Respiratory Tract Infections

Upper and Lower Respiratory Tract Infections

• Recognize symptoms of upper and lower respiratory system
• The most common cause of upper and lower respiratory tract infections
• Discuss epidemiology and risk factors of upper and lower respiratory tract infection
• Outline the management plan of upper and lower respiratory tract infection
• Discuss preventive strategies for upper and lower respiratory tract infection

Risk Factors for URTI

• Close contact with children
• Medical disorders: asthma and allergic rhinitis
• Smoking
• Immunocompromised individuals: DM, prolonged use of corticosteroids, transplantation, and post-splenectomy
• Anatomical anomalies: deviated nasal septum

Symptoms of Upper Respiratory Tract Infections (URTI)

• Cough
• Sore throat
• Running nose
• Nasal congestion
• Headache and facial pain
• Low-grade fever
• Facial pressure
• Sneezing
• Lethargy

Is it Cold or Flu?

• Rhinitis and common cold: rhinoviruses, gradual onset, rare fever, slight aches, uncommon chill, sometimes fatigue and weakness, common sneezing, mild to moderate chest discomfort, common stuffy nose, common sore throat, rare headache
• Influenza (Flu): influenza, abrupt onset, usual fever, usual aches, common chill, usual fatigue and weakness, sometimes sneezing, common chest discomfort, sometimes stuffy nose, sometimes sore throat, common headache

Treatment of URTI

• Symptomatic treatment
• Influenza vaccine
• Good health habits

Lower Respiratory Tract Infections

• Bronchitis
• Pneumonia

Acute Bronchitis

• Inflammation of bronchus, which occurs either as an extension of upper respiratory tract infection or may be caused directly by bacterial agents
• Causative organisms: Streptococcal pneumonia, B. pertussis, Mycoplasma pneumoniae, and Chlamydophila pneumoniae (bacterial), Influenza viruses, Adenoviruses, Rhinoviruses, and Coronaviruses (viral)

Clinical Picture of Acute Bronchitis

• Symptoms: cough, fever, retrosternal burning chest pain, wheeze, and dyspnea
• Signs: wheeze and coarse crackles

Treatment of Acute Bronchitis

• Symptomatic: cough syrup, antipyretic, antibiotics (amoxicillin or a macrolid antibiotic)
• If cough lasts longer than 2 weeks, a chest radiograph should be done

Community Acquired Pneumonia (CAP)

• Definition: an inflammatory condition of the lung affecting primarily the alveoli
• Etiology: bacterial (Streptococcus pneumoniae, Staph aureus), viral (Influenza, Parainfluenza virus, Respiratory syncytial virus, and Coronavirus), and atypical pneumonia (Legionella pneumophila, Mycoplasma pneumonia, Chlamydia, and Coxiella burnetii)

Diagnosis of CAP

• Clinical Features: fever, chills, cough, sputum production, dyspnea, pleuritic pain, tachypnea, tachycardia, hypoxemia, decreased breath sounds, bronchial breath sounds, crackles on auscultation, dullness to percussion, and egophony
• Chest Radiography: confirms the clinical diagnosis, shows classical lobar infiltrate, and sputum Gram stain shows S. pneumoniae