... Otitis, and Other
Upper RespiratoryTractInfections
(Part 1)
Harrison's Internal Medicine > Chapter 31. Pharyngitis, Sinusitis, Otitis,
and Other UpperRespiratoryTractInfections
Pharyngitis, ... Infections
Pharyngitis, Sinusitis, Otitis, and Other UpperRespiratoryTract
Infections: Introduction
Infections of the upperrespiratorytract (URIs) have a tremendous impact
on public health. ...
syndromes, acute infections are diagnosed largely on clinical grounds. Thus the
judicious use of antibiotics in this setting is challenging.
Nonspecific Infections of the UpperRespiratoryTract
Nonspecific...
...
pneumoniae, and Enterobacter species. Often, these infections are polymicrobial
and involve organisms that are highly resistant to numerous antibiotics. Fungi are
also established causes of ... life-threatening infections.
The best-known example is rhinocerebral mucormycosis caused by fungi of the
order Mucorales, which includes Rhizopus, Rhizomucor, Mucor, Absidia, and
Cunninghamella. These infections ... methicillin-resistant S. aureus
(MRSA) as an emerging cause. Anaerobes are occasionally found in association
with infections of the roots of premolar teeth that spread into the adjacent
maxillary sinuses. The...
... to antibiotics within 30
d, recent treatment failure, or >30%
prevalence of penicillin
-
resistant S.
Chapter 031. Pharyngitis, Sinusitis, Otitis, and Other
Upper RespiratoryTractInfections ... viral infections
such as the common cold and is not specific to bacterial infection. Other
nonspecific manifestations include cough, sneezing, and fever. Tooth pain, most
often involving the upper ... colds have sinus inflammation, although
bacterial sinusitis complicates only 0.2–2% of these viral infections. Common
presenting symptoms of sinusitis include nasal drainage and congestion, facial...
... associated with either bacteria
Chapter 031. Pharyngitis, Sinusitis, Otitis, and Other
Upper RespiratoryTractInfections
(Part 4)
Acute Sinusitis: Treatment
Most patients with a diagnosis ... patient's characteristics.
Treatment of nosocomial sinusitis should begin with broad-spectrum
antibiotics to cover common pathogens such as S. aureus and gram-negative
bacilli. Therapy should ... 10–14 days, and patients with more severe symptoms (regardless
of duration) should be treated with antibiotics (Table 31-1). Empirical therapy
should consist of the narrowest-spectrum agent active...
... water).
Antibiotics are most effective when given topically. Otic mixtures provide
Chapter 031. Pharyngitis, Sinusitis, Otitis, and Other
Upper RespiratoryTractInfections
(Part 5)
Infections ... bacteria are known causes of these
infections, some of which result in significant morbidity if not treated
appropriately.
Infections of the External Ear Structures
Infections involving the structures ... warm
compresses and oral antibiotics such as dicloxacillin that are active against typical
skin and soft tissue pathogens (specifically, S. aureus and streptococci). IV
antibiotics, such as a...
... debridement, once an important component of the
treatment approach, is now rarely indicated.
Infections of Middle-Ear Structures
Otitis media is an inflammatory condition of the middle ear ... d
otalgia, decreased hearing,
tinnitus, vertigo, erythematous
tympanic membrane
Exposure to antibiotics
within 30 d or recent treatment
failure
a,c
Amoxicillin, 90 mg/kg
qd (up to 2 ...
mg/kg
qd PO in divided doses
(bid),
or
Ceftriaxone, 50 mg/kg
IV/IM qd for 3 d
Exposure to antibiotics
within 30 d or recent treatment
failure
a,c
Ceftriaxone, 50 mg/kg
the development...
... recurrences are new infections. In
general, the same pathogens responsible for acute otitis media cause recurrent
disease; even so, the recommended treatment consists of antibiotics active against ... evident but is nonspecific
as it is frequently seen in association with inflammation of the upperrespiratory
mucosa (e.g., during examination of young children). Other signs and symptoms
that ... considerable debate on the usefulness of antibiotics for the
treatment of acute otitis media. Although most cases resolve clinically 1 week
after the onset of illness, antibiotics appear to be of some...
... are usually evident on CT.
Chapter 031. Pharyngitis, Sinusitis, Otitis, and Other
Upper RespiratoryTractInfections
(Part 8)
Serous Otitis Media
In serous otitis media (otitis media with ...
usually requiring repeated courses of topical antibiotic drops during periods of
drainage. Systemic antibiotics may offer better cure rates, but their role in the
treatment of this condition remains ...
Mastoiditis
Acute mastoiditis was relatively common among children before the
introduction of antibiotics. Because the mastoid air cells connect with the middle
ear, the process of fluid collection...
... only by the clinical history.
Oropharyngeal infections range from mild, self-limited viral illnesses to
serious, life-threatening bacterial infections. The most common presenting
symptom ... each year are for sore throat; the
majority of cases of acute pharyngitis are caused by typical respiratory viruses.
The most important source of concern is infection with group A β-hemolytic ... estimated, since a significant
proportion of cases (~30%) have no identified cause. Together, respiratory viruses
are the most common identifiable cause of acute pharyngitis, with rhinoviruses...
... adenovirus, HSV, EBV, CMV, and M. pneumoniae, are
available in some locations and can be used when these infections are suspected.
The diagnosis of acute EBV infection depends primarily on the detection...
... resulting in mediastinitis, or it
Chapter 031. Pharyngitis, Sinusitis, Otitis, and Other
Upper RespiratoryTractInfections
(Part 11)
Pharyngitis: Treatment
Antibiotic treatment of pharyngitis ... cold sores, oral or IV
acyclovir is often needed for primary infections, extensive oral infections, and
from an infected or recently extracted tooth, most commonly the lower second and
third molars. ... typically involves needle
aspiration or incision and drainage.
Oral Infections
Aside from periodontal disease such as gingivitis, infections of the oral
cavity most commonly involve HSV or Candida...
... copeptin, a
novel biomarker, in lower respiratorytract infections. Eur J Clin Invest
2007, 37:145-152.
22. Christ-Crain M, Muller B: Biomarkers in respiratorytract infections:
diagnostic guides ... for prediction of adverse medical
outcome in community-acquired pneumonia and
lower respiratorytract infections
Philipp Schuetz
†1
, Marcel Wolbers
†2,3
, Mirjam Christ-Crain
1
, Robert Thomann
1,4
, ... risk
stratification in patients with community-acquired pneumonia (CAP) and other lower respiratorytractinfections (LRTI).
Methods: We assessed clinical parameters and five biomarkers, the precursor...
... and children in primary care
Respiratory tract infection (RTI) is defined as any infectious disease of the
upper or lower respiratory tract. Upperrespiratorytractinfections (URTIs)
include ... clinical guideline 69 – respiratorytractinfections – antibiotic prescribing
13
1.3 Overview
1.3.1 Prescribing of antibiotics for self-limiting respiratorytract
infections in adults and ... Centre for Clinical Practice at NICE
Respiratory tractinfections
– antibiotic prescribing
Prescribing of antibiotics for
self-limiting respiratorytract
infections in adults and children
in...