Respiratory Infections And Children


Oh, kids. Angel for a second, a monster the next second! But you can’t deny their natural ability to brighten up your day with their sunshine smile and hearty chuckle and innocent soul. The gloomy days arrive when the kids get sick, leaving their parents with a headache (literally) and a whole lot of work undone. If you happen to have kids around you, you might want to take note of this article about cough and flu among the pediatric age group to make sure you don’t miss any chance of sending your child to the GP when necessary.

Respiratory infections are classified according to the level of the respiratory tract most involved:

  • Upper respiratory tract infection (URTI)

  • Laryngeal/ tracheal infection

  • Bronchitis

  • Bronchiolitis

  • Pneumonia

(P/S: Asthma is not an infection, though it can be exacerbated by infections.)

Upper respiratory tract infection (URTI)

The common cold is the commonest infection of childhood. It is the least severe infection and easy to treat. Some might not even need any treatment for it can resolve itself with time. The features include a clear or mucopurulent nose discharge and nose block. Sometimes, there will be fever and this can be treated with paracetamol instead of blindly giving antibiotics as this is a viral infection, not a bacterial infection. Of course, consult your GP before self-prescribing medication.

A sore throat (pharyngitis) is the inflammation of the pharynx, usually caused by viral infections. Besides having a sore throat, the sick will also have sneezing, runny nose, headache, cough, fatigue, and fever.

Tonsillitis is another URTI that is seen commonly among children. Ask any of your friends whether they have had a surgery to remove enlarged tonsils when they were a kid, most probably the answer would be yes in at least one of them. The enlarged and inflamed tonsils will cause them to have a sore throat, white coating on the tonsils, painful blisters or ulceration on the tonsils, headache, loss of appetite, fever, abdominal pain, difficulty in swallowing or breathing through the mouth. There is also enlargement of lymph nodes around the neck region.

Though it may sound odd to relate the ear with the respiration, acute infection of the middle ear (acute otitis media) is considered one of the URTIs due to the connected structures. The Eustachian tubes are shorter in children and are more prone to infection compared to the adults. There is pain in the ear and fever. In this case, the ear drum is inflamed and may rupture and cause hearing loss. Your child might complain of ear pain or cry while pulling the ear. Most cases of acute otitis media resolve spontaneously, however, if the complication arises, the infection could ascend to the brain and cause meningitis. On the other hand, the hearing loss can be detrimental to the kids and affect their development.

Sinusitis is evidenced by the presence of pain, swelling and tenderness (pain on touching) over the cheek due to the infection.

Laryngeal/ tracheal infection (Croup)

 Move on to the next part of the respiratory tract, we have the larynx and trachea. When the larynx, trachea and part of the bronchi are inflamed, it is called laryngotracheobronchitis, with another simpler name called croup. The source is usually viral, with the typical symptoms of barking cough like a sea lion, stridor (a rasping sound heard predominantly on inspiration), hoarseness of voice, fever and a common cold. The symptoms are often worse at night. Children with age between 6 months to 3 years old are at higher risk. The worry of developing croup is that the swelling of the vocal cords and narrowing of the trachea can cause severe shortness of breath, which render the kids in a potentially dangerous condition.

Another emergency condition is acute epiglottitis, which causes the obstruction of the respiratory tract too. The child may appear very ill with high-grade fever, painful throat that prevents them from swallowing, thus drooling of saliva, an inspiratory stridor, and an upright sitting position like they are catching for breath. Urgent admission to the emergency department is required if suspected.


Pertussis (per-tuh-sis) or whooping cough is a highly contagious respiratory infection. The special feature of this infection is a cough characterized by a series of short, severe coughs that are followed by a high-pitched inspiration which very much sounds like “whoop”, thus, the name. Sometimes they cough so hard the eye vessels are clearly visible and reddish and the nose starts to bleed. Try to limit close contact if suspected and send your child to the nearest GP immediately. You wouldn’t want to hear more “whoop whoop” sound, trust me.


 If your child, usually within 2 years of age, wheezes the first time with the symptoms of common cold and a low-grade fever and also seems a little short of breath, you might want to bring him/her to the GP for this could be bronchiolitis, which is commonly caused by respiratory syncytial virus (RSV).

(PS: wheeze is the whistling or rattling sound in the chest produced during exhalation.)


Does this term ring a bell? Pneumonia occurs commonly in all age group but peaks in infancy and old age. Fever with chills and rigors, cough with yellowish or greenish sputum and shortness of breath are the main key features, while others are like lethargy, poor feeding, sweating. Even though the conjugate vaccine (Prevenar) is not included in the routine immunization schedule, most parents bring their newborn for injection. Never estimate the power of risk reduction.

Last but not least,


Once again, asthma is not an infection, though it can be preceded by infections. Diagnosing asthma in preschool children is often difficult. Approximately half of all children wheeze at some time during the first 3 years of life. In general, there are two types of wheezing:

  • Transient early wheezing

This is usually triggered by viruses that cause the common cold. The parents are typically free of asthma, allergy or eczema. Fortunately, this pattern of wheezing resolves by 5 years of age.

  • Persistent and recurrent wheezing

With a positive family history of atopy (rhinitis, eczema, food allergy), children with frequent wheezing can be triggered by many stimuli, for instance, dust, pollens, cold weather, pets etc. The symptoms are usually worse at night and in the early morning. Frequent follow-ups to the GP should be done to prevent worsening of the condition.


Good luck!





Angie Loh

by Angie Loh

A medical student with nothing but passion and a pen. Poems and novels never fail to make me feel alive. I'm inspired to make the world a better place and fill it with a little bit more love. But first, where's my coffee? View all articles by Angie Loh.


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