Kašelj pri otrocih

Abstract

in delovna skupina za pediatrično pulmologijo IzvlečekKašelj je zelo pogosta težava pri otroku. Glede na trajanje ga delimo na akutni kašelj (do tri tedne), subakutni (3-8 tednov) in kronični (več kot 8 tednov).Akutni kašelj je najpogosteje posledica virusnih okužb dihal, ki izzvenijo same po sebi. Potrebno pa je izključiti morebitne resne osnovne bolezni.Subakutni kašelj se najbolj pogosto pojavi po akutni okužbi dihal (postinfekcijski kašelj) in izzveni brez specifičnega zdravljenja. Če je otrok sicer zdrav, kašelj pa suh, se postopno izboljšuje in niso prisotni specifični kazalci, ki bi kazali na resno bolezen, je potrebno otroka le spremljati. Če pa obstaja možnost, da je subakutni kašelj posledica aspiracije tujka, kronične pljučne bolezni ali če se kašelj stopnjuje, je potrebno čimprej opraviti dodatne preiskave.Tudi kronični kašelj je najpogosteje posledica okužb dihal, lahko pa tudi težkih bolezni, ki ogrožajo življenje. Potrebno je ločiti med specifičnim kašljem (poleg kašlja so prisotni simptomi in znaki osnovne bolezni) in nespecifičnim kašljem (prisoten je le suh kašelj brez drugih simptomov in znakov bolezni).Da bi preprečili nepotrebne preiskave in neučinkovito zdravljenje otrok s kašljem, ob tem pa ne bi spregledali katere od težkih bolezni, je potrebno upoštevati priporočila za obravnavo otrok s kašljem, ki temeljijo na medicini, podprti z dokazi. AbstractCough is a common problem in children. Acute cough lasts less than 3 weeks, subacute 3-8 weeks and chronic cough more than 8 weeks.Acute cough is usually caused by common viral upper respiratory tract infection. However, the child should be thoroughly evaluated to rule out a serious underlying condition or disease responsible for the cough.The commonest cause of subacute cough is a viral infection (postinfectious cough) and it usually resolves spontaneously. If the child is otherwise well and the cough is dry and there are no specific alerts for a serious disease and the cough is resolving, a period of observation is all that is recommended. If there are any specific pointers in history and examination identified for an inhaled foreign body, chronic lung disease, or in a case of progressive cough, immediate investigations are needed.Most chronic coughs in childhood are due to viral infections, but may signify a serious underlying disease too. Chronic cough is subdivided into specific cough (i.e., cough associated with other symptoms and signs suggestive of an associated or underlying problem) and nonspecific cough (i.e., dry cough in the absence of an identifiable respiratory disease of known etiology).