Upper respiratory tract infection (URTI)
The cause of disease
70% ~ 80% of upper respiratory tract infections are caused by viruses. Include rhinovirus, coronavirus, adenovirus, respiratory syncytial virus, echovirus, coxsackie virus, etc. Another 20% ~ 30% of infections are caused by bacteria. Bacterial infection can be directly infected or secondary to viral infection, with hemolytic streptococcus being the most common, followed by Haemophilus influenzae, pneumococcus and staphylococcus. Even gram-negative bacteria.
Various reasons that lead to the decline of local defense function of the whole body or respiratory tract, such as catching cold, getting caught in the rain, sudden change of climate, fatigue, etc., can make viruses or bacteria that already exist in the upper respiratory tract or invade from the outside multiply rapidly, thus inducing diseases. Patients with weak body, low immunity or chronic respiratory diseases are vulnerable.
clinical picture
There are different types of clinical manifestations according to the etiology and lesion scope:
1. Cold
Commonly known as "cold", also known as acute rhinitis or upper respiratory catarrh, it is mostly caused by rhinovirus, followed by coronavirus, respiratory syncytial virus, echovirus virus and coxsackie virus.
Acute onset, incubation period 1 ~ 3 days, depending on the virus. Enterovirus is short, adenovirus and respiratory syncytial virus are long. Mainly manifested as nasal symptoms, such as sneezing, stuffy nose and runny nose, but also manifested as cough, dry throat, itchy throat or burning sensation, and even dripping sensation after nose. Symptoms such as sneezing, stuffy nose and runny nose may appear at the same time or after a few hours. After 2 ~ 3 days, the runny nose thickens, often accompanied by sore throat, tears, decreased taste, poor breathing, hoarseness and so on. Generally, there is no fever and systemic symptoms, or only low fever, discomfort, mild chills and headache. Physical examination revealed congestion, edema, secretion of nasal mucosa and mild congestion of pharynx.
Symptoms such as hearing loss can occur when eustachian tube inflammation is complex. Severe symptoms of purulent sputum or lower respiratory tract suggest viral infection other than rhinovirus or secondary bacterial infection. If there are no complications, it can be cured in 5 ~ 7 days.
2. Acute viral pharyngitis or laryngitis
(1) Acute viral pharyngitis is mostly caused by rhinovirus, adenovirus, enterovirus and respiratory syncytial virus. The clinical features are itching or burning sensation in the pharynx, rare cough and inconspicuous sore throat. When swallowing pain, it is often suggested that there is streptococcus infection. When infected with adenovirus, fever and fatigue may occur. Adenovirus pharyngitis can be accompanied by conjunctivitis. Physical examination showed obvious congestion and edema in pharynx and swelling and tenderness of submandibular lymph nodes.
(2) Acute viral laryngitis is mostly caused by rhinovirus and adenovirus. The clinical manifestations are hoarseness, difficulty in speaking and pain when coughing, often accompanied by fever, sore throat or cough. Physical examination showed edema and congestion of larynx, slight swelling and tenderness of local lymph nodes, and wheezing of larynx could be heard.
3. Acute herpetic angina
Often caused by Coxsackie virus A, it is characterized by obvious sore throat and fever. The course of disease is about 1 week, which is more common in children and occasionally in adults. Physical examination found that the pharynx was congested, and there were gray-white herpes and superficial ulcers on the surface of soft palate, uvula, pharynx and tonsil, and the surrounding area was red, and later herpes was formed.
4. Pharyngoconjunctival fever
It is mainly caused by adenovirus and coxsackie virus. The clinical manifestations are fever, sore throat, photophobia and tears. Physical examination found that the pharynx and commissure were obviously congested. The course of the disease lasts for 4-6 days, mostly in summer. Children are more common, but swimmers are easy to spread.
5. Bacterial pharyngeal tonsillitis
Most of them are caused by hemolytic streptococcus, followed by Haemophilus influenzae, pneumococcus and staphylococcus. Acute onset, obvious sore throat, chills and fever (body temperature can reach above 39℃). Physical examination showed that the pharynx was obviously congested, the tonsils were swollen and congested, there were yellow purulent secretions on the surface, the submandibular lymph nodes were swollen and tender, and there were no abnormal signs in the lungs.
treat cordially
1. Symptomatic treatment
(1) People who are seriously ill or old and weak should stay in bed, avoid smoking, drink plenty of water and keep indoor air circulation.
(2) Antipyretic and analgesic If you have symptoms such as fever, headache and muscle aches, you can choose antipyretic and analgesic drugs, such as compound aspirin, acetaminophen, indomethacin, painkillers and ibuprofen. For sore throat, various throat moistening tablets can be taken orally, such as lysozyme tablets, throat moistening tablets or traditional Chinese medicine Liushen pills.
(3) Pseudoephedrine hydrochloride or 1% ephedrine can be used for congestion and edema of nasal mucosa.
(4) antihistamines often have increased nasal mucosa sensitivity, sneezing and runny nose, and antihistamines such as chlorphenamine maleate or diphenhydramine can be selected.
(5) antitussive drugs For those with obvious cough symptoms, dextromethorphan, pentoverine and other antitussive drugs can be given.
2. Etiology therapy
(1) Antibacterial drugs are not needed for the treatment of simple virus infection. When there is evidence of bacterial infection such as leukocytosis, pus coating on throat and cough with yellow phlegm, penicillin, first-generation cephalosporins, macrolides or quinolones can be used as appropriate. There is little need to choose sensitive antibacterial drugs according to pathogenic bacteria.
(2) There is no specific antiviral drug for antiviral drug treatment at present, and the abuse of antiviral drugs can cause cold virus resistance. Therefore, if there is no fever and the immune function is normal, patients who have been ill for more than two days generally do not need to apply it. Immunodeficiency patients can be routinely used in the early stage. Ribavirin and oseltamivir, broad-spectrum antiviral drugs, have strong inhibitory effects on respiratory syncytial virus and can shorten the course of disease.
3. Chinese medicine treatment
You can also choose traditional Chinese medicine that can clear away heat and toxic materials and resist viruses, which will help improve symptoms and shorten the course of disease. Xiaochaihu granules and Banlangen granules are widely used.
prevent
1. Avoid incentives
Avoid cold, rain and fatigue; Avoid contact with cold patients and avoid dirty hands touching the mouth, eyes and nose. Old, frail and susceptible people should pay more attention to protection. When upper respiratory tract infection is prevalent, they should wear masks to avoid going in and out in crowded public places.
strengthen body physique
Adhering to moderate and regular outdoor exercise and improving immunity and cold tolerance are the main methods to prevent this disease.
3. Immunomodulatory drugs and vaccines
For elderly patients with frequent diseases, recurrent attacks and low immunity, immune enhancers can be used as appropriate.
1, Yali pear is an ancient local fruit variety in Hebei Province. Strong adaptability, high yield, large and beautiful fruit,