Signs Of Upper Respiratory Infection Research Articles

The Behavior of Primary Healthcare Doctors Toward Antibiotic Prescriptions for Upper Respiratory Tract Infections.

Unnecessary prescription of antibiotics for patients with upper respiratory tract infections (URTIs) carries the potential risk to the development of bacterial resistance. This study aimed to investigate the behavior of primary healthcare (PHC) physicians toward an antibiotic prescription for URTI, Al-Madinah City, Saudi Arabia in 2021. A cross-sectional study was conducted at PHC centers in Al-Madinah City, Saudi Arabia. The study invited all physicians in the randomly selected 28 PHC centers to participate in the study. A master sheet adopted from a researcher done in the Asir region of Saudi Arabia about the pattern of prescription for URTIwas used and included data about socio-demographic characteristics and data about presenting symptoms and signs of URTIs, the clinical diagnosis, type of medication prescribed, and duration of treatment also, included data about the factors that press physicians to prescribe antibiotics and their response. The questionnairewas filled out and returned back by 140 physicians. The collected data were analyzed and tabulated using appropriate statistical tests. The mean age of the studied physicians was 34.4 ± 7.6 years (25-59 years). General practitioners and specialists were 66.4% and 33.6%, respectively. The prevalence of antibiotic prescriptions was 44.3%. The most prescribed antibiotics were amoxicillin (58.6%)and Augmentin(28.6%). Congested tonsils (87.1%), ear discharge (84.2%), and cervical lymphadenopathy (89.3%) were the most clinical factors that affected physicians' decisions to prescribe antibiotics for URTI. The non-clinical factors affecting physicians' decisions include patient request (52.8%) and press (28.5%), with no statistically significant difference detected between general practitioners and specialists. The study findings indicate the need to develop intervention programs targeting physicians as well as the general population to decrease inappropriate antibiotic prescriptions in primary care centers.

Clinical Profile of Covid Patient

Coronaviruses are included in the subfamily Coronavirinae of the family Coronaviridae. Orthocoronavirinae or Coronavirinae are the scientific name of corona virus. The ongoing blazehappening due to the coronavirus SARS coV previously called 2019-nCOV ,started in city named Hubei province of the people’s republic of china which subsequently unrolled to various other countries. The world health organisation emergency committee announced a global health emergency in January 2020 on the grounds of rapid increase in china as well as all the international locations .initially the infection caused high morbidity and mortality in china but the incidence in other nations were low. Coronavirus is characterised by positive single stranded large RNA viruses ,enveloped and can infect humans and also a wide range of animals. According to the reports SARS-coV-2 was transferred from animal to human on sea food in market of Wuhan, China .there is no enough information about the possibility of a intermediate host.
 Pneumonia was the first clinical sign that ledto the recognition of SARS CoV 2 related disease COVID 19. Though several other symptom related to covid 19 has being defined, pneumonia is the most severe symptom. All the observations suggest that the range of incubation period is 0-24 days but the mean incubation period is 7days. symptomatic patients the clinical presentation is within 7days with complains of fever,cough,nasal congestion fatigue and other signs of upper respiratory infections which can further turn into symptoms of pneumonia in almost 75%of patients.Most corresponding signs of viral pneumonia include decrement in Oxygen saturation,chest x ray ,blood gas changes, and further imaging modality shows ground glass appearance,patchy consolidations alveoli filled with exudates and interlobular involvement pointing towards deterioration. other common blood picture is lymphopenia and increase in c reactive proteins and proinflammatory cytokines.

173 Upper respiratory tract colonization in infants with cystic fibrosis diagnosed by newborn screening

Cystic fibrosis, is characterised by production of abnormally thick and viscous mucus. It results in disturbances of mucociliary clearance, a basic defensive mechanism of the respiratory system, leading to increased susceptibility to recurrent and chronic respiratory infections in over 90% of patients. The aim of this study is to evaluate nasopharyngeal cavity colonization in infants with cystic fibrosis diagnosed by newborn screening. Material and Methods: Nasal and pharyngeal swabs were obtained from 26 infants aged 10−20 weeks, without any signs of infections, who were examined in the Cystic Fibrosis Outpatient Clinic. Isolates were identified by means of routine diagnostic methods. Results: Negative nasal swabs were obtained in 10 (40%) infants, negative pharyngeal swabs − in 6 (23%), and in 4 patients both nasal and pharyngeal swabs were negative. In the nasal swabs the most frequently observed growths were: Staphylococcus aureus MSSA(+) in 9 (34.5%), Corynebacterium sp. in 6 (23.5%), and b-lactamase(+) Moraxella catarrhalis in 2 (8%). Pharyngeal swabs revealed a-hemolytic Streptococcus in 20 (80%), Staphylococcus aureus MRSA(+) in 7 (27%), Neisseria sp. in 4 (15%), Escherichia coli ESBL(−) and Candida albicans in 3 (11.5%) examined infants. Conclusion: Nasopharyngeal cavity colonization by pathogenic bacteria in infants suffering from cystic fibrosis occurs during the first months of life, in the absence of noticeable signs of upper respiratory infection.

