SINUSITIS
INTRODUCTION
Infections of the sinuses are not a pleasant thing to have for anyone. Each year, once spring comes and again during cold and flu season, a large number of people develop allergies or sinus blockages that are typically very unpleasant. Allergies from pollen and blockages from the cold or flu, sometimes develop into more serious conditions such as sinusitis. Both acute and chronic sinusitis can be debilitating; as anyone that has ever had a sinus infection can attest to. Anyone who suffers sinusitis can testify to the headaches, difficulty breathing and its ability to impair the simplest of tasks. For people, prone to these infections, life can be difficult and they will seek and form of relief. However, there are
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The human skull, as any medical student will tell you, has four pairs of sinuses named the Frontal, Maxillary, Sphenoid, and Ethmoid. These sinus cavities simplistically explained, filter our air and help give contour to our faces. But, what happens when we breath in a foreign body, a particle, bacteria or even a virus? In many cases, humans can develop an infection know as sinusitis and it can be either acute or it can be chronic in nature. In a paper titled, “Evaluating Complications of Chronic Sinusitis,” authors Hong, Pereyra, Guo, Breslin & Melville, (2017) defined the differences in sinusitis as, “Acute sinusitis is usually viral, whereas chronic sinusitis is mostly caused by anaerobes, gram-negative bacteria, Staphylococcus aureus, and fungi (para. 1). As one can see there are several causes of sinusitis. Viruses such as the kind you would have during the cold or flu, account mostly for acute sinusitis but does not define the condition. Different forms of bacterial infections and fungal spores contribute to chronic sinusitis but do not define the condition either. It is the duration and symptoms that define whether it is classified as acute or chronic and not by the type of infection. Sinusitis itself has several factors that must be met in order for it to be diagnosed as acute or chronic. The criteria required to diagnose sinusitis’s different forms per Morcom, Phillips Pastuszek & Timperley (2016) is …show more content…
However, chronic sinusitis that has turned bacterial can be treated and the normal course of action is to prescribe antibiotics. Antibiotics are effective in treating Sinusitis and according to Richard Rosenfeld, M.D., (2016) in his paper titled “Acute Sinusitis in Adults,” it is stated that, “antibiotics are prescribed for 84 to 91% of patients with acute sinusitis that is diagnosed in emergency departments and outpatient settings” (p. 962). Although antibiotics are the go to cure for Sinusitis, making the duration shorter, it has been shown that most cases clear up on their own with no need for medications at all. In his paper, Doctor Rosenfeld (2016) also notes, “approximately 85% of persons have a reduction or resolution of symptoms within 7 to 15 days without antibiotic therapy” (p.962). So, it has been shown that although a nuisance, most people have sinusitis resolve itself after about 2 weeks and antibiotics really should only be used for severe cases that do not resolve on their own. So, what does a severe case of sinusitis look like, what factors are involved and just how bad can this infection get when it does not resolve on its own but instead turns much
Bronchitis is the inflammation of the mucous membranes of the bronchi, the airways that carry airflow from the trachea into the lungs. The thin mucus lining of these airways can become irritated and swollen; the cells that make up the lining may leak fluids in response to the inflammation. Bronchitis most often occurs during the cold and flu season usually coupled with an upper respiratory infection. Bronchitis can be divided into two categories: acute or chronic each of which has distinct etiologies, pathologies, and therapies. I chose this condition because it seemed like an interesting topic to research on, and I am also interested in learning more
The infection will spread into her sinuses because the pharynx, sinuses, larynx, and trachea are all connected and the infection is prone to spread to the surrounding areas if not treated in a timely manner.
