Upper respiratory tract infection (URTI)

Mind Map by , created almost 6 years ago

Paediatrics (Respiratory) Mind Map on Upper respiratory tract infection (URTI), created by v.djabatey on 12/12/2013.

Created by v.djabatey almost 6 years ago
Cystic fibrosis
Laryngeal & tracheal infections
The Tempest
Dirk Weibye
1PR101 1.test - 10. část
Nikola Truong
Respiratory System
Chronic Respiratory Conditions
Kirsty Jayne Buckley
Respiratory System Year 2/
Sole C
Respiratory System 2nd Year PMU Anatomy
Med Student
Upper respiratory tract infection (URTI)
1 account for 80% of all respiratory infections
2 involve nose, throat, ears or sinuses only
3 involves many conditions
3.1 Coryza (the common cold)
3.1.1 the commonest infection of childhood
3.1.2 Features Nasal discharge mucopurulent clear Nasal blockage
3.1.3 Pathogens viruses commonest causative orgs rhinoviruses >100 different serotypes coronaviruses RSV
3.1.4 self-limiting
3.1.5 no specific curative treatment paracetamol/ibuprofen for fever & pain Abx of no benefit common cold is viral in origin secondary bacterial infection is uncommon
3.2 Sore throat (pharyngitis)
3.2.1 inflamed pharynx & soft palate
3.2.2 enlarged & tender local lymph nodes
3.2.3 Pathogens Viral usual cause respiratory viruses adenoviruses enteroviruses rhinoviruses Bacteria group A beta-haemolytic streptococcus common in older children
3.2.4 Tonsillitis a form of pharyngitis intense inflammation of the tonsils often w/ purulent exudate Pathogens bacteria group A beta-haemolytic streptococci marked constitutional disturbance more common headache headache apathy abdo pain white tonsillar exudate more commmon cervical lymphadenopathy more common cause 1/3rd of cases virus Epstein-Barr virus (EBV) [infectious mononucleosis] surface exudates said to be more purulent than bacterial clinically not possible to distinguish btw viral & bacterial tonsillitis Rx Abx penicillin or erythromycin (if pen allergic) 10 days to eradicate strep (thus prevent rheumatic fever) no longer indicated in UK rheumatic fever is rare avoid amoxicillin can cause maculopapular rash if tonsillitis is due to EBV for severe cases hospital admission IV fluid admin if unable to swallow solids or liquids analgesia for recurrent tonsillitis tonsillectomy


  • other indications for tonsillectomy -peritonsillar abscess (quinsy) -obstructive sleep apnoea (adenoids also normally removed) NB: large tonsils aren't in themselves an indication for tonsillectomy- many kids have large ones & they shrink spontaneously in late childhood reduces no of episodes of tonsillitis by 1/3 (from 3 to 2/ yr)
3.2.5 Rx Abx penicillin or erythromyin for severe pharyngitis
3.3 Acute otitis media
3.3.1 epidemiology most kids'll have min 1 episode commonest at 6-12 mths old up to 20% will have 3 or more episodes
3.3.2 infants & young children are prone Eustachian tubes short horizontal don't work well
3.3.3 Presentation ear pain fever otoscopy tympanic mb red bulging loss of normal light reflection acute perforation of eardrum sometimes pus visible in external canal
3.3.4 Pathogens Viruses RSV Rhinovirus Bacteria Pneumococcus non-typeable H. influenzae Moraxella catarrhalis
3.3.5 Complications serious but uncommon mastoiditis meningitis of recurrent AOM otitis media w/ effusion (glue ear/serous otitis media) presentation asymptomatic but decreased hearing maybe eardrum dull retracted fluid level often visible Ix tympanogram flat trace pure tone audiometry conductive hearing loss distraction hearing test reduced hearing in younger kids epidemiology v common btw 2-7 years old peak incidence btw 2.5 & 5 yrs commonest cause of conductive hearing loss in kids interfere w/ normal speech development -> learning difficulties usually resolves spontan Rx grommets OME intefering w/ normal speech development kids w/ recurrent URTIs and chronic glue ear that don't resolve w/ conservative measures adenoidectomy more long term benefit adenoids harbour orgs within biofilms that spread up Eustachian tubes w/ reinsertion of grommets after grommet extrusion tonsillectomy + adenoidectomy


  • also indicated for obstructive sleep apnoea for recurrent otitis media w/ effusion w. hearing loss esp if reinsertion of grommets considered
3.3.6 Treatment Analgesia paracetamol/ibuprofen regular up to a week until acute inflammn resolves most cases resolve spontaneously Abx shorten duration of pain don't reduce risk of hearing loss Amoxicillin prescribe but parents to use only if child remains unwell after 2-3 days
3.4 sinustitis
3.4.1 infection of paranasal sinuses
3.4.2 pathogens viral secondary bacterial infection pain swelling tenderness over cheek infection of maxillary sinus
3.4.3 frontal sinusitis uncommon in 1st decade of life frontal sinuses don't develop til late childhood
3.4.4 Rx acute sinusitis Abx + intranasal corticosteroids/antihistamines quicker recovery (recent evidence) analgesia
4 presentation
4.1 commonest
4.1.1 nasal discharge nasal blockage fever painful throat earache
4.1.2 cough
4.2 complications
4.2.1 difficulty feeding (infants)
4.2.2 febrile convulsions
4.2.3 acute exacerbations of asthma

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