Flashcards in respiratory infections ACUTE RHINOSINUSITIS Deck (17)
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1
what is an acute inflammation of the mucosal lining of the nasal passage and paranasal sinuses
acute rhinosinusitis
2
how long can acute rhinosinusitis last
up to 4 weeks
3
what normally causes acute rhinosinusitis
virus
(antibiotics are often prescribed unnecessarily)
4
what can cause acute rhinosinusitis
1. allergens
2. environmental irritants
3. infection (viral 90-98% of time)
5
what bugs can cause acute bacterial rhinosinusitis (five total)
1. S. pneumonia
2. H influenza
3. S. Pyrogenes
4. S. aureus
5. M. catarrhalis
6
what bugs can cause acute bacterial rhinosinusitis but be prevented with vaccinations
1. S. pneumonia
2. H influenza
7
what are the 3 pathophysiological steps of ABRS
1. starts as a viral infection
2. inflammation causes obstruction
3. mucosal secretions become trapped and infection proliferates
8
what is the greatest barrier to efficient use of antibiotics in ABRS?
lack of simple diagnostic test
9
what is the gold standard for ABRS diagnosis
sinus puncture (very costly invasive and painful)
10
what are the 3 clinical presentations of ABRS
1. onset with persistant symptoms for longer than 10 days
2. onset with severe symptoms w/ fever of 102 or greater
3. facial pain lasting 3 or 4 consecutive days
4. "double sickening"- symptoms get better for a bit then much worse
11
what are the risk factors for antibiotic resistance for treating ABRS (five of them)
1. age less than 2 or older than 65
2. prior antibiotics that month
3. prior hospitalization in past 5 days
4. comorbidities (diabetes...)
5. immunocompromised
12
what is the first line therapy for ABRS
amoxicillin clavulanate
13
if someone has risk factors for antibiotic resistance, what should be used for ABRS
amoxicillin clavulanate
or
doxycycline
14
If a patient has a B-lactam allergy, what should be used to treat ABRS
doxycycline
levofloxacin
moxifloxacin
15
why is ciprofloxacin not used for ABRS
decreased spectrum against strep., a common bug in ABRS
16
if someone has a severe ABRS infection requiring hospitalization, what treatment should be used
levofloxacin PO or IV
moxifloxacin PO or IV
ceftriaxone IV
cefotaxime IV
17
