URTI's

Question 1

Define upper respiratory tract?

Answer 1

Anything above the trachea aka larynx, pharynx, sinuses.

Question 2

What are the common types of URTI’s? (3)

Answer 2

1. Coryza aka the common cold.
2. Pharyngitis aka sore throat.
3. Sinusitis: an infection of the paranasal sinuses may occur with viral URTIs. Occasionally there may be secondary bacterial infection with pain, swelling and tenderness over the cheek from infection of the maxillary sinuses

NOTE: Epiglottitis is a very severe URTI but is now very rare due to

Question 3

Coryza (common cold)

Common pathogens?

Treatment?

Answer 3

The commonest pathogens are:

• Rhinoviruses
• Coronaviruses
• RSV

Treatment:

• Parents should be advised that these are self-limiting and no specific treatment is required

Question 4

Pharyngitis

What is it?

Common pathogens?

Answer 4

Sore throat - this is where the pharynx and soft palate are inflammed and local lymph nodes are enlarged and tender

Common pathogens:

• Usually due to viral infections with respiratory viruses:
  
  • Adenoviruses
  • Enteroviruses
  • Rhinoviruses
• In older children group A B-haemolhytic streptococcus is a common pathogen

Question 5

What is sinusitis?

Viral or bacterial?

What sinuses are more likely to be infected?

Answer 5

An infection of the paranasal sinuses which may occur with viral URTIs

May be bacterial infection with pain, swelling and tenderness over the cheek from infection of maxillary sinuses

Frontal sinuses do not develop until later childhood so frontal sinusitis is uncommon in the first decade of life

Question 6

Treatment for sinusitis?

Answer 6

Abx and analgesics are used for acute sinusitis in addition to topical decongestants

The concurrent use of intranasal steroids or antihistamines with abx may hasten recovery

Question 7

What questions should be asked when presented with a child suffering from fever?

Answer 7

1. Likely source? - e.g. tonsils or otitis media ect.
2. How old is the child? (younger than 6months bacterial infections more likely and they present very vaguely with fever. Viral infections less likely due to passive immunity from mother)
3. How unwell is the child? (Obs etc)
4. Risk factors (immunocompromised, ill contact - humans and animals, unimmunised, travel)
5. Is there a rash?
6. Is there a focus for infection?

Question 8

How should you manage a URTI?

Answer 8

Depends on severity

Usually self limiting viral infections which can be managed at home with good hydration, and anti-pyrexials.

If source is unknown do not send home until it is discovered

If severely unwell consider bacterial infection and treatment in hospital.