This document provides an overview of upper respiratory tract infections, including their causes, symptoms, and treatment approaches. It discusses several specific infections that fall under this category, such as tonsillitis, pharyngitis, otitis media, sinusitis, rhinitis, and laryngitis. For each infection, the summary highlights common causative agents, signs and symptoms, diagnostic approaches, and antibiotic treatment options when indicated. The document aims to inform medical students about upper respiratory infections and their clinical management.
This document provides information on upper respiratory tract infections including causative organisms, signs and symptoms, diagnosis, and treatment recommendations. It discusses conditions such as acute tonsillitis, pharyngitis, otitis media, sinusitis, the common cold, laryngitis, and mastoiditis. Differential diagnosis and appropriate use of antibiotics for streptococcal infections is covered. Laboratory tests, scoring systems, and treatment guidelines including antibiotic choices are presented.
This document provides information on upper respiratory tract infections including causative organisms, signs and symptoms, diagnosis, and treatment recommendations. It discusses conditions such as acute tonsillitis, pharyngitis, otitis media, sinusitis, the common cold, laryngitis, and mastoiditis. Differential diagnosis and appropriate use of antibiotics for streptococcal infections are addressed.
UPPER RESPIRATORY TRACT INFECTION BY AKRAM KHANAkram Khan
This document discusses upper respiratory tract infections including acute tonsillitis, pharyngitis, otitis media, sinusitis, the common cold, laryngitis, and mastoiditis. It outlines the typical causative organisms, signs and symptoms, diagnostic criteria, and treatment recommendations including appropriate antibiotic use. Differential diagnosis and scoring systems to determine need for antibiotics are also covered. The document is intended to help participants identify, diagnose, and manage various upper respiratory infections appropriately.
This document discusses various respiratory tract infections, including upper and lower respiratory tract infections. It covers topics such as otitis media (ear infection), pharyngitis (sore throat), sinusitis, bronchitis, bronchiolitis, and pneumonia. For each condition, it discusses etiology, clinical manifestations, diagnosis, treatment goals, and specific treatment options. Risk factors, pathogenesis, and monitoring of treatment response are also covered for some conditions. The document provides an overview of common respiratory infections seen in clinical practice.
This document provides an overview of upper respiratory tract infections including the common cold, sinusitis, pharyngitis, laryngotracheobronchitis, and otitis media. It discusses the causes, signs and symptoms, diagnosis, and treatment of each condition. The majority of upper respiratory infections are viral in origin and self-limiting, though bacterial infections can occur and may require antimicrobial treatment. Amoxicillin is usually the first-line treatment for bacterial sinusitis and otitis media, while penicillin is recommended for streptococcal pharyngitis.
This document provides an overview of upper respiratory tract infections including classification, common diseases, symptoms, diagnosis, and treatment. Upper respiratory tract infections involve the areas above the vocal cords such as the nose, sinuses, throat, and voice box. Common illnesses discussed are the common cold, acute rhinosinusitis, pharyngitis, and acute otitis media. The document outlines symptoms, causative agents, diagnostic approaches, and antibiotic treatment recommendations for each condition.
1) The document discusses the medical management of rhinosinusitis including the anatomy of the sinuses, underlying causes, diagnosis, and treatment approaches.
2) Key points include distinguishing bacterial rhinitis from sinusitis based on symptoms and imaging, addressing rhinologic headaches from structural issues, and treating acute versus chronic sinusitis with saline irrigation, nasal steroids, and antibiotics when indicated.
3) Treatment of chronic sinusitis involves hydration, long-acting nasal decongestants, nasal saline, and topical nasal corticosteroids with the aim of maintaining remission.
This document provides information on upper respiratory tract infections including causative organisms, signs and symptoms, diagnosis, and treatment recommendations. It discusses conditions such as acute tonsillitis, pharyngitis, otitis media, sinusitis, the common cold, laryngitis, and mastoiditis. Differential diagnosis and appropriate use of antibiotics for streptococcal infections is covered. Laboratory tests, scoring systems, and treatment guidelines including antibiotic choices are presented.
This document provides information on upper respiratory tract infections including causative organisms, signs and symptoms, diagnosis, and treatment recommendations. It discusses conditions such as acute tonsillitis, pharyngitis, otitis media, sinusitis, the common cold, laryngitis, and mastoiditis. Differential diagnosis and appropriate use of antibiotics for streptococcal infections are addressed.
UPPER RESPIRATORY TRACT INFECTION BY AKRAM KHANAkram Khan
This document discusses upper respiratory tract infections including acute tonsillitis, pharyngitis, otitis media, sinusitis, the common cold, laryngitis, and mastoiditis. It outlines the typical causative organisms, signs and symptoms, diagnostic criteria, and treatment recommendations including appropriate antibiotic use. Differential diagnosis and scoring systems to determine need for antibiotics are also covered. The document is intended to help participants identify, diagnose, and manage various upper respiratory infections appropriately.
This document discusses various respiratory tract infections, including upper and lower respiratory tract infections. It covers topics such as otitis media (ear infection), pharyngitis (sore throat), sinusitis, bronchitis, bronchiolitis, and pneumonia. For each condition, it discusses etiology, clinical manifestations, diagnosis, treatment goals, and specific treatment options. Risk factors, pathogenesis, and monitoring of treatment response are also covered for some conditions. The document provides an overview of common respiratory infections seen in clinical practice.
This document provides an overview of upper respiratory tract infections including the common cold, sinusitis, pharyngitis, laryngotracheobronchitis, and otitis media. It discusses the causes, signs and symptoms, diagnosis, and treatment of each condition. The majority of upper respiratory infections are viral in origin and self-limiting, though bacterial infections can occur and may require antimicrobial treatment. Amoxicillin is usually the first-line treatment for bacterial sinusitis and otitis media, while penicillin is recommended for streptococcal pharyngitis.
This document provides an overview of upper respiratory tract infections including classification, common diseases, symptoms, diagnosis, and treatment. Upper respiratory tract infections involve the areas above the vocal cords such as the nose, sinuses, throat, and voice box. Common illnesses discussed are the common cold, acute rhinosinusitis, pharyngitis, and acute otitis media. The document outlines symptoms, causative agents, diagnostic approaches, and antibiotic treatment recommendations for each condition.
1) The document discusses the medical management of rhinosinusitis including the anatomy of the sinuses, underlying causes, diagnosis, and treatment approaches.
