what are the six URI syndromes
cold URI Bronchitis Otitis Sinusitis Pharyngitis Epiglotitits
Etiologies of URIs
all are viruses thus there is zero role for antibiotics -rhinovirus -enterovirus (Coxsackie virus A) -RSV Coronavirus
characteristics of URIs
viral
lasts 7-10 days (3 days coming, 3 days going, 3 days leaving)
pharyngitis prevalence
sore throat
70% viral in kids 90% in adults
bacterial causes of pharyngitis
Group A strep, diphtheria, pertussis
Characteristics of Group A pharyngitis
sudden onset fever headache n/v/d pharyngeal inflammation discrete exudate tender cervical nodes ages 5-15 winter to spring exposure NOT a cough congestion conjunctivitis
Otitis prevalence
84% of kids 1 episode, 50% more than 4
50% viral
bacteria causes of otitis
pneumonia, H. flu, moraxella
otitis is common following what?
a URI
do you usually have a fever with otitis?
60% no
do antibiotics have value in otitis?
not really
Sinusitis
more common in adults
follows URIs
Most viral, but same bacteria as otitis
sinusitis symptoms
facial pain headache maxillary teeth pain opacity by transillumination x-rays not specific
epiglotitis
NOT A COLD medical emergency\
caused by Haemophilis influenzae
symptoms of epiglotitis
dysphagia(difficulty swallowing) , drooling stridor(can’t take a breath in)
what do you need to do diagnose?
lateral neck x-ray and protect airway
how to diagnose URIs
throat culture or rapid test
treatment of URIs
treat group A Treat epiglottitis Don't treat others unless: complicated course immunosuppressed
what there any difference in augmentin vs placebo in sinusitis and otitis?
nope
with bronchitis was there any difference in taking an antibiotic on the outcome?
no it was the same as no antibiotic
