Upper Respiratory Tract Infections Flashcards
What is an upper respiratory tract infection?
An infectious process of the sinuses, nasal passages, pharynx or larynx
What is an inflammation of the nasal cavity known as?
Rhinitis
Nasopharyngitis is more commonly known as
the common cold
Epiglottitis is the inflammation of
the upper portion of the larynx or the epiglottis
Pharyngitis is the inflammation of
the pharynx, uvula and tonsils
What is an inflammation of the larynx and trachea known as?
Laryngotracheitis
Most URTIs are caused by viral infections and are
self-limiting
How are URTIs spread?
Person-person by inhaling or having other contact with respiratory droplets from coughing or sneezing
What causes a URTI?
Direct invasion of the inner lining of the upper airway by a virus or bacteria
What physical barriers are present in the upper respiratory tract to protect against URTI?
- Hair lining the nose
- Mucous inside nasal cavity
- Cilia lining trachea
What immune barriers do we have in the upper respiratory tract to protect against URTI?
Adenoids and tonsils
Viruses an bacteria adapt various mechanisms to
resist destruction
What can viruses/bacteria do to resist destruction?
- Produce toxins
- Change shape or outer structural proteins
- Produce adhesion factors (bacteria)
Viruses which infect with fewer numbers than others are
more pathogenic
What is the incubation period for Rhinoviruses?
1-5 days
What is the incubation period for Influenza and Parainfluenza viruses?
1-4 days
What is the incubation period for Pertussis?
7-21 days
Give a risk factor for URTI
- Physical/close contact with infected people
- Poor hand hygiene
- Smoking
- Immunocompromised patients
- Anatomical abnormalities e.g. facial trauma
Give 3 common symptoms of URTI
- nasal congestion
- runny nose
- nasal breathing
- sneezing
- sore/scratchy throat and painful swallowing
- cough
- malaise
- fever (commonly in children)
Give 3 less common symptoms of URTI
- halitosis
- hyposmia (poor smelling sensation)
- headache
- dyspnoea
- sinus pain
- itchy watery eyes
- nausea/vomiting/diarrhoea
After how long should a patient with a URTI see a doctor?
- When symptoms last more than two weeks or are severe and worsening
- If URTI is recurrent
- When breathing/swallowing is impaired
How long do symptoms of a URTI normally last?
3-14 days
Lab testing in URTIs would be appropriate under what circumstances?
- suspected strep throat
- possible bacterial infection
- prolonged symptoms
- suspected Ebstein-Barr virus
URTIs are not normally treated with
antibiotics
What general measures can be taken to treat a self-limiting URTI?
- rest
- increased fluid intake
- non-steroidal anti-inflammatory drugs for pain/fever
What medication may be taken to treat nasal congestion?
Decongestants
When taken incorrectly or when they are not needed, antibiotics might promote
bacterial resistance and secondary infections
First line antibiotics may be given for 5-7 days to treat Rhinosinusitis in what circumstances?
- if symptoms persist without improving for more than 10 days
- if symptoms are sever or worsening over a period of 3 or more days
What is the treatment for epiglottitis?
- admission to hospital
- IV antibiotics after collecting culture specimens
- steroids if severe
- IV fluids
What antibiotic would be given to treat streptococcus pyogenes (group a strep)?
Oral penicillin or amoxicillin (for 10 days)
- first generation cephalosporin used in patients with non-anaphylactic penicillin allergy
- clindamycin/clarithromycin/azithromycin for penicillin-allergic patients
What complication might arise from Epiglottitis?
Respiratory compromise
What effect will a URTI have on a patient with an underlying chronic lung disease?
Worsening of underlying disease
Spread of a URTI to the heart can cause
Pericarditis/Myocarditis
What measures can be taken to improve the immune system in order to help prevent URTI?
- smoking cessation
- reducing stress
- adequate/balanced diet
- regular exercise
The flu vaccine is especially recommended for what groups of people?
- elderly
- people with chronic medical conditions
- health care workers
Give 3 common viral infective agents in URTIs in children
- adenovirus
- influenza (A, B)
- Parainfluenza (I, III)
- RSV
- Rhinovirus
Give 3 common bacterial infective agents in URTIs in children
- Haemophilus Influenzae
- Moraxella catarrhalis
- Staph aureus
- Mycoplasma
- Streptococci
Give a common, beta haemolytic, bacterial infective agent in URTIs in children
Streptococcus pyogenes
Give a common, non-haemolytic, bacterial infective agent in URTIs in children
Streptococcus pneumoniae
The “Illness Index” of a child allows you to do what?
Determine what stage of an infection a child is at i.e. whether they are at their worst, will get worse or are past the worst
What changes can occur due to Rhinovirus that can cause a cold to lead to a more serious condition?
Rhinovirus changes harmful bacteria living symbiotically in our system to an invasive organism
Give an illness of which Rhinitis may be a prodrome
- pneumonia
- bronchiolitis
- meningitis
- septicaemia
What effect does otitis media have on the ear drum?
- erythema occurs on ear drum
- spontaneous rupture of ear drum
Otitis media may occur as a secondary infection with what?
- Pneumococcus
- H. influenzae
Tonsillitis may be difficult to treat as it is hard to distinguish whether it is
bacterial or viral
What antibiotic is used to treat bacterial tonsillitis in children?
10 days penicillin
Is epiglottitis rare or common?
Rare
What antibiotics would be used to treat Croup in children?
Oral dexamethasone