Unit of Pediatric Emergency, Department of Adult and Childhood Human Pathology, University Hospital of Messina, Messina, Italy.
Department of Woman, Child and of General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.
Pediatr Allergy Immunol. 2020 Feb;31 Suppl 24:19-21. doi: 10.1111/pai.13160.
Recurrent respiratory infections (RRIs) are frequent in children and are characterized by more than 6 airway infections in 1 year or more than 1 upper airway infection per month in the period between September and April or more than 3 lower airway infections in 1 year. Often pediatric RRIs are related to predisposing factors, such as reduced airway size, poor tussive reflex, and immaturity of the immune system. RRIs due to immature immune system are a transient condition, with spontaneous resolution in the school age. However, some RRIs are expression of more complex diseases. Red flags are the onset of symptoms in the first year of life, the involvement of other systems, unusual pathogens, slowing of growth, severe infections of the lower airways, and recurrence of the infection site. To help the pediatrician in the RRI differential diagnosis, we have created a roadmap based on scientific literature data and clinical practice that identifies 6 macro areas: immunodeficiencies, simple minimal genetic immunodeficiency, atopy, obesity, nutritional deficiencies, autoinflammatory diseases, and complex diseases.
反复呼吸道感染（RRIs）在儿童中很常见，其特征是在 9 月至 4 月期间每年发生超过 6 次气道感染或每月发生超过 1 次上呼吸道感染，或每年发生超过 3 次下呼吸道感染。儿科 RRIs 通常与易患因素有关，如气道狭窄、咳嗽反射不良和免疫系统不成熟。由于免疫系统不成熟导致的 RRIs 是一种短暂的情况，在学龄期会自行缓解。然而，一些 RRIs 是更复杂疾病的表现。RRIs 的警示症状包括在生命的第一年出现症状、涉及其他系统、不常见的病原体、生长迟缓、下呼吸道严重感染以及感染部位复发。为了帮助儿科医生对 RRIs 进行鉴别诊断，我们根据科学文献数据和临床实践制定了一张路线图，确定了 6 个宏观领域：免疫缺陷、简单的微小遗传免疫缺陷、特应性、肥胖、营养缺乏、自身炎症性疾病和复杂疾病。
