... or upper urinary tract infection. The presence of symptomatic bacteriuria can be established with a single urine sample. upper urinary tract infection (UUTI)evidence of urinary tractinfection ... symptoms such as dysuria, urgency or frequency (suggesting lower urinary tract infection) or loin pain (suggesting upper urinary tract infection) are extremely likely to have bacteriuria (see ... lower urinary tract abnormalities (mainly involving bladder outflow obstruction) in 80% of adult males presenting with simple or recurrent urinary tract infections, but without prior urinary symptoms...
... Other UpperRespiratoryTract Infections Pharyngitis, Sinusitis, Otitis, and Other UpperRespiratoryTract Infections: Introduction Infections of the upperrespiratorytract (URIs) have a tremendous ... Sinusitis, Otitis, and Other Upper RespiratoryTract Infections (Part 1) Harrison's Internal Medicine > Chapter 31. Pharyngitis, Sinusitis, Otitis, and Other UpperRespiratoryTract ... syndromes, acute infections are diagnosed largely on clinical grounds. Thus the judicious use of antibiotics in this setting is challenging. Nonspecific Infections of the UpperRespiratoryTract Nonspecific...
... cause sinusitis through impaired mucus clearance. In the hospital setting, nasotracheal intubation is a major risk factor for nosocomial sinusitis in intensive care units. Acute infectious sinusitis ... although there is increasing concern about community strains of methicillin-resistant S. aureus (MRSA) as an emerging cause. Anaerobes are occasionally found in association with infections of the ... be retained, producing the typical signs and symptoms of sinusitis. The retained secretions may become infected with a variety of pathogens, including viruses, bacteria, and fungi. Sinusitis...
... sinus inflammation, although bacterial sinusitis complicates only 0.2–2% of these viral infections. Common presenting symptoms of sinusitis include nasal drainage and congestion, facial pain ... include cough, sneezing, and fever. Tooth pain, most often involving the upper molars, is associated with bacterial sinusitis, as is halitosis. In acute sinusitis, sinus pain or pressure often ... fungal sinusitis, or sinusitis from noninfectious causes (e.g., allergic rhinosinusitis). In the case of an immunocompromised patient with acute fungal sinus infection, immediate examination...
... Pharyngitis, Sinusitis, Otitis, and Other Upper RespiratoryTract Infections (Part 4) Acute Sinusitis: Treatment Most patients with a diagnosis of acute rhinosinusitis based on clinical grounds ... of culture and susceptibility testing of sinus aspirates. Chronic Sinusitis Chronic sinusitis is characterized by symptoms of sinus inflammation lasting >12 weeks. This illness is most ... active against the most common bacterial pathogens, including S. pneumoniae and H. influenzae—e.g., amoxicillin. No clinical trials support the use of broad-spectrum agents for routine cases...
... Pharyngitis, Sinusitis, Otitis, and Other Upper RespiratoryTract Infections (Part 5) Infections of the Ear and Mastoid Infections of the ear and associated structures can involve both the ... penicillinase-resistant penicillin plus an antipseudomonal quinolone (e.g., nafcillin plus ciprofloxacin) is typically used. Incision and drainage may be helpful for culture and for resolution of infection, which ... appropriately. Infections of the External Ear Structures Infections involving the structures of the external ear are often difficult to differentiate from noninfectious inflammatory conditions...
... nasopharynx are introduced into the inflammatory fluid collected in the middle ear (e.g., by nose blowing during a URI). The proliferation of these pathogens in this space leads to Cefdinir, 14 ... an inflammatory condition of the middle ear that results from dysfunction of the eustachian tube in association with a number of illnesses, including URIs and chronic rhinosinusitis. The inflammatory ... used in place of the aminoglycoside and can even be administered orally, given the excellent bioavailability of this drug class. In addition, antibiotic drops containing an agent active against...
... A switch in regimen is recommended if there is no clinical improvement by the third day of therapy, given the possibility of infection with a β-lactamase-producing strain of H. influenzae ... months or four episodes within 12 months) is generally due to relapse or reinfection, although data indicate that the majority of early recurrences are new infections. In general, the same pathogens ... With bacterial infection, the tympanic membrane can also be erythematous, bulging, or retracted and occasionally can spontaneously perforate. The signs and symptoms accompanying infection can...
... Other Upper RespiratoryTract Infections (Part 8) Serous Otitis Media In serous otitis media (otitis media with effusion), fluid is present in the middle ear for an extended period and in ... keratinaceous debris (cholesteatoma) at the site of invasion. This mass can enlarge and has the potential to erode bone and promote further infection, which can lead to meningitis, brain abscess, ... present with pain, erythema, and swelling of the mastoid process along with displacement of the pinna, usually in conjunction with the typical signs and symptoms of acute middle-ear infection. ...
... and yersinial) often present as exudative pharyngitis with or without other clinical features. Their etiologies are often suggested only by the clinical history. Oropharyngeal infections ... for a minority of cases, although these serogroups are nonrheumatogenic. The remaining bacterial causes of acute pharyngitis are seen infrequently (<1% each) but should be considered in appropriate ... of acute infection is debatable. Clinical Manifestations Although the signs and symptoms accompanying acute pharyngitis are not reliable predictors of the etiologic agent, the clinical presentation...
... such as influenza virus, adenovirus, HSV, EBV, CMV, and M. pneumoniae, are available in some locations and can be used when these infections are suspected. The diagnosis of acute EBV infection ... Penicillin VK, 50 mg/kg qd PO in divided doses (bid), or History of rheumatic fever or Cephalexin, 50 mg/kg qd PO in divided doses (qid), or Documented household exposure or Benzathine penicillin ... heterophile agglutination assay (monospot slide test) or enzyme-linked immunosorbent assay. Testing for HIV RNA or antigen (p24) should be performed when acute primary HIV infection is suspected....
... or incision and drainage. Oral Infections Aside from periodontal disease such as gingivitis, infections of the oral cavity most commonly involve HSV or Candida species. In addition to causing ... metastatic infection to the lung and other distant sites. Occasionally, the infection can extend along the carotid sheath and into the posterior mediastinum, resulting in mediastinitis, or ... is entirely symptom-based except in infection with influenza virus or HSV. For influenza, a number of therapeutic agents exist, including amantadine, rimantadine, and the two newer agents oseltamivir...
... medicine. Chapter 031. Pharyngitis, Sinusitis, Otitis, and Other Upper RespiratoryTract Infections (Part 12) Infections of the Larynx and Epiglottis Laryngitis Laryngitis is defined ... After the introduction of the Hib vaccine in the mid-1980s, disease incidence among children in the United States declined dramatically. Nevertheless, lack of vaccination or vaccine failure ... peak incidence at ~3.5 years of age. In some countries, mass vaccination against Hib has reduced the annual incidence of acute epiglottitis in children by >90%; in contrast, the annual incidence...
... Pharyngitis, Sinusitis, Otitis, and Other Upper RespiratoryTract Infections (Part 13) Clinical Manifestations and Diagnosis Epiglottitis typically presents more acutely in young children than in ... severe respiratory distress, with inspiratory stridor and retractions of the chest wall. These findings diminish as the disease progresses and the patient tires. Conversely, oropharyngeal examination ... symptoms for <24 h, including high fever, severe sore throat, tachycardia, systemic toxicity, and (in many cases) drooling while sitting forward. Symptoms and signs of respiratory obstruction...