22. Upper respiratory tract infections Flashcards Preview

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Flashcards in 22. Upper respiratory tract infections Deck (16):

Describe the upper respiratory tract

This includes the nose, paranasal sinuses, middle ear, nasopharynx, oropharynx, laryngopharynx, tonsils and adenoids

All of this is colonised by a variety of flora


What are some common infections of the upper respiratory tract?

Pharyngitis i.e. core throat
Otitis media (middle ear infection)

These are mainly caused by viruses


Give the name of some viral pathogens

Parainfluenza virus
Respiratory syncytial virus


Describe 'colds' as URTIs

These are caused by numerous strains of rhinoviruses
Often preceded by a sore throat, sometimes accompanied by a fever and often followed by an opportunistic bacterial infection

Can lead to otitis media (middle ear infection) in children and sinusitis in adults


Briefly describe rhinoviruses and how they can present clinically

Over 100 serotypes
Responsible for 50% of common colds

Incubation period is short - 1 to 3 days followed by headache, sore throat, blocked nose
Watery discharge from the nose
Infection resolves in about a week


Following a cold, is the patient then immune to the rhinovirus?

Following a rhinovirus cold, there is a short period of immunity to all colds

There is also prolonged immunity to the specific serotype causing the recent infection


What is pharyngitis?

This is an inflammation of the pharynx - generally due to a group A strep infection

Commonly known as a sore throat


What are the clinical features of pharyngitis?

Incubation period of 2-3 days
Sore throat, fever, feel ill,
Tender cervical nodes
Can lead to quincy
May occasionally lead to scarlet fever


What is quincy?

Inflammation of the throat
May be an abscess in the region of the tonsils


How can pharyngitis be diagnosed and treated?

Send throat swab for bacterial culture

Treated with antibiotics


What is otitis media and how is it treated?

Middle ear infection due to viruses e.g. stretpcoccus phyogenes, streptococcus pneumoniae, haemophilus influenza

Generally occurs in children and is much less common in adults

Treated with antibiotics


What is sinusitis and how is it treated?

Inflammation of a nasal sinus

Can be due to viral infection such as those causing otitis media or due to bacterial infection e.g. streptococcus pneumomniae

Treatment is not always necessary in this instance -dependant on the patient


What is epiglottitis and how is it treated??

This is an inflammation of the epiglottis (prevents food from entering the trachea) - almost always bacteraemic

Can lead to rapid onset of respiratory obstruction - a CT scan/lateral x-ray can show swelling of the soft tissues in the neck

This is a medical emergency - tracheostomy, antibiotics, prophylaxis


What is the 'Epstein Barr Virus'?

EBV - causes glandular fever
Causes a systemic disease but this usually presents as a sore throat

Can present as pharyngeal and tonsillar swelling and also often get enlargement of the spleen and the liver


What is 'Respiratory syncytial virus'?

RSV - single major pathogen in respiratory conditions in childhood

Causes a localised infection of the respiratory tract - infants have no maternal passive protection


Give the mechanism of a viral infection

Viruses are intracellular parasites

Binds to the surface of the cell and enters the cell cytoplasm
Then release the viral genome into the cell for replication
Viral proteins are then produced and progeny virus particles are formed and released
These go on to infect further host cells