Upper Respiratory Tract Infections. Dr. Meenakshi Aggarwal MD Emory Family Medicine. Definition. Inflammation of the respiratory mucosa from the nose to the lower respiratory tree, not including the alveoli. Objectives. List the various categories of upper respiratory tract infections
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Dr. Meenakshi Aggarwal MD
Emory Family Medicine
Inflammation of the respiratory mucosa from the nose to the lower respiratory tree, not including the alveoli.
Common Symptoms: Nasal discharge, nasal congestion, facial pressure, cough, fever, muscle aches, joint pains, sore throat with hoarseness.
Symptoms resolve in 10-14 days
Common in fall, winter and spring.
Nontypeable Haemophilus Influenzae
Feeling of fullness and pressure over the involved sinuses, nasal congestion and purulent nasal discharge.
Other associated symptoms: Sore throat, malaise, low grade fever, headache, toothache, cough > 1 week duration.
Symptoms may last for more than 10-14 days.
Based on clinical signs and symptoms
Physical Exam: Palpate over the sinuses, look for structural abnormalities like DNS.
X-ray sinuses: not usually needed but may show cloudiness and air fluid levels
Limited coronal CT are more sensitive to inflammatory changes and bone destruction
Coronal computed tomographic scan showing ethmoidal polyps. Ethmoid opacity is total as a result of nasal polyps, with a secondary fluid level in the left maxillary antrum.
a) Amoxicillin (500mg TID) OR
b) TMP/SMX ( one DS for 10 days).
c) Alternative antibiotics: High dose amoxi/clavunate, Flouroquinolones, macrolides
Fewer than 25% of patients with sore throat have true pharyngitis.
Primarily seen in 5-18 years old. Common in adult women.
A) Viral: Most common.
Rhinovirus (most common).
Symptoms usually last for 3-5 days.
B) Bacterial: Group A beta hemolytic streptococcus (GABHS).
Early detection can prevent complications like acute rheumatic fever and post streptococcal GN.
Throat Cultures: Not required usually. Needed only when suspicion is high and rapid strep is negative.
A) Symptomatic: Saline gargles,
analgesics, cool-mist humidification and
a) Benzathine Pn-G 1.2 million units
IM x 1OR Pn V orally for 10 days
b) For Pn allergic pts:
Erythromycin 500mg QID x 10 days
OR Azithro 500 mg Qdaily x 3 days.
Inflammation of the bronchial respiratory mucosa leading to productive cough.
B) Bacterial (Bordetella pertussis, Mycoplasma pneumoniae, and Chlamydia pneumoniae)
If cough persists for more than 10 days:
Azithro x 5 days OR
Clarithro x 7 days
Treatment: Adequate fluid intake, rest, humidified air, and over-the-counter analgesics and antipyretics.
Etiology: Influenza A & B
Symptoms: Fever, myalgias, headache, rhinitis, malaise, nonproductive cough, sore throat
Diagnosis: Influenza A &B antigen testing
Treatment: Supportive care, oseltamivir, amantidine