URTIs Flashcards
Describe the common cold (acute coryza) aetiology?
Usually caused by rhinovirus infection
Spread by droplets and close personal contact
Incubation period= 12hours- 5 days
Symptoms of common cold?
Malaise
Slight pyrexia
Sore throat
watery nasal discharge- becomes mucopurulent after a few days
Differential diagnosis of common cold is from rhinitis. How is common cold treated?
Symptomatic
What is sinusitis?
Infection of paranasal sinuses
Is often accompanied by allergic rhinitis or an URTI due to mucosal oedema
Commonly caused by streptococcus pneumoniae or haemophillus influenzae
Symptoms of sinusitis? (diagnosis is clinical)
Frontal headache
Nasal discharge
Facial pain and tenderness
Treatment for sinusitis?
Broad spectrum antibiotics (co-amoxiclav)
Topical corticosteroids to reduce local mucosal swelling
fluticasone propionate nasal spray
What is rhinitis?
inflammation of the mucous membrane of the nose, caused by a virus infection (e.g. the common cold) or by an allergic reaction (e.g. hay fever).
Sneezing attacks, nasal blockage or nasal discharge occurring for over 1 our on most days
Seasonal rhinitis is also known as hay fever
What causes this?
How does it present?
Allergy to grass and tree pollen, and a variety of mould spores (e.g. Aspergillus fumigatus) which grow on cultivated plants
Nasal symptoms + itching of eyes and soft palate
Describe perennial rhinitis
May be allergic – allergens similar to those of asthma
Or non-allergic – triggered by cold air, smoke and perfume
Symptoms rarely affect eyes or soft palate
Nasal polyps may develop – nasal obstruction
Diagnosis of rhinitis?
Clinical
Skin-prick testing and RAST tests (measuring serum IgE antibody against the antigen) to identify causal agents
Management of rhinitis?
Avoid allergens
Antihistamines: cetirizine or loratidine tablets
Topical decongestant steroids (beclametasone spray)
How do anti-histamines work?
Antagonist of H1 receptor
prevents IgE binding causing release of histamine
What is acute pharyngitis aetiology?
Usually viral- adenoviruses
Bacterial causes are more severe
How does acute pharyngitis present?
Sore throat and fever – self-limiting, rarely require symptomatic treatment
More persistent and severe pharyngitis implies bacterial infection – haemolytic Strep, Haemophilus influenza, staphylococcus aureus. Requires treatment with penicillin
If a patient with bacterial acute pharyngitis is allergic to penicillin what can be used instead?
erythromycin
