TAILIEUCHUNG - Chapter 031. Pharyngitis, Sinusitis, Otitis, and Other Upper Respiratory Tract Infections (Part 1)

Harrison's Internal Medicine Chapter 31. Pharyngitis, Sinusitis, Otitis, and Other Upper Respiratory Tract Infections Pharyngitis, Sinusitis, Otitis, and Other Upper Respiratory Tract Infections: Introduction Infections of the upper respiratory tract (URIs) have a tremendous impact on public health. They are among the most common reasons for visits to primary care providers, and, although the illnesses are typically mild, their high incidence and transmission rates place them among the leading causes of time lost from work or school. Even though the minority (~25%) of cases are caused by bacteria, URIs are the leading diagnoses for which antibiotics are prescribed on an. | Chapter 031. Pharyngitis Sinusitis Otitis and Other Upper Respiratory Tract Infections Part 1 Harrison s Internal Medicine Chapter 31. Pharyngitis Sinusitis Otitis and Other Upper Respiratory Tract Infections Pharyngitis Sinusitis Otitis and Other Upper Respiratory Tract Infections Introduction Infections of the upper respiratory tract URIs have a tremendous impact on public health. They are among the most common reasons for visits to primary care providers and although the illnesses are typically mild their high incidence and transmission rates place them among the leading causes of time lost from work or school. Even though the minority 25 of cases are caused by bacteria URIs are the leading diagnoses for which antibiotics are prescribed on an outpatient basis in the United States. The enormous consumption of antibiotics for these illnesses has contributed to the rise in antibiotic resistance among common community-acquired pathogens such as Streptococcus pneumoniae a trend that in itself has had an enormous influence on public health. Although most URIs are caused by viruses distinguishing patients with primary viral infection from those with primary bacterial infection is difficult. Signs and symptoms of bacterial and viral URIs are in fact indistinguishable. Because routine rapid testing is neither available nor practical for most syndromes acute infections are diagnosed largely on clinical grounds. Thus the judicious use of antibiotics in this setting is challenging. Nonspecific Infections of the Upper Respiratory Tract Nonspecific URIs are a broadly defined group of disorders that collectively constitute the leading cause of ambulatory care visits in the United States. By definition nonspecific URIs have no prominent localizing features. They are identified by a variety of descriptive names including acute infective rhinitis acute rhinopharyngitis nasopharyngitis acute coryza and acute nasal catarrh as well as by the inclusive label common cold. Etiology The

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