URTI Flashcards
Sinusitis Causes
Initial inflammation of sinusitis might be
initially triggered by a cold or allergies.
• Fungus in people who have compromised
immune systems.
• Defects in the structure of the nasal passage.
• Growth like a nasal polyp.
clinical features of Sinusitis
No clinical finding is diagnostic of acute sinusitis. Suggestive clinical features include: • Purulent nasal discharge • Facial pain and tenderness • Periorbital swelling • Headache/toothache • Fever • Symptoms should be present for at least 7 days.
therapy of Sinusitis
therapy
• Antibiotics.
• Painkillers: Ibuprofen Acetaminophen
• Decongestants.
• Allergy medicines
• Surgery with chronic sinusitis or acute sinusitis
that keeps coming back
Acute Infective Rhinitis (Common cold)
➢ Nasal stuffiness, sneezing, rhinorrhea.
➢ Fever, malaise and muscular aches in more severe
infections.
➢ Purulent discharge does not necessarily indicate secondary bacterial infection as desquamated epithelial and inflammatory cells can produce it.
➢ Sometimes a cough may be present indicating some
inflammation of the larynx, trachea or bronchi.
Pharyngitis & Tonsillitis
Most prevalent in children between 4 to 10 years of age.
➢ Sore throat
➢ Cough
➢ Fever, malaise, nasal stuffiness
➢ Pharyngeal erythema ± tonsillar redness / swelling and exudates
➢ Cervical lymphadenopathy
➢ Presence of nasal stuffiness and cough are more typical
of viral infection although occurring in 20% of Streptococcal
pharyngitis.
Croup syndrome
Croup syndrome includes essentially viral croup: a- Acute laryngotracheobronchitis b- Acute Epiglottitis c- acute infectious laryngitis d-Acute spasmodic laryngitis.(Spasmodic cough)
Differential diagnosis of croup
Differential diagnosis of croup • Spasmodic cough • Laryngeal or esophageal foreign body • Angioneurotic edema • Retropharyngeal abscess
Acute laryngotracheobronchitis
The most common type of croup syndromes
• Etiology: 1. Para influenza virus 2. Respiratory syncytial virus 3. influenza virus 4. Rubeola virus 5. adenovirus
Pn; PAIR+MC
Tt of croup
Therapy:
• Supportive: 1-Humidification: by cold, humidified O2 Monitoring by arterial blood gases analysis 2- Racemic epinephrine (2.5 solution ) delivered by
nebulizer improves air exchange. 3- corticosteroids: 2.5 mg/ kg dexamethazone
in severe cases.
Etiology
Of epiglotitis
Cp
Haemophilis influenza type B in almost cases
• Clinical picture: abrupt onset of : High fever Respiratory distress Stridor drooling of saliva
Diagnosis of epiglottis
• Visualization of swollen, cherry- red epiglottis by
laryngoscope
• Radiology: Lateral veiw of nasopharynx (edematous epiglottis )
• Immunologic tests for H. influenza antigen in serum
or urine
Epiglottis tt
1-intubation Ventilatory support until edema subsides.
• I.V. antibiotic therapy: Ampicellin Third generation cephalosporin
Acute infectious laryngitis
common illness
• in all age groups
• caused by viruses: Rhinoviruses Parainfluenza
viruses, Respiratory syncytial virus, Adenoviruses, Influenza viruses, Measles virus, Mumps virus, Bordetella pertussis, Varicella-zoster virus.
Clinical picture:
Of Acute infectious laryngitis
Clinical picture: • Fever. • sore throat. • Hoarseness. • Cough. • swollen lymph nodes • possibly mild inspiratory stridor. Respiratory distress is rare with the exception of young infants.
Acute infectious laryngitis
Tt
Therapy
• Analgesic
• Antipyretic
• Inhalation of humidified air.
• Antibiotics are indicated if diphtheria is thought to
be the cause.
• A short course of steroids (prednisone, prednisolone, or dexamethasone) may be used to decrease the inflammation and shorten the course of symptoms.
Acute spasmodic laryngitis.(Spasmodic cough)
Etiology
Repeated attacks of croup but less severe.
• Mostly in children 1-3 years old.
• Probably allergic in nature.
- Infectious viral
- Allergic
- Psychological may be seen more frequently in anxious
or excitable children - Familial predisposition
Acute spasmodic laryngitis.(Spasmodic cough)
CLINICAL FEATURES:
• 1. Prodrome
usually preceded by mild-to-moderate coryza and hoarseness
• 2. Respiratory Manifestations:
• Croupy cough and inspiratory stridor.
• Sudden onset usually at night during sleep.
• Episodes tend to be brief (hours) and occur over 2-3 nights.
• Tends to recur throughout year.
• Symptoms less severe than in infectious croup.
• Patients appear well after an episode except for slight hoarseness and cough.
Acute spasmodic laryngitis.(Spasmodic cough)
Therapy
1. Supportive
Respiratory support with severe or life-
threatening upper air-way obstruction, i.e.,
intubation, tracheostomy 2. Breaking of Laryngeal Spasm by humidified air (cold or
warm) used either acutely or over 2-3 days until the cough has subsided.
3. May also break episode by inducing vomiting.
