Common Upper Respiratory Tract Infections (URI) Encountered in Primary Care Flashcards
What makes up the upper respiratory tract?
- nose
- nasal cavity
- ethmoidal air cells
- frontal sinuses
- maxillary sinus
- sphenoidal sinus
- larynx
- trachea
What viruses are implicated in the common cold?
> 200 types inc:
- rhinovirus
- coronaviruses
- parainfluenza viruses
- adenoviruses
- enteroviruses
Are antibiotics recommended of the common cold?
NO.
Are narcotics/antihistamines or antihistamine/decongestants recommended to treat cough or col sx in children?
NO.
What is acute rhinosinusitis (sinusitis)?
-inflammation of paranasal sinuses
What pathogens cause acute rhinosinusitis?
-majority of viral etiology
Bacterial pathogens:
- Streptococcus pneumonia
- Haemophilus influenzae
other:
- beta-hemolytic streptococcus
- staphylococcus aureus
- anaerobes
What are the sx of acute bacterial rhinosinusitis (ABRS)
PODS
P-facial Pain/pressure/fullness
O: nasal Obstruction
D: nasal purulence/Discoloured postnasal Discharge
S: hyposmia/anosmia (smell)
need at least 2 w P or O included.
What are the complications of acute rhinosinusitis?
- local extension (to bone in the region i.e. sinus bones)
- meningitis
- brain abscess
- intracranial venous sinus infx
What is pharyngitis?
inflammation of the pharynx (acute sore throat)
What percentage of pharyngitis cases are caused by viruses?
50-80%
What viruses cause pharyngitis (top to bottom %):
- Streptococcal
- Epstein-Barr Virus
- Chlamydia pneumoniae
- Mycoplasma pneumoniae
- Neisseria gonorrheae
- Haemophilus influenzae type b
- Candidiasis
- Diphtheria
*rare: fusobacterium necrophorum (Lemierre’s syndrome)
What rare complications exist for Streptococcal pharyngitis?
- Rheumatic fever
- Peri-tonsillar abscess
(why we treat with antibiotics…well warranted)
What is the gold standard Rx for Streptococcal pharyngitis?
Penicillin V
no resistance anywhere in world
What is the usual pathogen causing Hand foot and mouth (pharyngitis) in children?
Coxsackie A virus
What are the indications for tonsillectomy?
- 6 episodes of tonsillitis/year
- recurrent peritonsillar abscess
- obstructive sleep apnea due to large tonsils
- suspected tumor (rare)
What is the main pathogen causing infectious mononucleosis (a form of pharyngitis)?
- EBV
* risk of spleen rupture (1% cases)
What are causes of pharyngitis besides mono and strep?
- Gonococcal pharyngitis (antibiotic Rx)
- oral “thrush” (candida causes this esp in immunocompromised patients)
- Lemierre’s syndrome (18% mortality)
What is ‘CROUP’?
What are the causes of croup?
Laryngeotracheitis
- Parainfluenza (1,2,3)
- influenza A,B
- Adnovirus
- RSV
- Mycoplasma (rarely)
What are the sx of epiglottitis?
- high fever
- sore throat
- stridor
- cyanosis
- drooling
- difficulty breathing (tripod)
- difficulty swallowing
- voice change (hoarse)
What resp viruses cause the majority of Acute Bronchitis?
- influenza A and B
- parainfluenza
- respiratory syncytial virus
- URI viruses (rhinovirus, coronavirus)
