URTI Flashcards
Acute bronchitis common pathogens
respiratory viruses
Acute bronchitis presentation
cough
sore through
runny/stuffy nose, sneezing, post-nasal drip
headache
fever
malaise
NORMAL CHEST IMAGING
Acute bronchitis treatment
symptomatic management
Acute exacerbation of chronic bronchitis
Inflammation, increase mucous glands and mucus, muscle hypertrophy
Acute exacerbation of chronic bronchitis common pathogens
Streptococcus pneumoniae
Haemophilus influenzae
Moraxella catarrhalis
Pseudomonas–>patients with frequent antibiotic use
Enterobacterales–>patients with frequent antibiotic use
Acute exacerbation of chronic bronchitis presentation
Increased sputum purulence
Increased sputum volume
Increased cough or SOB
Acute exacerbation of chronic bronchitis diagnosis
Chronic cough with productive sputum for > or equal to 3 consecutive months for 2 consecutive years
Acute exacerbation of chronic bronchitis treatment
Duration 5-7 days
Preferred:
- Augmentin 875/125 mg PO q12h
- Cefuroxime 500 mg PO q12h
- Cefpodoxime 200 mg PO q12h
Alternative:
- Doxycycline 100 mg PO q12h
- Bactrim 1 DS PO q12h
- Azithromycin 500 mg PO day 1, 250 mg PO daily days 2-5
P. aeruginosa risk
- Levofloxacin 750 mg PO daily
Acute Pharyngitis pathogens
Bacteria: streptococcus pyogenes (Group A)
Virus: rhinovirus, coronavirus, adenovirus
Acute Pharyngitis presentation
Sudden onset sore throat
Dysphagia
Fever
Pharyngeal hyperemia
Tonsillar swelling
Swollen lymph nodes
Red, swollen ovula
Acute Pharyngitis complications associated
Rheumatic fever–>HF
Glomerulonephritis
Rhino sinusitis
Mastoiditis
Otitis media
Abscess
Acute Pharyngitis diagnostic testing
Throat culture–>24-48 hours to return
Rapid antigen detection test (RADT)–>sensitivity 70-90% (false-negatives)
If negative follow up with culture or PCR to confirm
Acute Pharyngitis treatment
Duration 10 days
1st line:
- Penicillin V 250 mg PO TID or 500 mg PO BID x 10 days
- Amoxicillin 500 mg PO TID or 875 mg PO BID X 10 days
Penicillin allergy non-anaphylaxis:
- Cephalexin 500 mg PO BID x 10 days
- Cefuroxime 500 mg PO BID x 10 days
- Cefpodoxime 500 mg PO BID x 5-10 days
- Cefadroxil 500 mg PO BID x 10 days
Penicillin allergy anaphylaxis:
- Azithromycin 500 mg PO on day 1, 250 mg PO daily on days 2-5
- Clindamycin 300 mg PO TID x 10 days
Acute bacterial rhinosinusitis common pathogens
Streptococcus pneumoniae
Haemophilus influenzae
Moraxella catarrhalis
Pseudomonas–>patients with frequent antibiotic use
Enterobacterales–>patients with frequent antibiotic use
Acute bacterial rhinosinusitis presentation
Major symptoms
- Purulent anterior/posterior nasal discharge
- Nasal congestions & obstruction
- Facial congestion
- Facial pain & pressure
- Hyposmia
- Fever
Minor symptoms
- Headache
- Ear pain, pressure
- Halitosis
- Dental pain
- Cough
- Fatigue
Acute bacterial rhinosinusitis diagnosis
Symptoms suggestive of ABRS
- Persistent symptoms
- Severe symptoms
- Worsening symptoms
CT scan, culture, or puncture not routinely done
Acute bacterial rhinosinusitis treatment
Duration 5-7 days
- Initiative antibiotic therapy as soon as infection established
1st line: Augmentin 500/125 mg PO TID or 875/125 mg PO BID
2nd line:
- Doxycycline 100 mg PO BID
- Levofloxacin 500 mg PO daily
- Moxifloxacin 400 mg PO daily
MRSA Concern–>add doxycycline, Bactrim, linezolid
P. aeruginosa–>levofloxacin 750 mg PO daily
- Watchful waiting for 7 days