2) Key points include distinguishing bacterial rhinitis from sinusitis based on symptoms and imaging, addressing rhinologic headaches from structural issues, and treating acute versus chronic sinusitis with saline irrigation, nasal steroids, and antibiotics when indicated.
3) Treatment of chronic sinusitis involves hydration, long-acting nasal decongestants, nasal saline, and topical nasal corticosteroids with the aim of maintaining remission.
Diphtheria is caused by Corynebacterium diphtheriae, which produces an exotoxin. It is characterized by a grayish-white pseudomembrane forming over the tonsils, pharynx, and larynx. Common complications include myocarditis and neuritis. Diagnosis is confirmed through bacterial culture. Treatment involves antibiotics, diphtheria antitoxin serum, and supportive care. Public health interventions focus on vaccination and antibiotic prophylaxis for contacts to control outbreaks.
1. Rhinosinusitis is inflammation of the nose and paranasal sinuses that can be acute or chronic. Acute sinusitis lasts less than 4 weeks while chronic lasts over 12 weeks.
2. Common causes include viral, bacterial, and fungal infections. Bacteria like Streptococcus pneumoniae and Haemophilus influenzae often cause acute bacterial rhinosinusitis.
3. Symptoms depend on the involved sinus but may include nasal congestion, facial pain, headache, and fever. Diagnosis involves medical history, exam, and imaging tests like x-ray or CT scan of the sinuses.
This document discusses the management of common childhood respiratory diseases. It focuses on upper respiratory tract infections like rhinitis, pharyngitis, tonsillitis, croup, and epiglottitis. It describes the causes, signs, symptoms, diagnosis, and treatment of each condition. Pertussis is also reviewed as it is a contagious bacterial infection of the respiratory tract that is particularly dangerous for infants. Proper management of respiratory diseases in children requires identifying the infection and providing symptomatic relief or antibiotic treatment when necessary.
Upper respiratory tract infections are characterized by self-limited irritation and swelling of the upper airways together with a cough that does not indicate pneumonia, does not have a coexisting medical condition that could be the cause of the patient's symptoms, and does not have a history of chronic bronchitis, emphysema, or COPD. Presentation gives an overview on "Upper Respiratory Tract Infections", including causes, symptoms, diagnosis, and Treatment to cure. For more information, please contact us: 9779030507.
Upper respiratory tract infections are very common and include conditions like sinusitis, ear infections, epiglottitis, and sore throat. While most are mild and viral, inappropriate antibiotic use has led to increased antibiotic resistance. Acute bacterial rhinosinusitis is usually treated with amoxicillin/clavulanic acid for 5-7 days. Chronic rhinosinusitis requires long-term treatment including nasal steroids, saline irrigation, and sometimes antibiotics or surgery. Group A streptococcal pharyngitis is the only commonly occurring sore throat for which antibiotics are indicated to prevent complications like rheumatic fever. A rapid strep test aids early diagnosis and penicillin remains the treatment of choice.
This document discusses common upper respiratory conditions in children including the common cold, pharyngitis, neck infections, tonsillitis, and sinusitis. It provides details on the typical pathogens, clinical manifestations, diagnosis, and treatment of each condition. The common cold is usually viral in origin while pharyngitis can be viral or strep-related. Neck infections include retropharyngeal and lateral abscesses. Tonsillitis can lead to peritonsillar abscess. Sinusitis typically follows a viral upper respiratory infection. Symptoms, exams, and appropriate antibiotic treatment are outlined for each condition.
- Sinusitis is inflammation of the paranasal sinuses, most commonly caused by viral or bacterial infection following a cold or allergy. The maxillary and ethmoid sinuses are most frequently involved.
- Symptoms include facial pain, headache, nasal congestion and discharge. Diagnosis is made clinically but imaging may be used if symptoms are severe or persistent.
- Treatment involves pain relief, decongestants, antihistamines, nasal saline washes and a 10-14 day course of antibiotics like amoxicillin for bacterial sinusitis. Follow up and preventing triggers can help reduce risk of recurrence.
This document discusses the management of upper respiratory tract infections including sinusitis, otitis media and pharyngitis. For sinusitis, general measures include steam inhalation, analgesics and nasal irrigation. Antibiotics such as amoxicillin are recommended if there are signs of bacterial infection. For otitis media, antibiotics like amoxicillin are used to treat acute infections while chronic infections may require ear irrigation. Glue ear or otitis media with effusion can be managed with antihistamines, decongestants and myringotomy if effusion persists. Viral pharyngitis usually requires supportive care only, while group A streptococcal infections should be treated with a full
This document provides an outline and overview of a seminar presentation on pneumonia. It discusses the epidemiology, pathophysiology, etiology, classification, clinical manifestations, laboratory/diagnostic investigations, treatment approaches, and complications of pneumonia. Pneumonia remains a common cause of severe sepsis and a leading infectious cause of death. Treatment involves antibiotics targeting the likely causative pathogens, with choices dependent on patient age, location of infection (community-acquired, hospital-acquired, ventilator-associated), and risk of drug-resistant organisms. Patient education on prevention, symptom management, and completing antibiotic courses is also emphasized.
UPPER RESIRATORY TRACT INFECTIONS IN CHILDREN , ACUE PHARYGITIS , COMMON COLD , ACUTE SINUSITIS , ACUTE OTITIS MEDIA , APPROACH TO PATIENT WITH URTI , MANAGEMENT OF URTI IN CHILDREN
Rhinosinusitis is an inflammation of the nasal cavity and paranasal sinuses. It is classified based on duration into acute (<4 weeks), recurrent acute (≥4 episodes/year), subacute (4-12 weeks), and chronic (>12 weeks). Common symptoms include facial pain, nasal congestion, discharge, and loss of smell. Acute bacterial rhinosinusitis is diagnosed clinically based on symptoms persisting after 10 days or worsening within 5-6 days of initial improvement. Treatment involves symptom relief and may include antibiotics for acute bacterial rhinosinusitis. Surgery is considered for recurrent or persistent cases after medical treatment failure. Complications can affect the sinuses, orbit, brain and cause sepsis.
Diphtheria & Pertussis lecture in the subject of Tropical diseasesshumailascn
Diphtheria and pertussis are serious bacterial infections spread through respiratory droplets. Diphtheria causes a thick gray membrane in the throat that can block breathing. The bacteria also produce a toxin affecting the heart and nerves. Pertussis causes violent coughing fits and whooping sounds, especially in infants and children. Both diseases are preventable through vaccination programs using DPT/DTaP vaccines. Prompt treatment of cases with antibiotics and antitoxins can reduce mortality from these infections.
