Upper respiratory tract infections Flashcards
What are the different URTIs
Rhinitis
Tonsillitis
Otitis media
Pharyngitis
Laryngitis
Epiglottitis
~Croup (laryngotracheobronchitis)
What is rhinitis?
Rhinitis = runny nose
Inflammation of mucous membranes of the nose
Describe the natural course of rhinitis
Usually self-limiting and not serious
Rarely is the prodrome to another illness such as pneumonia, meningitis or septicaemia
Most children’s symptoms will resolve by 10-14 days
What condition does this show?
What features give away this diagnosis?
Nothing - this is a normal ear
Light reflex
No erythema
No bulging
What condition does this show?
What features give away this diagnosis?
Otitis media
Infection of the middle ear
Erythema & opacification
Bulging tympanic membrane –> no light reflex
What microorganisms are involved in otitis media?
Primary viral infection
Secondary bacterial infection - pneumococcus or H. influenzae
Describe the typical presentation for otitis media?
Otalgia (ear ache)
+/- fever
+/- hearing loss (effusion)
+/- discharge from ear (if perfed eardrum)
Often history of preceeding viral URTI (eg coryzal symptoms)
Occasionally hearing loss may be only symptom
Describe the natural course of otitis media?
Usually self limiting
Symptoms usually resolve within 7 days
Describe the management of otitis media
Analgesia
Antibiotics uncommonly given under specific circumstances…
Indications:
- symptoms not improving after 4 days
- <2 y/o with bilateral OM
- ruptured tympanic membrane with discharge
- immunocompromised
Describe the typical presentation for tonsillitis?
Pharyngitis (sore throat)
Oedematous, puss-ey tonsills
Fever
Malaise
Lymphadenopathy
Scarlet fever rash - may be seen with strep throat
What microorganisms cause tonsillitis & pharyngitis?
Bacterial - strep pyogenes most common
Viral
How is tonsillitis investigated and treated?
Throat swab for investigation
Bacterial - 10 days penicillin
Viral - do nothing
Do not give amoxycillin
On the topic of epiglottitis:
a) What organism causes it?
b) What are the main features?
c) How is it treated?
a) H. influenzae type B
b) Stridor, drooling, very unwell
c) Intubation & IV antibiotics
On the topic of croup:
a) Whats its proper name?
b) What organism causes it?
c) How does it present?
d) How is it treated?
a) Proper name = laryngo-tracheo-bronchitis
b) Parainfluenza viruses - (esp Parainfluenza 1)
c) Presentation:
- coryza
- barking cough (esp at night)
- stridor
- hoarse voice
d) Treatment - oral dexamethasone
How long does croup last?
1-3 days
