Upper respiratory tract infections - young Flashcards
Examples of upper respiratory tract flora
Streptacoccus viridans
commensal Neisseria ssp
Diphtheroids
anaerobes
What are the 3 usual suspects of respiratory infections?
Streptococcus pneumoniae
Moraxella catarrhalis
Haemophilus influenza
What does it mean by ‘transient colonisation post antibiotics’?
Microorganisms that arise due to disruption in normal flora because of antibiotics
What condition does bordetella pertussis cause?
whooping cough
what condition does corynebacterium diphtheriae cause?
Diphtheria
What is parainfluenza viruses?
tend to cause the common cold - can be more severe in immunosuppressed patients
What group of people is Respiratory Synactial virus (RSV) most common in?
Children
What type of pneumonia does mycoplasma pneumoniae cause?
Atypical
How are respiratory diseases spread?
Droplet spread
What is the most common virus that causes the common cold/coryza?
Rhinovirus
What is ‘coryza’?
inflammation of the mucosa membranes in the nose
What are the symptoms of a common cold?
Nasal discharge
Sneezing
Sore throat
What are the symptoms of rhino-sinusitis?
Facial pain
Nasal blockage
Reduction in smell
What microorganisms cause rhino-sinusitis?
Streptococcus pneumoniae Haemophilus influenza Streptococcus milleiri group anaerobes fungal
What is a clinical sign of increased sniffing?
crease on the nose
What procedure should be undertaken in the hospital setting with sinusitis?
Sinus washout
What is the treatment for rhino-sinusitis?
Viral - no antibiotics
Amoxicillin if severe
What can rhino-sinusitis be misdiagnosed for and why?
dental infection - referred pain
What viral organisms cause Pharyngitis/Tonsillitis?
RSV Influenza Adenovirus Epstein barr virus HSV1
What bacterial organism cause Pharyngitis/Tonsillitis?
Streptococcus pyogenes
How is Pharyngitis/Tonsillitis diagnosed?
throat swab
what are the signs and symptoms of Pharyngitis/Tonsillitis?
sore throat dysphagia malasia red tonsil/uvular area exudate Lymphadenopathy - swollen lymph nodes
what is common type of organism that causes Pharyngitis/Tonsillitis in children?
group A streptococcal
what is the treatment for group A streptococcal infection?
penicillin
How is group A streptococcal infection diagnosed?
antistreptococcal antibody titres
What organism is infectious mononucleosis/ glandular fever/kissing disease caused my?
Epstein barr virus
Who is infectious mononucleosis/ glandular fever/kissing disease most common in?
teenagers and older people
What are the symptoms of infectious mononucleosis/ glandular fever/kissing disease?
sore throat
fever
cervical lymphadenopathy
What antibiotic should you avoid in infectious mononucleosis/ glandular fever/kissing disease and why?
ampicillin - can cause a rash that may be mistaken for a penicillin allergy
What diagnostic tests are used in infectious mononucleosis/ glandular fever/kissing disease?
Serology - IgG, IgM, Paul Bunnell Test
PCR
What are the symptoms of Diphtheria causing Pharyngitis/Tonsillitis?
Malasia
fatigue
fever
sore throat
What is the treatment for diphtheria causing Pharyngitis/Tonsillitis?
Erythromycin
penicillin
antitoxin
What does Candida ssp cause?
thrush
When does Candida ssp occur?
after antibiotics or steroids
What infections come under Pharyngitis/Tonsillitis?
Group A streptococcal infection
infectious mononucleosis/ glandular fever/kissing disease
Diphtheira
Thrush
Which URTI is a medical emergancy?
Epigottitis
What is epiglottitis?
cellulitis of the epiglottis which causes airways obstruction
What are the symptoms of epiglottitis?
fever irritable difficulty speaking (act as though there is a hot potato in their mouth) difficulty swallowing leans forward drools stridor hoarse voice
What imaging is undertaken in epiglottitis and what does it show?
Laternal neck x ray - shows enlarged epiglottis
Why should you send blood cultures and not a throat swab with someone that has epiglottitis?
putting anything down the throat can cause an obstruction - only okay if incubated
What is the treatement for epiglottitis?
maintain airway
cefotaxime
What organism most commonly causes epiglottitis these days?
s. aureus
respiratory bacteria
What antibiotic is effective against the ‘common 3 suspects’ of respiratory infection?
cefotaxime
What are the symptoms of acute laryngitis?
Hoarse/husky voice globus pharyngeus (lump in the throat) fever myalgia (pain in muscles) dysphagia
What are the causes of acute laryngitis?
usually viral
sometimes bacterial - the usual suspects
non infective causes e.g. voice abuse (singing), malignancy
What is the treatment for acute laryngitis?
bacteria or severe - antibiotics
make airway patent if stridor
What is ‘croup’ a leymans term for?
Acute laryngotracheobronchitis
What is Acute laryngotracheobronchitis?
Inflammation of larynx and trachea after infection of the upper airway
What is the treatment for Acute laryngotracheobronchitis?
Symptomatic treatment only
What is a common, very contagious RTI that can occur in adults as well as children?
Whooping cough
What are the symptoms of Whooping cough after the incubation time?
dry, non productive cough
short bursts of exhalation followed by inspiratory gasps
What is the treatment for Whooping cough?
supportive
erythromycin
Which RTI are notifiable diseases?
Whooping cough
Diphtheria
What is otitis externa?
infection of the external auditory canal - like any other skin condition but in the canal
what are the symptoms of otitis externa?
pain itch swelling erythema - superficial reddening of the skin otorrhoea - ear discharge
What are the 3 types of otitis externa?
Acute
chronic
malignant
What is the main organism that causes acute Otitis externa?
A. aureus - likely if pustular
pseudomonas ssp - esp after swimming
What is the treatment for acute Otitis externa?
eardrops with: Saline alcohol acetic acid antibiotics antifungals steroids
wick insertion
What is chronic Otitis externa?
irritation from drainage from perforated tympanic membrane
What are the symptoms of chronic Otitis externa?
Itchy
What type of antibiotic should you avoid in Otitis externa if perforated?
aminoglycosides
What is malignant Otitis externa?
severe necrotising infection that spreads more deeply
What organism causes malignant Otitis externa?
Pseudomonas aeruginosa
What are the symptoms of malignant Otitis externa?
very severe pain and drainage of pus
Who is malignant Otitis externa most common in?
Elderly
diabetics
immunosuppressed
What is the treatment for malignant Otitis externa?
IV ceftazidime
followed by PO ciprofloxacin
4-6 week treatment
What is otitis media?
Middle ear inflammation
fluid present - send sample
Who is otitis media most common in?
children
What are the symptoms of otitis media?
Fever
pain
impaired hearing
red, bulging tympanic membrane
What organisms cause otitis media?
Viral
H. influenza
S. pneumoniaw
M. catarrhalis
What is the treatment for otitis media?
Symptomatic
if unwell, amoxicillin
What is mastoiditis?
inflammation of the mastoid air cells after a middle ear infection - pus collects in the cells which may lead to necrosis of the bone
What are the symptoms of mastoiditis?
pain itch swelling erythema - superficial reddening of the skin otorrhoea - ear discharge swelling over mastoid
How do you diagnose mastoiditis?
bacteriology samples
CT imaging
What is the treatment for mastoiditis?
eardrops and wick
unless gram -ve the broad spectrum cover needed
co-amoxiclav is 1st line in LTHT
