Respiratory tract infections Flashcards
Normal bacteria in respiratory tract
Staph, strep, pneumonia, haemophilius, anaerobes
Rhinosinusitis
- If viral: less then 10 days, self-resolves, caused by rhinovirus, influenza or parainfluenza - MUCH MORE COMMON
- If bacterial: bi-phasic illness so more than 10 days, secondary infection to allergic/viral rhinitis, caused by strep, haemophilus influenzae or moraxella catarrhalis
- Upper respiratory tract
- Asthma affecting upper tract causes rhinitis
- Neck stiffness etc = meningitis
- Can lead to thrombosis in cavernous sinus = septic
- Inflammation of sinuses causes mucus to drip into throat = cough
Complications of rhino sinusitis
Cellulitis Subperiosteal abcess Osteomyelitis of sinus Meningitis Intracranial abcess Cavernous sinus thrombosis
Treatment for viral rhino sinusitis
Will self resolve but can use supportive therapy with analgesics, intranasal steroids, decongestants
Treatment for bacterial rhino sinusitis
Will self resolve but antibiotics can be used if persists for longer than a week
Symptoms of common cold
Dry cough, sore throat, tiredness, runny nose
Common cold
- Benign, self-limiting syndrome
- Most common upper tract infection
- Majority caused by rhinoviruses, coronavirus, influenza
- Severe economic effects
- Up to 2 hrs on skin, 8 hours on surfaces
- Effective treatments: supportive, decongestants, analgesics, antihistamines
- Ineffective treatments: antibiotics, antivirals, vitamin C, echinacea, codeine, intranasal glucocorticoid
- Potential complications: acute rhinosinusitis, lower tract infection, asthma exacerbation, acute otitis media
- Upper tract
Tonsilitis
- Swollen tonsils and lymph glands
- Adenovirus, rhinovirus and coronavirus cause fatigue, nasal congestion and cough
- Group A,C,G and strep (bacteria) cause sore throat and fever, tonsilar exudate and pharyngeal edema, tender anterior cervical lymphadenopathy, rash
- Infectious causes and mononucleosis (Epstein-Barr virus) causes high fever, posterior cervical lymphadenopathy, splenomegaly and atypical lymphocytosis
How to treat tonsillitis
If viral, will self resolve
Bacterial infection = white dots on tonsils, needs penicillin
Symptoms of bronchiolitis
Fever, cough, wheezing, increased respiratory rate, poor feeding
Bronchiolitis
- Viral infection of small airways
- Lower tract
- URTI prodrome followed by secondary inflammation of bronchi/bronchioles
- Caused by RSV (autumn/winter) - leading cause of admission for 0-5 year olds
- ‘sounds like dying of asthma’
Clinical course of bronchiolitis
Day 0: URTI symptoms 0 runny nose etc Day 2: LRTI symptoms, wheeze, cough Day 3-5: peak illness Day 15: cough resolves 90% resolve within 3 weeks
Risk factors for bronchiolitis
Prematurity Age <12 weeks Lung disease Anatomic defects Congenital heart disease
Treatment for bronchiolitis
- Will normally self resolve
- Discharge when clinically stable, taking oral fluids, SpO2>92%
- Respiratory failure: can’t exchange oxygen for CO2 - blood turns acidic, fix by ventilation (CPAP - opens airways in type i respiratory failure and BiPAP - 2 levels of ventilation and opens lungs like bell)
- BiPAP in type ii failure
- Should not use antibiotics, hypertonic saline, adrenaline, salbutamol, systemic/inhaled corticosteroids, montelukast, ipratropium bromide
- Adrenaline used in croup
- Montelukast used in asthma
Symptoms of pneumonia
Cough with green sputum
Lower RHS chest pain breathing in
Fatigue
Confusion