This document discusses common childhood diseases, with a focus on respiratory illnesses. It covers:
1. Common respiratory diseases in children include respiratory infections (ARI), pneumonia, and diseases like asthma that are exacerbated by respiratory infections.
2. Children are particularly vulnerable to respiratory illnesses due to developmental differences like smaller airways and fewer alveoli.
3. Specific respiratory diseases covered include the common cold, influenza, sinusitis, otitis media (ear infections), tonsillitis, and pneumonia. Signs and symptoms, diagnoses, and treatment approaches are discussed for each.
1) Pharyngo-tonsillitis refers to inflammation of the pharynx and/or tonsils that can be caused by viruses or bacteria. Clinical features include fever, sore throat, and tender lymph nodes.
2) Differentiating between viral and bacterial causes based on symptoms alone is difficult, but bacterial causes are more likely if the patient presents with purulent tonsils, toxic appearance, and severe throat pain.
3) Management involves symptomatic relief and considering rapid antigen detection tests or throat culture if antibiotics are warranted. For confirmed bacterial infections, penicillin is recommended for 10 days to prevent complications like rheumatic fever.
This document discusses pharyngitis (inflammation of the pharynx). It notes that the most common infectious causes are streptococcus and various viruses. It then covers the etiology, symptoms, physical exam findings, complications, diagnosis and treatment of both viral and bacterial (specifically streptococcal) pharyngitis. Key points include that viral pharyngitis is usually self-limiting and only requires supportive care, while bacterial pharyngitis often requires antibiotics to prevent complications like rheumatic fever. Rapid strep tests and throat cultures can help diagnose the cause. Laryngitis, an inflammation of the larynx, is also briefly discussed.
The document provides information on various respiratory tract infections including their classification, anatomy, defenses, risk factors, causes, pathophysiology, clinical presentation, diagnosis, and treatment. It discusses common upper respiratory infections such as rhinitis, common cold, sinusitis, pharyngitis, laryngitis, tonsillitis and their epidemiology. For each infection, it describes the etiological agents, signs and symptoms, complications and recommended treatment approaches.
This document provides guidance on managing common childhood diseases. It discusses acute airway obstruction including croup, epiglottitis, and recurrent croup. It also covers acute respiratory infections like the common cold and pertussis. Guidance is provided on evaluating and treating pneumonia, tonsillitis, and gastrointestinal infections in children under 5 years old. Clinical signs, manifestations, diagnostics, and management approaches are outlined for each condition.
This document provides an overview of diphtheria, including its epidemiology, transmission, pathogenesis, clinical presentation, diagnosis, treatment and prevention. It describes diphtheria as an infectious disease caused by Corynebacterium diphtheriae bacteria that produces a toxin affecting the throat and other organs. Symptoms include sore throat and swollen glands. Complications can include myocarditis, neuropathy or respiratory failure. Diagnosis involves culture and identification of the bacteria. Treatment involves antibiotics and antitoxin administration. Vaccination is recommended to prevent diphtheria.
This document summarizes meningitis, including:
- Types of meningitis (infectious, non-infectious) and locations (leptomeningitis, pachymeningitis)
- Common causes of bacterial meningitis worldwide including Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae
- Risk factors, signs and symptoms, investigations, and management considerations for different types of meningitis. Treatment depends on identified organism and may involve antibiotics, steroids, or vaccines. Complications can include neurologic sequelae.
This case presentation discusses a 20-year old female patient who presented with worsening right arm and shoulder pain over the past year. Key findings on examination included decreased pulse and sensation in the right upper extremity. Imaging showed thickening of the right radial artery suggestive of vasculitis. The differential diagnoses discussed were Takayasu arteritis, giant cell arteritis, polymyalgia rheumatica, and polyarteritis nodosa. Polyarteritis nodosa was then described in more detail regarding its epidemiology, etiology, clinical manifestations, and laboratory features.
This document discusses venous thromboembolism (VTE), which includes deep vein thrombosis and pulmonary embolism. It notes that VTE can be caused by material traveling to the lungs through the pulmonary circulation. Risk factors include surgery, pregnancy, cardiorespiratory disease, lower limb problems, malignancy, and immobility. Symptoms range from none for small embolisms to chest pain and circulatory collapse for large embolisms. Diagnosis involves assessing risk factors and alternative causes, with tests like chest x-rays, electrocardiograms, and D-dimer levels. Treatment is anticoagulation with heparin or warfarin and supportive measures.
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Similar a URTI.pptfkloojvcxzzyi3iiijjjrjhhhbbhhhhhhhhj
Diphtheria is caused by Corynebacterium diphtheriae, which produces an exotoxin. It is characterized by a grayish-white pseudomembrane forming over the tonsils, pharynx, and larynx. Common complications include myocarditis and neuritis. Diagnosis is confirmed through bacterial culture. Treatment involves antibiotics, diphtheria antitoxin serum, and supportive care. Public health interventions focus on vaccination and antibiotic prophylaxis for contacts to control outbreaks.
1. Rhinosinusitis is inflammation of the nose and paranasal sinuses that can be acute or chronic. Acute sinusitis lasts less than 4 weeks while chronic lasts over 12 weeks.
2. Common causes include viral, bacterial, and fungal infections. Bacteria like Streptococcus pneumoniae and Haemophilus influenzae often cause acute bacterial rhinosinusitis.
3. Symptoms depend on the involved sinus but may include nasal congestion, facial pain, headache, and fever. Diagnosis involves medical history, exam, and imaging tests like x-ray or CT scan of the sinuses.
This document discusses the management of common childhood respiratory diseases. It focuses on upper respiratory tract infections like rhinitis, pharyngitis, tonsillitis, croup, and epiglottitis. It describes the causes, signs, symptoms, diagnosis, and treatment of each condition. Pertussis is also reviewed as it is a contagious bacterial infection of the respiratory tract that is particularly dangerous for infants. Proper management of respiratory diseases in children requires identifying the infection and providing symptomatic relief or antibiotic treatment when necessary.
