Acute respiratory diseases

Acute respiratory diseases (acute respiratory disease, acute catarrh of the upper respiratory tract, acute respiratory infections) are widespread, characterized by general intoxication and primary airway disease. Relate to anthroponosis with an airborne droplet transmission mechanism. Children are more often ill. They occur in the form of sporadic cases and epidemic outbreaks.

Etiology, pathogenesis. ARI can be caused by a large number (over 200) of different etiologic agents. These include:

• Influenza viruses of different antigenic types and variants;

• Parainfluenza viruses - 4 types;

• Adenoviruses - 32 types;

• Reoviruses - 3 types;

• Rhinoviruses - more than 100 types;

• Coronavirus - 4 types;

• Recursive syncytial virus;

• Enteroviruses - about 70 types;

• Herpes simplex virus;

• Mycoplasma;

• Streptococci, staphylococci and other bacterial agents.

Gates of infection - different parts of the respiratory tract, where there are inflammatory changes.

Symptoms, course. Moderate symptoms of general intoxication, predominant upper respiratory tract infection and benign course are typical. The localization of the most pronounced changes in the respiratory tract depends on the type of pathogen. For example, rhinovirus diseases are characterized by a predominance of rhinitis, adenovirus - rhinopharyngitis, parainfluenza manifests primarily laryngeal damage, influenza-trachea, respiratory syncytial viral disease - bronchus. Some etiological agents, other than the respiratory tract, cause the appearance of other symptoms. In adenoviral diseases, conjunctivitis and keratitis can occur, with enterovirus diseases - signs of epidemic myalgia, herpangins, exanthems. Duration of acute respiratory infections, not complicated by pneumonia, varies from 2-3 to 5-8 days. In the presence of pneumonia, the disease can last up to 3-4 weeks.

Clinical differential diagnosis of sporadic cases of acute respiratory infections is difficult, therefore, in the work of a practical physician the etiological character of the disease often remains unsolved. During epidemic outbreaks, characteristic clinical manifestations suggest the etiology of the disease. Confirmation of the diagnosis is the growth of the titer of specific antibodies in paired sera. The first serum is taken until the sixth day of the disease, the second - after 10-14 days. The diagnosis is confirmed by the increase in titres 4 times or more. Use RSK and RTGA. A rapid method for deciphering the etiology of diseases is the detection of pathogens by the immunofluorescence method. With the similarity of clinical manifestations, the transferred diseases leave only type-specific immunity after themselves. In this regard, the same person can tolerate ARI 5-7 times during the year. Especially it is observed in children's groups.

Treatment. Patients with uncomplicated ARI are treated at home. Hospitalization is subject to patients with severe and complicated forms of the disease, as well as individuals from organized collectives. Antibiotics and chemopreparations will act on viruses, therefore they are appointed only in the presence of microbial complications (otitis media, pneumonia, sinusitis, etc.). During the febrile period, the patient must comply with bed rest. Assign a complex of vitamins (vitamin C up to 300 mg, thiamine and riboflavin up to 6 mg, nicotinic acid 20 mg / day). To reduce cough use steam inhalation, expectorant. With pronounced rhinitis, a 2% solution of ephedrine, sanorin, etc. is instilled in the nose. If necessary, other symptomatic agents are prescribed. You can use antigrippin, which is a complex of symptomatic drugs (see Flu). In severe forms of the disease, it is possible to administer (if possible in the first days of the disease) normal human immunoglobulin, (gamma globulin) to 6 ml IM. When developing the syndrome of false cereal in children, it is recommended to humidify the air indoors (hang up wet towels, put dishes with hot water), superimpose warm or hot compresses on the neck, prescribe chloral hydrate in enemas in age doses; Prescribe also phenobarbital.

The prognosis is favorable. The average length of incapacity for work is 5-7 days.

Prevention. Isolation of the patient from others, the allocation of individual dishes, which should be scalded with boiling water. Measures in the hearth are the same as for influenza.