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Definition

UNIT III: Upper Respiratory Tract Infections Mrs.Indumathi Lecturer YNC. Definition. Inflammation of the respiratory mucosa from the nose to the lower respiratory tree(nose, sinus, pharynx, larynx ). Rhinitis.

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Definition

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  1. UNIT III: Upper Respiratory Tract InfectionsMrs.Indumathi Lecturer YNC

  2. Definition Inflammation of the respiratory mucosa from the nose to the lower respiratory tree(nose, sinus, pharynx, larynx)

  3. Rhinitis • Inflammation and irritation of mucus membrane of the nose • Types • Acute, Chronic: • Allergic, non allergic:

  4. Allergic rhinitis

  5. causes • Virus, bacteria • Irritants, allergens • Environmental: temp change, humidity • Foods(banana, watermelon) • OTC Drugs • Foreign body • Common cold

  6. Pathophysiology • Causes • Inflammation and congestion of mucus membrane of nose • Become edematous • Swollen nasal conchae block sinus opening • Mucus discharge

  7. Clinical manifestations • Rhinorrhea • Nasal congestion • Nasal discharge • Sneezing • Pruritus of nose, roof of nose, throat, eyes, ears

  8. Medical management • Desensitizing immunization • Corticosteroids • Antimicrobial agents • Repair nasal septal defect,nasal polyp • Antihistamines: cetrizine, chlorpheniramine • Nasal spray

  9. Inhalation of intranasal ipratropium in each nostrils 2-3 times/ day

  10. Viral rhinitis

  11. Definition • Afebrile infectious acute inflammation of the mucus membrane of nasal cavity • Causes: • Causative agent- influenza • Others rhinovirus, coronavirus

  12. Clinical manifestations • Nasal congestion • Rhinorrhea • Nasal discharge • Snezzing • Tearing watery eyes • Sore throat • Low grade fever , chills • cough

  13. Management • Adequate fluid intake • Rest • Expectorants • Warm salt water gurgle • NSAIDS- aspirin, • Antihistamines • Topical decongestants • Antimicrobial agents

  14. SINUSITIS

  15. SINUSES

  16. Introduction • Sinuses are mucus lined cavities filled with air, drain, into nose • They are frontal, ethmoid, maxillary sphenoid • Inflammation of sinuses called sinusitis

  17. causes • Deviated nasal septum • Polyp • Tumor • Sinus infection • Swimming • Tooth infection • Trauma to nose • Bacteria- streptococcus pnemonia, hemophillus influenza

  18. Types • Acute: rapid onset of infection in one or more of the paranasal sinuses that resolves with treatment • Sub acute: persisttant purulant nasal discharge dispite of therapy symptoms lasting less than 3 months • Chronic: episodes of prolonged inflammation

  19. Pathophysiology • Causes • Inflammation, congestion with thickened mucus secretions filling sinus cavities • Occluding the opening • Provide excellent medium for bacterial growth

  20. Clinical manifestations

  21. Diagnosis • History P/E • Tenderness on palpation • Sinus Xray • CT • endoscopic culture technique

  22. complications • Meningitis • Brain abscess • Ischemic brain infarction • Osteomylitis • Orbital cellulitis

  23. Management • Antibiotic therapy amoxicillin, ampicillin Nasal decongestants Nasal saline spray Saline irrigation for opening blocked passage

  24. Saline irrigation

  25. Surgical • Endoscopic surgery to correct structural deformities • Excising and cauterizing nasal polyp • Correcting deviated septum • Incising deviating sinuses • Tumor removal • Antimicrobial agents before and after the surgery

  26. Pharyngitis

  27. Inflammation of the pharynx • Occurs in younger than 25 years of age • Primary symptom is sore throat

  28. causes • Viral infection: adenovirus, influenza • Bacterial infection: group A hemolytic streptococci

  29. Pathophysiology • Causes • Inflammatory response in pharynx • Results in pain, fever, vasodilation, edema, tissue damage • Manifestaed by redness , swelling in the tonsillar pillars, soft palate • Creamy exudate in the tonsils

  30. Signs and Symptoms red pharyngeal membrane and tonsils Absence of Cough Fever anorexia Sore throat Malaise Rhinorrhoea High fever, tonsillar exudates Tender cervical lymphnodes

  31. Diagnosis • Physical Exam: Tonsillar exudates • Rapid strep: Throat swab. • Blood culture .

  32. Management A) Symptomatic: Saline gargles, analgesics, cool-mist humidification B) Antibiotics: a) Benzathine Pencillin-G 1.2 million units IM /orally for 10 days b) For Pencillin allergic pts: Erythromycin 500mg QID x 10 days OR Azithro 500 mg daily x 3 days.

  33. Tonsillitis and adenoiditis • Acute infection of tonsils • Cause: gp A beta hemolytic streptococci

  34. Causes • Sore throat, fever, snoring, difficulty swallowing • Enlarged adenoids causes mouth breathing, ear ache, draining ears, frequent headaches, foul smelling breath, noisy respiration • Infection spreads to middle ear, mastoid cell

  35. Diagnosis • History and physical examination • Culture, Audiometric examination Medical managemnt: • Increased fluid intake • Analgesics • Salt water gurgle • Rest • Penicillin for 7-10 days / alternative erothromycin • Tonsillectomy , adenoidectomy

  36. Peritonsillar abscess

  37. Collection of purulant exudate between tonsillar capsule and surrounding tissues including soft palate • Causes: • after acute tonsillar infection • Beta heamolytic streptococci

  38. Diagnosis • Intra oral ultrasound • Culture • CT

  39. Management • Corticosteroids • Per mucosal aspiration with fine needle • Incision and drainage • IV antibiotics • IV fluids • Gurgle • Tonsillectomy • Rarely require: intubation, cricothyroidectomy, tracheostomy

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