Viral Infections Flashcards
What is bronchitis?
Short term (1-3 weeks), MC form is acute bronchitis; primarily caused by viral infections, most infections are self limiting (tx with rest, hydration and reassurance), highest incidence in fall and winter
What is the hx for someone with viral bronchitis?
possible sick contacts, onset days ago (usually acute), URI can proceed or overlap bronchitis, constant cough (may have phlegm), runny nose, possible CP due to cough, rarely fever, fatigue, muscle pain, SOB that could be exasperated by the cold, wheezing, sore throat
What are the PE findings for viral bronchitis?
pt may appear in mild discomfort, but not tripoding, confused, losing consciousness or appears severely ill; wheezing on auscultation, resonant to percussion, tactile fremitus or egophony will be negative
When should you get a CXR?
to rule out PNA (look for signs of consolidation), rales, signs of pleural inflammation (+ pleural rub, inflammation has progressed passed the bronchi), previous pulmonary disease, hemoptysis, immunocompromised pt, severely ill pt (significant fever, confusion, hypotension, tachycardia, increased RR)
What tests or labs should be performed for viral bronchitis?
not generally required, sputum culture and gram stain are not recommended; get tests if suspect PNA, influenza, pertussis or COVID
What pts are at high risk for complications from influenza and should therefore be tested?
pregnant or 2 weeks post partum, kids <5 yo, adults >65 yo or resident of long term facilities, neuro disorders (CP, MD, MS, etc), lung disease (CF, severe asthma, COPD), Heart dz, blood disorders (sickle cell), DM or CKD, immunocompromised, BMI >39.9
What tests are performed for influenza?
RT-PCR (most sensitive and specific) or rapid Ag testing
What is the tx for influenza?
<48 hours of sx onset, give oseltamivir (1st line), baloxavir or zanamivir (inhaled)
What is the MC manifestation of severe COVID?
pneumonia, but bronchitis is also possible
What are the leading causes of death associated with COVID?
ARDS is the lead cause of death followed by sepsis, cardiac complications, and secondary infections
What are the sx of COVID?
fever, fatigue, dry cough, myalgia, HA, SOB, loss of taste or smell
What are the sx of pertussis?
uncontrollable violent coughing that can result in SOB and dry heaving/vomiting; culture not required, get PCR or serology
What are common causes of viral bronchitis?
Influenza, parainfluenza, COVID, rhinovirus, RSV, adenovirus
What is the MCC of respiratory tract infections worldwide?
parainfluenza
What is parainfluenza virus?
Infection common infants, young kinds, and immunocompromised individuals; high yield sign of croup (infection of upper airway that obstructs the airway causing a barking cough)
