Respiratory Tract Infections
Terms in this set (17)
Rhinitis - Causes, Pathogenesis, Transmission, Seasonality, Symptoms
CAUSES: Rhinovirus (1/3), PIV, RSV (children), Coronavirus (also Adenovirus & Influenza)
PATHOGENESIS: Infection of ciliated cells but little damage
TRANSMISSION: Aerosols, hand-to-nose contact
SEASONALITY: Late Summer - Early Spring
SYMPTOMS: Self-limiting rhinorrhea; peaks at 3-4 days & persists 1-2 weeks
Pharyngitis - Etiology, Seasonality, Symptoms
ETIOLOGY: viral, bacterial (Strep), unknown
SEASONALITY: Cold months
SYMPTOMS: Sore throat, fever, HA, chills, exudate, lymphadenopathy
-Step that produces pyrogenic toxin may give scarlet fever rash/desquamation
NOTE: No way to tell from Hx/PE if bacterial or viral!! Also, must be careful culturing sputum since Strep colonizes lots of people & may not be cause of infection.
Laryngitis - Etiology, Symptoms, Diagnosis, Treatment
ETIOLOGY: Viral, Mycoplasma, Chlamydia, Strep (These can also cause Pharyngitis)
SYMPTOMS: Hoarseness, dry cough
DIAGNOSIS: Hx, larynx exam, Gram strain/culture
TREATMENT: Pain relief, resting voice
-Usually viral, so abx usually useless
Acute Infectious Bronchitis - Symptoms
SYMPTOMS: Fever, chills, Severe cough (predominant complaint, can last > 1 month)
What's a good way to see how sick someone is?
Loss of appetite. If you still have an appetite, probs not super sick. When really sick, IL-1 production makes you not wanna eat. Can also use to monitor progression.
Influenza - Epidemics/Pandemics
Influenza - Symptoms, Complications, Viral Titer
SYMPTOMS: Rhinorrhea, FEVER, COUGH, malaise
COMPLICATIONS: 2° bacterial pneumonia (S. pneumo or S. aureus)
Viral titer peaks early & before symptoms are present.
Viral Pneumonia Radiograph
Bilateral Interstitial Infiltrate
Lots of viruses give this picture- cannot diagnose from radiograph alone! Can only suggest ddx.
Influenza Treatment & Prevention
Zanamivir, Oseltamivir: NA Inhibitors given < 48 hours from onset. Make disease less severe & 1 day shorter.
-Also used for prevention
VACCINE: A+B, formulated annually. Vaccinate > age 50, 6 mo - 2 years, chronically ill, health care workers
Pneumococcal Pneumonia - Prevalence, Etiology, Route of Infection, Symptoms, Risk Factor, Diagnosis, Treatment
PREVALENCE: Most common
cause of pneumonia
ETIOLOGY: S. pneumoniae (5-10% are natural carriers)
ROUTE OF INFECTION: Aspiration
of rigors, chills, chest pain, cough followed by (rusty) sputum
-Also, most common cause of otitis media in small children.
RISK: Paralyzed ciliary epithelium (caused by Influenza)
DIAGNOSIS: Gram-Positive, Lancet-shaped Diplococci
TREATMENT: Penicillin, Cephalosporin
Conjugate Vaccine for children < age 2
Polysaccharide Vaccine for older children & adults
23 Valent Conjugate Vaccine recommended for all infants, elderly, & all w/chronic pulmonary disease or splenectomy
-Since it's encapsulated, those w/splenectomy can die quickly if get infected
Pneumococcal Pneumonia Radiograph
75% only have ONE lobe involved
Klebsiella Pneumonia - Classical Characteristic & Patient
"Currant-Jelly" Sputum in Alcoholics & Hospitalized Patients
S. aureus Pneumonia - Diagnosis, Risk Groups
Gram-Positive cocci in clusters
Risk Groups: Patients w/Influenza, drug users
S. aureus - Characteristic of Pneumonia
Tends to form abscesses in lungs
Atypical Pneumonia (Mycoplasma) - Symptoms/Presentation, Diagnosis, Treatment, Similar Syndrome Cause
"Walking pneumonia" causing bronchitis, HA, dry cough, sore throat.
Not very severe - radiograph looks much worse than patient.
Cold Agglutinin Test
(Positive 33%), Serology, Culture
TREATMENT: Azithromycin or Tetracycline
SIMILAR SYNDROME caused by Chlamydia
Aspiration Pneumonia - PE, Risk Groups, Risk Factors, Gram Stain
PE: Inspect dentition!! (Odor, teeth condition, abscesses, etc)
RISK GROUPS: Drug users, alcoholics, etc.
RISK FACTORS: mental status changes or decreased ability to cough; sedation, anesthesias, stroke, etc.
GRAM STAIN: Gram-Positive Anaerobes mainly, Gram-Negatives
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