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Respiratory infections

This is an overview of infections of the respiratory tract. I created this presentation with Google Slides. Images were created or adapted from Wikimedia Commons. ADDITIONAL TAGS: moraxella catarrhalis too much amoxicillin resistance amox clav augmentin first line allergic penicillin? adults doxycycline resp fluoroquinolone levofloxacin child mild rxn third gen cephalosporin + clindamycin major levoflox levofloxacin pain swallowing pharyngeal hyperemia neck lymph nodes coxsackie enteroviruses +rash hands feet mouth adenovirus +conjunctivitis bacterial! next slide differentiate retropharyngeal abscess painful neck decreased neck jaw muffled ‘hot potato’ voice foul breath peritonsillar retropharyngeal deviated uvula drooling treat supportive +beta agonists if wheezing only peds swallow eat cough conjunctivitis exam red oropharynx petechiae upper palate white tonsillar exudates anterior cervical tender nodes bug group betahemolytic streptococci gabhs from mono if unvaxxed abscess viral herpangina coxsackie viruses dots lips modified centor criteria mcisaac score empiric treatment abx controversial first line amoxclav cephalosporin macrolides for pen allergy sequelae rheumatic fever crossrxn between ag joints heart major minor major carditis migratory polyarthritis subcutaneous nodules erythema marginatum chorea arthralgias heart block esr long pr chronic penicillin steroids nsaids poststrep glomerulonephritis weeks after throat skin signs dark urine htn periorbital edema abx diuretics scarlet days sandpaper body rash neck groin armpits worse creases strawberry tongue pharyngitis multisystem inflammatory syndrome children misc icu meningitis bacteremia mastoiditis fever petechiae lymphadenopathy splenomegaly suspect strep culture sick + dx positive monospot d epsteinbarr virus or cytomegalovirus care avoid contact sports splenic rupture pts misdiagnosed treated penicillin amoxicillin ampicillin get an itchy maculopapular dry myalgias loose stool nonfocal lung consolidation antiviral oseltamivir zanamivir immunosuppressed preggo dz severe illness hospitalized spread through droplets loss smell anosmia fatigue diarrhea than difficulty breathing dehydration prevent vaccine inflammation bronchioles smaller airways most likely pathogen syncytial peak incidence babies wheeze cyanosis reduced activity cxr routine bronchial inflammation hyperinflation bilateral hilar fullness arrows diagnose nasopharyngeal swab routine tachycardia tachypnea low blood sat labored resp scattered wheezing flaring intercostal retraction hospital hydration suction iv fluids tube feeds immunocompromised cardiac abnormality old hospital palivizumab monoclonal ab maybe laryngotracheobronchitis cough seallike barking inspiratory stridor nose xray steeple sign parainfluenza most common usually severe racemic epi dexamethasone tracheitis aureus gas … visualize tracheal purulence ent antibiotics frank hacking congestion tends persist + sputum wheezes ronchi hemoptysis ronchi clears coughing otherwise clear lungs rest humid air bronchodilators airway reactive + antitussives copd course catarrhal stage initial gradual progression looks like cold starts resolvethen paroxysmal phase weeks weight loss pitched gasping sound posttussis emesis convalescent gradually improves less common bordetella azithromycin smxtmp nd description video boy cough demonstrating cough's distinctive "whoop" sound date source dysphagia drooling “hot potato” voice rapid onset classic tripod position leaning forward chin open flu type b necessary thumbprint grey pseudo membranous plaques wall don’t touch them high dyspnea swollen corynebacterium diphtheriae antitoxin don’t secure necessary association wet hypotension flushed skin energy chest pleuritic lower lobe chills bacteremia signs consolidation egophony e sounds a tactile fremitus feel vibrations when pt speaks crackles short sounds whispered pectoriloquy louder thru stethoscope percussion dullness cxr focal lobar leukocytosis mostly neutrophils left shift bugs aspiration drunk strokes bad teeth breath anaerobes oral flora rll standing rul supine alcoholic diabetics klebsiella recent infection aureus hiv cd pcp smxtmp birds chlamydia psittaci ceftriaxone st moxifloxacin nd allergic bacteremia sepsis pleural effusion thoracentesis r o empyema seen xray a b abnormal lung middle inferior white area side image interstitial spaces leave alveoli empty infiltrates insidious onset ung pt ‘walking pneumonia’ pleuritic vague n v d mycoplasma chlamydia flu rsv measles varicella parainfluenza gram stain contaminated water ac ventilation gi+cns symptoms legionella urinary macrolide azithromycin st nd within such hospitalization copd mi ventilator vap same cap plus mrsa pseudomonas aerobic neg e coli pneumoniae enterobacter pos staph mrsa other mrsa factors besides healthcare sports hiv military recruit drugs work need antipseudomonal antimrsa broad spectrum abx pip tazo vancomycin + sepsis protocol fluids