Respiratory Tract Infections - Case Study Example

Respiratory Tract Infections Name Institutional Affiliation Assignment 2 Discuss respiratory tract infections Abstract Respiratory tract infections (RTIs) are diseases that affect the respiratory system of the body. In addition, RTIs are classified into upper and lower RTIs. Upper RTIs are specific to the upper airway parts of the body while lower RTIs are specific to lower airways in the chest area. Examples of upper respiratory tract infections are nasopharyngitis (common cold), sinusitis, pharyngitis, laryngitis, and tonsillitis. Upper respiratory tract infections such as the common cold are easy to treat and have lesser complications compared to lower respiratory tract infections such as pneumonia. Lower respiratory tract infections contribute to higher morbidity and mortality rates in the community. Examples of lower respiratory tract infection are pneumonia, bronchitis, and broncholitis. Respiratory tract infections are caused by various strains of viruses and bacteria. Introduction Respiratory tract infections (RTIs) comprise various diseases that affect parts of the respiratory system. RTIs are grouped into upper respiratory tract infections (UTRI) and lower respiratory tract infections (LTRI) depending with the part of the tract that they occur. This paper discusses the significance of RTIs, differences between URTI and LRTIs, and the causes, symptoms, and laboratory diagnosis of respiratory tract infections. 1. General content a. Significance of RTIs The respiratory tract tends to be more prone to infections compared to other parts of the body. The inevitable process of breathing makes it easier for pathogenic bacteria and viruses to enter the RT (Antonova 2012). RTIs contribute significantly to people’s visits to their general practitioners and pharmacists especially during cold months (Andreeva & Melbye 2014). Most people affected with respiratory tract infections such as the common cold can get well after a few days (Singanayagam, et al. 2012). However, children, the elderly and patients with immunosuppressed systems may require special treatment, for example prevention with pertussis vaccine (Islam et al. 2013). In children, the immune system is still developing, while the elderly may have weakened immune systems because of age-related comorbidities. It is difficult for the body to fight infections when its immune function is weakened (Esposito & Musio 2013). b. Difference between upper (URTIs) and lower (LRTIs) respiratory tract infections URTIs affect the sinuses, tonsils, throat, pharynx and larynx (Esposito & Musio 2013). Common URTIs include the common cold, sinusitis, pharyngitis, and laryngitis (Addey & Shephard 2012; Kung et al. 2014). LRTIs affect the trachea, bronchi, bronchioles, and lungs. Common LRTIs include bronchitis, bronchiolitis, croup and pneumonia (Thompso & Cohen 2013). Pneumonia is the infection of the alveoli and surrounding lung tissue (Andreeva & Melbye 2014). Influenza is an infection of both the URT and LRT as the influenza viruses can affect any part of the respiratory tract (Esposito & Musio 2013). URTI’s tend to be mild while LRTI such as pneumonia are more severe and incapacitating, especially when the infection occurs in the lungs. The highest mortality rates from infectious diseases are from lower respiratory tract infections (Esposito & Musio 2013). c. Patient symptoms and laboratory diagnosis: i. URTIs and main causative microbial agents Common cold symptoms include coughing, sneezing, running nose, sore throat and fever identified through self-diagnosis (Addey & Shephard 2012). Rhinovirus is the most common viral cause of common cold although over 200 virus strains are associated with the infection and include human coranavirus, influenza viruses, and adenoviruses (Ruperto et al. 2011). Sinusitis symptoms include blocked or runny nose, pain in the face, fever, reduced sense of smell, sneezing, itchy watery eyes and nose, and watery mucus (Addey & Shephard 2012). Sinusitis can either be a bacterial or viral infection (Addey & Shephard 2012). A small sample of mucus or cells from the nasal lining are collected and sent to the laboratory to determine whether the cause is viral or bacterial (Kung et al. 2014). Pharyngitis symptoms include inflammation at the pharynx, difficulty swallowing, swollen glands and tonsils, pain in the ears or neck. Microorganisms involved include Rhinoviruses, Coronoviruses, Infleunza A and B viruses and parainfluenza virus, and bacterial agents including Streptococcus pharyngitis and other Group A Streptococcus (Islam et al. 2013). A throat swab is usually conducted to rule out bacterial causes (Kung et al. 2014). Tonsillitis symptoms include sore throat, inflamed tonsils, fever, tiredness, headache, white pus on the tonsils, pain in the ears and neck, and swollen glands (Kung et al. 2014). Viral agents cause majority of the tonsillitis cases and include parainfluenza viruses, influenza viruses and rhinoviruses (Addey & Shephard 2012). The bacteria Streptococcus pyogenes can also cause tonsillitis. Tonsillitis and pharyngitis can occur simultaneously. In the laboratory, a sterile cotton swab is used to take small sample from the cells of the tonsils and pharynx, which are cultured on agar (Kung et al. 2014). Laryngitis symptoms include sore throat, hoarse voice, speaking difficulty, fever, headache, cough and increased saliva production. Laryngitis is caused by both common cold and flu viruses and bacteria including Group A Streptococcus, Bacillus anthracis and Haemophilus