Congenital abnormal airway development: such as tracheobronchial stenosis, tracheobronchial softening, tracheobronchial bridges, these malformations often cause obstruction of airway secretions and recurrent pneumonia.
4, congenital heart malformations: various congenital heart diseases, especially the left-to-right shunt type, can cause recurrent pneumonia due to pulmonary stasis.
5, primary ciliary dyskinesia: when cilia are structurally or functionally impaired, pathogenic microorganisms are retained in the respiratory tract due to impaired clearance of respiratory mucus easily leading to recurrent pneumonia or chronic pneumonia.
6, cystic fibrosis: In western countries, cystic fibrosis is the most common cause of recurrent pneumonia in children. Oriental yellow species rare, China’s mainland and Taiwan have reported individual cases in children, suggesting the possibility of this disease in our children.
7, intra-airway obstruction or extra-tubular compression: The most common disease causing intra-airway obstruction in children is bronchial foreign body, followed by tuberculous granuloma and caseous material obstruction, and occasionally tracheal and bronchial primary tumors. The causes of extra-osseous compression of the airway are mostly mediastinal, tracheobronchial lymph node tuberculosis, tumors, and vascular malformations.
8, bronchial dilatation: various causes of limited or extensive bronchial dilatation, due to the obstruction of secretion clearance, can repeatedly occur pneumonia.
9. Repeated aspiration or foreign body: Children with swallowing dysfunction such as mental retardation, delayed development of cricopharyngeal muscles, neuromuscular disease, and children with gastroesophageal reflux have repeated pneumonia due to repeated aspiration.
Diseases that need to be differentiated from recurrent pneumonia: tuberculosis, idiopathic pulmonary iron-containing xanthogranuloma, bronchial asthma, occlusive bronchitis with mechanized pneumonia, eosinophilic pneumonia, allergic alveolitis, idiopathic interstitial pneumonia.