Clinical Spectrum of Disease in Children

  • David Isaacs


There have always been problems with the definitions of acute childhood respiratory infections. In 1965, when embarking on a Medical Research Council survey of childhood respiratory infections involving a number of hospitals, Donald Court noted that there was no generally accepted clinical classification of acute respiratory infections in children [11]. Paediatricians thought that they were all diagnosing the same disease, when making a clinical diagnosis, but there was no evidence that this was true. Indeed quite the opposite appeared to be the case when the study was carried out. There was great variation in the diagnostic labels given to children with similar clinical presentations in different institutions that were geographically quite close. In four hospitals, for example, the proportion of all respiratory illnesses diagnosed as either bronchitis or bronchiolitis was almost constant, varying from 59% in Glasgow to 70% in Manchester. However, in Glasgow 52% of all infections were called bronchitis and only 7% called bronchiolitis, whereas in Birmingham the reverse was true: 21% were called bronchitis and 45% bronchiolitis [11]. It seemed highly likely that different diagnostic labels were being applied to infected children in different centres, and that this reflected differing interpretation of signs and local diagnostic preferences.


Respiratory Syncytial Virus Acute Otitis Medium Lower Respiratory Tract Infection Respiratory Syncytial Virus Infection Common Cold 
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© Chapman & Hall 1996

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  • David Isaacs

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