Upper respiratory tract infections are characterized by self-limited irritation and swelling of the upper airways together with a cough that does not indicate pneumonia, does not have a coexisting medical condition that could be the cause of the patient's symptoms, and does not have a history of chronic bronchitis, emphysema, or COPD. Presentation gives an overview on "Upper Respiratory Tract Infections", including causes, symptoms, diagnosis, and Treatment to cure. For more information, please contact us: 9779030507.
Upper respiratory tract infections are very common and include conditions like sinusitis, ear infections, epiglottitis, and sore throat. While most are mild and viral, inappropriate antibiotic use has led to increased antibiotic resistance. Acute bacterial rhinosinusitis is usually treated with amoxicillin/clavulanic acid for 5-7 days. Chronic rhinosinusitis requires long-term treatment including nasal steroids, saline irrigation, and sometimes antibiotics or surgery. Group A streptococcal pharyngitis is the only commonly occurring sore throat for which antibiotics are indicated to prevent complications like rheumatic fever. A rapid strep test aids early diagnosis and penicillin remains the treatment of choice.
This document discusses common upper respiratory conditions in children including the common cold, pharyngitis, neck infections, tonsillitis, and sinusitis. It provides details on the typical pathogens, clinical manifestations, diagnosis, and treatment of each condition. The common cold is usually viral in origin while pharyngitis can be viral or strep-related. Neck infections include retropharyngeal and lateral abscesses. Tonsillitis can lead to peritonsillar abscess. Sinusitis typically follows a viral upper respiratory infection. Symptoms, exams, and appropriate antibiotic treatment are outlined for each condition.
- Sinusitis is inflammation of the paranasal sinuses, most commonly caused by viral or bacterial infection following a cold or allergy. The maxillary and ethmoid sinuses are most frequently involved.
- Symptoms include facial pain, headache, nasal congestion and discharge. Diagnosis is made clinically but imaging may be used if symptoms are severe or persistent.
- Treatment involves pain relief, decongestants, antihistamines, nasal saline washes and a 10-14 day course of antibiotics like amoxicillin for bacterial sinusitis. Follow up and preventing triggers can help reduce risk of recurrence.
This document discusses the management of upper respiratory tract infections including sinusitis, otitis media and pharyngitis. For sinusitis, general measures include steam inhalation, analgesics and nasal irrigation. Antibiotics such as amoxicillin are recommended if there are signs of bacterial infection. For otitis media, antibiotics like amoxicillin are used to treat acute infections while chronic infections may require ear irrigation. Glue ear or otitis media with effusion can be managed with antihistamines, decongestants and myringotomy if effusion persists. Viral pharyngitis usually requires supportive care only, while group A streptococcal infections should be treated with a full
This document provides an outline and overview of a seminar presentation on pneumonia. It discusses the epidemiology, pathophysiology, etiology, classification, clinical manifestations, laboratory/diagnostic investigations, treatment approaches, and complications of pneumonia. Pneumonia remains a common cause of severe sepsis and a leading infectious cause of death. Treatment involves antibiotics targeting the likely causative pathogens, with choices dependent on patient age, location of infection (community-acquired, hospital-acquired, ventilator-associated), and risk of drug-resistant organisms. Patient education on prevention, symptom management, and completing antibiotic courses is also emphasized.
UPPER RESIRATORY TRACT INFECTIONS IN CHILDREN , ACUE PHARYGITIS , COMMON COLD , ACUTE SINUSITIS , ACUTE OTITIS MEDIA , APPROACH TO PATIENT WITH URTI , MANAGEMENT OF URTI IN CHILDREN
Rhinosinusitis is an inflammation of the nasal cavity and paranasal sinuses. It is classified based on duration into acute (<4 weeks), recurrent acute (≥4 episodes/year), subacute (4-12 weeks), and chronic (>12 weeks). Common symptoms include facial pain, nasal congestion, discharge, and loss of smell. Acute bacterial rhinosinusitis is diagnosed clinically based on symptoms persisting after 10 days or worsening within 5-6 days of initial improvement. Treatment involves symptom relief and may include antibiotics for acute bacterial rhinosinusitis. Surgery is considered for recurrent or persistent cases after medical treatment failure. Complications can affect the sinuses, orbit, brain and cause sepsis.
Diphtheria & Pertussis lecture in the subject of Tropical diseasesshumailascn
Diphtheria and pertussis are serious bacterial infections spread through respiratory droplets. Diphtheria causes a thick gray membrane in the throat that can block breathing. The bacteria also produce a toxin affecting the heart and nerves. Pertussis causes violent coughing fits and whooping sounds, especially in infants and children. Both diseases are preventable through vaccination programs using DPT/DTaP vaccines. Prompt treatment of cases with antibiotics and antitoxins can reduce mortality from these infections.
This document discusses common childhood diseases, with a focus on respiratory illnesses. It covers:
1. Common respiratory diseases in children include respiratory infections (ARI), pneumonia, and diseases like asthma that are exacerbated by respiratory infections.
2. Children are particularly vulnerable to respiratory illnesses due to developmental differences like smaller airways and fewer alveoli.
3. Specific respiratory diseases covered include the common cold, influenza, sinusitis, otitis media (ear infections), tonsillitis, and pneumonia. Signs and symptoms, diagnoses, and treatment approaches are discussed for each.
1) Pharyngo-tonsillitis refers to inflammation of the pharynx and/or tonsils that can be caused by viruses or bacteria. Clinical features include fever, sore throat, and tender lymph nodes.
2) Differentiating between viral and bacterial causes based on symptoms alone is difficult, but bacterial causes are more likely if the patient presents with purulent tonsils, toxic appearance, and severe throat pain.
3) Management involves symptomatic relief and considering rapid antigen detection tests or throat culture if antibiotics are warranted. For confirmed bacterial infections, penicillin is recommended for 10 days to prevent complications like rheumatic fever.
This document discusses pharyngitis (inflammation of the pharynx). It notes that the most common infectious causes are streptococcus and various viruses. It then covers the etiology, symptoms, physical exam findings, complications, diagnosis and treatment of both viral and bacterial (specifically streptococcal) pharyngitis. Key points include that viral pharyngitis is usually self-limiting and only requires supportive care, while bacterial pharyngitis often requires antibiotics to prevent complications like rheumatic fever. Rapid strep tests and throat cultures can help diagnose the cause. Laryngitis, an inflammation of the larynx, is also briefly discussed.
