Acute Respiratory Viral Infections = Upper Respiratory Tract

Acute Respiratory Viral Infections = Upper Respiratory Tract Infections
URTI – group of self-limited viral diseases, characterized by : - catarrhal syndrome; -
Examples of URTI viruses
Seasonal characteristics
Frequency of URTI
Main clinical syndromes Short incubation period Catarrhal syndrome (by topics) Intoxication
Topics of different URTI
Differential diagnosis
Laboratory diagnosis
Antiviral therapy (First 48 hours!)
URTI prophylaxis – vaccines Influenza Adenovirus (for military personnel) RSV (for newborns, high risk
Influenza
Epidemiology Winter-Spring А, В, С types of virus Hemagglutinin and neuraminidase typing (H &
Clinics Acute beginning Intoxication syndrome first Fever 39-410 С ; Astenic syndrome, myalgias Catarrhal
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
Mortality risk factors Age under 3 years or elderly Chronic lung diseases Chronic heart
Therapy Oral or IV desintoxication NSAIDs – ibuprophen, paracetamole Aspirin contraindicated! Antivirals – first
Parainfluenza
Croup – inflammation of larynx:
Differential diagnosis Epiglottitis Diphtheria Bacterial laryngitis Retropharyngeal abscess Spasmodic croup Foreign body Angioneurotic laryngeal
Therapy of stenosis Epinephrin - inhalations through nebulizer Cortocosteriods - IM, PO Oxygen Moist
Acute bronchiolitis
Acute bronchiolitis First two years of life Obstruction of small bronchi and bronchiolae Etiology:
Main symptoms Dry cough for 2-4 days → more moist Dyspnea (expiratory, apnea) Respiratory
Treatment Bronchodilators – salbutamol Oxygen Antivirals – ribavirin Adequate fluid balance
Adenoviral infection
Etiology DNA containing Persists in lymphoid tissue → clinics, chronic tonsillitis and adenoiditis Oncogenic
Clinical forms URTI Rhino-pharyngeal fever Follicular conjunctivitis Epidemic kerato-conjunctivitis Pertussis-like disease Hemorrhagic cystitis Acute
Clinics Subfebrile fever Prominent catarrhal syndrome Under 3 years of age – often +
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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