Histologic and Molecular Correlation in Shelter Cats with Acute Upper Respiratory Infection

This is a descriptive study designed to correlate diagnostic real-time PCR results with histopathologic lesions in cats with clinical signs of upper respiratory infection (URI). The study occurred over a 9-month period in a single open-intake animal shelter. Cats that were selected for euthanasia by the shelter staff and additionally had URI were included in the study, for a total of 22 study cats. Combined conjunctival and oropharyngeal swab specimens were tested by quantitative real-time PCR (qPCR) for feline herpesvirus type 1 (FHV-1), feline calicivirus (FCV), Mycoplasma felis, Chlamydophila felis, and Bordetella bronchiseptica. Necropsy was performed on all cats, and a complete set of respiratory tract tissues was examined by histopathology. Among 22 cats, 20 were qPCR positive for FHV-1, 7 for M. felis, 5 for FCV, 1 for C. felis, and 0 for B. bronchiseptica. Nine cats were positive for two or more pathogens. Histopathologic lesions were present in all cats, with consistent lesions in the nasal cavity, including acute necroulcerative rhinitis in 16 cats. Histologic or antigenic detection of FHV-1 was seen in 18 of 20 cats positive for FHV-1 by qPCR. No lesions that could be specifically attributed to FCV, M. felis, or C. felis were seen, although interpretation in this cohort could be confounded by coinfection with FHV-1. A significant agreement was found between the amount of FHV-1 DNA determined by qPCR and the presence of specific histopathologic lesions for FHV-1 but not for the other respiratory pathogens.

Parental administration of antipyretics to children with upper respiratory tract infections without consultation with a physician

AimTo evaluate the administration of antipyretics to children with upper respiratory tract infections (URTI) by their parents or guardians without consultation with physicians, and compare epidemiological and clinical characteristics of patients who received antipyretics and of untreated patients.MethodsA prospective observational study was performed in three pediatric clinics in Zagreb, Croatia, from March to June 2002. A total of 171 children aged from 2 to 14 years with symptoms and signs of URTI lasting more than 2 days and fever above 38°C lasting more than 2 days were included in the study. Data were collected on the usage of antipyretics, patients’ demographic and epidemiological characteristics, and clinical signs and symptoms.ResultsAntipyretics, predominantly paracetamol, were used in 29.8% of patients. Their usage was less frequent in children attending day-care centers (49% of treated and 70% of untreated children, P = 0.014) and in children with reiterated URTIs (33.3% of treated and 55.8% of untreated children, P = 0.008). However, it was more frequent in children with recent URTIs in the family (33.3% of treated and 7.5% of untreated children, P < 0.001). Overall, most clinical signs and symptoms of URTI were notably less pronounced in patients treated with antipyretics.ConclusionsAntipyretics use correlated with less pronounced clinical signs and symptoms of infection, which indicates their anti-inflammatory activity, but also with negative effects such as lethargy. It is necessary to educate parents on the positive and negative aspects of antipyretics use and on the optimal choice of an antipyretic drug.

Clinical diagnosis of pneumonia, typical of experts

Clinical diagnosis of pneumonia is a concern when a patient presents with recent cough--new or worsened--together with fever as the chief complaint. Given this presentation, the doctor would benefit from having access to software that specifies, first, what diagnostic indicators experts typically use in that diagnosis; then, upon entry of those facts, what experts' typical probability of pneumonia is in such a case; and finally, how much this probability might change upon adding the facts from chest radiography. We specified a set of 36 hypothetical presentations of this type by patients 20-70 years of age, involving a comprehensive set of clinical-diagnostic indicators. Members of three separate expert panels independently set the probability of pneumonia in each of these cases, and also the range of possible post-radiography probabilities. A logistic function of the diagnostic indicators was fitted to the medians of the probabilities. The median probability of pneumonia was a joint function of the patient's age and current rate of cigarette smoking; history as to the cough's duration, the fever's maximum, dyspnea (including whether on effort only) and rigors; and physical examination as to temperature, signs of upper respiratory infection, prolongation of expiration, dullness on percussion and some auscultation findings. Non-contributory were history of wheezing, pain on inspiration, type of sputum and signs of cold or influenza. This probability function, and the post-radiography functions based on the same indicators, are accessible at http://www.evimed.ch/pneumonia. The expert inputs to clinical diagnosis that were derived and made readily accessible provide for expertly clinical diagnosis of pneumonia, relevant for decisions about radiography and treatment without it.