The document provides information on various respiratory tract infections including their classification, anatomy, defenses, risk factors, causes, pathophysiology, clinical presentation, diagnosis, and treatment. It discusses common upper respiratory infections such as rhinitis, common cold, sinusitis, pharyngitis, laryngitis, tonsillitis and their epidemiology. For each infection, it describes the etiological agents, signs and symptoms, complications and recommended treatment approaches.
This document provides guidance on managing common childhood diseases. It discusses acute airway obstruction including croup, epiglottitis, and recurrent croup. It also covers acute respiratory infections like the common cold and pertussis. Guidance is provided on evaluating and treating pneumonia, tonsillitis, and gastrointestinal infections in children under 5 years old. Clinical signs, manifestations, diagnostics, and management approaches are outlined for each condition.
This document provides an overview of diphtheria, including its epidemiology, transmission, pathogenesis, clinical presentation, diagnosis, treatment and prevention. It describes diphtheria as an infectious disease caused by Corynebacterium diphtheriae bacteria that produces a toxin affecting the throat and other organs. Symptoms include sore throat and swollen glands. Complications can include myocarditis, neuropathy or respiratory failure. Diagnosis involves culture and identification of the bacteria. Treatment involves antibiotics and antitoxin administration. Vaccination is recommended to prevent diphtheria.
This document summarizes meningitis, including:
- Types of meningitis (infectious, non-infectious) and locations (leptomeningitis, pachymeningitis)
- Common causes of bacterial meningitis worldwide including Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae
- Risk factors, signs and symptoms, investigations, and management considerations for different types of meningitis. Treatment depends on identified organism and may involve antibiotics, steroids, or vaccines. Complications can include neurologic sequelae.
Similar a URTI.pptfkloojvcxzzyi3iiijjjrjhhhbbhhhhhhhhj (20)
This case presentation discusses a 20-year old female patient who presented with worsening right arm and shoulder pain over the past year. Key findings on examination included decreased pulse and sensation in the right upper extremity. Imaging showed thickening of the right radial artery suggestive of vasculitis. The differential diagnoses discussed were Takayasu arteritis, giant cell arteritis, polymyalgia rheumatica, and polyarteritis nodosa. Polyarteritis nodosa was then described in more detail regarding its epidemiology, etiology, clinical manifestations, and laboratory features.
This document discusses venous thromboembolism (VTE), which includes deep vein thrombosis and pulmonary embolism. It notes that VTE can be caused by material traveling to the lungs through the pulmonary circulation. Risk factors include surgery, pregnancy, cardiorespiratory disease, lower limb problems, malignancy, and immobility. Symptoms range from none for small embolisms to chest pain and circulatory collapse for large embolisms. Diagnosis involves assessing risk factors and alternative causes, with tests like chest x-rays, electrocardiograms, and D-dimer levels. Treatment is anticoagulation with heparin or warfarin and supportive measures.
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A 50-year-old female presented with multifocal pneumonia, sepsis, acute kidney injury, and anemia. On examination, she had decreased breath sounds and crackles bilaterally. Laboratory tests showed leukocytosis, elevated creatinine and urea, and normal chest x-ray and ECG. She was started on oxygen, antibiotics, and monitoring of vital signs. Further tests planned included repeat blood cultures and Gene Xpert to identify the causative organism.
This document discusses pneumonia, including its classification, pathophysiology, risk factors, diagnosis, treatment, and complications. Pneumonia is an infection of the lungs that can be community-acquired, hospital-acquired, or ventilator-associated. It results from microbial pathogens in the lungs and the body's immune response. Common symptoms include fever, cough, and difficulty breathing. Diagnosis involves chest x-ray and culture of sputum samples. Treatment is usually initial empirical antibiotics but may require adjustment based on severity and failure to improve. Complications can include respiratory failure, shock, and lung abscesses.
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This document provides an overview of respiratory system physical examination. It begins with learning objectives focused on anatomy, examination techniques, and abnormal findings. It then details anatomy of the lungs, trachea, and bronchi. The cardinal steps of respiratory examination are described as inspection, palpation, percussion, and auscultation. Normal findings for each step are outlined. The document provides guidance on examining breathing patterns, chest shape, symmetry of movement, clubbing, cyanosis, and more. Percussion notes and auscultation of breath sounds are also explained.
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Disseminated intravascular coagulation (DIC) is a syndrome characterized by widespread fibrin formation due to excessive blood coagulation that overcomes natural anticoagulation. Common causes are sepsis, cancer, trauma, and obstetric complications. Purpura fulminans is a severe form of DIC resulting in skin thrombosis, particularly in young children with infections and coagulation deficiencies. DIC is diagnosed based on clinical signs of bleeding and thrombosis as well as laboratory abnormalities including prolonged clotting times, thrombocytopenia, and elevated fibrin degradation products. Treatment focuses on managing the underlying condition while replacing clotting factors and platelets to control bleeding.
This document summarizes leishmaniasis, a vector-borne zoonotic disease caused by Leishmania protozoa. The disease exists in three main forms: visceral, cutaneous, and mucocutaneous. It is transmitted through the bite of infected sand flies, with dogs serving as a main reservoir. Clinical presentation and treatment depends on the form of the disease. Leishmaniasis affects over 12 million people globally and is a major public health problem in many parts of the world.
This document discusses several papulosquamous disorders including psoriasis, pityriasis rosea, and lichen planus. Psoriasis affects 2-3% of the population and has a genetic and polygenic cause, with trigger factors like physical trauma, infections, and stress. It is characterized by silvery-white scaly plaques and is treated individually based on each patient's case. Pityriasis rosea causes a distinctive rash and is self-limiting. Lichen planus causes pruritic violaceous papules and affects the skin, nails, hair and mucous membranes, and is usually effectively treated with steroids.
This document discusses different types of cutaneous drug eruptions including exanthematous drug eruptions, urticaria and angioedema, fixed drug eruptions, erythema multiforme, and Stevens-Johnson syndrome and toxic epidermal necrolysis. Exanthematous drug eruptions present as symmetric macules and papules on the trunk and extremities within 3 weeks, while urticaria and angioedema cause transient wheals and edema. Fixed drug eruptions result in solitary or multiple plaques or erosions that recur in the same site with repeat exposure to the causative drug. Erythema multiforme presents as stable circular erythemas or ur
1) Dermatitis and eczema refer to inflammation of the skin that can have chronic stages and be caused by endogenous or exogenous factors. Atopic eczema is a chronic pruritic skin condition with a hereditary predisposition that often begins in infancy.
