upper resp infection Flashcards
viruses that cause colds
usually rhino virus (non-enveloped ssRNA+)
maybe also flu, paraflu, corona, adeno, RSV, enterovirus
(pertussis, chlamydia, mycoplasma)
complications of cold
sinusitis, OM, pneumonia (.5-2%). hard to tell the difference in symptoms but consider if symptoms worsen over time or new onset fever occurs.
typical length of cold. treatment.
7 days
treat with NSAIDs, decongestants
Pathophysiology of cold
viral attachment protein VP1 attaches to cellular receptor ICAM1. Infected cells release IL-8 (important) which cuases an infilux of PMNs and increased vascular permeability, swelling, secretions.
pharyngitis: etiology
flu, cold, enterovirus, EBV, CMV, HIV, HSV, group A strep, groups C and G strep, archano bacteria, secondary syphilis, diptheria, gonorrhea
flu and pharyngits
may involve fever, cough, headache
enteroviruses and pharyngitis
coxsachie, echovirus, enterovirus. fecal/oral route but no GI symptoms. may show throat and vesicular lesions. hand, foot and mouth disease
EBV pharyngitis
large tonsils, exudate, fever, cervical lymphadenopathy
splenomegaly, hepatitis, thrombocytopenia.
STIs and pharyngitis
primary HIV infection: fever, sore throat, difuse lymphadenpathy and diffuse rash
HSV: primary. also see vesicles and ulcers.
syphilis and gonorrhea- consider based on sexual history. be specific about asking for oral sex history.
features of group A strep infection
younger than 15 and older than 3 fever anterior cerival adenopathy tonsillar swelling and exudates no cough
archanobacteria
look like strep and cause scarltiniform rash but doesn’t desquamate. seen in teens.
diphtheria pharyngitis
sore throat, fever, LAN, grey and white spots in throat and maybe MEMBRANE FORMATION
features of rheumatic fever
Hx of group A strep
carditis, polyarthritis, chorea, erythema marginatum, subcunateous nodules
treatment for rheumatic fever
aspirin and prednisone pluse monthly IM penicillin
Sequelae of group A strep
TSS, glomerulonephritis, scarlet fever, necrotizing fascitis, impetigo
parapharyngeal space infection: involved structures
deep to lateral wall of phayrnx. includes carotid artery, internal jugular veins, cervical sympathetic chain, parts of CNIX-XII, opens to posterior mediastinum
features of parapharyngeal space infection
polymicrobial, unilateral sore throat, muffled voice, fever. most common deep neck infection in kids and teens.
treatment of parapharyngeal space infection
airway management, drainage of fluid collections, IV antibiotics
Lemierre’s disease
septic thrombophebitis of the internal jugular vein caused by anaerobes or mixed bacterial pictures. may be copuled with spetic pulmonary embolit and can extend along the carotid sheat and to the posterior mediastinum/erode the carotid artery. requires IV antibitics and surgical drainage and a thrombolytic
sinusitis presentation
usually, what matters is length of symptoms. if more than 10 days, give antibiotics. (fever facial pain, headaches, thick/purulent nasal drainage
baceria of sinusitis
strep pneumo, H. flu, moraxella cattarrhalis
in hospitals, consider MRSA, pesudomonas, kelbsiella
fungal sinusitis
mucormycosis and aspergillis. mucomycosis can cause rapidly progressive necrotizing infection esp. in immunocompromised and diabetics. fungi can eat bone and brain
comlications of bacterial sinusitis
thrombosis, orbital cellulis, meningits, epidural abscess, brain absces
complications of fungal sinusitis
thrombosis orbital cellulitis, meningitis, epidural and brain abscesses, nasopharyngeal ulcerations, epstaxis, bony erosion, cranial nerve involvement.
treatment for fungal sinusitis
antifungals and IMMEDIATE REFERRAL TO ENT
