Viral Respiratory Illnesses

Question 1

The common cold, what is most often the cause?

Answer 1

depends on seasons:
  Rhinoviruses: colder months 
  Adenoviruses: all seasons 
  RSV: late fall-early spring (jan-feb peak) 
  Influenza virus: fall-winter 
  Enterovirus: summer cold

Question 2

With the common cold (generally speaking), how long do you expect to see symptoms for?

Answer 2

5-7 days

Question 3

T/F Antibiotics can prevent complications of the common cold and limit duration of purulent rhinitis

Answer 3

False; ANTIBIOTICS WILL NOT PREVENT COMPLICATIONS OF THE COMMON COLD and DO NOT LIMIT
DURATION OF PURULENT RHINITIS!

Question 4

What treatment is given to a patient with the common cold?

Answer 4

supportive care
<2 yr. old: hydration, humidified air, suctioning

> 2 yr. old: PO antihistamines, decongestants, cough suppressants

vit C, zinc, topical decongestants – not shown to improve symptoms

Question 5

Parainfluenza: most often affects what age? When do you often see an outbreak?

Answer 5

based on clinical symptoms
barking seal cough
PCR<24hr result

Question 6

Human Metapneumovirus Infection (hMPV)

age, season, s/s, dx, tx, duration of s/s

Answer 6

<5 yr old 
occurs late autumn-early spring 
cough sore throat, acute wheezing 
PCR of resp secretions 
no treatment available 
duration is shorter in hMPV than RSV symptoms

Question 7

Adenovirus

age, season, transmission, specific findings, dx

Answer 7

< 2 yr old
winter and spring (daycare)
DROPLET TRANSMISSION, incubation 3-10 days, URI symptoms
antigen detection, PCR, culture (depends on type)

Question 8

Most common adenovirus caused disease?

Answer 8

Pharyngitis

Question 9

Patient presents with fever, pharyngitis, and conjunctivitis – Diagnosis?

Answer 9

Pharyngoconjunctival Fever (secondary to adenovirus) – THIS HAS NO LOWER RESPIRATORY SYMPTOMS

Question 10

Patient presents with FB sensation, photophobia, swelling of conjunctiva/eyelids - Diagnosis?

Answer 10

Epidemic Keratoconjunctivitis secondary to adenovirus

Question 11

< 4 yr old with short-lived diarrhea. Diagnosis?

Answer 11

enteric adenovirus (type 40/41)

Question 12

How is adenoviruses diagnosed?

Answer 12

viral culture (results in <48hr) or PCR

Question 13

How do you treat adenovirus?

Answer 13

no specific treatment exists; let it run its course / supportive therapy

Question 14

Parechovirus (HPeV)

causes, age, transmission, season

Answer 14

severe infections in young children (sepsis and meningitis) before the age of 2-5yr
Transmission is fecal-oral or from
respiratory secretions
Summer-fall outbreaks

Question 15

Patient presents with sore throat, abdominal discomfort, 3-4 day duration, vesicle/papules on pharynx without exudate. Diagnosis?

Answer 15

acute febrile pharyngitis secondary to enterovirus

Question 16

Patient presents with febrile, pharyngitis with non-ulcerative yellow-white papules along posterior palate for the last 1 - 2 weeks - Diagnosis?

Answer 16

acute lymphonodular pharyngitis secondary to coxsackie virus

Question 17

Patient presents with vesicles / papules on tongue, oral mucosa, hands, feet, 1-2 weeks duration, fever sore throat, hand foot and
mouth: when fever goes down - a rash can appear simulating roseola

Answer 17

hand foot and mouth disease secondary to coxsackie virus

Question 18

Patient presents with acute onset of fever and posterior pharyngeal GRAYISH WHITE VESICLES that quickly form ULCERS
LINEARLY ALONG POSTERIOR PALATE, + abdominal pain, 4-5 day duration - Diagnosis?

Answer 18

herpangina secondary to coxsackie virus

Question 19

Patient presents with abrupt onset of unilateral or bilateral spasmodic pain of variable intensity over the lower ribs or upper abdomen. Findings of headache, fever, and decreased thoracic excursion. Diagnosis? Specific treatment?

Answer 19

pleurodynia secondary to coxsackievirus (normal CXR, 1-week duration)
THIS IS DISEASE OF THE MUSCLES! Give potent analgesic agents, teach chest splinting