Clinical features

• • Often starts with rhinopharyngitis, descend progressively to larynx, pharynx, tracheitis
  • Irritating, productive cough sometimes with scanty mucoid, blood streaked sputum
  • Chest tightness, sometimes with wheezing
  • Fever may be present No tachypnoea or dyspnoea
  • Secondary bacterial infection: fever > 5°C, dyspnoea, purulent expectorations
• DDx; Bronchial asthma, emphysema, Pneumonia, tuberculosis
• Investigations; Diagnosis based on clinical features Chest X-ray

Management/treatment

• • Most cases are viral and mild
  • Paracetamol 1 g every 4-6 hours (max: 4 g daily)
  • Child: 10 mg/kg (max: 500 mg) per dose
  • Plenty of oral fluids
  • Children: nasal irrigation with normal saline to clear the airway
  • Local remedies for cough (honey, ginger, lemon)
  • If there is suspicion of bacterial infection, especially if patient is in general poor conditions (malnutrition, measles, rickets, severe anaemia, elderly, cardiac disease)

• Give Amoxicillin 500 mg every 8 hours Child: 40 mg/kg dispersible tablets every 12 hours
• Or Doxycycline 100 mg every 12 hours Child >8 years: 2 mg/kg per dose

Prevention

• • Avoid predisposing factors above