... Other UpperRespiratoryTractInfections Pharyngitis, Sinusitis, Otitis, and Other UpperRespiratoryTract Infections: Introduction Infections of the upperrespiratorytract (URIs) have a tremendous ... Sinusitis, Otitis, and Other Upper RespiratoryTractInfections (Part 1) Harrison's Internal Medicine > Chapter 31. Pharyngitis, Sinusitis, Otitis, and Other UpperRespiratoryTract ... antibiotics in this setting is challenging. Nonspecific Infections of the UpperRespiratoryTract Nonspecific URIs are a broadly defined group of disorders that collectively constitute the leading...
... cause sinusitis through impaired mucus clearance. In the hospital setting, nasotracheal intubation is a major risk factor for nosocomial sinusitis in intensive care units. Acute infectious sinusitis ... variety of organisms, including viruses, bacteria, and fungi. Viral rhinosinusitis is far morecommon than bacterial sinusitis, although relatively few studies have sampled sinus aspirates for ... although there is increasing concern about community strains of methicillin-resistant S. aureus (MRSA) as an emerging cause. Anaerobes are occasionally found in association with infections of the...
... 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 pain ... include cough, sneezing, and fever. Tooth pain, most often involving the upper molars, is associated with bacterial sinusitis, as is halitosis. In acute sinusitis, sinus pain or pressure often ... fungal sinusitis, or sinusitis from noninfectious causes (e.g., allergic rhinosinusitis). In the case of an immunocompromised patient with acute fungal sinus infection, immediate examination...
... Sinusitis, Otitis, and Other Upper RespiratoryTractInfections (Part 4) Acute Sinusitis: Treatment Most patients with a diagnosis of acute rhinosinusitis based on clinical grounds improve ... pathogens, including S. pneumoniae and H. influenzae—e.g., amoxicillin. No clinical trials support the use of broad-spectrum agents for routine cases of bacterial sinusitis, even in the current ... amphotericin B. Specific therapy should be individualized according to the fungal species and the individual patient's characteristics. Treatment of nosocomial sinusitis should begin with...
... Pharyngitis, Sinusitis, Otitis, and Other Upper RespiratoryTractInfections (Part 5) Infections of the Ear and Mastoid Infections of the ear and associated structures can involve both the ... exists in several forms: localized, diffuse, chronic, and invasive. All forms are predominantly bacterial in origin, with P. aeruginosa and S. aureus the most common pathogens. should include ... appropriately. Infections of the External Ear Structures Infections involving the structures of the external ear are often difficult to differentiate from noninfectious inflammatory conditions...
... nasopharynx are introduced into the inflammatory fluid collected in the middle ear (e.g., by nose blowing during a URI). The proliferation of these pathogens in this space leads to Cefdinir, ... Pseudomonas (e.g., ciprofloxacin) are usually prescribed and are combined with glucocorticoids to reduce inflammation. Cases of invasive Pseudomonas otitis externa recognized in the early stages can ... an inflammatory condition of the middle ear that results from dysfunction of the eustachian tube in association with a number of illnesses, including URIs and chronic rhinosinusitis. The inflammatory...
... bulging, or retracted and occasionally can spontaneously perforate. The signs and symptoms accompanying infection can be local or systemic, including otalgia, otorrhea, diminished hearing, ... frequently seen in association with inflammation of the upperrespiratory mucosa (e.g., during examination of young children). Other signs and symptoms that are occasionally reported include vertigo, ... months or four episodes within 12 months) is generally due to relapse or reinfection, although data indicate that the majority of early recurrences are new infections. In general, the same pathogens...
... the surrounding bone and the formation of abscess-like cavities that are usually evident on CT. Chapter 031. Pharyngitis, Sinusitis, Otitis, and Other Upper RespiratoryTractInfections (Part ... person-years in countries with high prescribing rates for acute otitis media. In countries like the Netherlands, where antibiotics are used sparingly for acute otitis media, the incidence rate ... otitis media more similar to that in the United States. In typical acute mastoiditis, purulent exudate collects in the mastoid air cells (Fig. 31-1), producing pressure that may result in erosion...
... nonspecific URI. Findings on physical examination are uncommon; fever is rare, and tender cervical adenopathy and pharyngeal exudates are not seen. In contrast, acute pharyngitis from influenza virus ... for a minority of cases, although these serogroups are nonrheumatogenic. The remaining bacterial causes of acute pharyngitis are seen infrequently (<1% each) but should be considered in appropriate ... and yersinial) often present as exudative pharyngitis with or without other clinical features. Their etiologies are often suggested only by the clinical history. Oropharyngeal infections...
... such as influenza virus, adenovirus, HSV, EBV, CMV, and M. pneumoniae, are available in some locations and can be used when these infectionsare suspected. The diagnosis of acute EBV infection ... Penicillin VK, 50 mg/kg qd PO in divided doses (bid), or History of rheumatic fever or Cephalexin, 50 mg/kg qd PO in divided doses (qid), or Documented household exposure or Benzathine penicillin ... or Erythromycin, 250 mg PO qid, or Documented household exposure or Benzathine penicillin G, single dose of 1.2 million units IM Positive rapid strep screen Children Clinical suspicion...
... treatment 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 ... needed for primary infections, extensive oral infections, and from an infected or recently extracted tooth, most commonly the lower second and third molars. Improved dental care has substantially ... is entirely symptom-based except in infection with influenza virus or HSV. For influenza, a number of therapeutic agents exist, including amantadine, rimantadine, and the two newer agents oseltamivir...
... isimportant in mediating the effects of FSH on inhibin-A,activin-A, oestradiol and progesterone secretion and alsoimportant in mediating IGF-I stimulated inhibin-A,activin-A, follistatin, oestradiol ... immunization of sheep against an aminoterminal peptide of the inhibin αC subunit on intrafollicularlevels of activin A, inhibin A and follistatin. Journal of Endocrinol-ogy 1998, 157:157-168. ... Jenkins PJ, Bustin SA: Evidence for a link between IGF-I and can-cer. European Journal of Endocrinology 2006, 151:S17-22.21. Evans ACO, Martin F: Kinase pathways in dominant and subor-dinate...
... Circulating levels of copeptin, a novel biomarker, in lower respiratorytract infections. Eur J Clin Invest 2007, 37:145-152.22. Christ-Crain M, Muller B: Biomarkers inrespiratorytract infections: ... procalcitonin-guided treatment on antibiotic use and outcome in lower respiratorytract infections: cluster-randomised, single-blinded intervention trial. Lancet 2004, 363:600-607.30. Christ-Crain ... Nicolas-Chanoin MH, Wolff M, Spencer RC, Hemmer M: The prevalence of nosocomial infection in intensive care units in Europe. Results of the European Prevalence of Infection in Intensive Care (EPIC)...