Diseases Of The Upper Respiratory Tract PDF

DISEASES OF THE UPPER RESPIRATORY TRACT URTIs  Most common include:  Coryza Vast majority are caused  Pharyngitis by viruses. In adults are  Acute tracheobronchitis, usually short lived & rarely serious....

DISEASES OF THE UPPER RESPIRATORY TRACT URTIs  Most common include:  Coryza Vast majority are caused  Pharyngitis by viruses. In adults are  Acute tracheobronchitis, usually short lived & rarely serious.  The common cold (acute coryza)  This highly infectious illness causes a mild systemic upset and prominent nasal symptoms.  infection by a wide range of respiratory viruses. rhinoviruses  Other common cold viruses include coronaviruses and adenoviruses  Close person contact, droplets, overcrowding & poor ventilation  Clinical features  Tiredness & malaise  Pyrexia  Sore nose & pharynx  Sneexing  Watery nasal discharge – thick mucopurulent  Sinusitis  Sinusitis is an infection of the paranasal sinuses  Streptococcus pneumoniae and Haemophilus influenzae  associated with an upper  respiratory tract infection and can occur with asthma  Symptoms include frontal headache, purulent rhinorrhoea, facial pain with tenderness and fever. Treatment of Sinusitis  nasal decongestants  Xylometazoline  Antibiotics  Topical steroids , Nasal spray  Steam  Rhinitis  inflammation and swelling of the mucous membrane of the nose  Sneezing attacks, nasal discharge, nasal blockage occurring hours to days  usually caused by the common cold or a seasonal allergy Seasonal rhinitis  commonest allergic disorder  ‘hayfever’ more precisely seasonal (or intermittent) allergic rhinitis  Nasal irritation, sneezing and watery  rhinorrhea, itching of eyes, soft palate, ear  Seasonal allergens Perennial rhinitis  Throughout the whole year (perennial or persistent rhinitis).  Rarely symptoms that affect the eyes or throat - symptoms predominantly of sneezing and watery rhinorrhea & nasal blockage.  The patient may lose the sense of smell and taste.  Sinusitis occurs in about 50% of cases. Investigations and diagnosis  The allergic factors causing rhinitis can usually be identified from the history.  Skin prick testing  Allergen-specific IgE antibodies can be measured in blood  Treatment  Allergen avoidance  Removal of the source  Pollen avoidance? – sun glasses, mask, shut windows of car, avoid  walks.  Mite allergen exposure can be reduced by enclosing bedding in fabric specifically designed to prevent the passage of mite allergen. Treatment`  Antihistamines  Decongestants  effective against sneezing and  For nasal obstruction itching  Loratadine, desloratadine,cetirizine,  Orally but commonly in spray fexofenadine.  Xylometazoline and oxymetazoline Treatment  Corticosteroids  topical corticosteroid  before the beginning of seasonal symptoms  Steroids + antihistamines  Sprays Pharyngitis  adenoviruses – most commonly involved  Sore throat  oropharynx and soft palate are reddened and the tonsils are inflamed and swollen.  Within 1–2 days the tonsillar lymph nodes enlarge.  The disease is selflimiting and only requires symptomatic treatment without antibiotics. Pharyngitis  For time the proportion of sore throats due to bacterial infections, e.g. haemolytic streptococcus, has fallen. Laryngotracheobronchitis  occasional  Caused by parainfluenza viruses and measles  Most severe in children under the age of 3 years  Inflammatory oedema extends to the vocal cords and the epiglottis, causing narrowing of the airway.  tracheitis or tracheobronchitis  The voice becomes hoarse  barking cough  Stridor  Sever cases – central cyanosis  Nebulized adrenaline (epinephrine) gives shortterm relief.  Oral or i.m. corticosteroids (e.g. dexamethasone)  Oxygen & fluids Inhalation of foreign bodies  Children inhale foreign bodies  More often effects the bronchus?  In adults, inhalation may occur after  Wheez excess alcohol or under general anaesthesia.  Pneumonia  The person chokes  Lung abcess  Death  Management? Influenza  Viral pathology  The illness starts abruptly with a fever, shivering and generalized aching in the limbs  severe headache, soreness of the throat and a dry cough that can persist for several weeks.  Diarrhoea  Secondary bacterial infection is common following influenza virus infection, particularly with Strep. pneumoniae and H. influenzae. Diagnosis and treatment  antibody or the haemagglutinin antibody measured at onset and after 1–2 weeks  Treatment is by bed res  Paracetmaol  Antibiotics  Neuraminidase inhibitors  Laninamivir  Oseltamivir (Tamiflu)  Peramivir (Rapivab)  Zanamivir