Otorrhée purulente chez l'enfant : conduite à tenir

The onset of a suppurating otorhea in a child may be encountered when the eardrum is perforated or when the child is having a tympanostomy tube. In the first case, the diagnosis of acute otitis media with perforated eardrum must lead to the prescription of the usual antibiotic therapy. In the second case, an acute otitis media is also possible, especially if the effusion appeared suddenly, was bilateral and associated with associated with signs of upper respiratory infection. In case of unilateral otitis, without any signs of upper respiratory infection or fever, the most probable cause is external otitis, on foreign body, namely tympanostomy tube. The observation of granuloma on the external part of the eardrum provides further evidence for this diagnosis, an Pseudomonas aeruginosa is probably responsible. Drops of Ofloxacine in the external ear canal can therefore be proposed. If this probabilistic treatment fails, a bacterial analysis of the pus is useful.

Outbreak of human metapneumovirus infection in norwegian children.

Human metapneumovirus (hMPV) was recently discovered in children with acute respiratory tract infection. We have studied the occurrence of hMPV and report clinical findings of 50 hMPV-infected children who were hospitalized during an outbreak in Norway. During 5 months from November 15, 2002 to April 14, 2003 we collected nasopharyngeal aspirate specimens from 236 children admitted because of respiratory tract infection (RTI). Samples were analyzed for influenza virus A/B, parainfluenza viruses 1, 2 and 3 and respiratory syncytial virus by direct immunofluorescence assays and cell culture. Rhinovirus, adenovirus and hMPV were identified by polymerase chain reaction. Human metapneumovirus was identified in 50 of 236 children (21%). Most (41 of 50) hMPV-infected children were hospitalized between November 15 and January 15, and during these 2 months hMPV was the most common isolate (41 of 72 isolates; 57%). Respiratory syncytial virus was identified in 36 children (15%), among whom 34 were admitted after the hMPV outbreak. The median age of hMPV-infected children was 12 months (range, 1 to 115 months), and one-half of the children had an underlying chronic disease. The most common symptoms were fever (86%), cough (90%), dyspnea (80%), wheezing (56%), rhinorrhea (44%), anorexia (48%) and vomiting (36%). Eight (16%) had an upper respiratory tract infection (rhinopharyngitis, n = 6; laryngitis, n = 2), 24 (48%) had bronchiolitis and 17 (34%) had pneumonia. Two-thirds with a lower RTI also had signs of upper RTI. Fourteen (28%) children needed supplemental oxygen, 1 was treated with continuous positive airway pressure and 2 were ventilated mechanically. Human metapneumovirus was the most common virus isolate during the winter season 2002 to 2003 in children hospitalized for respiratory tract infection. Upper respiratory tract infections and mild to severe bronchiolitis were most common, but a relatively high proportion of hospitalized children developed severe pneumonia.

Does Adenoidectomy Prevent Recurrent Otitis in Young Children?