2) Atopic eczema is caused by an immune system imbalance and dysregulation, characterized by elevated IgE levels and cytokine abnormalities. Family history of atopy is present in many cases.
3) Treatment involves identifying triggers, using emollients and topical corticosteroids, managing allergy and infection, and escalating to immunomodulators or systemic therapy if needed. Other conditions discussed include contact dermatitis
This document discusses several pilosebaceous disorders including acne vulgaris, rosacea, and perioral dermatitis. Acne vulgaris is caused by multiple factors and presents in different forms from comedonal acne to nodulocystic acne. Treatment ranges from topical antibiotics and retinoids for mild acne to oral tetracyclines and isotretinoin for more severe forms. Rosacea primarily affects facial skin and has four stages from mild redness to severe thickening. It is treated with metronidazole and tetracyclines. Perioral dermatitis appears as erythematous papules around the mouth and is also treated with topical
This document discusses the various skin manifestations that can occur in patients with HIV/AIDS. It notes that up to 92% of patients will experience one or more skin disorders throughout their illness. Conditions range from common issues like seborrheic dermatitis and xerosis to more specific diseases such as Kaposi's sarcoma, bacillary angiomatosis, and oral hairy leukoplakia. Bacterial, viral, and fungal infections are also more frequent and severe in immunocompromised HIV/AIDS patients. Recognizing cutaneous signs of HIV can lead to earlier diagnosis and treatment.
This document discusses different types of cutaneous tuberculosis, which is a relatively uncommon form of tuberculosis that occurs in the skin rather than the lungs. It describes several types: tuberculous chancre, which results from direct inoculation of the bacteria into the skin of someone without immunity and appears as a papule or ulcer; tuberculous verrucosa cutis, which occurs in previously infected individuals as a warty plaque; lupus vulgaris, a chronic form originating from underlying tuberculosis foci; tuberculous colliquativa cutis, resulting from skin breakdown over a tuberculosis focus; and tuberculous guma, a metastatic abscess from hematogenous spread. Risk factors, clinical presentations,
This document outlines topics related to dermatology including: the anatomy and physiology of skin; diagnosing and treating common skin diseases and infections; skin care; pilosebaceous disorders; dermatitis; photodermatoses; papulosquamous disorders; pigmentary disorders; autoimmune disorders; drug eruptions; and skin cancer. It recommends textbooks on clinical dermatology and lists subspecialties of dermatology such as cosmetic, tropical, and pediatric dermatology. It poses questions about prevalence of skin diseases and the integumentary system.
This document provides an overview of glomerular disease, including the pathogenesis, clinical evaluation, and treatment. It begins with an introduction to glomerular anatomy and physiology. Common causes of glomerular disease include genetic mutations, infections, autoimmunity, and atherosclerosis. Clinical presentations range from asymptomatic urine abnormalities to nephrotic syndrome. Evaluation involves history, physical exam, urine analysis, renal function tests, and sometimes renal biopsy. Main treatment approaches depend on the specific glomerular disease and include controlling hypertension and proteinuria, immunosuppression, and dialysis. Complications can include renal failure and chronic kidney disease if not properly treated.
This 25-year-old male presented with chest pain and was diagnosed with a Killip class II STEMI. He reported squeezing chest pain radiating to his left shoulder and back for 1 day along with sweating, shortness of breath, and vomiting. Examination found decreased breath sounds and a grade III heart sound. ECG showed ST elevation in leads V2-V6. The patient was treated with medications, monitored, and planned for further tests and follow up.
This document provides an overview and guidelines for the management of COPD exacerbations. It defines a COPD exacerbation and lists the main causes. Exacerbations are classified by severity from mild to very severe/life-threatening. The document outlines potential indications for hospitalization, management of severe exacerbations, and indications for intensive care, noninvasive ventilation, and invasive mechanical ventilation. Discharge criteria and recommendations for follow-up are also provided. Case studies with discussion points are included to demonstrate application of the guidelines.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
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Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
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These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
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7. Due to streptococci:
• Spreads by close contact and through air
• Spread more in crowded areas (KG, school, army..)
• Most common among 5-15 age group
• More frequent among lower socio-economic classes
• Most common during winter and spring
• Incubation period 2-4 days
/ 42 7
8. Signs/symptoms
Sore throat
Anterior cervical LAP
Fever > 38 C
Difficulty in swallowing
Headache, fatigue
Muscle pain
Nausea, vomiting
/ 42 8
Tonsillar hyperemia /
exudates
Soft palate petechia
Absence of coughing
Absence of nose drip
Absence of hoarseness
9. Viral tonsillitis/pharyngitis
• Viral tonsilo-pharyngitis is most common.
• Rhinovirus (most common).
• Symptoms usually last for 3-5 days.
Having additional rhinitis, hoarseness, conjunctivitis and
cough
Pharyngitis is accompanied by conjunctivitis in adenovirus
infections
Oral vesicles, ulcers point to viruses
/ 42 9
12. Laboratory
• Throat swab culture
• Gold standard
• Rapid antigen test
• If negative need swab
• Sensitivity of 80% and specificity of
95%.
• ASO
• May remain + for 1 year
• WBC count
• Peripheral smear
/ 42 12
13. Throat Culture
• Pathogens looked for
• Group A beta hemolytic streptococci
• C. diphteriae (rare)
• N. gonorrhoeae (rare)
• Not required usually. Needed only when suspicion is high
and rapid strep throat swab is negative.
/ 42 13
15. Aim of Treatment
• Prevention of complications
• Starting treatment within 9 days is enough to prevent ARF
• Symptomatic improvement
• Bacterial eradication
• Prevention of contamination
• Reducing unnecessary antibiotic use
/ 42 15
16. Treatment of GABHS
A) Symptomatic: Saline gargles,
analgesics, cool-mist humidification and
throat lozenges.
B) Antibiotics:
a) Benzathine Pn-G 1.2 million units
IM x 1 OR 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.
/ 42 16
17. Antibiotics NOT to be used for GABHS
• Tetracycline
• Sulphonamides
• Co-trimoxasole
• Cloramphenicole
• Aminoglycosides
/ 42 17
18. GABHS
• Control culture after full dose treatment?
