Viral respiratory infection Flashcards
Uncomplicated influenza
- popultion
- virus
- in general population -> usually self-limiting
(usually n one week)
- caused by type A or B influenza virus
Management of uncomplicated influenza
Treatment: supportive care
- antipyretics
- analgesics
- increased fluid intake
Pregnant women presenting with
uncomplicated influenza, with no evidence of
systemic disease -> Zanamivir or oseltamivir
offered (these are antivirus, neuraminidase
inhibitors)
Complicated influenza
- virus causing it
- complications
- More severe symptoms occur -> mostly associated with influenza A
- Complications: otitis media, bacterial sinusitis, primary viral pneumonia, secondary bacterial pneumonia
General Rx modes in complicated influenza
Treatment of complications:
- aggressive supportive care
- hospitalisation
- antibiotics
- antivirals
What drug (classes) are used to manage complicated influenza?
- Antivirals -> effective against influenza A and B: neuraminidase inhibitors
- M2 inhibitors -> only against influenza A -> not used as 1st line
Examples of anti-viral drugs used in Mx of complicated influenza
zanamivir, oseltamivir, peramivir
Example of M2 drugs used in Mx of complicated influenza
amantadine and rimantadine
SEs (2) of oseltamivir
Oseltamivir - for complicated influenza
- oseltamivir - well tolerated in adults but
vomting in children
- Potential to influence behaviour - higher risk
to self - injury/harm in children taking
oseltamivir
Another name of Croup
Laryngo-tracheo-bronchitis
Age group mostly affected by Croup
- usually in 6 months - 5 years old
- coccus mostly in autumn
Symptoms of Croup
- ‘barking’ cough, stridor and a hoarse voice
- increased work for breathing and noisy airflow (stridor)
- Other symptoms: fever, runny nose
*often start or worse at night
Croup causative organisms
Parainfluenza and influenza
Investigations in Croup
- usually on basis of signs and symptoms
- after more severe causes e.g. epiglottitis or airway foreign bodies have been ruled out
- Further investigations (blood tests, X rays and cultures) usually not needed
(2) serious differential diagnosis in Croup
- epiglottitis
- foreign body
What’s that?

In Croup
- Although rarely performed, characteristic sign -> Steeple sign on X ray due to narrowing of the trachea
(Steeple sign is suggestive of diagnosis but not present in 50% of patients)
Prevention of Croup (2)
Many causes of croup are prevented with vaccinations -> influenza and diphtheria
Treatment of Croup
- single dose of oral steroid (dexamethasone, budesonide)
- in severe cases: inhaled epinephrine
- if O2 sats under 92% -> oxygen treatment given (‘blow-by’ administration, holding oxygen source near to child’s face is recommended over mask - as causes less agitation, and agitation may increase RR -> more work for breathing)
prognosis of croup
Prognosis: self-limiting disease, half of cases resolving in a day, 80% will resolve in two
days time
What anatomical structures are affected in bronchopneumonia?
alveoli and bronchi
Causes of bronchopneumonia
as in pneumonia:
- Streptococcus Pneumonia
- Haemophilus Influenzae (type B)
- viral and fungal lung infection
Complications of bronchopneumonia
- sepsis
- pleuritis
- empyema
- lung abscess
- respiratory failure
Typical X-ray findings of bronchopneumonia
