Upper respiratory tract

Pharyngitis: 50% caused by viruses, and 50% of bacteria of which, most important is Strep pyogenes & Group A beta-haemolytic streptococci. Next most important is: EBV (pharyngitis, lymphadenitis, fever & rash)Symptoms: malaise, fever, headache, sore throat. White exudate visible in the pharynx and tonsils are enlarged. Treatment: Penicillin G for 10 days continuous (bacterial cause).

Acute laryngitis vs Chronic laryngitis: former: viral syndrome, latter: investigate for malignancy

Croup (laryngotracheobronchitis): Parainfluenzae virus Type I – usually in children

Otitis media (middle ear infection): The middle ear is connected to the nasopharynx. URT infections may cause otitis media. The mucous membranes become inflamed and you get fluid build up  infection settles in. Cause: RSV complication, Group A streptococci, Haemophilus influenza, Strep. Pneumoniae etc.

Epiglottiditis: inflammation of the epiglottis. This is a rapidly progressing cellulitis of the supraglottis structures  sometimes leading to total airway obstruction. Cause: Haemophilus Influenza type B. Clinical features: usually childhood illness, great difficulty breathing, cant swallow and drools. Must not do a throat swab because potential total airway obstruction, unless someone present to intubate. Treatment: 3^rd generation cephalosporins + intubation. Vaccination is available, so not common at present day.

Category: Microbiology Notes