Respiratory Tract Infections Flashcards
What is the name for the common cold?
Coryza
What is coryza?
Acute viral infection of the nasal passages. Spread by droplets and fomites/
What are the symptoms of coryza?
Rhinorrea
Mild fever
sore throat
What are the complications of coryza?
Sinusitis
Acute bronchitis
What is acute sinusitis?
Preceded by the common cold.
Purulent masal discharge
What is diptheria?
A life threatening upper respiratory tract illness caused by Corynebacterium diphtheriae, a facultative anaerobic, Gram-positive bacterium
Why is diptheria so life threatening?
Toxin production
What are the characteristics of diptheria?
Pseudomembrane of the tonsils
Swollen ‘bull’ neck
What is acute epiglottitis?
Inflammation of the epigottis usually in children
What causes epiglottis?
Haemophilus influenzae
What are the complications of acute epiglottitis?
Respiratory obstuction
Death
How do you diagnose acute epiglottitis?
Upper respiratory tract
Small gram negatic bacillus on microscopy
Choclate agar- small translucent colonies on cultue
X and V test- H.influenza requires both to grow
What is the treatment for acute epiglottitis?
ITU and ceftriaxone
What is acute bronchitis?
The cold which goes to the chest
Preceded by coryza
What are the clinical features of acute bronchitis?
Productive cough
Fever
Normal chest examination and normal CXT
Transcient wheeze
What is the treatment for acute bronchitis?
Self limiting
unless underlying chronic lung disease
What is an acute exacerbation of COPD?
Worsening COPD symptoms due to a viral or bacterial infection
What are the clinical features of an exacerbation of COPD?
Preceded by upper resp tract infection- viral
Worsening sputum production- purulent now
More wheezy
Increased breathless ness
What may be found on examination in a patient with an acute exacerbation of COPD?
Coarse crackles
Cyanosis
Ankle oedema in advanced disease
What usually cause an exacerbation of COPD?
Viral 30 percnet
Bacterial- 50 percent
What bacteria most commonly cause exacerbations of COPD?
Normal upper resp flora:
H.influenzae
Strep. pneumoniae
Moraxella catarrhalis
What is the treatment for acute exacerbations of COPD?
Give antibiotics if increased purulence. Antibiotics not needed if no increased sputum unles CXR shows consilidation/pneumonia. Treat same way as mild CAP pneumonia.
Consider bronchodilator inhalers
Steroids in some cases
When would you admit a patient with a COPD exacerbation to hospital?
Evidence of resp failure
Not coping at home
How would you manage a patient with COPD exacerbation in hospital?
ABG
CXR
Oxygen if there is resp failure
What is cystic fibrosis?
Inheritied defect which leads to abnormally viscid mucus which blocks tubular structures in many different organs including the lungs thus chronic resp infection a problem
What bacteria tend to cause infections in CF?
Staph aureus and H.influenzae
Pseudomonas aeruginosa
Burkholderia cepacia
What is pertussis?
Whooping cough
Acute tracheobronchitis
What causes whooping cough?
Bordella pertussis
What are the clinical features of whooping cough?
Cold like symptoms for two weeks
Paroxysmal coughing for two weeks (violent)
vomiting common
residual cough for a month or so
How do you diagnose pertusis?
Pernasal swab
Serology
Clinical
What is the treatment for whooping cough?
Most effective in first ten days
Vaccine
How are influenza cases described?
Seasonal- every year- small number of cases
Pandemic- not very often- large number of cases, rapid spread, minimal immunity
Bird flu- migration of avian flu to poultry workers- high mortality- little man to man transmission
What are the clinical features of flu?
Incubation 1-4 days Abrupt onset Fever, chills, headache, sore throat, myalgia, malaise, anorexia, dry cough, prostration Clear nasal discharge 3-5 days in bed 5-6 days recovery
What can be the causes of flu?
Classical: Influenza A- world wide pandemics- develops new antigens Influenza B-local outbreaks Flu- like illneses: Parainfluenza Bacterial: H.influenzae Secondary invader
What are the complications of flu?
Primary influenzal pneumonia- high mortality- bloody sputum
Secondary bacterial pneumonia- new fever on day 7
Myosistis
Encephalitis
Depression
What are the treatments for flu?
Bed rest, fluids, paracetamol
Anti-viral drugs
What anti viral drugs are used to treat flu?
Neuramindase inhibitors:
Zanamavir
Oseltamivir (tamiflu) oral- many benefits reduce symptom time, reduce antibiotic use
What is H5N1?
Pathigenic avian flue
Influenza A
How woulf you confirm a flu diagnosis?
PCR- detect virus Nasopharyngeal swabs Throat swabs Antigen detection Virus culture Immunofluorescense
How is flu prevented?
Vacinnation- killed
Intra nasal live vaccine in children
What flu prophylaxis is indicated?
NICE indicate antiviral prophylaxis after exposure- rarely used
During ‘containment phase of first wave of pandemic
What is bronchiolitis?
Inflammation of the bronchioloes in the 1st and 2nd year of life
What are the clinical features of bronciolitis?
Fever Coryza Cough Wheeze Severe case- gruntin, decrease PaO2, intercostal, sternal indrawing
What are the complications of bronciolitis?
Resp and cardiac failure
What causes bronchiolitis?
Respiratory Syncytial virus
How do you confirm bronchiolotis?
PCR by throat or pernasal swabs
What therapy is used to treat bronchiolitis?
Supportive
Nebulised ribavirin no longer used
How are outbreaks of bronchiolitis controled?
No vaccine
In hospital- cohort nusing
Passive immunity with monoclonal antibodies not effective
What other virus is common in children with acute resp tract infection such as bronciolitis?
Metapneumovirus
What can chlamydia trachomatis cause?
STI which can cause infantile pneumonia
diagnosed with PCR
What can chlamydophila pneumoniae cause?
Mild resp infections
person to person spread