• NO
• If history of ARF:
• Take control culture after treatment
• No need to screen or treat carriers
/ 42 18
19. Mc Isaac Scoring
• Developed by Mc Isaac and friends
• Decreases antibiotic usage by 48%
• No increase in throat swabs
/ 42 19
20. Mc Isaac Scoring
Clinical Findings Score
Fever > 38 C 1
Absence of coughing 1
Tonsillary hypertrophy or
exudates
1 (If < 6 years give 0)
Sensitivity at the anterior
cervical nodes
1
Age 3 – 14 1
Age > 45 -1
/ 42 20
21. Mc Isaac Scoring
Total score Suggestions
0 - 1 points No culture, no antibiotics
2 - 3 points Take culture (or antigen test),
order antibiotics only if
GABHS +
4 - 5 points Take culture (or antigen test),
order antibiotics only if
GABHS +.
If the c/f is severe, start
antibiotics without testing
/ 42 21
22. Antibiotics in Tonsillitis/pharyngitis due to GABHS
ORAL
Penicilline V Children:2x250 mg or 3x250mg,10 days
Adults:3x500 mg or 4x500mg,10 days
PARENTERAL
Benzathine penicilline Adults:<27kg:600 000 U single dose, IM
>27 kg:1.200 000 U single dose, IM
ALLERGY TO PENICILLINE
Erithromycine estolate 20-40 mg/kg/day, 2x1 or 3x1, 10 days
Erithromycine ethyl succinate 40 mg/kg/day, 2x1 or 3x1, 10 days
/ 42 22
23. Acute Otitis Media
• The diagnosis of AOM requires
the presence of a middle ear
effusion and acute signs of middle
ear inflammation
• AOM not responding to
treatment: Sustained clinical and
otoscopy findings despite 48-72
therapy
• Recurrent atitis media: 3 AOM
attacks within 6 moths or 4
attacks within 1 year
/ 42 23
25. AOM causes
• S. pneumoniae 30%
• H. İnfluenzae 20%
• M. Catarrhalis 15%
• S. pyogenes 3%
• S. aureus 2%
• No growth 10-30%
• Chronic otitis media: P. aeruginosa, S. aureus, anaerobic bacteria
/ 42 25
26. Acute Otitis Media
• 85% of children up to 3 years experience at least one,
• 50% of children up to 3 years experience at least two attacks
• AOM is usually self-limited. Rarely benefits from antibiotics.
• 81 % undergo spontaneus resolution.
/ 42 26
27. Signs and Symptoms
•Symptoms
•Autalgia
•Ear draining
•Hearing loss
•Fever
•Fatigue
•Irritability
•Tinnitus, vertigo
•Otoscopic findings
•Tympanic membrane
erythema
•Inflammation
•Bulging
•Effusion
•Hearing loss
/ 42 27
28. Antibiotics
First choice
Amoxicilline 40 mg/kg/day, 3 doses
Trimet./Sulfamethoxazole 8mg TM/40mg SMX/kg 2 dose
Second choice
Amoxicilline/clavulanate 45 mg/kg/day, 2 doses
Erythromycin 40-50 mg/kg/day, 3 doses
Reurrent AOM prophylaxis
Sulfisoxazole 75 mg/kg/day, single dose 3-6 mo
Amoxicilline 20 mg/kg/day, sinle dose 3-6 mo
/ 42 28
30. Sinusitis
Acute sinusitis
• Str. pneumoniae %41
• H. influenzae %35
• M. catarrhalis %8
• Others %16
Strep. pyogenes
S. aureus
Rhinovirus
Parainfluenzae
Veilonella, peptokoccus
Chronic sinusitis
• Anaerob bakteria:
Bactroides, Fusobacterium
• S. aureus
• Strep. pyogenes
• Str. pneumoniae
• Gram (-) bakteria
• Fungi
/ 42 30
31. Acute Sinusitis
• Paranasal sinuses:
• Frontal
• Ethmoid
• Maxillary
• Sphenoid
• Most common during childhood
• Maxillary
• Ethmoid
• After age 10
• Frontal
/ 42 31
32. Acute Bacterial Sinusitis
• Causative agents are usually the normal inhabitants of the
respiratory tract.
• Common agents:
Streptococcus pneumoniae
Nontypeable Haemophilus Influenzae
Moraxella Catarrhalis
/ 42 32
33. Signs and Symptoms
• 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.
/ 42 33
36. Diagnosis
• 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
/ 42 36
38. Treatment
• About 2/3rd of patients will improve without treatment in 2
weeks.
• Antibiotics: Reserved for patients who have symptoms for
more than 10 days or who experience worsening
symptoms.
• OTC decongestant nasal sprays should be discouraged for
use more than 5 days
• Supportive therapy: Humidification, analgesics,
antihistaminics
/ 42 38
39. Antibiotics
a) Amoxicillin (500mg TID) OR
b) TMP/SMX ( one DS for 10 days).
c) Alternative antibiotics: High dose amoxi/clavunate,
Flouroquinolones, macrolides
/ 42 39
40. Acute Rhinosinusitis
• Most important: Headache and postnasal dripping
• Common in fall, winter and spring.
• Face congestion
• Fever, fatigue, headache increased by leaning forward
• Nose obstruction
• Nose dripping
• Purulent secretions (rhinoscopy)
• Sensitivity over the sinuses
• Halitosis
/ 42 40
41. Acute rhinosinusitis
Rhinitis
• Increased symptoms after 5 days
• Symptoms resolve in 10-14 days
• Decreasing viral symptoms, nasal secretion becoming more purulent
are indicative for acute rhinosinusitis
41
42. Diagnosis
• Direct x-ray
• Diffuse opacification
• Mucosal thickening >4 mm
• air-fluid level
• Sinus aspiration
• Rarely performed
• Nasal endoskopy
• Tomography
• More sensitive compared with direct x-ray
• Indicated before surgery
/ 42 42
44. Treatment
• Antibiotics questionable
• Stalman: 192 patients. No difference between placebo and
doxycycline.
• Van Buchem: 214 patients. No difference between amoxycilline and
placebo.
• Lindbaek: 130 patients. compared Pen V, Amoxycilline and placebo.
86 % of patients receiving antibiotics and 57% of patients receiving
placebo improved.
