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

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Clinical Significance of C-reactive Protein

Abstract

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.

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Abbreviations

ADA:

Adenosine deaminase

AIDS:

Acquired immune deficiency syndrome

AOM:

Acute otitis media

ARI:

Acute respiratory infections

BMI:

Basal Metabolic Rate

bpm:

Breaths/minute

CAP:

Community-acquired pneumonia

CBC:

Complete blood count

CBNAAT:

Cartridge-based nucleic acid amplification test

CHERG:

Child Health Epidemiology Reference Group

COVID-19:

Coronavirus disease 2019

CRP:

C-reactive protein

CT scan:

Computed tomography scan

ED:

Emergency department

ESR:

Erythrocyte sedimentation rate

GAPP:

Global Action Plan for Pneumonia

GBD:

Global Burden of Diseases

H1N1:

Influenza type A virus

Hib:

Haemophilus influenzae type b

HIV:

Human immunodeficiency virus

HMPV:

Human metapneumovirus

Hs-CRP :

High-sensitivity C-reactive protein

ICU:

Intensive care unit

IL-6:

Interleukin-6

ILI:

Influenza-like illness

IV:

Intravenous

LBW:

Low birth weight

LMIC:

Lower and middle income countries

LRTI:

Lower respiratory tract infection

MDR:

Multidrug resistant

NIS:

National Immunization Schedule

OPD:

Outpatient department

PCOS:

Polycystic ovary syndrome

PFT:

Pulmonary function test

RSV:

Respiratory syncytial virus

RTI:

Respiratory tract infection

RV :

Respiratory virus

SARS-CoV-2:

Severe Acute Respiratory Syndrome Coronavirus 2

TB:

Tuberculosis

UNICEF:

The United Nations Children’s Fund

URTI:

Upper respiratory tract infection

VAP:

Ventilator-associated pneumonia

WBC:

White blood cells

WHO:

World Health Organization

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Authors and Affiliations

  1. Department of Respiratory Medicine, Nilratan Sarkar Medical College Hospital, Kolkata, West Bengal, India

    Chandra Shekhar Das

  2. Kolkata Municipal Corporation, Kolkata, West Bengal, India

    Chandra Shekhar Das

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Editors and Affiliations

  1. Department of Zoology, Behala College, Kolkata, West Bengal, India

    Waliza Ansar

  2. School of Biological Sciences, NISER Bhubaneswar, India, Orissa, India

    Shyamasree Ghosh

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Das, C.S. (2020). Acute Respiratory Ailments in Pediatric Age Group and Role of CRP in Diagnosis and Management. In: Ansar, W., Ghosh, S. (eds) Clinical Significance of C-reactive Protein. Springer, Singapore. https://doi.org/10.1007/978-981-15-6787-2_8

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