10 COMMON DISEASES

CAUSES OF 10
COMMON SYMPTOMS

RESPIRATORY

 
Subject Contents

Respiratory syncytial virus (RSV)

 
Definition
Respiratory syncytial virus (RSV) is a very common virus that causes mild cold-like symptoms in adults and older healthy children. It can cause serious respiratory infections in young babies, especially those born prematurely, who have heart or lung disease, or who are immunocompromised.
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Alternative Names
RSV
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Causes, incidence, and risk factors
RSV is the most common respiratory pathogen in infants and young children. It has infected nearly all infants by the age of two years. Seasonal outbreaks of acute respiratory illness occur each year, on a schedule that is somewhat predictable in each region. The season typically begins in the fall and runs into the spring. RSV is spread easily by physical contact. Touching, kissing, and shaking hands with an infected person can spread RSV. Transmission is usually by contact with contaminated secretions, which may involve tiny droplets or objects that droplets have touched. RSV can live for half an hour or more on hands. The virus can also live up to five hours on countertops and for several hours on used tissues. RSV often spreads very rapidly in crowded households and day care centers. In infants and young children, RSV can cause pneumonia , bronchiolitis (inflammation of the small airways of the lungs), and tracheobronchitis ( croup ). In healthy adults and older children, RSV is usually a mild respiratory illness. Although studies have shown that people produce antibody against the virus, infections continue to occur in people of all ages. Each year up to 125,000 infants are hospitalized due to severe RSV disease; and about 1-2% of these infants die. Infants born prematurely, those with chronic lung disease, those who are immunocompromised, and those with certain forms of heart disease are at increased risk for severe RSV disease. Those who are exposed to tobacco smoke, who attend daycare, who live in crowded conditions, or have school-age siblings are also at higher risk.
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Symptoms
  • nasal congestion
  • nasal flaring
  • cough
  • rapid breathing
  • (tachypnea)
  • breathing difficulty
  • or labored breathing
  • shortness of breath
  • cyanosis
  • (bluish
  • discoloration of skin caused by lack of oxygen)
  • wheezing
  • fever
  • croupy cough (often described as a "seal bark" cough)
  • Note: Symptoms are variable and differ with age. Infants less than one year old are most severely affected and often have the most trouble breathing . Older children usually have only mild, cold-like symptoms. Symptoms usually appear 4-6 days after exposure.
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    Signs and tests
    Listening to the chest with a stethoscope ( auscultation ) may reveal wheezes or other abnormal lung sounds. Tests used in the diagnosis of RSV include:
  • a
  • chest X-ray (may show pneumonia or bronchiolitis )
  • a
  • serology for RSV (positive for RSV)
  • arterial blood gas analysis
  • (demonstrates decreased oxygen saturation)
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    Treatment
    Antibiotics do not help in the treatment of RSV. Mild infections resolve without treatment. A severe infection in infants and children may require hospitalization to provide supplemental oxygen, humidified air, and hydration by intravenous fluids. Respiratory support may be needed, using a breathing machine (ventilator). Your doctor will be the best judge as to what treatment to use. A medication to open the airways of the lungs (bronchodilator) is sometimes used. In some instances, an antiviral medication such as Ribavirin is used.
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    Support Groups

