Complicated Respiratory Tract Infections

Generally, there are two groups of respiratory infections:

• Upper respiratory tract infections (URTIs). These infections affect the nose, throat and sinuses.
• Lower respiratory tract infections (LRTIs). These infections occur in the airways and the lungs.

Usually, respiratory infections are cured completely if treated early, but serious, complex infections may be life-threatening if proper treatment is not provided.

Complications of a respiratory infection may include:

• Empyema. Empyema is a collection of pus beside the lungs, caused by a bacterial infection that can lead to life-threatening problems such as sepsis (bacteria in the blood) and shock. Symptoms include fever, cough, shortness of breath and chest pain.
• Lung abscess. A lung abscess is a pus-filled cavity in the lung surrounded by inflamed tissue. It is usually caused by a severe infection such as pneumonia or tuberculosis or from inhaling material into the lungs from the mouth.
• Potts puffy tumor. This is an uncommon complication of sinusitis (a type of upper respiratory tract infection that causes inflammation of the sinus cavities in the skull). It is an abscess of the forehead area with frontal swelling. Potts puffy tumor is usually seen in late childhood or adolescence. Symptoms include red, tender swelling in the mid-forehead, headache and fever.
• Orbital cellulitis. Orbital cellulitis is another possible complication of sinusitis. This is an infection of the tissue within the eye socket and around the eye. Symptoms include pain, swelling, red eye, fever, a bulging eye, impaired vision and impaired eye movements.
• Orbital abscess. Also a further complication of sinusitis causing orbital cellulitis, orbital abscess is a collection of bacteria and pus behind the eye. Symptoms include eye pain, bulging of the eye, redness of the eye, changes in vision and fever.
• Mastoiditis. Mastoiditis is a complication of otitis (a type of upper respiratory tract infection that causes inflammation and possible infection of the middle ear). This is a serious bacterial infection that affects the mastoid bone behind the ear. Symptoms may include ear pain, fever, headache, drainage from the infected ear, redness, swelling and tenderness in the affected ear.

Some respiratory infections and their complications can be prevented with timely vaccination against influenza virus and pneumococcus.

Diagnosis of Complicated Respiratory Tract Infections

If your child has a complicated respiratory infection, the doctor may perform one or more of these tests:

• Blood tests. These tests are performed to see if bacteria are in the blood.
• Imaging tests. A chest X-ray or computed tomography (CT) scan may be performed to check for infections in the chest, lungs, orbits or sinuses.
• Throat or nasal swab. This test takes a sample of cells and mucus from the nose, throat or tonsils to find the cause of the infection.