Otolaryngology| May 01 2003 Does Adenoidectomy Prevent Recurrent Otitis in Young Children? AAP Grand Rounds (2003) 9 (5): 56–57. https://doi.org/10.1542/gr.9-5-56 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Does Adenoidectomy Prevent Recurrent Otitis in Young Children?. AAP Grand Rounds May 2003; 9 (5): 56–57. https://doi.org/10.1542/gr.9-5-56 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: adenoidectomy, otitis Source: Mattila PS, Joki-Erkkila V, Kilpi T, et al. Prevention of otitis media by adenoidectomy in children younger than 2 years. Arch Otolaryngol Head Neck Surg. 2003;129:163–168. The authors from Helsinki University Central Hospital, Tampere University Hospital, and National Public Health Institute, Finland, conducted a prospective study comparing adenoidectomy and tympanostomy with tympanostomy alone in preventing acute otitis media (AOM) in children younger than 2 years of age. Participants were selected from 2,497 children enrolled in the Finnish Otitis Media Vaccine Trial.1 A diagnosis of AOM was made if there were signs of effusion and symptoms related to acute otitis. Signs of effusion included “a visually abnormal membrane…suggesting middle ear effusion.” Symptoms included fever, ear pain, signs of upper respiratory infection, irritability, diarrhea, vomiting, or discharge from the ear. A total of 306 children between ages 1 and 2 who had experienced recurrent AOM (defined as 3 to 5 episodes of AOM during the last 6 months or 4 to 6 episodes of AOM during the past 12 months) were randomized into 1 of 2 groups. One hundred sixty-two of the 306 children were randomized to undergo tympanostomy alone and 144 to undergo tympanostomy and adenoidectomy. Of the 306 children randomized, 137 agreed to participate in the trial. Sixty-three of the 137 children had been randomized to the tympanostomy alone group (39% of the 162 children initially randomized to be treated with tympanostomy alone). Five of these 63 children later received adenoidectomy (before follow-up ended at the age of 2 years) and were transferred to the tympanostomy and adenoidectomy group for analysis. Seventy-five of the 137 patients had been randomized to the tympanostomy and adenoidectomy group (51% of the 144 children initially randomized to have tympanostomy and adenoidectomy). The children were followed to the age of 2 years. Specimens of middle ear effusion for culture were obtained from tympanostomy tube drainage or myringotomy in children presenting with AOM. Outcome measures included overall rate of AOM and rates of AOM caused by Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. A secondary outcome measure was the number of days of otorrhea. The comparison of the risk of AOM between the treatment groups was made by Cox proportional hazards model adjusted for pneumococcal vaccine status, sex, number of siblings, and preoperative number of AOM episodes. In the randomized group, the rate of overall AOM per person-year was 2.40 for the tympanostomy group and 2.05 for the tympanostomy with adenoidectomy group. The efficacy of concurrent adenoidectomy was 19% (95% CI, −14% to 43%). The reduction in overall rate of AOM was mainly due to reduction in the rate of pneumococcal AOM (58%; 95% CI, 16% to 79%). There was no statistically significant difference in the frequency of days with purulent ear discharge between the 2 groups. In the non-randomized group, the efficacy of concurrent adenoidectomy was 25% (95% CI, −13% to 50%). Although there was a trend in favor of beneficial effect of concurrent adenoidectomy, the... You do not currently have access to this content.

Virus-specific, antibody-secreting cells during upper respiratory infections.

The humoral immune response of 18 army recruits with febrile upper respiratory infection (URI) was studied by enumerating virus-specific, antibody-secreting cells in the peripheral blood. Diagnosis was based on viral antigen detection in nasopharyngeal specimens, virus isolation from throat swabs, or on antibody measurement from paired serum samples. At the time of the sample collection, three viruses, including adenovirus, influenza A, and influenza B, were found mainly to cause URIs among the recruits, and ELISPOT assay for enumeration of the specific antibody-secreting cells was selected for these viruses. Of the 36 patients with febrile URI studied, viral diagnosis was made in 18 cases, which included 11 patients with adenovirus infection, three with influenza A, and four with influenza B. The first blood sample was collected at the first signs of URI and the second and third samples at 2-week intervals. The adenovirus-positive patients developed a strong IgG class antibody-secreting cell response against the homologous virus, which peaked at the first sample and decreased steeply by the second and third samples. In the influenza A and B patients, the response was similar kinetically to that seen in adenovirus-positive patients. In those cases where also IgA and IgM class antibody-secreting cells were determined, the IgG response dominated. The ELISPOT method has potential also as a diagnostic tool for respiratory infections.

Familial fatal varicella.

To the Editor:— The authors of the article, Familial Fatal Varicella ( 206 :305, 1968), give apt descriptions of this most distressing complication of chickenpox. My concern pertains to the therapy described. Each one of the five children received a tetracycline antibiotic at some point. This was begun after the appearance of a varicelliform rash in cases A, B, and C, and after signs of upper respiratory infection in cases D and E; in the latter case, the child was 2 years old. Demecocycline hydrochloride was given in spite of recent articles, 1,2 which have pointed out the dangers of the indiscriminate administration of tetracyclines in pediatric practice and have discussed the indications for the use of these drugs. Upper respiratory infections and varicella are not generally considered proper indications. Although case A had bronchopneumonia, few would say that tetracycline is the first drug of choice. In the face of many

Leptospira canicola infection: report of 81 cases and review of the literature.

