Upper Respiratory common Tract Infection.pptx

Upper Respiratory common Tract Infection.pptx

1. Upper Respiratory Tract Infections Diana Odhiambo

2. Definition Inflammation of the respiratory mucosa from the nose including the pharynx and larynx , not including the trachea, lungs alveoli.

3. Objectives List the various categories of upper respiratory tract infections Obtain a pertinent history in a patient with a uspected UR T I. erform a targeted and thorough physical examination to confirm diagnosis of UR T I. erform and interpret selected tests to diagnose R T I , Manage and treat uncomplicated UR T l's.

4. Anatomy of the respiratory system

5. Categories Acute Rhinosinusitis Acute Pharyngitis Acute Tonsillitis

6. Differential Diagnosis Influenza Pneumonia Tuberculosis Asthma

7. Anatomy of Sinuses lurbinale

8. Acute Rhinosinusitis (Viral) Common Symptoms: Nasal discharge, nasal congestion, facial pressure, cough, fever, muscle aches, joint pains, sore throat with hoarseness. Symptoms resolve in 10- 14 days Common in cold seasons . Treatment: Symptomatic

9. Acute Bacterial Sinusitis Causative agents are usually the normal inhabitants of the respiratory tract. Common agents: Streptococcus pneumoniae Haemophilus lnfluenzae Moraxella Catarrhalis

10. Feeling of fullness and pressure over the involved sinuses, nasal congestion and purulent nasal discharge. Other associated symptoms: Sore throat, malaise, low grade fever, headache, toothache, cough > 1 week duration. Symptoms may last for more than 10- 14 days.

11. Diagnosis Based on clinical signs and symptoms Physical Exam: Palpate over the sinuses, look for abnormalities , pain , tenderness X-ray sinuses: not usually needed but may show cloudiness and air fluid levels coronal CT are more sensitive to inflammatory changes and bone destruction

12. Treatment About 213 rd of patients will improve without treatment in 2 weeks. Antibiotics: Reserved for patients who have symptoms for more than 5 days or who experience worsening symptoms. OTC decongestant nasal sprays shouId be discouraged for use more than 5 days Supportive therapy: Humidification, analgesics, antihistaminics

13. Antibiotics Amoxicillin TMP/SMX ( DS ). Alternative antibiotics: High dose amoxi/clavunate, Flouroquinolones, macroIides

14. Acute Pharyngitis Epidemiology Fewer than 25 % of patients with sore throat have true pharyngitis. Common in 5-18 years old and adult women.

15. Etiology Viral: Most common. Rhinovirus (most common). Symptoms usually last for 3- 5 days. Bacterial: Group A beta hemolytic streptococcus (GABHS). Early detection can prevent complications like acute rheumatic fever and post streptococcal GN.

16. Signs and Symptoms Absence of Cough Fever Sore throat Malaise Rhinorrhoea Classic triad of GABHS: High fever , tonsillar exhudates and ant. cervical lymphadenopathy. NO COUGH

17. Diagnosis Physical Exam: Tonsillar exhudates, anterior cervical Rapid strep: Throat swab. Sensitivity of 80 % and specificity of 95 % . Throat Cultures: Not required usually . Needed only when suspicion is high and rapid strep is negative.

18. Management Symptomatic: Saline gargles, analgesics, humidification and throat lozenges. Antibiotics: Benzathine Pn- G OR P e n V orally for 10 days For P e n icillin allergic pts: Erythromycin 500mg QID x 10 days OR Azithro mycin 500 mg Q ID x 3 days.

19. Acute Tonsillitis Inflammation of the Tonsils ( masses of lymphoid tissue ) located in the pharyngeal cavity. Tonsillitis often occurs with Pharyngitis. Etiology • Viral or bacterial

20. Anatomical changes

21. Etiology: A)Viral B) Bacterial ( Streptococcus pyogenes , other Strep strains ) S / S: Difficulty swallowing , pain rarely fever .

22. Diagnosis Physical examination: To check for signs of infection of tonsils-swelling, exudates, erythema. Palpating the lymph nodes: Gently feeling the swelling in lymph nodes in the neck. Throat culture: Secretion sample from throat examined microscopically. Complete blood count (CBC): To assess the levels of blood cells and determine the cause of tonsillitis.

23. Treatment Antibiotics if bacterial Warm salt water gargles, analgesic and antipyretic drugs Tonsillectomy- Indicated for recurrent and orthopnea cases

24. Non specific UR T l's Common Cold Etiology: Rhinovirus Adenovirus RSV Parainfluenza Enteroviruses Diagnosis: Clinical Treatment: Adequate fluid intake, rest, humidified air, and over- the- counter analgesics and antipyretics.