     
    Expectations (prognosis)
    RSV infection may rarely cause death in infants, but this is unlikely if the child is seen early in the course of the illness. In older children and adults, the disease will usually be quite mild. There is evidence suggesting an increased incidence of asthma in children who have developed RSV bronchiolitis. It is unknown whether the factors that predispose the child to asthma also predisposed him to developing bronchiolitis as an infant, or if the RSV bronchiolitis itself predisposes the child to develop asthma later.
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    Complications
  • ear infections
  • pneumonia
  • respiratory
  • failure
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    Calling your health care provider
    Call your health care provider if breathing difficulties or other symptoms of this disorder appear. Any breathing difficulties in an infant should be regarded as an emergency and the appropriate help sought.
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    Prevention
    A simple way to help prevent RSV infection is to wash your hands often, especially before touching your baby. It's important to make certain that other people, especially care givers, take precautions to avoid giving RSV to your baby. The following simple steps can help protect your baby:
  • Insist that others wash their hands with warm water and soap before touching your baby.
  • Have others avoid contact with the baby if they have a cold or fever. If necessary, it may be helpful to wear a mask.
  • Be aware that kissing the baby can spread RSV infection.
  • Try to keep young children away from your baby. RSV is very common among young children and is easily spread from child to child.
  • Do not smoke near your baby. Exposure to tobacco smoke increases the risk of RSV illness.
  • Parents with high-risk young infants should avoid crowds during outbreaks of RSV. Moderate-to-large outbreaks are often reported in the local news and newspapers to provide parents with an opportunity to avoid exposure. Additionally, two important products are available to prevent RSV infection: RespiGam (RSV Immune Globulin - Intravenous) and Synagis (palivizumab). Both have been approved for prevention of RSV disease in children younger than 24 months of age who are at high risk for serious RSV disease. Neither RespiGam nor Synagis has been approved for treatment of RSV infection, making prevention for high-risk children even more important. RespiGam is given once per month as an IV infusion just before and throughout the RSV season. Synagis is given as a monthly shot to protect your child from contracting RSV. If your child is in a high-risk group, ask your doctor about using a preventive medicine.
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    Respiratory acidosis

     
    Definition
    Respiratory acidosis occurs when the lungs cannot remove all of the carbon dioxide (a normal by-product of metabolism) produced by the body. This causes a disturbance of the acid-base balance in which body fluids become excessively acidic. Respiratory acidosis can be a consequence of any lung disease that prevents removal of carbon dioxide. Common lung diseases that lead to respiratory acidosis include: chronic obstructive pulmonary disease (COPD), severe asthma , or airway obstruction . Other diseases that may lead to respiratory acidosis include: the obesity hypoventilation syndrome, excessive fatigue of the diaphragm or muscles of the rib cage, or severe deformities of the spine and rib cage (for example, severe scoliosis). In chronic respiratory acidosis, mild impairment of the lungs' ability to remove carbon dioxide occurs over a long period of time, leading to a stable situation. This is because the kidneys increase their retention of bicarbonate to maintain an acid-base balance in the blood that is almost normal. In severe cases, the carbon dioxide builds up very quickly, leading to severe disturbances in the acid-base balance of the blood.
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    Alternative Names
    Chronic respiratory acidosis; Ventilatory failure; Respiratory failure
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    Causes, incidence, and risk factors
    Nearly any lung disease may lead to respiratory acidosis. Chronic obstructive pulmonary disease (COPD) is a major cause of respiratory acidosis. COPD is most often caused by cigarette smoking.
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    Symptoms
    Symptoms of the disease that causes respiratory acidosis are usually noticeable, and may include shortness of breath, easy fatigue, chronic cough, or wheezing. When respiratory acidosis becomes severe, confusion, irritability, or lethargy may be apparent.
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    Signs and tests
  • A chest X-ray or CAT scan may be done to diagnose possible lung disease
  • Pulmonary function tests may help diagnose lung disease
  • Arterial blood gases help assess the severity of the respiratory acidosis, and may detect abnormal oxygen levels
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    Treatment
    Treatment is aimed at the underlying lung disease.
  • Smoking cessation is extremely important
  • Bronchodilator drugs may reverse some airway obstruction
  • Oxygen may be necessary if the blood oxygen level is low
  • Mechanical ventilation may be necessary if the respiratory acidosis is severe
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    Support Groups

     
    Expectations (prognosis)
    The prognosis depends on the underlying disease.
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    Complications
  • Respiratory acidosis may be a sign of respiratory failure, with dangerously low blood oxygen levels.
  • Excessive respiratory acidosis may lead to confusion, lethargy, or poor organ function. In extreme cases, low blood pressure and shock may result.
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    Calling your health care provider
  • Call your health care provider if you have symptoms of lung disease.
  • Call 911 or get to an emergency room if you suspect you have severe respiratory acidosis, as this is a medical emergency.
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    Prevention
    Not smoking -- or quitting if you already smoke -- can prevent the development of many severe lung diseases that can lead to respiratory acidosis.
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    Respiratory alkalosis

