Respiratory Distress in a Child

Common Causes of Respiratory Distress in a Child Include:

1. Pneumonia: The child may present with signs of respiratory distress viz. tachypnea, chest indrawing (due to consolidation), grunting, nasal flaring and head nodding. Presence of cyanosis and convulsions or pneumonia in a baby of less than 2 months is a severe state and should be treated as an emergency.
2. Bronchial asthma: It mostly occurs in a child older than 2 months. There is sudden onset of respiratory distress (within a day or two). The patient is hyper-responsive to allergens, dust and cold. It is generally not associated with fever. Past history of similar episodes and family history must be taken thoroughly.
3. Bronchiolitis: It's most common in 2 months to 1 year of age. Prodormal symptoms (sneezing, runny nose, malaise) will be found due to the involvement of respiratory syncytial virus or RSV.
4. Foreign body inhalation: There will be a sudden onset of respiratory distress (within minutes). The condition may worsen over time due to edema and swelling up of hygroscopic foreign bodies. There may be history of choking.
5. Congestive Cardiac Failure: Younger children may present with congenital heart disease characterised by feeding problems (inability to continue feed after 10 minutes) and sweating during feeds. Growth may be delayed indicating a state of "Failure to Thrive". Older children may present with Rheumatic heart disease associated with migratory joint pain and rheumatic fever.