Acute Respiratory Viral Infections = Upper Respiratory Tract

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acute_viral_infections.ppt

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>Acute Respiratory Viral Infections = Upper Respiratory Tract Infections Acute Respiratory Viral Infections = Upper Respiratory Tract Infections

>URTI – group of self-limited viral diseases, characterized by : - catarrhal syndrome; - URTI – group of self-limited viral diseases, characterized by : - catarrhal syndrome; - intoxication.

>Examples of URTI viruses Examples of URTI viruses

>Seasonal characteristics Seasonal characteristics

>Frequency of URTI Frequency of URTI

>Main clinical syndromes Short incubation period Catarrhal syndrome (by topics) Intoxication Main clinical syndromes Short incubation period Catarrhal syndrome (by topics) Intoxication

>Topics of different URTI Topics of different URTI

>Differential diagnosis Differential diagnosis

>Laboratory diagnosis Laboratory diagnosis

>Antiviral therapy (First 48 hours!) Antiviral therapy (First 48 hours!)

>URTI prophylaxis – vaccines Influenza Adenovirus (for military personnel) RSV (for newborns, high risk URTI prophylaxis – vaccines Influenza Adenovirus (for military personnel) RSV (for newborns, high risk infants)

>Influenza Influenza

>Epidemiology Winter-Spring А, В, С types of virus Hemagglutinin and neuraminidase typing (H & Epidemiology Winter-Spring А, В, С types of virus Hemagglutinin and neuraminidase typing (H & N) Pandemias – mostly type A (1918, 1977yy.) Epidemics - mostly for type B Sporadic cases - mostly for type C

>Clinics Acute beginning Intoxication syndrome first Fever 39-410 С ; Astenic syndrome, myalgias Catarrhal Clinics Acute beginning Intoxication syndrome first Fever 39-410 С ; Astenic syndrome, myalgias Catarrhal syndrome – tracheitis, tonsilopharyngitis, conjunctivitis Severe cases – hemorrhagic syndrome and neurotoxicosis

>Particularities in newborns Sepsis-like clinics: Lethargy Feeding refusal Capillary refill decreased Apnoe Petechia rash Particularities in newborns Sepsis-like clinics: Lethargy Feeding refusal Capillary refill decreased Apnoe Petechia rash

>Complications Bacterial: otitis, sinusisits, pneumonia, etc. Acute myositis Reye syndrome Neurologic (encephalitis neurotoxicosis, Guilliene-Barre Complications Bacterial: otitis, sinusisits, pneumonia, etc. Acute myositis Reye syndrome Neurologic (encephalitis neurotoxicosis, Guilliene-Barre syndrome, myelitis) Cardiological (myocarditis)

>Mortality risk factors Age under 3 years or elderly Chronic lung diseases Chronic heart Mortality risk factors Age under 3 years or elderly Chronic lung diseases Chronic heart diseases Diabetes mellitus Neurological and muscle diseases Malignancy

>Therapy Oral or IV desintoxication NSAIDs – ibuprophen, paracetamole Aspirin contraindicated! Antivirals – first Therapy Oral or IV desintoxication NSAIDs – ibuprophen, paracetamole Aspirin contraindicated! Antivirals – first 48 hour, 5 days (Oseltamivir (Tamiflu), Zanamivir, Remantadin)

>Parainfluenza Parainfluenza

>Croup – inflammation of larynx: Croup – inflammation of larynx:

>Differential diagnosis Epiglottitis Diphtheria Bacterial laryngitis Retropharyngeal abscess Spasmodic croup Foreign body Angioneurotic laryngeal Differential diagnosis Epiglottitis Diphtheria Bacterial laryngitis Retropharyngeal abscess Spasmodic croup Foreign body Angioneurotic laryngeal edema

>Therapy of stenosis Epinephrin - inhalations through nebulizer Cortocosteriods - IM, PO Oxygen Moist Therapy of stenosis Epinephrin - inhalations through nebulizer Cortocosteriods - IM, PO Oxygen Moist air Comfortable surrounding for the child

>Acute bronchiolitis Acute bronchiolitis

>Acute bronchiolitis First two years of life Obstruction of small bronchi and bronchiolae Etiology: Acute bronchiolitis First two years of life Obstruction of small bronchi and bronchiolae Etiology: RSV (60-85 %); Parainfluenza 3rd type; CMV; Adenovirus; Micoplasma; Chlamydia.

>Main symptoms Dry cough for 2-4 days → more moist Dyspnea (expiratory, apnea) Respiratory Main symptoms Dry cough for 2-4 days → more moist Dyspnea (expiratory, apnea) Respiratory insufficiency Thorax emphysema (severe cases) Hemodynamic disturbances Mild intoxication syndrome

>Treatment Bronchodilators – salbutamol Oxygen Antivirals – ribavirin Adequate fluid balance Treatment Bronchodilators – salbutamol Oxygen Antivirals – ribavirin Adequate fluid balance

>Adenoviral infection Adenoviral infection

>Etiology DNA containing Persists in lymphoid tissue → clinics, chronic tonsillitis and adenoiditis Oncogenic Etiology DNA containing Persists in lymphoid tissue → clinics, chronic tonsillitis and adenoiditis Oncogenic ability and long-life carriage Tropic to respiratory, GI and conjunctival mucous Infections - all the seasons

>Clinical forms URTI Rhino-pharyngeal fever Follicular conjunctivitis Epidemic kerato-conjunctivitis Pertussis-like disease Hemorrhagic cystitis Acute Clinical forms URTI Rhino-pharyngeal fever Follicular conjunctivitis Epidemic kerato-conjunctivitis Pertussis-like disease Hemorrhagic cystitis Acute diarrhea Reye or Reye-like syndrome In immunodeficient patients (pneumonia with bronchiolitis, bronchoectasis, pneumofibrosis)

>Clinics Subfebrile fever Prominent catarrhal syndrome Under 3 years of age – often + Clinics Subfebrile fever Prominent catarrhal syndrome Under 3 years of age – often + diarrhea Rhinitis, conjunctivitis, pharyngitis Poly-lymphadenopathy Pneumonia and OM complications