When CAP occurs, it is determined if the need for hospitalisation is necessary as it depends on the seriousness of the infection. Gram- positive organisms such as S. pneumoniae, naturally occur in the upper respiratory tract, is one cause of lower respiratory infections such as pneumonia, but is also a culprit in causing upper respiratory infections like otitis media. H. influenzae is just one of many bacterial infections that can result in CAP, it therefore can be subacute and present with a low-grade fever and a persistent cough for a few weeks before a patient has a diagnosis. Adults that have very little or no immunity are an easier target for certain viruses such as that of the Cytomegalovirus, which is a viral pathogen that is commonly contracted within the community, other common virus are adenovirus and herpes simplex. When a virus starts to become acute, it starts an infection within the ciliated cells within the airway. When pneumonia occurs from this viral infection, the inflammatory action starts to seep into the alveolar areas and leads to the problem of excess exudation and oedema within the respiratory tract. It is sometimes often difficult to differentiate symptoms of a viral pneumonia from that of bacterial pneumonia (Smeltzer &
The infection in Cari’s nasal passages and pharynx was able to spread into her sinuses due to the sinuses being a drainage area for the nasal passages.
A 25 Y/O male present with acute sinusitis. Based on your knowledge, the most likely causative organisms include all of the following except:
Acute tonsillitis is inflammation of the tonsils secondary to an infectious process causing painful swallowing and is more commonly attributed to a viral cause rather than bacterial (Shepherd, 2013). A physical assessment of the tonsils may reveal an increase in size with edema and erythema. This is often associated with upper respiratory symptoms like, headache and cough (Shepherd, 2013). Another diagnosis is pharyngitis. Pharyngitis is also a sore throat which is secondary to inflammation noted at the back of the throat and associated with complaints of pain when swallowing (Shepherd, 2013). Viral pharyngitis is the most common and can be contributed to the rhino or coronavirus which lasts between 5-7 days and presents with associated symptoms like cough, headache, fatigue and mild fever (Ruppert & Fay, 2015). Finally, GABHS or more commonly noted as strep throat is a potential diagnosis. This bacterial infection is most common in children and adolescents. Often individuals present with symptoms including throat pain, fever, chills, headache, cervical lymphadenopathy and exudate noted to tonsils or in the pharyngeal (Ruppert & Fay, 2015). This infectious process in younger children may also present with gastrointestinal symptoms like nausea, vomiting and abdominal pain but is not accompanied by cough or nasal
Otitis Externa is most often caused by Staphylococcus aureus and Pseudomonas aeruginosa. Acute otitis media can be caused by bacterial or viral pathogens. Some of the pathogens associated with acute otitis media (AOM) include, S. pneumoniae, H. influenza, M. catarrhalis, and Streptococcus pyogenes. The common cold or rhinosinusitis is likely caused by rhinoviruses, adenoviruses, coronaviruses, enteroviruses, influenza and parainfluenza viruses, and respiratory syncytial virus (Burns, Dunn, Brady, Starr, & Blosser, 2013). Acute bacterial rhinosinusitis (ABRS) is a result of the S. pneumoniae, H. influenza, M. catarrhalis and/or B-hemolytic streptococci bacterias. Sore throats or acute pharyngitis is 90 percent of the time caused by a viruse. Bacterial sore throats are often a result of the group A streptococci bacteria. According to Burns et al., 2013, Mycoplasma pneumoniae, Chlamydia pneumoniae, groups C and G streptococci, and Arcanobacterium hemolyticum can cause acute pharyngitis. Pathogens that typically cause infections of the tonsils include B-hemolytic streptococci, group D streptococcus, and S. pneumonia (Burns, et al., 2013). The pathogens involved in acute cervical adenitis include B-hemolytic strep, staphylococcus, B. heneslae, viruses, and atypical
Many people don’t realize that sinus conditions can often be treated quite successfully. A careful examination combined with special imaging techniques can reveal the reasons for these sinus conditions. They can be the result of three main problems: allergies and pollutants that thicken the nasal tissues and cause nasal blockage; poor nasal breathing, which can worsen sinus conditions; or closed sinus openings which prevent adequate drainage of the sinuses. The new specialized techniques which have been recently developed use tiny endoscopes, to relieve specific blockage for the nasal passages. The treatment is done as an outpatient and does not require nasal packing. Patients can usually return to work in a few
A deep infected sinus, extending from the skin to the subcutaneous tissues, can frequently mask osteomyelitis and delay healing.
