Care of Toddlers

It accounts for significant morbidity and mortality, especially in those with underlying cardiac or pulmonary disease. The etiologic agent is respiratory syncytial virus (RSV), an RNA virus whose growth appears to be primarily in the respiratory tract epithelium. Other viruses, such as influenza virus, adenovirus, and parainfluenza virus, can produce similar clinical states. Almost all children have been infected by RSV by the age of 3 years. The peak rate of hospitalization occurs at before 6 months of age. Both the diseases affect children below 1 year.
In this paper, we have made a study of two toddlers, one affected by acute Epiglottitis and the other by acute Bronchiolitis both under the age of 6, for the similarities in their symptoms, diagnosis, and treatment and care requirements.
Epiglottitis is an acute swelling of the glottic structures caused by bacterial infection. It is a true medical emergency and requires rapid, accurate diagnosis and treatment to avoid airway obstruction. Epiglottitis involves infection of the supraglottic structures, usually with Haemophilus influenzae type b (HIB). On rare occasions other pathogens are involved, including Streptococcus pneumoniae, staphylococcus aureus, -hemolytic streptococcus, and H. influenzae type a. Epiglottitis is has virtually disappeared in North America as a result of widespread immunization. The disease may rarely be caused by group A streptococci. Epiglottitis occurs throughout the year but is more common in the winter months. Eighty percent of infected children are younger than 5 years of age, with the peak incidence between 2 and 6 years of age. Since the institution of the HIB vaccine, the incidence appears to be declining, and epiglottitis currently accounts for only 1 to 10 of every 10,000 pediatric admissions. Older children may be affected by supraglottitis that is more indolent and is caused by group A streptococcus. There may be genetic and immunogenic factors which predispose individuals to invasive HIB disease.
On the other hand, Bronchiolitis is an inflammation of the small airways that results in expiratory obstruction and wheezing. The term bronchiolitis is usually applied to an illness of young infants and children, characterized by respiratory distress and hypoxemia. Older children may also have wheezing with viral infections. Bronchiolitis is typically caused by respiratory syncytial virus (RSV). Other agents that have been associated with bronchiolitis include adenoviruses, parainfluenza viruses, rhinoviruses, and Mycoplasma pneumoniae. Transmission occurs primarily by direct contact with infected secretions. Viral shedding typically lasts 6 to 10 days. Attack rates among family members are 45 per cent, and transmission in daycare centers approaches 100 per cent among infants previously uninfected.
In the case of the toddler with acute epiglottitis, the symptoms might include acute illness with high temperature (often 39.5C+) and associated toxic state for less than 2 days, acute onset of severe inspiratory and expiratory stridor which is rapidly progressive. The child appears anxious, still, swallowing is painful and so there often is drooling of saliva. The child with epiglottitis presents with an abrupt onset of fever, sore