16. Upper Respiratory Tract Infections Flashcards
What is the most common way respiratory infections present themselves?
As a cold
What is the upper respiratory tract?
Anything from larynx and above
What are the most common URTIs? (6)
- otitis media
- rhinitis
- tonsillitis
- pharyngitis
- laryngitis (epiglottitis)
- sinusitis
What are the most common VIRAL infective agents in URTIs? (6)
- adenovirus
- Influenza A and B
- Para flu 1 and 3
- RSV (respiratory syncytial virus)
- Rhinovirus
- Epstein-barr virus (EB)
What are the most common BACTERIAL infective agents in URTIs? (4)
- H influenzae
- M catarrhalis (mycoplasma)
- S. aureus
- Streptococci:
- B haemolytic, S. pyogenes
- Non-haemolytic, S. pneumoniae
What is another name for croup?
laryngotracheobronchitis (inflammation of lower and upper resp. tracts commonly caused by para influenza type 1)
How many respiratory infections does an average human have a year?
5-10 a year (particularly clustered around winter time)
What is the most common type of URTI with the most admissions per year?
Acute URTIs
If the child is very ill, what must the URTI be most likely caused by?
bacteria
If the child is well, what must be the URTI be most likely caused by?
virus
When is rhinitis most common?
During winter months (self-limiting condition)
Rhinitis is an early symptoms which can often lead to which 3 other conditions?
- pneumonia (bronchiolitis)
- meningitis
- septicaemia
What is rhinitis?
- Inflammation of mucous membranes inside the nose
- can be caused by viruses, bacteria, allergens and irritants
What are common symptoms for rhinitis?
cold-like symptoms:
itchiness, sneezing, runny or blocked nose
What is best treatment for rhinitis?
Usually similar to cold treatment but in more serious cases non-sedating anihistamines or rinsing nasal passages may be prescribed
Among which population group is otitis media very common among?
children (esp. infants between 6-15 months)
What is otitis media?
- infection of the middle ear
causing build up of fluid behind the ear drum
What colour is the ear drum in otitis media patients?
very red (pink in normal)
What is the pathogen causing primary otitis media?
virus
What is the pathogen causing secondary infection in otitis media?
bacterial (pneumococcus/ Haemophilus influenzae)
What is used to treat otitis media?
- antibiotics don’t usually help
- most clear up within 3-5 days
- painkillers used for pain and pyrexia
Why is the use of drugs to treat many common URTs a common clinical dilemma?
Because they include many side effects (e.g. diarrhoea, nappy rash, discomfort) yet they only help slightly whereas without them, the child will become well naturally- do benefits outweigh harm??
When is pain in otitis media at its worse and when do antibiotics usually start working?
- pain worse at day 1
- antibiotics only start their action in day 2-3
- antibiotics often make little difference as treatment for pain can be given instead
What percentage of patients will experience side effects from antibiotics?
~50% (“do not harm” is the dilemma)
