HI EVERYONE hopes you all are well. today's topic is a very common problem of everyone that is cold, so here I m presenting you a blog about upper respiratory tract infection in simple and short form hope you will get benefits from this blog and please share and comments your opinion.
UPPER RESPIRATORY TRACT INFECTION
Upper respiratory tract infection is the most common infection
in OPD and most common transmission of URTI is through inhalation and direct
contact.
The virus is the commonest etiology of URTI but bacterial infection also causes URTI.
There are Four (4) type of Upper respiratory tract
infection.
1) COMMON COLD & INFLUENZA
Common cold and influenza caused by a virus
and it's most common in URTI. Influenza means a severe form of the common cold
caused by the influenza virus. There is a new virus which is taken in the form of
pandemic (swine flu).
The virus that is causing common cold infection.
1) Influenza virus
2) Picornaviruses
3) Respiratory syncytial virus
4) Parainfluenza virus
5) Adenovirus
Clinical feature: - Sing and symptoms
- Sneezing, rhinorrhoea, nasal congestion
- Sore throat
- Non-productive cough
- Headache and pain in the eye
- Fever
- Conjunctivitis, laryngitis
- Skin rash
- Postnasal discharge
- Erythema around nose
- Pharynx congested
- Tonsillitis
- Lymph node enlarges and tender
Diagnosis
- Nasal pharyngeal swab
- Throat swab
- Real-time polymerase chain reaction
- Culture test
Management
The common cold is usually treated by symptomatic and supportive
treatment
Bed rest and adequate fluid
- Anti-cholinergic spray (ipratropium)
- Nasal decongested (xylometazoline)
- Saline nasal drop
- In the case of influenza
- The household spread of disease should be controlled
- Isolation of pt. in well ventilated isolation room
- Anti-viral drug e.g. Oseltamivir should start to treat and prevent severe illness
- Anti-viral prophylaxis should be provided to a health care professional
- Supportive therapy
- Intravenous fluid
- Parenteral nutrition
- Oxygen therapy
- Ventilator support ( if need)
- Anti-biotic for secondary infection
- Vasopressor for shock
- Aspirin and salicylate medication is contraindicated in influenza(Reyes syndrome)
- Pt. should monitor for secondary bacterial infection
2)RHINITIS
Rhinitis
is defined as inflammation of the membranous lining of the nose.
There are two types of rhinitis
- Allergic rhinitis
- Non allergic rhinitis
1) Allergic rhinitis is occurring when contact allergen and due
to contact of allergen there will be an inflammation of the membranous lining of the nose. Inflammation is due to immunoglobulin E mediate.
After exposed to allergen pt. has symptoms of sneezing,
itching, clear rhinorrhoea, nasal congestion, obstruction appears after 4 to 6
hour of exposure.
The main cause of acute infectious rhinitis is a virus. If acute
infectious rhinitis is not treated then there will be an increasing chance of
secondary bacterial infection in which pt. have mucopurulent nasal discharge,
facial pain and fever may present.
2)Nonallergic rhinitis is inflammation of the inner part of the nose
that is not caused by an allergen and without infection
Sing and symptoms are as follow
- Nasal obstruction
- Rhinorrhoea
- Exacerbated by certain alcohol, spicy food and emotion.
- Environmental factor such as temperature, barometric pressure, bright light can aggravate
MANAGEMENT
- Anti-histamine for itching and sneezing (cetirizine/fexofenadine)
- Corticosteroids
- WHO recommended using a combination of anti-histamine and anti-leukotriene
- Topical corticosteroids (such as budesonide, mometasone and beclomethasone provide relief to pt.
- Rhinorrhoea relieving drug may cause sedation due to systemic absorption.
3)Pharyngitis
Pharyngitis is inflammation of the pharynx, hypopharynx, uvula, and tonsil due to virology. Pharyngitis caused by a group of Alfa-beta hemolytic
streptococci. Most common in children (4 to 6 years)
Clinical feature
- Throat discomfort
- Odynophagia
- Cough
- Fever, headache, malaise, and myalgia
- Tonsillopharyngeal erythema
- Foul smelling
- Swollen and tender cervical lymph node
- Conjunctivitis and maculopapular rash
Diagnosis: - Throat swab culture reviled the viral infection
or bacterial. Serological test also help.
MANAGEMENT
- Viral pharyngitis is self-limiting diseases which resolve spontaneously.
- Anti-viral may require in some case
- Symptomatic treatment
4)SINUSITIS
Sinusitis is defined as inflammation of Paranasal sinuses
CAUSES OF SINUSITIS
- Anatomic abnormalities of osteomas complex(e.g. deviated nasal septum, concha bullosa, and bone spurs)
- Allergic rhinitis
- Nasal polyps
- Nasotracheal, nasogastric intubation
- Tumour causing obstruction
- Dental surgery
- Recurrent URTI
- Cystic fibrosis
- Tobacco smoking
Clinical feature
- Symptoms of sinusitis are frequent and persistence even after the common cold subsides.
- Nasal congestion
- Headache fever
- Facial pain
- Headache is increasing when bending forward
- In chronic sinusitis pain and fever are rarely present
- Nasal obstruction, purulent nasal discharge, postnasal drip
- Chronic cough
Diagnosis of sinusitis
- Nasal Endoscopy
- Radiography of Paranasal sinus
- CT scan
Management of sinusitis
- Controlling of predisposing factor
- Symptomatic treatment
- Antibiotic
- Nasal decongestant(xylometazoline)
- Surgery is recommended for chronic sinusitis, recurrent sinusitis, large obstructive polyp, and tumor.
DR. AMIN BAYAD
BHMS