influenzae (Benedetto & Sevieri 2013). Fungal laryngitis is caused by Candida, Blastomyces and Histoplasma species in immunocompressed persons (Esposito & Musio 2013). In addition to examining the symptoms, diagnosis by determining the inbection-causing microorganism can be achieved in the laboratory by swabbing sterile cotton to take a sample from the throat, which is cultured on agar. Influenza symptoms include fever, headache, sneezing, dry chesty cough, sore throat, fatigue, appetite loss, and muscle pain (Antonova 2012). It is caused by the Orthomyxoviridae, a family of RNA viruses including Influenza viruses A, B and C (Antonova 2012). In addition to symptoms, a sample of cells and mucus from the nose or throat is taken using a sterile cotton swab and tested to confirm the diagnosis (Antonova 2012). ii. LRTIs including different sorts of lung infections 1. Community acquired pneumonia Community acquired pneumonia (CAP) usually affects infants, children and adults living in a community where pathogens are present in the environment in large numbers (Andreeva & Melbye 2014). CAP is different from pneumonia that is acquired nosocomially or in a nursing home. Symptoms suggestive of CAP include cough, pleurisy, sputum production, fever and dyspnea (Andreeva & Melbye 2014). A culture of aerobic and anaerobic bacteria and mycobacteria is done on pleural fluid or sputum (Andreeva & Melbye 2014). Bacteria that cause CAP include S. pneumoniae, E.coli, K. pneumoniae, M. catarrhalis, and S. Aureus (Benedetto & Sevieri 2013). Viral causes include respiratory synctial virus, adenovirus, metapneumovirus, rhinovirus, influenza and parainfluenza (Fattouh et al. 2011; Singanayagam et al. 2012). Parasites and fungi are also common causes of CAP. Diagnosis of CAP is done by evaluating the symptoms, physical examination of the patient and chest x-ray. Treatment is by macrolide antibiotics. Vaccines are available to prevent some forms of CAP, for example, the pneumococcal polysaccharide vaccine for persons between ages 2 and 65 years who are at risk of pneumococcal pneumonia (Plint et al. 2009). 2. Atypical pneumonia Atypical pneumonia is caused by Mycoplasma pneumoniae, affecting people under 40 years of age (Benedetto & Sevieri 2013). Other atypical pneumonia causes include Chlamydophila pneumoniae and Legionella pneumophila affecting middle aged and older adults, smokers and people with weakened immune system (Islam et al 2013). Atypical pneumonia symptoms include chills, cough, fever and dyspneao. Treatment includes antibiotics orally or intravenously, NSAIDs to control fever, fluids and rest (Kung et al. 2014). 3. Aspiration pneumonia Aspiration pneumonia develops in patients that experienced dysphagia or aspiration and the glottis was unable to block the gastric contents from entering the lower respiratory tract (Benedetto & Sevieri 2013). Aspiration can be asymptomatic or show symptoms that include wheezing, dyspnea, cyanosis, hypotension and hypoxia (Huang et al. 2010). Chest radiographs and hypoxia are used to identify ill-defined infiltrates that have caused lung damage and confirm the diagnosis of aspiration pneumonia (Huang et al. 2010). Treatment includes starting the patient on empiric, broad spectrum antibiotics against Gram-negative bacteria (Huang et al. 2010). Routine use of antibiotics with anaerobic coverage is not required unless the patient is known to have severe periodontial disease, necrotizing pneumonia, or lung abscess visualized in a CT scan (Huang et al. 2010). 4. Lung abscess An abscess is a cavity within the lungs that is filled with pus (Huang et al. 2010). In addition, the abscess may occur if the bronchial passage is blocked by aspiration. The infiltrates, be it food particles, vomit or chemicals accumulate in the lungs and cause the infection from bacteria or fungi (Huang et al. 2010). Empirical antibiotics are started on a patient diagnosed with lung abscess (Huang et al. 2010). Bronchoscopy, which refers to drainage of the pus, can be applied if the abscess is in a reachable location (Huang et al. 2010). Conclusions Respiratory tract infections affect both the upper and lower respiratory tracts. Upper respiratory tract infections include the common cold, tonsillitis, pharyngitis, and sinusitis. Lower respiratory tract infections include pneumonia, and bronchitis. LRTIs like pneumonia are more severe than URTIs like common cold. They are responsible for high rates of morbidity and mortality, if not treated timely, and with the appropriate therapy. Microorganisms causing respiratory tract infections include the viruses, rhinovirus, adenovirus and Orthomyxoviridae and the bacteria Group A Streptococcus and mycobacteria. The paper has discussed the symptoms present in both upper and lower respiratory tract infections, Common symptoms in RTIs are nasal inflammation, fever, cough, dyspnea, and mucous and pus secretions. Broad spectrum antibiotics are used bacterial infection cases. Symptom management by use of over-the-counter medication can be used in both viral and bacterial infection cases. Chest X-rays and culture of throat swabs are common laboratory investigation procedures for RTIs. References: Addey, D & Shephard, A 2012, ‘Incidence, causes, severity and treatment of throat discomfort: A four-region online questionnaire survey’, BMC, Ear, Nose & Throat Disorders, vol. 12, no. 9. 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Thompson, M & Cohen, H 2013, ‘Duration of symptoms of respiratory tract infections in children: Systematic review’, BMJ 347:f7027 Read More