Research Cover Page
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Student’s Name: عبدالرحمن محمد احمد شمس الدين
ID No: 314
Block Name: Respiratory and renal systems
Block Code: RRS- 209
Research Title: Respiratory tract infection
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Introduction
The respiratory tract is the most frequent site of infection It’s pathogens. Annually, children acquire between two and five upper respiratory tract infections and adults acquire one or two infections. The respiratory tract is a frequent site of infection because it comes in direct contact with the physical environment and is exposed to airborne microorganisms. A wide range of organisms can infect the respiratory tract, including viruses, fungi, bacteria, and parasites.
the upper respiratory tract anatomy is composed of many features help to get rid of many pathogens and particles The nasal cavity has a mucociliary lining similar to
that of the lower respiratory tract. The inside of the nose is lined with hairs, which act to filter larger particles that are inhaled. The turbinate bones (baffle plates) are covered with mucus that collects particles not filtered by nasal hairs. Particles about 5–10 μm in diameter are usually either stuck in the nasal hair or embedded in the nasal hair. Impinge on the surfaces of the nasal mucosa . After the inhaled air passes into the nasal passages, The upper airway anatomy changes direction and allows many of the larger airborne particles to impinge on the back of the throat. Adenoids and tonsils are lymphoid organs in the upper respiratory tract that are important for the development of an immune response to pathogens. Adenoids and tonsils located in an area where many of airborne particles are in contact with the mucosal surface.
Most of the upper respiratory tract surfaces (including nasal and oral passages, nasopharynx and oropharynx) are colonized by normal flora, which is a normal inhabitant and rarely causes disease. Normal upper respiratory flora has two key roles that are critical for maintaining a healthy host state: these organisms compete with pathogenic organisms for potential sites of attachment and they can produce bactericidal substances that prevent pathogen infection. In the lower respiratory tract,
there are no resident bacteria. Organisms that are able to penetrate alveoli are normally removed by alveolar macrophages. Alveolar macrophages are thought to be the most effective means of killing species as they enter the lungs. Most bacteria (e.g. Streptococcus pneumoniae, Klebsiella ,pneumoniae, Haemophilus influenzae) that cause lung infection (pneumonia) produce a capsule that can prevent phagocytosis by the alveolar macrophage.
So, we will discuss some of most infections that can infect the upper and lower respiratory tract and respiratory airways . and their etiology, manifestations, Epidemiology, diagnosis, treatment and prevention.
INFECTIONS OF THE UPPER RESPIRATORY TRACT
COMMON COLD :
Etiology: The common cold caused by a multitude of organisms about 90% of cases due to viruses. Most common cold cases are caused by rhinoviruses then coronaviruses, adenoviruses, myxoviruses, echoviruses, coxsackieviruses A and B, Mycoplasma pneumoniae , Chlamydophila pneumoniae
Manifestations: Initially, common cold starts with nasal stuffiness, sneezing, and headache. Rhinorrhea happens with increasing severity. General malaise, lacrimation, sore throat, mild fever and anorexia are normal in moderate to severe cases. When organisms enter the trachea and bronchi, tracheobronchitis occurs and there may be cough and a sensation of sub sternal discomfort.
Epidemiology : The common cold is spread all over the world. A child under 5 years of age will develop between 5 and 7 colds a year, and an adult will develop one or two. Common cold is seen more in the winter months, because more person-to – person interaction happens during this time of year.
Diagnosis : Diagnosis of common cold depends on the patient’s symptoms, localization of the disease cycle, and time of year. Laboratory culture of the viruses and serologic testing is rarely performed.
Treatment and prevention : Standard cold care includes supportive medication to alleviate the patient’s pain, including zinc acetate lozenges and zinc gluconate-containing nasal gel.Large doses of vitamin C can reduce the duration of illness and the severity of symptoms of common cold. Handwashing and disinfecting contaminated surfaces can help to prevent acquiring the common cold as well as avoiding contact with others during the cold season.
Acute pharyngitis, tonsillitis (including glandular fever) :
Etiology: Most cases of acute pharyngitis are caused by viruses. Many of the common cold-associated viruses can also result in Pharyngitis which contains rhinoviruses, coronaviruses, enteroviruses, adenoviruses, influenza and parainfluenza viruses and RSV. Epstein – Barr virus (EBV) and cytomegalovirus (CMV) can also cause acute pharyngitis (glandular fever),bacteria Streptococcus pyogens and rarely other
B-haemolytic streptococci groups C and G. Other bacteria (e.g. Arcanobacterium haemolyticum, Neisseria gonorhoeae) can rarely cause pharyngitis.
Manifestations: Fever, sore throat, edema, and tonsils hyperemia and pharyngeal walls are typical findings in patients with viral and bacterial causes of pharyngitis. Other results strongly suggest that viral rather than bacterial agents cause pharyngitis and include conjunctivitis, cough, coryza , hoarseness, and diarrhea; anterior stomatitis and discreet ulcerative lesions; and viral exanthema.
Epidemiology :Viral Transmission by direct contact and aerosol. Bacterial: Approximately 5–10 per cent of the population have Streptococcus pyogenes in
the pharynx; transport levels are higher among children, especially during the winter. Spread is by aerosol and direct touch, and is rising in families. Epidemics of streptococcal pharyngitis can occur occasionally in institutions such as boarding schools.
Diagnosis: Viral infections of the throat are rarely cultured because of its mild self-limiting nature of the disease and the cost associated in The world of pathogens. There are fewer cases of bacterial infections of the throat compared to viral pharyngitis however, delaying treatment with S pyogen pharyngitis until 9 days after symptoms begin increases the patient’s risk of developing rheumatic fever and suppurative complications e.g., peritonsillary abscess, mastoiditis.Therefore, methods for the diagnosis of acute pharyngitis infections are mainly aimed at identifying patients with S pyogenes pharyngitis that need antimicrobial therapy, as well as preventing excessive care of patients diagnosed with acute viral pharyngitis.