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RESP. MICROBIOLOGY > S1 Clinical Presentation & Etiology of URTIs > Flashcards

S1 Clinical Presentation & Etiology of URTIs Flashcards

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1
Q

What does Most common URTIs involve ? (7)

A

 Nose (rhinitis or common cold)

 Pharynx (pharyngitis, sore throat, tonsillitis)

 Ear (otitis media, otitis externa)

 Sinuses (sinusitis)

 Epiglottis (epiglottitis)—

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2
Q

Why URTIs are most common site of infections in human ?

A

URT most common site exposed constantly to potential pathogens from environment during breathing and from hands

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3
Q

What is the most common causes of URTIs ?

A

Viruses

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4
Q

What are the normal bacteria ( oral flora of the mouth ) ? What is the pathogens that can be carried asymptomatic ?

A

NORMAL FLORA :

  1. Streptococcus viridins
  2. Diphtheroids
  3. Anaerobic cocci

PATHOGENS CARRIED ASYMPTOTIC:

  1. Streptococcus pyogens ( most )
  2. Streptococcus pneumonia
  3. Hemophlus influenza
  4. Cornybactrium diphtheria (least )
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5
Q

What are the mechanisms to protect URT from infections ? (6)

A

 Mechanical defenses ( These includes: cough, gag and sneeze reflex )

 Viscous mucous secretions which entrap particulate materials

 Ciliated epithelium in the nose and sinuses

 Lysozyme in saliva

 Lymphoid tissue, secretory immunoglobulin IgA

 Rich vasculature that can rapidly deliver phagocytic lymphocyte

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6
Q

When does Bacterial URTIs usually occur ?

A

After insult to the mechanical defenses due to :
- allergic rhinitis
- irritation
- viral infections
As they impair the ciliary function and produce mucosal edema that block the draining channels of the sinuses and middle ear

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7
Q

What are the etiological causes of pharyngitis?

A
  1. Viruses ( more than 70%)

2. Bacteria

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8
Q

What are the viruses that cause pharyngitis?

A
  1. Influenza A,B,C
  2. parainfluenza
  3. Rhinitis
  4. Adenovirus
  5. Coronavirus
  6. ebstain-bar virus
  7. HSV
  8. CMV
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9
Q

What are the bacteria that causes pharyngitis ?

A
  1. Group A streptococci ( streptococcus pyogenes ) most common type
  2. Group C and D
  3. Cornybacterium diphtheria
  4. N. Gnoreah
  5. Vincet angina
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10
Q

How you can differentiate between viral and bacterial pharyngitis?

A
  1. VIRAL
    - Mild pharyngeal symptoms
    - rhinorrhea
  2. BACTERIAL or EBV
    - High fever
    - tonsillar exudates
    - cervical lymphadenopathy
    - absence of cough
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11
Q

What are the features of streptococcus pyogenes ?

A
  1. Group A streptococci
  2. Beta hemolytic
  3. Agglutinate to anti-body A
  4. Sensitive to bacitracin
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12
Q

How S.pyogens are treated ? Why ?

A

Start with penicillin
If allergic use erythromycin

Aim of treatment is to prevent complications ?

  1. Acute rheumatic fever
  2. Acute glomerulonephritis
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13
Q

What are the systems that are affected by C. Diphtheria complications ?

A
  1. Central nervous system ( polyneuritis )

2. Cardiac system ( myocarditis)

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14
Q

What are the Clinical feature of diphtheria ?

A
  • Fever
  • pharyngitis
  • Enlarged cervical lymph nodes
  • Pseudomemebrane that may cause airway obstruction
  • Myocarditis with cardiac failure
  • polyneuritis
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15
Q

What are the features of C. Diphtheria ?

A
  1. Gram positive bacilli

2. Produce exotoxins ( detected by PCR )

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16
Q

How you can treat C. Diphtheria?

A
  • Isolation of suspected cases
  • Antibiotics should be started before confirmation (erythromycin)
  • Antitoxin
  • Prophylaxis for contacts (erythromycin)
17
Q

What is otitis media ? And What are the main clinical features ?

A 
- inflammation and formation of pus and its accumulation behind ear-drum 
Clinical features :
* fever 
* ear ache
* irritability and refuse to eat
18
Q

What are the etiological causes of otitis media ?

A

VIRAL ( more than 50% )

  • influenza
  • rhinovirus
  • RSV
  • enterovirus

BACTERIA ( SSS+ MM+ H)

  • streptococcus pneumonia
  • streptococcus pyogenes
  • staphylococcus aureus
  • morexella cataralis
  • mycoplasma pneumonia
  • hemophilus influenza
19
Q

What is the management of otitis media ?

A

Antimicrobial agents to cover common bacterial pathogens
 Amoxicillin
 Amoxicillin & clavulanic acid
 Cephalosporin

Symptomatic treatment:
 Decongestants & antihistamines to reduce
congestion of the respiratory mucosa and relieve obstruction of the Eustachian tube

20
Q

What is the cause of Chronic otitis media ?

A
  • Caused mainly by bacterial pathogens

- Range of causative agents is wider than AOM including many Gram-negative bacteria

21
Q

What is the prevention of the recurrent infections of otitis media ?

A

 Chemoprophylaxis (once daily amoxicillin)

 Immunoprophylaxis ( pneumococcal vaccine)

 Surgery ( myringotomy= incision of the ear drum )

22
Q

What are the main types of otitis externa ? What is their etiologies ?

A
  1. Acute
    - localized ( pustules or fruncles ) due to staph. Aureus
    - diffuse ( swimmer ear ) due to pseudomonas aurignosa
  2. Chronic
    - Drainage problem in patients with suppurative otitis media
  3. Malignant
    - Mainly P. aeruginosa
23
Q

How sinusitis is normally caused ?

A

Mainly occur as a result of bacterial complications following viral infection

24
Q

What are the main complications of sinusitis?

A

It affects CNS mainly, leading to

  • meningitis
  • brain abscess
25
Q

What are the common etiological causes of sinusitis ?

A 
▫ Bacteria: ( SSS+ M + H + A )
 S. pneumoniae
 H. influenzae
 Anaerobic bacteria
 S. aureus
 S. pyogenes
 M. catarrhalis

▫ Viruses ( RAP )
 Rhinovirus
 Parainfluenza virus
 Adenovirus

▫ Fungal causes:
 Aspergillus spp ( A. fumigatus, A. flavus & A. niger)
 Cryptococcus neoformans
 Zygomyces ( mucor)

26
Q

What is the treatment of sinusitis?

A

Treatment:
▫ Antimicrobial therapy

▫ Supportive therapy:
decongestants and antihistamines

▫ Surgical therapy: Drainage

27
Q

What are the clinical features of epiglotites ?

A
  1. High fever
  2. Dyspnea
  3. Tachypnea
  4. Inspiratory stridor
28
Q

What is the main organism that cause epiglottitis ? What are the main features ?

A

Hemophilus influenza type b

  • gram negative
  • coco bacilli
  • capsulated
  • require X ( hemin ) and V ( NAD ) to grow
29
Q

What is the management of epiglottits ?

A
  • Respiratory support (intubation and ventilation)
  • Intravenous antibiotics ( cefotaxime)
  • Prevention :

 Immunoprophylaxis Hib vaccine (conjugate vaccine)

 Chemoprophylaxis for unvaccinated children < 5 years (Rifampicin)

RESP. MICROBIOLOGY (3 decks)

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