Prevalent respiratory disease: Allergic rhinitis, bronchiolitis, sinusitis and laryngitis

The respiratory pathology represents for the paediatrician a heavy work because of its great prevalence. Allergic rhinitis, sinusitis, laryngitis and bronchiolitis are diseases that must be approached under the prism of the best evidences that the investigation puts to our reach. Allergic rhinitis affects to 10-25% of the general population and although it isn?t a serious disease, it has great importance because of the impact on the quality of life and the school performance. Its etiologic diagnosis is necessary due to its implications on treatment. The diagnosis of the acute bacterial sinusitis (ABS) in paediatrics is clinical and the use of simple radiology is not indicated. The antibiotic use in the ABS depends on the pattern of local bacterial sensitivity and the antihistaminic drugs should not be used, because they make difficult the drainage of secretions. The diagnosis of the laryngitis is clinical and it must be differentiated from the epiglottitis, of little present incidence due to the vaccine against haemophilus. In the treatment of the laryngitis, adrenalin and budesonide in nebulization and systemic dexamethasone have shown their effectiveness. The diagnosis of bronquiolitis is based on clinical history and exploration: severity scales have not been validated to predict the clinical course. Systemic corticoids neither alter the course of the disease nor diminish the number of admissions. The adrenaline and the beta-agonists do not diminish the admissions or the days of stay in the hospital, but they can be used if there is some improvement after an essay.