SummaryThirty to forty new cases of leptospirosis appear annually in Israel. A third of these are canicola fever. The annual average of 10–12 cases of this disease is very high and represents a morbidity rate of 8 per million (calculated for 1949–1957). In other countries the rate is less than one per million.Most of the cases of canicola fever appeared in three geographical areas in which concentrations of infected pigs and jackals were found. It was earlier proved that in Israel jackals are the main reservoir of Leptospira canicola and are responsible for its transmission to pigs and cattle. Men are infected especially through contact with pigs. It seems that stricter control of sanitary conditions in pigsties is essential for reduction of morbidity.In this series 81 cases were collected over a period of eight and a half years (1952–1960). Of these, 67 were hospitalized and 14 treated ambulatorially. Fifty-nine of the hospitalized patients and all of the ambulatory patients satisfied the diagnostic criteria of a compatible clinical picture and serological confirmation. The eight others met the clinical and epidemiological criteria but lacked sufficient serological examination. There were 63 men and 18 women, the majority in the younger age group (16–45 years). Thirty-three cases had contact with pigs and only eight with dogs. In the other 40 cases the source of infection was not ascertained, but 80% were farmers from areas having concentrations of pigsties infected with porcine leptospirosis canicolaris.The clinical manifestations were sudden fever, muscular pains, headache and conjunctival injection. This picture, together with high sedimentation rate and urinary findings, was highly suggestive of the diagnosis even before serological confirmation could be obtained. Signs of upper respiratory infection were found in a quarter of the patients. Meningeal signs appeared in 31% and in an additional 12% the central nervous system was involved. In all patients renal lesions appeared, usually mild and reversible. Only one patient died in acute renal failure. Mild jaundice was found in 21%. The level of blood bilirubin was usually lower than 3 mg%. Sometimes pathological liver function tests were found in non-icteric patients. Seven cases showed ECG changes, such as arrhythmias, T′ changes or patterns of myocardial damage, which were reversible in six. Iridocyclitis occurred in only one case. Leucocytosis with shift to the left appeared in 31% and shift to the left alone in 32% of the cases. Blood sedimentation rate was significantly increased in 88% of the cases. In 79% urinary findings were already positive in the first week of disease. Blood urea was elevated in nearly half of the patients and was more than 11 mg% in 13% of them.The course of the disease was usually short and benign, the one fatal case giving a mortality rate of 1.5%.The results of treatment with various antibiotics led to the impression that Terramycin is the drug of choice. It shortens the febrile period and accelerates the disappearance of urinary findings.

Puerperal breast abscess

The mechanism of breast infection is most likely one in which the infant acquires the pathogenic staphylococcus either in the hospital or home environment and transmits it to the breast upon suckling. Under favorable conditions of milk stasis, retrograde invasion of the duct occurs and an inflammatory process is initiated which may progress to abscess formation. Since the average duration of symptoms was 7.7 days before the patients sought medical care, personalized postpartum instruction to nursing mothers seems essential. This would permit earlier awareness of breast abnormality and allow for prompt antibiotic therapy in order to circumvent abscess formation. Infants who exhibit signs of upper respiratory infection should be removed from the breast, isolated (manual emptying of breasts instituted temporarily), and receive proper antibiotic care. In such cases the two conditions apparently necessary for promoting breast infection are present: (a) inability of sick infants to feed well with resultant ineffectual emptying of breasts, thereby promoting stasis and stagnation, and (b) the presence of a pathogenic organism in the upper respiratory tract of the infant.Infants of mothers who display breast infection should be placed in the isolation nursery and given antibiotic treatment. In smaller hospitals, when mastitis appears on the maternity floor, it would be feasible to administer antibiotics prophylactically to all infants in an attempt to prevent cross infection. At Cook County Hospital this practice would be virtually impossible. All normal postpartum patients leave the institution within 48 to 72 hours of delivery, long before signs and symptoms of infection are manifested. Also, the distribution of drugs to infants numbering in excess of 1,200 per month is in itself a prohibitive procedure. The ultimate but drastic measure for prevention of breast infection would be to eliminate all breast feeding during periods of increased breast infection. Breast feeding could be resumed when the infection has been curtailed.This protracted series of augmented numbers of breast infections would indicate that more than an “outbreak” has occurred. It is more plausible that a new norm or standard of bacterial virulence has been established, which is refractory to the more commonly used antibiotics, particularly penicillin.