【正文】 ulty, palpable liver and spleen. ? Pallor, cyanosis, restlessness ? Auscultation: diffuse rhonchi, fine rales ? Chest Xray:peribronchial thickening or interstitial pneumonia 60 pneumonia ? Age: 6mon2yrs ? main signs: acute onset, long duration of high fever， 7~ 10days or 2~3weeks then pelter ? Systemic toxic symptoms are obvious ?Frequent cough， paroxysmal wheeze, dyspnea,cyanosis 61 ? late appearance of rales(3~7days) ? myocarditis, heart failure, and encephalopathy ? Xray changes early 62 右肺中上野散在小灶狀浸潤(rùn)陰影。 recover during 5～ 15days 33 Laboratory examination ?WBC and differential cells count normal ?Virus detected by antigen detection, PCR, or culture. ?Xray: hyperinflation of the lungs, emphysema, scattered areas of consolidation 34 Differential diagnosis ?Asthma ?Cystic fibrosis ?Heart failure ?Foreign body in the trachea ?pertussis 35 36 兩側(cè)肺紋理粗重。左肺野中外帶見(jiàn)大片狀融合狀陰影。 differential diagnosis ? laryngeal diphtheria ? laryngeal spasm ? bronchial foreign bodies 24 treatment ? Maintaining of airway ： steam inhalation, clearing of secretion. ? antibiotics ? corticosteroid ? oxygen supply ? sedatives (phenergan) ? Ⅲ ↑ tracheotomy 25 Acute Bronchitis(tracheobronchitis) ? Etiology ? Virus or bacteria ? Allergy, climate, air pollution, chronic infection of URT, particularly sinusitis. ? Rickets, malnutrition 26 ? Clinical manifestations ? unproductive cough 3~4days → productive cough, purulent sputum → 5~10days ? Chest pain, shortness of breath ? Vomiting ? Physical finding: lowgrade fever, roughening of breath sounds, rhonchi, coarse moist rales. 27 ?Asthmatic bronchitis： ? ﹤ 3yrs old, eczema, allergy ? symptoms resemble asthma ? recurrent episodes reduced after 3~4yrs old. 28 ? Treatment ? increased fluid intake ? frequent shifts of position ? antibiotics ? cough suppressants ? expectorants , antihistamines ? acetaminophen 29 Bronchiolitis ? Etiology and epidemiology ? 50％ respiratory syncytial virus(RSV) ? parainfluenza 3 virus, mycoplasma, adenoviruses ? north——winter and early spring ? Guangdong——spring ,summer and early autumn 30 ?Lesion: small air passages (diameter75～ 300um) ?Edema, accumulation of mucus and cellular debris, spasm of sm