Acute viral infections

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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;- intoxication. : 

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 : 

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 : 

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

Influenza : 

Influenza

Epidemiology : 

Epidemiology Winter-Spring ?, ?, ? 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 : 

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

Particularities in newborns : 

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

Complications : 

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

Mortality risk factors : 

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

Therapy : 

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 : 

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

Therapy of stenosis : 

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

Acute bronchiolitis : 

Acute bronchiolitis

Acute bronchiolitis : 

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 : 

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 : 

Treatment Bronchodilators – salbutamol Oxygen Antivirals – ribavirin Adequate fluid balance

Adenoviral infection : 

Adenoviral infection

Etiology : 

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 : 

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 : 

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