抗生素PPT课件（英文精品）Upper Respiratory Tract .pptVIP

/ 42 Upper Respiratory Tract Infections Acute tonsillitis Acute pharyngitis Acute otitis media Acute sinusitis Common cold Acute laryngitis Otitis externa Mastoiditis Acute apiglottis Objectives At the end of this session, the participants should be able to; List upper respiratory tract infections Make differential diagnosis between URTI Define criteria for antibiotic use Apply and interpret the McIsaac scoring Tonsilitis-pharyngitis Bacteria S. pyogenes C. diphteriae N. gonorrhoeae Viruses Epstein-Barr virus Adenovirus Influenza A, B Coxsackie A Parainfluenzae Causative organisms 3 years ? 100 % viral 5-15 years 15-30 % GABHS Adult 10 % GABHS Due to streptococci: Spreads by close contact and through air Spread more in crowded areas (KG, school, army..) Most common among 5-15 age group More frequent among lower socio-economic classes Most common during winter and spring Incubation period 2-4 days Signs/symptoms Sore throat Anterior cervical LAP Fever 38 ?C Difficulty in swallowing Headache, fatigue Muscle pain Nausea, vomiting Viral tonsillitis/pharyngitis Having additional rhinitis, hoarseness, conjunctivitis and cough Pharyngitis is accompanied by conjunctivitis in adenovirus infections Oral vesicles, ulcers point to viruses Exudates GABHS EBV Adenovirus Primary HIV infection Candida albicans Francisella tularensis Lymphadenopathy GABHS Epstein-Barr virus Adenovirus Human herpesvirus type 6 Tularemia HIV infection Laboratory Throat swab Gold standard Rapid antigen test If negative need swab ASO May remain + for 1 year WBC count Peripheral smear Throat Culture Pathogens looked for Group A beta hemolytic streptococci C. diphteriae (rare) N. gonorrhoeae (rare) If GABHS do we need antibiogram? Is there resistence to penicilline? Tonsillitis due to Streptococci Supurative complications Abscess Sinusitis, otitis, mastoiditis Cavernous sinus thrombosis Toxic shock syndrome Cervical lymphadenitis Septic arthritis, osteomyelitis Recurrent tonsillitis/ph