SECTION ACUTE UPPER RESPIRATORY INFECTION AND ACUTE BRONCHITIS.docVIP

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SECTION ACUTE UPPER RESPIRATORY INFECTION AND ACUTE BRONCHITIS.doc

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SECTION ACUTE UPPER RESPIRATORY INFECTION AND ACUTE BRONCHITIS

SECTION 1 ACUTE UPPER RESPIRATORY INFECTION AND ACUTE BRONCHITIS Liu Zhong 一、Acute Upper Respiratory Infection Acute upper respiratory infection is a general designation of acute inflammation of nasal cavity, pharynx, and laryngeal, most in association with viral infection and less with bacteria involvement. Its incidence has no difference in age, sex, occupation, and region. Although upper respiratory infections are mild and self-limiting, they are the most common infection and the most frequent reasons for office visits in the world. （一）The Common Cold The common cold is a mild, self-limited upper respiratory infection. Most colds are caused by rhinovirus, coronavirus, influenza virus, parainfluenza virus, respiratory syncytial virus, or adenovirus. Peak incidence of colds occurs during the colder months. Symptoms develop 16 to 72 hours after inoculation, which include increased nasal discharge, sneezing, and nasal obstruction. The nasal discharge, at first watery or mucoid, later becomes purulent. Obstruction of the maxillary sinuses and Eustachian tubes by mucosal oedema often causes discomfort, and sometimes actual pain, in the face or ear. ‘Sore throat’ in the cold is usually a dry or rough sensation on the posterior part of the soft palate or the uvula and it is often the first symptom, heralding the onset of a cold. Systemic upset may occur with headache, malaise, muscular aching, lassitude and chilliness, but the symptoms are seldom severe. Fever is uncommon. The course of cold is self-limited and last for 5 to 7 days if there are no complications. （二）Pharyngitis and Laryngitis Most cases of acute pharyngitis occur as part of the common cold and are caused by viruses such as rhinovirus, adenovirus, influenza virus, parainfluenza virus, enterovirus, and respiratory syncytial virus. These cases are mild, nonexudative, and self-limiting. A severe, usually exudative pharyngitis occurs in about half of patients with either adenovirus infection or Epstein-Bar