     
    Definition
    respiratory alkalosis is a condition of excessive alkalinity of the body, most often associated with respiratory (breathing) disorders. The pH (a measure of acidity) is elevated and carbon dioxide levels are reduced. Common causes include hyperventilation ( increased rate of breathing ), anxiety , and fever . The symptoms may include light-headedness , dizziness , and numbness of the hands and feet. The treatment includes removal of the cause. Breathing into a paper bag (or use of a mask that causes re-breathing of carbon dioxide) helps reduce symptoms in some cases.
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    Alternative Names

     
    Causes, incidence, and risk factors
    Any lung disease that leads to shortness of breath may result in respiratory alkalosis. Fever and anxiety are also common causes of hyperventilation.
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    Symptoms
  • Light-headedness
  • Numbness
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    Signs and tests
  • Respiratory alkalosis is diagnosed by an arterial blood gas
  • A chest X-ray or pulmonary function test may be done to diagnose possible lung disease
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    Treatment
    Treatment is aimed at the disease that causes hyperventilation and respiratory alkalosis. Life-threatening respiratory alkalosis is very rare.
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    Support Groups

     
    Expectations (prognosis)
    The prognosis is based on the disease that causes the respiratory alkalosis.
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    Complications
    Seizures may occur if the alkalosis is extremely severe. This is very rare.
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    Calling your health care provider
    Call your health care provider if you have any symptoms of lung disease, such as chronic cough or shortness of breath.
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    Prevention

    Respiratory

     
    Definition
    Refers to the process or organs involved in breathing. Related topics:
  • apnea
  • dyspnea
  • lung disease
  • lung function
  • lung scan
  • rapid breathing
  • lung resection
  • pneumothorax
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    Alternative Names
  • Respiration
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    Information

    Respiratory syncytial virus antibodies

     
    Definition
    RSV antibody test is a blood test that measures the levels of antibodies (immunoglobulins) against the viral infection respiratory syncytial virus (RSV) .
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    Alternative Names
    RSV antibody test; RSV serology
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    How the test is performed
    Blood is drawn from a vein ( venipuncture ), usually from the inside of the elbow or the back of the hand. The puncture site is cleaned with antiseptic, and a tourniquet (an elastic band) or blood pressure cuff is placed around the upper arm to apply pressure and restrict blood flow through the vein. This causes veins below the tourniquet to distend (fill with blood). A needle is inserted into the vein, and the blood is collected in an air-tight vial or a syringe. During the procedure, the tourniquet is removed to restore circulation. Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding .
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    How to prepare for the test
    No restrictions of food or fluid are required for this test. If your child is to have this test performed, it may be helpful to explain how the test will feel (even practice or demonstrate on a doll). The more familiar your child is with what will happen to them, and the purpose for the procedure, the less anxiety they will feel.
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    How the test will feel
    When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.
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    Why the test is performed
    This test detects the body's response to RSV '>RSV , not the virus itself. If the body has produced antibodies against RSV, then either a current or past infection has occurred. In infants, RSV '>RSV antibodies which have been passed from mother to baby may also be detected.
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    Normal Values
    In infants, a positive test may detect the RSV '>RSV '>RSV '>RSV '>RSV '>RSV '>RSV '>RSV antibodies which have been passed from mother to child. In children, a positive test may indicate either current or past infection with RSV '>RSV '>RSV '>RSV '>RSV '>RSV '>RSV '>RSV . Most adults will have a positive test because most people have had an RSV '>RSV '>RSV '>RSV '>RSV '>RSV '>RSV '>RSV infection.
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    What abnormal results mean
    A positive test in age groups other than infants indicates a current or past infection with RSV. Because most adults have had an RSV infection, a positive test most likely reflects a past infection. In infants a positive test most likely reflects maternal antibody, and therefore may not indicate true infection with RSV.
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    What the risks are
    Risks associated with venipuncture are mild:
  • Excessive
  • bleeding
  • Fainting
  • or feeling lightheaded
  • Hematoma (blood accumulating under the skin)
  • Infection (a slight risk any time the skin is broken)
  • Multiple punctures to locate veins
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    Special considerations
    This test is of limited value because it does not detect RSV directly. It is not recommended in infants because maternal antibodies may be detected, and it is not useful in adults as most people will have antibodies due to prior infection.
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