How To Cure Your Sinus Infection
The staphylococci (figure 3-2) are ubiquitous in nature. They occur as normal inhabitants on the skin and in the respiratory and gastrointestinal tracts of man. The majority of such forms are the comparatively avirulent organisms. Staphylococcus epidermidis and the related forms of Micrococcus and Sarcina are saprophytes frequently isolated from the skin and mucous membranes. Staphylococcus aureus strains are usually responsible for the staphylococcal diseases of man. These forms occur especially in the upper respiratory tract of asymptomatic individuals. The asymptomatic carrier is of considerable importance in transmitting these organisms. Staphylococcal diseases are most commonly manifested in localized suppurations that may be in the form of simple pustules, hair follicle infections, boils, or extensive carbuncular conditions that may progress to form metastatic abscesses in any tissue. The latter results from the spread of the organism via the blood...
The encapsulated strain of H. influenza may cause pharyngitis, conjunctivitis, otitis, sinusitis, pneumonitis, or meningitis. Meningitis is rare, occurring primarily in children under three years of age. The nonencapsulated variety of H. influenzae is considered to be normal flora in the upper respiratory tract of adults. Haemophilus influenzae is a fastidious organism and requires a medium enriched with blood or hemoglobin to supply the X factor and also a supplement for the V factor. All strains of H. influenzae reduce nitrates and are soluble in sodium deoxycholate indole is produced by the encapsulated strains and fermentation reactions are variable. In cases of suspected meningitis caused by H. influenzae, spinal fluid is submitted. The specimen should be centrifuged and the supernatant disposed of in accordance with local laboratory procedures. The sediment is inoculated on a blood agar and a chocolate agar plate to which supplement has been added, or...
The answer is a Fauci 14e pp 14511455 Massive lifethreatening hemoptysis is 100 cc of blood in 24 h The most common
The answer is d. (Fauci, 14 e, pp 194-197.) The most common cause of chronic cough in adults is postnasal drip due to sinusitis or rhinitis (allergic, vasomotor, irritant, perennial nonallergic). Patients typically complain of having to clear their throats or a feeling of something dripping in the back of their throats. Physical examination reveals muco-purulent secretions and a cobblestone appearance to the mucosa. Asthma is more of an episodic disease with wheezing, but occasionally patients complain of only cough. Gastroesophageal reflux disease (GERD) must be considered in patients who complain of heartburn or regurgitation. Other causes of chronic cough include bronchitis, congestive heart failure, and use of angiotensin converting enzyme (ACE) inhibitors.
Analgesics and can be associated with malaise and weight loss, leading to misdiagnoses such as sinusitis, migraines, and brain tumour. Disten-tion of the nerve fibres secondary to scleral edema and necrosis of nerve endings are speculated to be responsible for pain that can be so severe as to awaken the patient. The most severe pain, often out of proportion to the extent of inflammation, is seen with progressive necrotizing scleri-tis, which can be a stark contrast to the absence of pain in scleromalacia perforans. The eye may feel tender to palpation due to the inflammation 45 . However,tenderness is generally not experienced in necrotizing scleritis without inflammation. In contrast to scleritis, episcleritis is not associated with significant pain or tenderness.
A 19-year-old man presents to the emergency department with pneumonia. Since the age of 6 months, he has had recurrent pneumonia and sinusitis due to Streptococcus pneumoniae and Haemophilus influenzae. Careful assessment of his immune function would likely reveal abnormal function of the
A 29-year-old G0 comes to your office complaining of a heavy vaginal discharge for the past 2 weeks. The patient describes the discharge as thin in consistency and of a grayish white color. She has also noticed a slight fishy vaginal odor that seems to have started with the appearance of the discharge. She denies any vaginal or vulvar prutitus or burning. She admits to being sexually active in the past, but has not had intercourse during the past year. She denies a history of any sexually transmitted diseases. She is currently on no medications with the exception of her birth control pills. Last month she took a course of amoxicillin for treatment of a sinusitis. On physical exam, the vulva appears normal and the cervix is not inflamed. There is a copious thin whitish discharge in the vaginal vault that is also adherent to the vaginal walls. Wet smear indicates the presence of clue cells.
A 25-year-old white female is referred to an internist by her family doctor for a workup of recurrent sinusitis, chronic otitis media, one episode of pneumonia that required hospitalization, and recurrent bouts of watery diarrhea. XR-Sinus opacification of paranasal sinuses (due to chronic sinusitis).
