Upper respiratory tract infections Flashcards
what are flora of upper respiratory tract infections.
Steptococcus viridans, commensal neisseria, diphtheroids, anaerobes
what respiratory pathogen may be carried asymptomatically
streptococcus pneumoniae, moraxella catarrhalis, haemophilus influenza, streptococcus pyognes.
names of pathogens which might involve transients colonisation post antibiotics
coliforms, pseudomonas, candida.
3 most common bacterial causes of upper respiratory tract infection.
haemophilius influenza
moraxella catarrhalis
streptococcus pnemoniae.
what are the viral causes of upper respiratory tract infections
adenovirus Epstein Barr virus Herpes simplex Influenza and parainfluenza virus. respiratory syncytical virus(RSV) rhinovirus enterovirus coronaviruses human metapneumovirus.
most common form of transmission of a upper respiratory tract infection
cough and sneezes
droplet spread.
most common causes of the common cold and its symptoms
rhinovirus,
nasal discharge, sneezing, sore throat.
clinical signs of rhinosinusitis
facial pain over sinus, reduction in smell, nasal blockage and sniffling.
bacterial and viral respiataory infections are most common in
children
most common causes of rhinosinusitus
• Streptococcus pneumoniae, Haemophilus influenzae, Streptococcus milleri group, anaerobes, fungal
complications of chronic sinusitis
Osteomyelitis, meningitis, cerebral abscess
what are sinus washouts used for
treatment and diagnosis of rhino sinusitis.
most common causes of tonsillitis (bacterial and viral)
viral- RSV, influenza, adenovirus, EBV, HSV1.
Bacterial- streptococcus pyogenes
what is used to to diagnose tonsillitis
throat swabs and rapid antigen testing.
most common signs and symptoms of tonsillitis
sore throat, dysphagia, fever, headache, red tonsillar/uvular area, lymphadenopathy.
what aspect of the history is unusual up important for tonsillitis
sex history- • Chlamydia and gonorrhoea are causes of tonsillitis
complications of group A streptococcal infections
acute glomerulonephritis/ rheumatic fever/scarlet fever
diagnosis of group A streptococcal infections
throat swab or ASOT antibody test.
what age group commonly gets group A streptococcal infections
children
common symptoms of EBV
– Sorethroat, fever, cervical lymphadenopathy, splenomegaly
complication of EBV
splenic rupture
common symptoms of diphtheria
malaise, fatigue fever and sore throat.
what term is used to describe the look of epiglottitis
cherry red.
what causes epiglottis
airway obstruction
treatment for group A streptococcal infections
penicillin
treatment for diptheria
• Erythromycin/ penicillin/antitoxin
clinical signs of epiglottis
fever, irratible, difficulty speaking and swallowing, drools and strider/hoarse voice
diagnosis of epiglottis
lateral neck x-ray- swollen epiglottis
blood culture
why mustn’t you swab the throat of a patient who is suspected to have got epiglottis unless you have incubated them
airway can close up resulting in lack of breathing
treatment for epiglottis
maintain airway, cefotaxime
clinical signs of acute laryngitis
Hoarse/husky voice, globus pharyngeus (lump in throat), fever, myalgia, dysphagia, temperature.
is laryngitis bacterial or viral infection (most commonly)
viral
clinical signs of of acute laryngotracheobronchitis
- sharp stridulous voice
* Inflammation of larynx and trachea after infection of upper airways
pathogen that cause whooping cough
• Bordetella pertussis
diagnosis of whooping cough
pernasal swab and then PCR
what are the 2 phases of whooping cough
catarrhal phase- runny nose, fever, malaise
later-dry non productive cough which becomes whooping
treatment for whooping cough
supportive and erythromycin
complications of whooping cough
ottis media, pneumonaie, convulsion, subconjunctival haemorrhages
prevention of whooping cough
vaccination
define otitis externa•
Infection of the external auditory canal (EAC)
common signs of otitis externa
Pain, itch, swelling and erythema, otorrhoea
main 3 types of otitis extern
acute OE, chronic OE and malignant OE.
main organism which cause otitis externa acute
skin types – S. aureus (likely if pustular) and Pseudomonas spp.(esp. after swimming)- staphs and streps.
diagnosis of otitis externa acute
swab EAC (external auditory canal)
treatment of otitis externa acute
toilet with saline and/or alcohol and acetic acid. Wick insertion.
• Topical drops (these may contain antibiotics, antifungals and steroids)
most common pathogen causing otitis externa malignant
pseudomonas aeruginosa
treatment for malignant ottisis externa malignant
-6 weeks altogether e.g. with iv ceftazidime then ciprofloxacin po- antipseudomonal antibiotics.
what groups of people commonly get ottisis externa malignant
Elderly, diabetics, immunosuppressed
define ottitis media
• Middle ear inflammation. Fluid present in the middle ear.
clinical symptoms of otitis media
• Fever, pain, impaired hearing. Red bulging tympanic membrane
common causes of otitis media
• VIRAL. H influenzae, S. pneumoniae, M. catarrhalis
what discharge occurs for ear during otitis externa malignant
pus
diagnosis of otitis media
pus from ear
treatment for otitis media
nothing
if really unwell- amoxicilin
define mastoiditis
• Inflammation of the mastoid air cells after middle ear infection
diagnosis of mastoiditis
bacterial samples
CT
common effect secondary to mastoiditis
acute osteomyelitis.
treatment for mastoiditis
treatment is co-amoxiclav (amoxicillin-clavulanate)- given over along period of time as it is a bone infection.
how do you make a diagnosis of a upper respiratory tract infection
- Culture- 24 hr result.
- Sensitivity testing
- Reference laboratory work (typing, toxin detection)
- Serology and antibody detection- IgG and IgM with glandular fever.
common antibiotics used to treat bacterial upper respiratory tract infections
- Penicillin and amoxicillin
* Erythromycin
