Management of URTIs PDF

MANAGEMENT OF URTIs By Dr. Okidi Oscar P’Okello SINUSITIS  SINUSITIS Inflammation of air sinuses of the skull Causes Allergy Foreign body in the nose Viruses, e.g. rhinovirus, often as a complication of URTI Dental focal infection Bacteria, e.g., Strepto...

MANAGEMENT OF URTIs By Dr. Okidi Oscar P’Okello SINUSITIS  SINUSITIS Inflammation of air sinuses of the skull Causes Allergy Foreign body in the nose Viruses, e.g. rhinovirus, often as a complication of URTI Dental focal infection Bacteria, e.g., Streptococcus pneumonae, Haemophilus influenzae, Streptococcus pyogenes  SINUSITIS Clinical features Rare in patients 1 week, unilateral facial pain, worsening of symptoms after an initial improvement) Amoxicillin 500 mg every 8 hours for 7-10 days Child: 15 mg/kg per dose  MANAGEMENT OF SINUSITIS If there is a dental focus of infection Extract the tooth Give antibiotics e.g. Amoxicillin plus Metronidazole If there is a foreign body in the nose Refer to hospital for removal  MANAGEMENT OF SINUSITIS Notes: Do NOT use antibiotics except if there are clear features of bacterial sinusitis, e.g., Persistent (> 1 week) purulent nasal discharge, Sinus tenderness, Facial or periorbital swelling, Persistent fever OTITIS MEDIA (SUPPURATIVE)  Otitis Media (Suppurative) An acute or chronic infection of the middle ear occurring mostly in children 6 weeks in spite of the above: Refer to ENT specialist PHARYNGITIS (SORE THROAT) Pharyngitis (Sore Throat) Inflammation of the throat Causes: Most cases are viral Bacterial: commonly Group A haemolytic Streptococci, diphtheria in non-immunized children Gonorrhoea (usually from oral sex) May also follow ingestion of undiluted spirits Candida albicans in the immunosuppressed  Pharyngitis (Sore Throat) Clinical features Abrupt onset Throat pain Pain on swallowing Mild fever, loss of appetite, general malaise In children: nausea, vomiting, and diarrhoea The presence of runny nose, hoarseness, cough, conjunctivitis, viral rash, diarrhea suggests viral infection The presence of tonsilar exudates, tender neck glands, high fever, and absence of cough suggest a bacterial pharyngotonsillitis Pharyngitis (Sore Throat) Differential diagnosis Tonsillitis, epiglottitis, laryngitis Otitis media if there is referred pain Investigations Throat examination with torch and tongue depressor Throat swab for microscopy, C&S Blood: Full blood count Serological test for haemolytic streptococci (ASOT)  Management of Pharyngitis (Sore Throat) Supportive care Most cases are viral and do not require antibiotics Keep the patient warm Give plenty of (warm) oral fluids e.g., tea Give analgesics, e.g. Paracetamol for 3 days Review the patient for progress  Management of Pharyngitis (Sore Throat) Notes: If not properly treated, streptococcal pharyngitis may lead to acute rheumatic fever and retropharyngeal or peritonsillar abscess –– Therefore ensure that the full 10- day courses of antibiotics are completed where applicable END