Upper respiratory tract infections Flashcards
List 5 types of upper respiratory tract infections
Sinusitis Otitis media Rhinitis Tonsillitis Pharyngitis
What is the incubation period for influenza?
1-4 days
What are the signs and symptoms associated with influenza?
Fever, dry cough, sore throat, coryzal symptoms,
headache, malaise, myalgia, conjunctivitis, eye pain ± photophobia
GI symptoms
How is influenza diagnosed clinically and investigation ally?
Clinically = acute onset + cough + fever has positive predictive value >79%
Tests which can be done = Viral PCR, Rapid antigen testing, Viral culture of clinical samples (Troat swab, nasal swab, naso-
pharyngeal washings, sputum)
In which groups of people are in the high risk group with regards to influenza?
Elderly >65 Young <6 months Pregnant women Those with chronic disease (lung, liver heart, kidneys, CNS, DM) BMI > 40 Those who are immunosuppressed
What us the difference between complicated and uncomplicated influenza?
Complicated influenza is defined by signs and symptoms which require hospital admission, involve the lower respiratory tract
(pneumonia/Hypoxaemia), central nervous system (meningitis), or cause significant exacerbation of an underlying medical condition
Uncomplicated influenza is only the usual symptoms
How is uncomplicated influenza treated?
Previously healthy = Usually no treatment- maybe paracetamol
In at risk group = Antivirals such as oseltamivir can be prescribed 48h after symptoms present if Dr feels patient is likely to develop complications
How is complicated influenza treated?
First line - Oseltamivir: PO or NG 75mg bd oral/NG x 5 days
Second line- Zanamivir: inhaled, nebulized, or IV.
Used if: oseltamivir resistance (eg A(H1N1)), poor clinical response to oseltamivir, concerns re GI absorption of
oseltamivir.
Which advice would you give to a patient with uncomplicated influenza?
drink adequate fluids, take paracetamol or ibuprofen to relieve symptoms, rest, and stay off work or school until the worst symptoms have resolved (usually about 1 week).
When should suspicion of influenza be investigated and how?
In secondary care via nasopharyngeal swab for flu PCR
What is Pharyngitis?
An infection/irritation of the pharynx and/or tonsils.
Which viruses can cause Pharyngitis?
12
7 common upper respiratory tract infections-
- Rhinovirus
- Influenza/ Parainfluenza
- Coronavirus
- Adenovirus
- Respiratory syncytial virus
- Coxackie
- Enterovirus
Plus-
- Epstein-Barr Virus
- Cytomegalovirus
- Herpes Simplex virus
- Measles
- HIV
Which bacteria’s can cause Pharyngitis?
4
- Group A,B,C Streptococci
- Mycoplasma Pneumonia
- Neisseria Gonorrhoea
- Corynebacterium Diphtheriae
- Arcanobacterium haemolyticus (scarlet fever)
What are the signs and symptoms of pharyngitis? (history taking and on examination)
- Fever, malaise, sore throat, myalgia
- Erythema and oedema of the tonsils and pharyngeal mucosa
- Purulent tonsillar exudate suggests streptococcal infection or EBV
- Conjunctivitis suggests adenovirus
- Chest signs may indicate LRTIs by M. pneumoniae or C. pneumoniae
- Hepatosplenomegaly may be seen in EBV infection
- Tender cervical nodes
What is a differential diagnosis for Pharyngitis?
Hepatosplenomegaly may be seen in EBV infection
