International Journal of Clinical Case Reports 2024, Vol.14, No.3, 157-166 http://medscipublisher.com/index.php/ijccr 162 6 Representative Clinical Cases of ALRIs 6.1 Case 1: severe bronchiolitis in an infant Presentation and Symptoms: An infant presented with symptoms of severe bronchiolitis, including nasal congestion, rhinorrhea, mild fever, and wheezing. The symptoms worsened over several days, leading to hypoxemia and respiratory distress, necessitating hospitalization (Alasmari et al., 2018; Lowe, 2022). Diagnostic Findings: The diagnosis was primarily clinical, based on the history and physical examination findings. Routine chest x-rays and blood tests were not recommended. The infant exhibited tachypnea, crackles, and wheezing upon auscultation (Alasmari et al., 2018; Lowe, 2022). Treatment and Outcomes: Management was supportive, including nasal suctioning, oxygen supplementation for hypoxemia, and hydration. The use of bronchodilators and systemic corticosteroids was not recommended for infants aged 1 to 23 months. The infant showed significant improvement with supportive care and was discharged after a few days of hospitalization (Alasmari et al., 2018; Lowe, 2022). 6.2 Case 2: pneumonia in a toddler Presentation and Symptoms: A toddler presented with symptoms of pneumonia, including fever, cough, breathing difficulty, and chest indrawing. The child also exhibited fast breathing and bronchial breath sounds or crackles on examination (Lowe, 2022; Sultana et al., 2022). Diagnostic Findings: The diagnosis was based on clinical features and confirmed by chest x-ray showing consolidation or patchy opacity. Blood cultures were not required for patients well enough to be treated as outpatients (Lowe, 2022; Sultana et al., 2022). Treatment and Outcomes: The toddler was treated with antibiotics, specifically amoxicillin, as the pneumonia was suspected to be of bacterial origin. Supportive care included hydration and oxygen supplementation as needed. The child showed significant improvement within a few days and was discharged with a follow-up plan. The length of hospital stay was approximately 5.8 days, and the child fully recovered (Lowe, 2022; Sultana et al., 2022). 6.3 Case 3: recurrent lower respiratory tract infections in a preschooler Presentation and Symptoms: A preschooler presented with recurrent episodes of lower respiratory tract infections (LRTIs), characterized by persistent cough, wheezing, and episodes of breathlessness. The child had a history of multiple hospitalizations for similar symptoms (McCallum et al., 2018; Vinaykumar and Maruti, 2020). Diagnostic Findings: The diagnosis was based on the clinical history of recurrent symptoms and physical examination findings. The child exhibited tachypnea, wheezing, and crackles on auscultation. Chest x-rays and blood tests were performed to rule out other underlying conditions (McCallum et al., 2018; Vinaykumar and Maruti, 2020). Treatment and Outcomes: Management included supportive care with oxygen supplementation and hydration during acute episodes. Antibiotics were not routinely prescribed unless a secondary bacterial infection was suspected. The child was monitored for persistent symptoms and received follow-up care to manage and prevent future episodes. Despite the recurrent nature of the infections, the child showed gradual improvement with appropriate management and preventive measures (McCallum et al., 2018; Vinaykumar and Maruti, 2020). 7 Insights into Treatment and Management 7.1 Key findings from clinical case evaluations Acute lower respiratory infections (ALRIs) in children, particularly those caused by respiratory syncytial virus (RSV), pose significant clinical challenges. Vinaykumar and Maruti (2020) explored the clinical features, risk factors, and outcomes of ALRIs in children aged 2 to 60 months. The study found that low birth weight, parental education level, household crowding, and immunization status significantly influence the occurrence of ALRIs (Figure 2). Additionally, children with bronchopulmonary dysplasia (BPD) and congenital heart disease (CHD)
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