| Site | Common Organisms | Pattern Recognition | Therapy |
| Naso-Pharyngitis (Common cold) | VIRAL: (commonest) Rhinovirus, Adenovirus, Coronavirus Coxsackie virus Influenza virus BACTERIAL: Gp. A.ß. Hemolytic- streptococci Mycoplasma coryne bacteria H. Influenza Strep. Pneumonia | * Seasonal (winter) * Outbreaks in community * Prodrome: Fever sneezing, rhinorrhea, lacrimation, nasal obstruction * Worsening of above symptoms * Increasing fever and constitutional symptoms * Purulent nasal discharge * Poor activity and appetite | Self limiting Paracetamol 50 mg/kg in 3-4 div doses Normal saline nasal drops/spray 3-4 times a day. In infants, ten minutes before feeding. Penicillins (Amoxycillin 50mg /kg/d in 3-4 divided doses for 5 days) OR Macrolides (Erythromycin 50 mg /kg/d in 3-4 divided doses for 5 days) |
| Pharyngo Tonsillitis > | VIRAL: (commonest) Rhinovirus, Adenovirus, Coronavirus Coxsackie virus Influenza virus BACTERIAL: Gp. A.ß. Hemolytic Streptococci Mycoplasma coryne bacterium Diphtheria | * Seasonal (winter) * Prodrome: Fever, cough, sore throat rhinitis * Throat: exam: Pharynx inflammed,exudates on the lymphoid follicles on hard palate and tonsils, cervical adenopathy, lymphocytosis * Over crowding * Prodrome: Headache vomiting, abdominal pain, fever > 40°C, poor appetite & activity * Throat exam: Tonsils enlarged, anterior pillar flushing, anterior cervical adenopathy, petichiae over the soft palate. * Neutrophilic leuco-cytosis. (Throat swab culture and sensitivity is warranted) | Warm liquid diet Saline gargle Paracetamol 50 mg /kg/d 3-4 divided doses to reduce pain Steam inhalation Penicillins (Penicillin V 50 mg /kg/d 3-divided doses for 5 days) before food or Macrolides Erythromycin 50 mg/kg/d 3-4 divided doses x 5 days |
- Rhinitis, hoarseness of voice and cough rarely occurs in bacterial and presence of 2 out of these indicates viral origin.
- Examination of the throat using tongue depressor
is mandatory in all cases presenting with soreness of throat (exception acute epiglottitis).
- Presence of membranous exudate over the tonsils indicates conditions like diphtheria, herpangina, infectious mononucleosis,
and agranulocytosis and warrants investigation (CBC, throat swab).
- Beware of complications like otitis media, chronic pharyngeal ulcers, peritonsillar abscess following attack of pharyngotonsillitis.
- Rheumatic fever and acute post streptococcal – glomerular nephritis are Immunological complications of Gp A ß hemolytic streptococcal pharyngotonsillitis and hence whenever suspected, treatment with penicillin V for 10 days (Primary chemoprophylaxis for rheumatic fever) is mandatory.
It is a common pediatric ailment. Frequent respiratory infections often leads to otitis media. The other predisposing factors include bottle feeding, recurrent tonsillitis, anatomical and physiological anomalies like cleft palate and cranio facial defects. Hearing defects,perforation and middle ear problems are common complications occurring due to lack of timely administration of medications.
Acute Upper Respiratory Infections
Otitis Media
| Site | Common Organisms |
| Otitis Media | Bacterial: Streptococcus pneumoniae H. Influenza Moraxella catarrhalis Streptococcus Group A Staphylococcus |
Comments
good info
good material. references should be given.
good site