Common infections In primary care

Question 1

List micrograms which cause infections commonly present in primary care

Answer 1

Rhinovirus

Streptococcus pneumonia

E.coli

Clostridium difficile- diarrhoea

Adenovirus- respiratory illness, conjunctivitis

Question 2

What is Rhinovirus: what does it cause? Symptoms? Risk factors? Treatment?

Answer 2

What does it cause?
- Highly virulent
- Cause of common cold
- Can mutate easily, therefore we get a different strain every year so no universal common cold vaccine
- Transmitted by direct contact or aerosol transmission

Symptoms
- Sore throat
- Cough
- Fever
- Myalgia

Risk factors:
- Exposure to affected individuals
- Young age
- Winter season
- Exposure to respiratory irritants such as cigarette smoke- smokers are more likely to have severe respiratory symptoms and the infection is more prolonged

Treatment:
- Symptom relief & rest
- Adequate fluids should be taken
- Antibiotics are ineffective and may cause adverse effects

Question 3

What is Streptococcus pneumonia?: Classification & properties? Virulence factors? Colonisation? Symptoms?Risk factors? Treatment?

Answer 3

Classification and properties
- Gram-positive, bacilli
- Grow in chains
- Has thick peptidoglycan cell wall- turns purple in gram stain
- Non-motile
- Does not form spores
- can survive in both aerobic and anaerobic conditions.

Virulence factors
- Encapsulated - the capsule contains pili &fimbriae(hair-like extensions that help attach to the host cell)
- Attach to a mucosal surface and multiply to produce biofilm
- Biofilm covers the bacteria & helps them evade the host’s immune system or antibiotics

Colonisation:
- Mucosal surfaces of the human surfaces of the human upper respiratory tract infections.
- Nasal cavities, sinuses.

Symptoms- Community-acquired pneumonia
- Patient presents w/ symptoms of lower respiratory tract infection:
- Cough
- Dyspnoea - shortness of breath
- Pleuritic chest pain
- Sputum - mucus and saliva
- Myalgia (muscle pain)

Risk factors:
- Young
- Elderly
- Pregnant
- Immunocompromised individuals, e.g. with HIV infection
- Smoking & drinking

Treatment:
- antibiotics

Question 4

What is E.coli?: Classification, colonisation, UTI, symptoms, risk factors, treatment?

Answer 4

Classification:
- Gram negative, rod-shaped
- Non-spore forming
- Can be motile (has flagella)/ non-motile.

Colonisation:
- E.coli from gut colonise urinary tract
- cause UTI

UTI:
- common among women
- acquired by sending route from the urethra to bladder
- can cause damage to kidney

Symptoms:
- Dysuria- pain whilst urinating
- urgency to pass urine
- frequency of micturition

Risk factors:
- pregnancy
- menopause
- birth control
- sexual activity

Treatment:
- Antibiotics should be prescribed with caution since there is a risk of developing complications
- Paracetamol/ibuprofen can be used for pain relief
- antibacterial drug used commonly: nitrofurantoin, amoxicillin, trimethoprim.