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Micro - Bacterial Upper Respiratory Tract Infections
Terms in this set (29)
What is the difference btwn Otitis Externa and Otitis Media?
- is an infection of the external auditory canal, it is localized like a pustule or can be diffuse like swimmer's ear. it is a skin infection, NOT a respiratory infection
- is when fluid accumulates in the middle ear and is accompanied by signs and symptoms such as ear pain, ear drainage, fever, impaired hearing and redness of the tympanic membrane
What is the difference btwn the upper and lower respiratory tracts?
- upper is consider above the larynx
- lower is considered trachea and below
In what age group do most Otitis Media infections occur?
Infants ages 6mo-3yrs
Why is it that infants are more prone to infections of Otitis Media?
- lack of acquired immunity to respiratory tract bacterium and viruses; once a infant has lost the mothers immunity they are susceptible
What are the most common microbial agents to cause Otitis Media?
1. streptococcus pneumoniae
2. haemophilus influenzae
3. moraxell catarrhalis
4. viral ( RSV, influenza, adeno virus, rhino virus)
How is Otitis Media Dx?
- usually sans clinical cultures
- otoscopy - observe tympanic membrane
- audiometry; pt w fluid in middle ear has 25dB hearing loss
--> need aspiration of fluid (tympanocentesis should be done in seriously ill pts, pts w/recurrent infections or to those who are not responding to antibiotics)
How is Otitis Media usually managed?
management is not needed in 50% of cases but;
- Amoxicillin can help 1-2 days earlier recovery (used in recurrent cases)
- Antihistamines can help with congestion
- surgery in very serious situations
- involves the inflammatory condition of one or more paranasal sinuses (maxillary, ethmoid, frontal, sphenoid) due to viral/bacterial infections, allergies or common cold.
What are the typical symptoms ass/w sinusitis?
- nasal discharge
- nasal obstruction
- facial puffiness
What will X-ray show in the case of Sinusitis?
- CT is the preferred scan and will show fluid in sinuses and thickening of membranes in chronic cases
What is the pathogenesis of Sinusitis?
- nose blowing inc pressure, pushing fluids and infection into sinuses-->failure of cilia to move material to ostium-->occlusion of infundibulum (passage of nose way)
What is the microbial cause of most Sinusitis?
- usually rhino
How is Sinusitis usually Dx?
Diagnosis is usually made clinically
- cultures of nasal or throat swabs are useless!
- culture of need aspiration are taken rarely with the exception of immunocompromised pts or in complicated cases
How is Sinusitis usually treated?
- no antibiotic usually; amoxicillin-clavulanate if bacterial cause is suspected
- usually decongestants and antihistamines help some symptoms
- Pharyngitis is usually diagnosed clinically due to sore throat, odynophagia, tonsillar enlargement( beefy red and white exudates), anterior cervical lymphadenopathy, fever, chills and headache
What is the most common cause of Pharyngitis?
2. gonococcal infection (in pts who partake in oral sex)
3. respiratory viruses
4. infectious mono
What are the microbiological characteristics of of Group A Strep?
- gram pos cocci in chains
- facultative anarobe
- Bacitracin susceptible
What are the Virulence factors of Pharyngitis?
1. M protein - anti-phagocytic, evokes immune response that causes acute rheumatic fever and acute glomerulonephritis
2. capsule of hyaluronic acid
3. streptolysin O & S: damage cells
4. Streptokinase: lyse clots
5. hyaluronidase: spreading factor
6. Lipoteichoic acid: adhesion
How is group A strep usually spread?
- respiratory droplets from nasal secretions and saliva
How is GAS Pharyngitis usually Dx?
- RADT - rapid antigen diagnostic test
- throat culture
What is the worst case scenario for a GAS Pharyngitis infection?
GAS pharyngitis can result in ARF resulting in Carditis, polyarthritis, chorea, subcutaneous nodules and erythema marginatum.
Is Penicillin a good treatment for GAS Strep?
NO! Penicillin is only going to cause a small decrease in pharyngitis symptoms but may/will clear infections of which several are need in order to cause ARF
What is a good measure of GAS organisms when checking for clearance?
What are the microbiological char of Cornybacterium Dipththeriae?
- gram pos rod
- non-spore forming
How is Diphtheriae spread ?
- spread by airborne respiratory droplets
What is the pathogenesis of Diphtheriae?
- organism enters-->colonizes-->grows in pharynx(incubation time:2-4d)-->organism produce exotoxin which enters epithelial cells where it kills cell by stopping organisms by stopping protein synthesis by inhibiting tRNA translocase(EF2) --> toxin can be absorbed from pharynx to reach heart where it causes myocarditis or reaches peripheral nerves where it causes motor and sensory neuropathies
What are the Symptoms of Diphtheriae infections?
- sore throat
- cervical lymphadenopathy
- low grade fever
What does someone with Diphtheriae die from?
- death by asphyxia due to leathery pseudomembrane covering the trachea, larynx, and tongue (due the exotoxin)
What are the possible Vaccines for Diphtheria?
Inactivates diphtheria toxin = toxoid
- always combined with other antigens
1. DTaP: for infants
2. Td: for adults every 10yrs
3. DT: for children with contraindications for pertussis vaccine
THIS SET IS OFTEN IN FOLDERS WITH...
Micro - Influenza
Pharm: - Anti-viral therapies
Micro - Typical Pneumonia
Path - disease of head and neck 1&2
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