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input_sample.txt
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Upper respiratory diseases
Pharyngitis acuta
Definition
Acute infection in the pharynx and tonsils
Symptoms
Chills
Fever
Swallowing pain
Irritation in the throat
Feeling of illness
Objective
Diffuse redness of the palate and tonsils
Whitish or yellowish deposits on the tonsils
Tender lymph node tumor on the neck
Treatment
Penicillin MIE x 3
If Penicillin allergy - clarithromycin 500 mg x 2
Fusobacteriosis
Definition
It is about disseminated infection with Fusobacterium species, which is part of the normal anaerobic oral flora.
Symptoms
Pharyngitis/tonsillitis
Fever
Chills
Swelling and pain corresponding to one lateral part of the neck
Shortness of breath
Cough
Joint pain
Objective
Unilateral swelling and tenderness on one side of the neck
Septic shock
Pneumonic murmurs during lung stethoscopy
Paraclinical
Leukocytosis
↑ CRP
Mild hyperbilirubinemia
Mild thrombocytopenia
Chest x-ray: scattered lung infiltrates, abscesses and pleural collections
CT/MR scan: involvement of the parapharyngeal space and internal jugular vein
Positive blood culture
Necrotizing mediastinitis (rare but serious complication)
Treatment
Penicillin 5 MIE iv x 4 + metronidazol 500 mg iv x 3
If Penicillin allergy - clindamycin 600 mg x 4 iv
Epiglottitis acuta
Definition
A septic abscess infection, primarily localized to the epiglottis.
It is almost always caused by H. Influenzae type B.
Seen in children between 3-6 years.
Symptoms
Fever
Affected general condition
Swallowing pain
Difficulty breathing
Objective
Strongly red, tense and swollen epiglottis
Treatment
securing free airways and antibiotics with cephalosporin, e.g. cefuroxime.
Pseudocroup
Definition
An acute viral mucosal affection with inspiratory stridor due to subglottic oedema.
Due to viral infection (most often parainfluenza virus) and is seen in young children aged ½-4 years.
Symptoms
Cough
Nasal discharge
Fever
Accelerated breathing
Barking cough (sea lion-like)
Objective
Edema of the vocal cords with accompanying hoarseness
Edema of the larynx just below the vocal cords
Inspiratory contractions above the clavicle in the jugulum, in the epigastrium and between the costae
Wheezing, stridor, especially during inspiration
Cyanosis due to anoxia
Hypotonia of the musculature due to exhaustion
Treatment
It is important to make the child calm down.
The edema usually decreases within a few hours if the child sitting up, preferably in a well-ventilated room with cool air.
Cyanosis attacks and stridor are almost always reason for admission.
In the worst case, treat with adrenaline inhalations and inhaled steroids.
Systemic glucocorticoid is indicated in the most severe cases, and it is only extremely rarely necessary to intubate. Antibiotics are ineffective. The prognosis is good.
Influenza
Definition
Acute respiratory infection caused by influenza virus belonging to the orthomyxovirus family, as in Denmark circulates every year to a greater or lesser extent from November to March, also called the flu season.
The genome consists of 8 segments (10 genes) of single-stranded RNA.
There are 3 human pathogenic influenza viruses based on capsid antigen: Type A, type B and type C
Symptoms
Sudden onset of chills
Fever up to 39-40 °C
Severe headache
Dry cough
Pain with eye movements
Dedolations
Hoarseness
General muscle pain
Objective
redness is found in the fauces.
Paraclinical
Neutropenia
↑ CRP
Virus in nasal secretion by PCR
Treatment
Neuramidase inhibitor
Oseltamivir shortens the course of the disease by 1-2 days, if treatment is started within 48 hours of the onset of symptoms. It is effective against both A and B flu. 75 mg x 2 are given for 5 days.
Mononucleosis infectiosa
Definition
Caused by the Epstein-Barr virus.
Symptoms
Fatigue
Headache
General feeling of illness
Muscle pain
Sweating
Fever
Swallowing pain
Generalized lymph node tumor
Objective
Tonsillitis with thick white deposits
Glandular tumor
Hepato-splenomegaly (50-75%)
Clinical jaundice (about 5%)
Paraclinical
Leukocytosis with lymphocytosis
↑ Liver count
Moderate ↑ or normal bilirubin
Thrombocytopenia
Heterophilic antibodies by rapid test (monospot, EMNI test) – 40% in 1st week and 85% in 3rd week
Treatment
The treatment is aciclovir, otherwise symptomatic