Lower Respiratory Infections
Common Health Issues

Lower Respiratory Infections

The lower respiratory tract resembles a tree turned upside down. On top of the main trunk sits the voice box (larynx). Beneath it lies the windpipe (trachea), which divides into left and right branches (the main-stem bronchi), and then into smaller branches (bronchioles) before reaching the “leaves” (alveoli) of the lungs.

Lower respiratory diseases may be more serious than are infections of the upper respiratory tract. But illnesses of the lower tract usually respond well to treatment, and a number of them are entirely preventable. As with all children’s illnesses, it is important to recognize symptoms early

Types of Lower Respiratory Infections

Some of the common types of lower respiratory infections are:

Cough and Other Symptoms

Like a fever, a cough is a symptom of illness, not a disease in itself. The forceful expulsion of breath is the body’s attempt to rid itself of something that is irritating the air passages.


Just as fever vary in degrees, coughs vary in kind; learning to recognize the different kinds of cough is important in deciding when to call the doctor.


The dry, hacking cough that accompanies the common cold is usually caused by mucus dripping from the nose to the back of the throat or blocking the passageway. You can relieve this kind of cough by propping the child up with extra pillows and by using a vaporizer and, if recommended by the doctor, decongestant cough medicine.

Much more serious is a severe, deep cough that comes in spasms and may be followed by vomiting. Such a cough can indicate an infection in the bronchial tubes or lungs. You should also be suspicious of a brassy, echoing, barking cough, especially if there is a labored intake of air.


It may signal the onset of croup. Any severe, persistent, or painful cough requires prompt treatment by the doctor.


A child with one or more of the following symptoms—especially if accompanied by a fever—should be checked for possible infection of the bronchi or lungs; severe, deep cough; chest pain; shortness of breath or labored breathing; poor color.



Cough Medicines

Parents often ask why the cough medicine prescribe for their child does not stop the cough. The answer is that in ridding the lower respiratory tract of foreign matter, such as mucus, the cough serves a useful purpose.


Most cough medicines are meant not to stop this natural reflex but to loosen and thin the mucus, to shrink swollen membranes, and to limit the production of new mucus. But if a cough is severe enough and interferes with a child’s sleep, for example, the doctor may prescribe a suppressant.



Croup involves an inflammation and obstruction of the larynx. It is usually caused by viruses but sometimes results from bacterial infection. In a typical case of acute spasmodic croup (the most common kind), the child starts off with a mild upper respiratory infection and low-grade fever, followed by the hoarseness that characterizes laryngitis.


Then, usually late at night, the characteristic ringing, barking cough begins. The child usually awakens in fright because he has trouble catching his breath between coughs.


Croups most often occur in winter and spring and usually attacks children between two and four years of age. A child is naturally terrified by his inability to breathe properly, so it is most important to keep calm yourself and to help him breathe by getting him into humid air at once.


If possible, have someone else set up a vaporizer in the child’s room and call the doctor, while you take the child into the bathroom, close the door, and turn on all the hot-water taps to humidify the air quickly. Sit with the child and talk to him quietly, or read him a story, until his breathing improves.


If it doesn’t, or if his color turns bluish from lack of air, call the doctor immediately or take the child to the hospital.


Most children are sufficiently relieved by the “steam room” treatment to go to bed comfortably afterward. In fact, many of them—except during the attacks themselves—do not seem very sick. But you should keep the humidity high in the child’s bedroom until the infection is gone; and for two or three nights a parent should stay in the room with him, in the event of another attack.

If the croup is severe, accompanied by fever of 39°C or higher, and the attack persists into the next morning, the cause may be bacterial and the doctor must be consulted. 


Viral croup often gets better with no other medicine than humid air and parental reassurance, but bacterial croup can be dangerous and will probably require antibiotic treatment.


Laryngitis and Tracheitis

The symptoms of inflammation of the larynx are hoarseness or voice loss and sometimes sore throat or fever. If there is an infection, it is usually viral. Have the child rest his voice, keep him in a humid atmosphere, and be alert for symptoms of croup.


As noted above, laryngitis is caused or aggravated by an allergy, and then it responds to antihistamine treatment. A hacking cough and voice loss may also indicate tracheitis, usually a viral infection of the windpipe. The condition usually clears up in a few days with rest and a humid atmosphere.



A cold, flu or other respiratory infection may spread down into the bronchial tubes and cause bronchitis. Although the child may not feel especially sick, he usually develops a loose, “juicy” cough and brings up a lot of mucus. Often his breath sounds squeaky.


Parents cannot always pinpoint a cough as bronchitis, but the doctor can diagnose the illness easily when he listens to the child’s chest with a stethoscope; the accumulation of mucus makes a bubbly sound. Antibiotics are often prescribed for bronchitis


Bronchitis may also be caused by an allergic reaction. In this case the child will exhale with a wheezing sound. Asthmatic bronchitis, as this condition is called, is usually treated with antibiotics and a humid atmosphere.


Frequent or chronic bronchitis may be the result of repeated infections in the sinuses, adenoids, or throat, and the problem will not clear up until these sources of infection are properly treated.



There is one type of bronchial infection, bronchiolitis (inflammation of the bronchioles), that is associated with severe difficulty in both inhaling and exhaling. It usually attacks infants and can cause such acute breathing problems that the child has to be hospitalized.



Like bronchitis, pneumonia, an infection of the lung’s alveoli, may have a variety of causes. Pneumonia is usually of bacterial origin and can normally be treated effectively with antibiotics but it is still a serious disease.

The commonest symptom is a fever of 38°C to 40°C combined with a hacking cough and chest pain. Twitching or convulsions may also occur when the fever is high. Even with these symptoms, it may be a few days before the doctor can make a firm diagnosis, but he will probably begin appropriate treatment immediately if pneumonia is suspected.


There are a number of ‘atypical’ pneumonia such as bronchopneumonia and viral pneumonia that are not usually as severe as the bacterial kind. However, they may actually last longer because they are more difficult to treat.


If a child has a cold and fever which seem to get better, but he then develops a persistent loose cough, a return of fever, and usually fatigue, call the doctor promptly. If even a very mild pneumonia is present, the child must rest frequently and keep his activities to an absolute minimum until his chest is completely clear.


Pulmonary Tuberculosis

Tuberculosis is now rare in children, thanks to improved methods of prevention and early detection, notably the Tuberculin Test. When the disease does strike children, it often affects the glands of the neck rather than the lungs. Any child with an obviously swollen neck gland that does not go down in a few weeks should be checked for tuberculosis infection

Foreign Bodies in the Lungs

A sudden onset of chocking and wheezing may indicate that a child has inhaled a particle of food or some other substance into his lungs. He must be examined by the doctor, who will remove the object surgically if necessary.


Rich Health Editorial Team

Health Research

Rich Health Editorial Team is made up of medical practitioners and experienced writers who provide information for dealing with health issues in a simple and easy-to-understand manner