Respiratory System Microbiology - Virology of the Common Cold
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| URT Infections include the following: | 1) Common Cold
2) Pharyngitis
3) Quinsy
4) Epiglottitis
5) Otitis media
6) Sinusitis
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| URT Infections are mostly caused by: | Viral infections
80-90%
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| What are the symptoms of the common cold? | Runny nose (rhinitis)
Headache
Sneezing
Mild fever
Coughing
General fatigue
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| Which two types of viruses most commonly cause the common cold? | Rhinovirus
Coronavirus
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| What is the main causative agent of pharyngitis/tonsillitis? | Viruses (80%)
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| Quinsy is: | Tonsillar abcess
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| What is the main cause of Quinsy? | Bacteria
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| What is the main cause of Epiglottitis? | Bacteria - Haemophilus Influenza
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| Why don't we examine a patient we suspect to have Epiglottitis with a tongue depressor? | This might leads to edema
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| Otitis media and Sinusitis are: | Inflammation of the middle ear and the paranasal sinuses respectively
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| They are most commonly caused by: | Bacteria
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| What time of the year does the common cold most likely affect patients? | Winter, then in the fall and spring
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| How is the common cold managed? | Provide supportive therapy
DO NOT GIVE ANTIBIOTICS
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| Symptomtic relief may be accompanied by mucopurulent rhinitis. Is this an indication for antimicrobial treatment? | No, not unless it persists without improvement for over two weeks (possible sinusitis)
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| The common could accounts for how much of the URT infections? | 1/3 or 1/2
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| Rhinoviruses are responsible for: | 30 to 50% of common cold
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| Coronaviruses are responsible for: | 10 to 30%
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| The other 20-60% is caused by which viruses? | Adenovirus
Respiratory syncytial virus ( RSV )
Enterovirus
Influenza and Parainfluenza virus
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| Why doesn't a common cold require medical intervention? | The common cold will resolve itself within 5-7 days
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| Why is there no vaccine for the common cold? | There are more than 100 serologic types of rhinovirus
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| What are the receptors for the rhinovirus? | I-CAM 1
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| Replication of the rhinovirus occurs in the nasal cavity because: | this virus prefers to replicate at 33-34 C as in the
nasal cavity
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| What is the incubation period of the rhinovirus? | 2-4 days
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| Mode of transmission: | Respiratory droplets
Hand to hand contact
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| How many times per year can an individual suffer? | 2 to 5 times
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| Increased levels of bradykinin cause: | 1) Increased secretions
2) Vasodilation
3) Cough and sore throat
4) Headache
5) Malaise
6) Chills (rigors)
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| What are the possible complications of the common cold? | 1) Acute bacterial sinusitis
2) Acute bacterial
3) Otitis media
4) Asthma attacks
5) Worsening of chronic bronchitis
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| How does viral infection lead to bacterial superinfection? | 1) Drop in patient immunity
2) Inflammation in the phayrnx
3) Narrowing of the connection between the middle ear and the oral cavity (Eustachian)
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| How can we decrease the cough and the amount of secretions and to improve the lifestyle of the patient? | 1) Antihistamine
2) nonsteroidal anti-inflammatory drugs (NSAID)
3) Decongestants
4) Cough suppressants (narcotics)
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| Coronavirus is: | Named because of crown-like projections on its surface. We
have at least 10 species recognized
1 Human coronavirus
It’s a + ssRNA , enveloped , has a helical symmetry
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| Three antigenic molecules are found in the virions: | Nucleocapsid
Surface projection
Transmembrane proteins
*The main antigenic determinants reside on the surface projections
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| Human coronavirus strains fall into serological groups, which are named: | OC43 and 229E
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| This virus has a high frequency of what mutations? | Deletion mutations and recombination during replication which is unusual for an RNA virus with unsegmented genome
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| Coronaviruses may be associated with: | Gastroenteritis which occurs year-round
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| Other viruses to cause common colds are | 1) Coxsackie virus which is an enterovirus that causes herpangina ( severe sorethroat and vesiculoulcerative lesions in the palate or around thetonsils )
2) Adenovirus, which also responsible for pharyngitis
and even for pneumonia
3-influenza
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| Pharyngitis is: | An inflammatory process of the pharynx caused by viral agents mainly and bacteria
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| Which bacteria? | Strep group A pyogenes
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| Symptoms: | 1) sore throat
2) pain during swallowing and dysphagia
3) Fever
4) enlargement of the cervical lymph nodes
5) common cold symptoms
6) Inflammation of the pharynx and tonsils
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| Exudative or Diffuse erythema is associated with : | Group A , C, G Streptococcus , EBV, Neisseriae
gonococcus C.diphtheriae, A.haemolyticum and
Mycoplasma pneumonia
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| Ulcerating vesicles are a sign of: | Viral infection
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| When you see an exudate, this is a sign of: | Bacterial infection
Small change of it being Adeno, EBV, and sometimes fungi (in the immunocompromised)
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| Quinsy is characterized by: | Tonsillar abscess , pain , fever and difficulty in swallowing Usually the treatment is done by drainage and antibiotics
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| The causative agents of epiglottitis are: | h.influenza( most common , now rare) , strep group A ,staph aureus and pneumococcus
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| We have two types of otitis media: | Acute and chronic
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| The acute one is linked to | Viral infection
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| Signs of Middle Ear Effusion: | 1) Bulging of tympanic membrane
2) Limited mobility
3) Airfluid level
4) otorrhoea
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| Evaluation of Signs and Symptoms of Middle Ear Inflammination: | Erythema of tymbanic membrane or Distinct otalgia
The patients most of the time –especially children - present with severe pain that prevents them from sleeping and
sometimes with otorrhoea
You should start antibiotic treatment immediately
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| The main causative organisms are: | 1) Strep Pneumoniae up to 50%
2) Haemphilus Influenzae 30%
3) Moraxella catarrhalis 3-30%
4)Rhinovirus/RSV/Coronaviruses/Adenoviruses/Enteroviruses –40-75% collectively .
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| Symptoms: | Infant excessive crying, pulling ear
Toddler: irritability , earache
Both may have otorrhoea
Signs: Fever ,bulging eardrum, fullness and erythema of tympanic membrane
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| Sinusitis is divided into: | Acute ,sub acute, recurrent acute, chronicand superimposed
*We are going to discuss the acute
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| What percentage of children's UTIs may be complicated by sinusitis? | 5-13%
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| Causative agents: | 1) strep pneumoniae
2) H.influenza
3) Moraxella catarrhali
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