Inheritable disorder of dextrocardia, chronic sinusitis (with the formation of nasal polyps), and bronchiectasis. Patients may also present with situs inversus. The disorder is due to a defect that causes the cilia within the respiratory tract epithelium to become immotile. Cilia of the sperm are also affected.
A 3-year-old has had repeated episodes of sinusitis and otitis media. He was recently admitted for osteomyelitis of his femur with Staphylococcus aureus. The family notes that while his first four or five months of life were normal, he has been persistently ill with multiple infections in the ensuing months. The mother notes that her brother had similar problems with infections and died at the age of 3 years from a lung infection. Physical examination is significant for the absence of lymph nodes and tonsillar tissue. (SELECT 1 TEST)
An 8yearold child has repeated episodes of nosebleeds Past history family history and physical examination are
The most common cause of epistaxis is as a result of picking the nose. Trauma, foreign bodies, and inflammation (from recurrent URI, sinusitis, and allergic rhinitis) can also cause nosebleeds. Rarely, vascular anomalies or bleeding disorders may be responsible. Epistaxis is rare outside of childhood. Juvenile nasopharyngeal angiofibroma should be considered in pubertal boys with profuse bleeding and an associated nasal mass. Foreign bodies may cause nosebleeds and are characterized by profuse, purulent, unilateral nasal drainage.
Periorbital cellulitis most commonly occurs as an extension of a paranasal sinusitis. Common causative organisms include nontypable Haemophilus influenza, Staphylococcus aureus, group_ A (3-hemoIytic Streptococcus, Streptococcus, pneumoniae, and anaerobes. Periorbital cellulitis can also occur after direct infection from a wound, as a result of bacteremia, or by local spreading from a contiguous site. Clinical manifestations of paranasal sinusitis can be divided into stages depending on location and extension.
Upper respiratory infections (URI), or the common cold, are caused by rhinoviruses, parainfluenza viruses, respiratory syncytial viruses, and coronaviruses. Children are the major reservoirs. The incubation period is 2-5 days. Transmission is by large droplets, small aerosol particles, or secretions. Symptoms include fever, nasal congestion, rhinorrhea, sneezing, pharyngitis, and malaise. Most symptoms resolve by 5-7 days. Treatment is not necessary. Complications include otitis media, sinusitis, and pneumonia. Sinusitis is caused by S. pneumoniae, M. catarrhalis, and nontypable H. influenzae. S. aureus and anaerobes are responsible for chronic sinusitis. Also, anything that impairs mucociliary transport or causes nasal obstruction impeding proper drainage can increase the risk of sinusitis. Symptoms include purulent nasal discharge and cough in children. Cold symptoms in children persisting longer than 7-10 days are suspicious for sinusitis. Older children and adolescents may...
Epistaxis, bleeding from the nose, may be either a primary disorder or a problem caused by another health condition. Nose bleeds in adults usually originate in the posterior septum and can be severe. Usually, a nose bleed occurs as a result of external or internal trauma for example, a blow to the nose, nose picking, or insertion of foreign objects. Nose bleeds can also be caused by polyps (growths in the nasal cavity), acute or chronic infections such as sinusitis or rhinitis, or inhalation of chemicals that irritate the nasal mucosa. Factors which increase the possibility of nose bleeds include
The obstruction of ostia in the anterior ethmoid and middle meatal complex by retained secretions, mucosal edema, or polyps promotes sinusitis. Staphylococcus aureus and gram-negative species may cause chronic sinusitis. Fungal sinusitis may mimic chronic bacterial sinusitis. Complications include orbital cellulitis and abscesses.
The maxillary sinus (antrum of Highmore) is a large pyramidal cavity in the maxilla with its base toward the nose. This cavity is separated from the nasal cavity by a very thin wall of bone (see figure 2-4). Within this wall is an irregular opening connecting the sinus with the nasal cavity above the inferior nasal conchae. The floor or lower wall of the sinus is formed by the maxillary alveolar process (see paragraph d below). It is level with the floor of the nose. Projecting into the floor of the sinus are many cone-shaped processes. These processes correspond to the roots of the maxillary teeth (usually bicuspids and molars) located in the region of the sinus. Because of this proximity, the pain of a sinus infection and that of a toothache are sometimes hard to tell apart.
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