Upper Respiratory Infections

Question 1

what are the typical pathogens associated with rhinopharyngitis?

Answer 1

rhinovirus - most common!

also parainfluenza, RSV, H. influenza, adenovirus

(aka common cold)

Question 2

what are the typical pathogens associated with tonsillopharyngitis?

Answer 2

Group A beta-hemolytic streptococcus

viral: adenovirus, parainfluenza, influenza, EBV, enterovirus

others: chlamydia pneumonia, mycoplasma, anaerobes,

Question 3

when would you expect to see tonsillopharyngitis caused by Group A Strep. or Influenza vs enterovirus?

Answer 3

Group A streptococcus and influenza more common in winter

enterovirus infections see in summer

Question 4

which patients most often present with tonsillopharyngitis?

Answer 4

disease of school age children

Humans are the only host

Group A beta-hemolytic Strep.

Question 5

describe how scarlet fever may present as a complication of tonsillopharyngitis caused by Group A beta-hemolytic streptococcus

Answer 5

due to erythrogenic toxin production by strep. pyogenes

sandpaper rash, strawberry tongue

*uncommon in US

Question 6

Respiratory illness characterized by a hoarse voice, dry/barking cough, inspiratory stridor and respiratory distress resulting from upper airway obstruction. What is?

Answer 6

Croup, a.k.a. laryngo-tracheitis or laryngotracheobronchitis

[inspiratory strider indicates upper airway obstruction]

Question 7

what is the most common pathological agent responsible for croup or laryngotracheitis?

Answer 7

parainfluenza 1

Question 8

which patients are most affected by croup or laryngo-tracheitis, and during what time of year do most illnesses occur?

Answer 8

mostly children 6 mo - 5 yrs, more boys than girls

late fall/early winter illness

15% of lower respiratory tract disease in pediatrics (usually caused by parainfluenza)

Question 9

What is the most common pathogen associated with epiglottitis in children?

Answer 9

Haemophilus influenza B

Incidence has decreased since introduction of the HIB vaccine

Question 10

Who typically presents with epiglottitis and how do they present?

Answer 10

Epiglottitis presents most commonly in children ages 2 to 6 years (usually due to Haemophilus influenza B)

Fever, drooling, dysphasia, stridor (but no cough/hoarseness as with croup)

Children commonly sit in tripod position