For two years I suffered from chronic headaches because my sinus pockets closed and filled to the brim with fluid. Any light was blinding which is particularly difficult for a modern student with classes taught on projectors and homework on a laptop. For almost a year of my sophomore year in high school, I was on antibiotics to keep sinus infections away. Each round was 20,
Pneumonia is an inflammation of the lung which results into an excess of fluid or pus accumulating into the alveoli of the lung. Pneumonia impairs gas exchange which leads to hypoxemia and is acquire by inhaling a contagious organism or an irritating agent. (Ignatavicius & Workman, 2013). Fungal, bacteria and viruses are the most common organisms that can be inhale. Pneumonia could be community-acquired or health care associated. Community –acquired pneumonia (CAP) occurs out of a healthcare facility while health care associated pneumonia (HAP) is acquired in a healthcare facility. HAP are more resistant to antibiotic and patients on ventilators and those receiving kidney dialysis have a higher risk factor. Infants, children and the elderly also have a higher risk of acquiring pneumonia due to their immune system inability to fight the virus. Pneumonia can also be classified as aspiration pneumonia if it arises by inhaling saliva, vomit, food or drink into the lungs. Patients with abnormal gag reflex, dysphagia, brain injury, and are abusing drug or alcohol have a higher risk of aspiration pneumonia (Mayo Clinic, 2013). In the case of patient E.O., this patient had rhonchi in the lower lobe and the upper lobe sound was coarse and diminished. Signs and symptoms of pneumonia include difficulty breathing, chest pain, wheezing, fever, headache, chills, cough, confusion, pain in muscle or
For sinus allergy therapies, one should avoid the causes that lead to sinus infection or allergy. Following are some measures that can be taken in to accounts for allergy and sinus relief.
Viral Upper Respiratory infection: Respiratory tract infections are responsible for most short-term disability in the United States (Brashers & Huether, 2014). Upper respiratory infections include common cold, pharyngitis, and laryngitis (Brashers & Huether, 2014). URIs may be caused by a numerous pathogens causing an inflammation response from toxins. The infections can start as a nosopharyngeal infection but it can spread to the sinus, ears, epiglottis, larynx and in complicated cases it could progress to a pneumonia (Dains, et. al., 2016). The most common symptoms include nasal congestion, cough, sore throat, chills, fever, and myalgias. Viruses such as the influenza may present with severe symptoms such as a higher fever, sneezing, and stuffy nose. Since the flu and URI have similar symptoms, a rapid flu testing can help during the flu season to rule out or confirm flu outbreaks (Dains, et. al.,
pneumoniae and there chemotactic signals and the host cell’s alternate pathway, invade the alveoli. Also red blood cells are recruited to this site. In the third stage, mostly neutrophils are packed into the alveoli and very few bacteria remain. In the final stage, macrophages eliminate the remaining residue from the inflammatory response. As one can see, the damage which is done to the lung is largely a result of the host’s inflammatory response, which causes the build up of fluids in the lungs. If S. pneumoniae is allowed to persist in the lungs it can then invade the blood, which causes bacteremia. When in the blood it can traverse the blood-brain barrier and infect the meninges, which results in meningitis. S. pneumoniae is also associated with diseases in other parts of the respiratory tract including the paranasal sinuses, which is better known as sinusitis, and the middle ear can become infected, which is known as otitis media. It has also been known to cause peritonitis, an inflammation of the peritoneum, the membrane that lines the abdominal wall, and it is also implicated in causing arthritis.
In case of clearly established bacterial infection to otorhinolaryngological evaluation or in the event of persistence of fever with painful symptomatology after the first 72 hours the antibiotic is necessary. Generally they use broad-spectrum antibiotics properly administered daily dose and duration. In the event of repeated infections, and in close suspicion of insufficient efficacy, sensitivity testing provides information useful sull'antibiotico to which the beat is sensitive or sull'antibiotico more effective for therapeutic treatment.