/ 42 44
45. Antibiotics for Sinusitis
• Amoxycilline (Alfoxil) 3x500mg/d PO 10 d
• Amoxycilline/clavulonate (Augmentin) 3x625 mg/d PO 10 d
• Cefuroxim (Zinnat) 2x250 mg/d PO 10 d
• Azithromycine (Zitromax) First day 1x500 mg, then 1x250 mg/d PO 5 d
/ 42 45
47. Laryngitis
• Most commonly upper respiratory viruses
• Diphtheria
• C. diphtheriae produces a cytotoxic exotoxin causing tissue necrosis at site
of infection with associated acute inflammation. Membrane may narrow
airway and/or slough off (asphyxiation)
/ 42 47
48. Acute epiglottitis
• H. influenza type B
• Another cause of acute severe airway
compromise in childhood
/ 42 48
50. Acute Bronchitis
• The cough in acute bronchitis most often lasts from 10 to 20
days
• Chronic bronchitis: cough and sputum production on most days
of the month for at least three months of the year during two
consecutive years
• Etiology: A)Viral
B) Bacterial (Bordetella pertussis, Mycoplasma
pneumoniae, and Chlamydia pneumoniae)
• Diagnosis: Clinical
• S/S: Productive cough, rarely fever or tachypnea.
/ 42 50
55. Influenza
• Sudden onset after 12-24 hours incubation
• General weakness and fatigue
• Feeling cold, shivering, temp. Up to 39-40 C
• No sore throat or running nose
• Severe back, muscle and joint pain
/ 42 55
57. DISEASE
• Influenza A virus cause
• worldwide epidemics (pandemic)
• major outbreaks of influenza
• occurs virtually every year.
• Influenza B virus cause
• major outbreaks of influenza
/ 42 57
58. VIRUS
• Segmented (8 segments in types A & B, 7 in type C) ssRNA
genome
• Helical nucleocapsid
• Outer lipoprotein envelope
• The envelope is covered with two different types of spikes, hemagglutinin and
a neuraminidase.
• Hemagglutinin binds cell surface receptor, to initiate infection.
• Neuraminidase releases progeny virus from infected cells.
• The internal ribonucleoprotein is the group specific antigen
that distinguishes influenza A, B and C.
/ 42 58
59. ORTHOMYXOVIRUSES
M1 protein
helical nucleocapsid (RNA plus
NP protein)
HA - hemagglutinin
polymerase complex
lipid bilayer membrane
NA - neuraminidase
Type A, B, C : NP, M1 protein
Sub-types: HA or NA protein
60. ANTIGENIC CHANGES
• Influenza viruses especially type A show changes in
antigenicity of hemagglutinin (H) and neuraminidase (N)
proteins.
• Antigenic shifts:
• major changes based on the reassortment of RNA segments. It occurs only
with influenza A.
• Other theories of antigenic shift includes:
• Recirculation of existing subtypes
• Gradual adaptation of animal viruses to human transmission
• Antigenic drifts:
• minor changes based on mutations in the RNA genome.
61. • Animal viruses (aquatic birds, chicken, swine) are the source of RNA
segments that encode antigenic shift variants.
• Because influenza B virus is only a human virus, there is no animal
source of new RNA segments. Influenza B virus shows only antigenic
drift, but not shift.
63. A / PHILIPPINES / 82 (H3N2)
A group antigen of influenza A
Philippines / 82 location and year the virus isolated
H3N2 Hemagglutinin and Neuraminidase types
H1N1 and H3N2 strains of influenza A are the most common types
at this time and are the strains included in the current vaccine.
64. Past Antigenic Shifts
1918 H1N1 “Spanish Influenza” 20-40 million
deaths
1957 H2N2 “Asian Flu” 1-2 million deaths
1968 H3N2 “Hong Kong Flu”700,000 deaths
1977 H1N1 Re-emergence No pandemic
At least 15 HA subtypes and 9 NA subtypes occur in
nature. Up until 1997, only viruses of H1, H2, and H3 are
known to infect and cause disease in humans.
66. CLINICAL FINDINGS
• Incubation period 24 – 48 hours
• Fever, myalgias, headache, dry cough, photophobia, shivering
• Resolve spontaneously in 4 – 7 days. Influenza B is similar to A, but
influenza C is usually subclinical or milder in nature.
67. COMPLICATIONS
• Tracheobronchitis and bronchiolitis
• Primary viral pneumonia
• Secondary bacterial pneumonia
• usually occurs late in the course of disease, after a period of
improvement has been observed for the acute disease. S.
aureus is most commonly involved although S. pneumoniae
and H. influenzae may be found.
• Myositis and myoglobinuria
• Reye's syndrome
• Reye's syndrome is characterized by encephalopathy and
fatty liver degeneration. It occurs in children with viral
infection and are taken aspirin to reduce fever. The disease
had been associated with several viruses; such as influenza A
and B, Coxsackie B5, echovirus, HSV, VZV, CMV and
adenovirus.
68. LABORATORY DIAGNOSIS
• Virus Isolation
• Throat swabs, NPA and nasal washings may be used for virus
isolation. It is reported that nasal washings are the best
specimens for virus isolation. Influenza viruses isolated from
embryonated eggs or tissue culture can be identified by
serological or molecular methods.
• Rapid Diagnosis by Immunoflurescence
• cells from pathological specimens may be examined for the
presence of influenza A and B antigens by indirect
immunofluorescence.
• Serology
• Demonstration of a rise in serum antibody to the infecting
virus
69. TREATMENT
• Amantidine
• The only effective against influenza A.
• Act at the level of virus uncoating.
• Both therapeutic and prophylactic effects.
• Significantly reduces the duration of fever (51 hours as opposed to
74 hours) and illness.
• 70% protection against influenza A when given prophylactically.
• Rimantadine is an amantadine derivative but not as effective as
amantadine and less toxic.
70. PREVENTION
• Vaccine
• killed influenza A (HINI and H3N2 isolates) and B viruses
• Protection lasts only 6 months
• Yearly boosters are recommended
• Should be given to people
• Older than 65 years
• With chronic respiratory diseases
• With chronic cardiovascular diseases.
• Immunity to Influenza
• Antibody against hemagglutinin (H) is the most important
component in the protection against influenza viruses.
71. AVIAN INFLUENZA
Avian influenza A viruses usually do not infect humans
Rare cases of human infection with avian influenza viruses have been
reported since 1997 with avian influenza A (H5N1) viruses
All strains of the infecting virus were totally avian in origin and there was
no evidence of reassortment.
Infection in humans are thought to have resulted from direct contact with
infected poultry or contaminated surfaces.
To date, human infections with avian influenza A viruses have not resulted
in sustained human-to-human transmission.