Upper respiratory tract infection Flashcards
what causes upper respiratory tract infections?
Problems with swallowing - stroke, MND, tumour, surgery Altered lung physiology Colonisation of upper airway Immune dysfunction Viral illness: Rhinovirus Influenza Coronavirus Adenovirus Parainfluenza Respiratory syncytial virus - children, bronchiolitis
what is the aetiology of pharyngitis?
mainly viral (rhinovirus adenovirus), bacterial (strep pyogenes, can also cause associated diseases e.g. scarlet fever, rheumatic fever, post strep GN ect., lemierre’s disease = throat and chest infection same time caused by fusobacterium necrophorum)
what is the aetiology of diptheiae?
children, unvaccinated, grey pseudomembrane
what is the aetiology of sinusitus?
usually viral, bacterial = unilateral pain purulent discharge with or without fever more than 10 days or with complications such as brain abscess, sinus vein thrombosis or orbital cellulitis (strep pneumoniae, haemophilus influenzae)
what is the aetiology of acute epiglotitis?
children or immunocompromised adults, haemophilus influenzae type B, rare due to Hib vaccine
what is the aetiology of croup?
acute laryngo-treacheobronchitis, parainfluenza viruses, children
what are the first line investigations for viral diseases?
Green viral throat swab - multiplex PCR, tests for viruses
Point of care tests PoC - rapid PCR, results in 15 mins, less accurate
how is pharyngitis treated?
group A strep most likely - amoxicillin
how is diptheriae treated?
treat with erythromycin or clarithromycin but may also need anti toxin
how is acute epiglotitis treated?
haemophilus influenza most likely - doxyxyline or co-amoxiclav
what do antibiotics starting with ‘c’ carry the risk of?
c.diff infection
what is the commensal flora?
Sinuses - sterile
Nares - staph epidermidis and corynebacterium, but can be colonised by S aureus – in 20%
Teeth - strep, lactobacilli
Mucous membranes - strep and lactic acid bacteria
Pharynx - strep, gram neg rods and cocci, but can be colonised by S pneumoniae Kids»adults, Haemophilus influenzae, S pyogenes (Group A Strep), Neisseria spp
