Respiratory tract infections

1. Respiratory tract infections
M. Jude Nilshan Fernando
JMJ 1

2. Upper respiratory tract diseases
• Common cold (acute coryza)
• Sinusitis
• Rhinitis
• Pharyngitis
• Acute laryngotracheobronchitis
• Acute epiglottitis
• Influenza
• Inhalation of foreign body
JMJ 2

3. Lower Respiratory Tract
Infections
• Acute bronchitis
• COPD
• Nocturnal hypoxia
• Obstructive sleep apnoea
• Bronchiectasis
• Cystic Fibrosis
• Chronic cough
• Lung- heartlung transplantation
• Asthma
• Pneumonia
• Tuberculosis
JMJ 3

4. Upper Respiratory tract
infections
JMJ
JMJ 4

5. Upper respiratory tract diseases
• Common cold (acute coryza)
• Sinusitis
• Rhinitis
• Pharyngitis
• Acute laryngotracheobronchitis
• Acute epiglottitis
• Influenza
• Inhalation of foreign body
JMJ 5

6. COMMON COLD (ACUTE
CORYZA)
JMJ 6

7. Common cold (acute coryza)
• highly infectious illness
• causes a mild systemic upset and
prominent nasal symptoms
• due to infection by a wide range of
respiratory viruses
• Infectivity from close personal contact
(nasal mucus on hands) or droplets
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8. Common cold (acute coryza)
• at least 100 different antigenic strains
of rhinovirus
• incubation period varies from 12 hours
to 5 days
JMJ 8

9. Common cold (acute coryza)
• clinical features are
– tiredness,
– slight pyrexia,
– malaise
– sore nose and pharynx.
• Sneezing and profuse, watery nasal discharge
are followed by thick mucopurulent secretions
which may persist for up to a week.
• Secondary bacterial infection occurs only in a
minority of cases
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10. RHINITIS
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11. Rhinitis
• Rhinitis is defined clinically as sneezing
attacks, nasal discharge or blockage occurring
for more than an hour on most days
– For a limited period of the year (seasonal or
intermittent rhinitis)
– Throughout the whole year (perennial or
persistent rhinitis)
JMJ 11

12. Seasonal rhinitis: hayfever
• commonest allergic disorder
• seasonal (or intermittent) allergic rhinitis
• Nasal irritation,
• sneezing and
• watery rhinorrhoea are the most troublesome symptoms,
• but many also suffer from itching of the eyes and soft
palate
• and occasionally even itching of the ears
• because of the common innervation of the pharyngeal
mucosa and the ear
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13. Seasonal rhinitis: hayfever
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14. Perennial rhinitis
• rarely have symptoms that affect the eyes
or throat
• sneezing and watery rhinorrhoea, nasal
blockage
• lose the sense of smell and taste
• Perennial rhinitis
– decreasing with age, and can be divided into four
main types.
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15. Perennial rhinitis
• 4 main types
– Perennial allergic rhinitis
– Perennial non-allergic rhinitis with
eosinophilia
– Vasomotor rhinitis
– Nasal polyps
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16. Perennial rhinitis
• Perennial allergic rhinitis
– commonest cause is allergy to the faecal
particles of the house-dust mite
– Mites live off desquamated human skin scales
– and the highest concentrations (4000 mites/g
of surface dust) are found in human bedding
– impact in the nose rather than the lungs,
unless the patient breathes through their
mouth
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17. Perennial rhinitis
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18. Perennial non-allergic rhinitis with
eosinophilia
• No extrinsic allergic cause
• eosinophilic granulocytes are present in
nasal secretions
• Most of these patients are intolerant of
aspirin/NSAIDs
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19. Vasomotor rhinitis
• no demonstrable allergy or nasal
eosinophilia
• Watery secretions and nasal congestion
are triggered by
– cold air, smoke, perfume, newsprint
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20. Nasal polyps
• round, smooth, soft, semi-translucent,
pale or yellow, glistening structures
attached to the sinus mucosa
JMJ 20