Respiratory

system 2
Zienab Halem
Acute pharyngitis •
Bronchitis •
 Acute pharyngitis
Inflammation of the back of the throat ( pharynx or •
tonsils )
Results in a sore throat and fever . •
 Most cases are viral . •
Most bacterial cases attributable to Streptococcus •
pyogenes . ( group A streptococcus GAS or group A B-
hemolytic streptococci GABHS )
Seasonal out breasks occur the incidence if GAS is •
highest in winter and early spring .
Children 5 – 15 years are most susceptible . •
Spread by direct , close contact with infected person . •
GAS Vs Viral pharyngitis
Features suggestives of GAS infection

Swollen , red tonsili •

Fever , abdominal pain , 5 – 15 years old •
Winter or early spring •
Scarlet fever rash , doughnut lessions . •
Sudden onset of sore throat . •
Features suggestives of viral infection

wide spread rash . •

Conjunctivitis •
Rhinitis •
Cough , hoarseness •
 Treatment

1- pain management •
( paracetamol , NSAIDs , lozenges , sprays containing
menthol and topical anesthetics )
2- alpha amylase .
 3- Trypsin + Chymotrypsin •
For edema and inflammation
 4- antibiotics •

Amoxicillin 40 – 50 mg / kg / day
Azithromycin 12 mg / kg once daily

Pencillin for Rheumatic fever patients

 Tonsillectomy recommendation

More than 7 episodes in the past year •

More than 5 episodes per year in the past 2 •
years
More than 3 episodes per year in the past 3 •
years
 Bronchitis
Inflammation in bronchial tube . •
This tube secrets mucus during inflammation which •
cause wet cough .
Acute bronchitis : cough ( hallmark ) lasts around 3 •
weeks .
90 % of cases the cause is viral infection

Chronic bronchitis : cough with sputum for at

least 3 months a year during a period of 2 consecutive
years .
Coughing with nasal congestion and •
rhinorrhea maybe

Common cold : lasts only 7 – 10 days

OR
Acute bronchitis : 3 weeks .
Pharmacotherapy

Antipyretics •
Bed rest •
Drink fluids •
Vaporizer •
 1 – analgesic •
2 – cough suppressants ( dextromethorphan ) •
N.B American academy of pediatrics and the FDA
recommended against the use of antitussive in children
younger than 2 years
Expectorants aren’t recommended for routine use in
patients with bronchitis .
3 – honey
4 – antibiotics
When pertussis : Macrolids
Patients with persistent fever or respiratory symptoms for
more than 4-6 days : Macrolids