Infecciones Respiratorias Altas (ENARM)

Acute otitis media is an infection in the middle ear characterized by mucosal inflammation and retention of fluid. The most common pathogens are Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. The condition can present with fever, otalgia, and diminished hearing. Diagnosis is made by history, clinical presentation, and otoscopic exam showing a bulging tympanic membrane with reduced mobility. Observation or antibiotics are the usual management approaches, but surgery for tympanostomy tubes may be required if there are recurrent infections. Potential complications include hearing loss, tympanic membrane perforation, and mastoiditis.

Sinusitis is inflammation of the mucosal lining of the paranasal sinuses that usually occurs concurrently with inflammation of the nasal mucosa (rhinitis), together known as rhinosinusitis. The most common etiology of acute rhinosinusitis is a viral infection; other causes include bacteria or fungi. Clinically, sinusitis presents with facial pain, nasal obstruction, mucopurulent drainage, and decreased olfaction. Diagnosis is usually clinical, and management is supportive; antibiotics are generally not recommended unless symptoms do not improve after 10 days. Chronic sinusitis lasts 12 weeks or longer and may be associated with nasal polyposis or allergic fungal rhinosinusitis. The goal of management in most chronic cases is to reduce symptoms and improve quality of life rather than cure the disorder, which may require surgery.

The ear is a sensory organ responsible for the sense of hearing and balance. Anatomically, the ear can be divided into 3 parts: the outer ear, the middle ear, and the inner ear. The outer ear consists of the auricle and ear canal. The middle ear houses the tympanic structures and ossicles, which are responsible for the detection and initial transmission of sound. Finally, the inner ear contains the bony labyrinth, along with other structures essential for spatial orientation, hearing, and balance.

Sinusitis refers to inflammation of the mucosal lining of the paranasal sinuses. The condition usually occurs concurrently with inflammation of the nasal mucosa (rhinitis), a condition known as rhinosinusitis. Acute sinusitis is due to an upper respiratory infection caused by a viral, bacterial, or fungal agent. Viral etiologies are the most common cause. Sinusitis presents with facial pain over the affected sinus and purulent rhinorrhea. Diagnosis is usually clinical and management is supportive, although it may require antibiotics.

Pharyngitis is an inflammation of the back of the throat (pharynx). Pharyngitis is usually caused by an upper respiratory tract infection, which is viral in most cases. It typically results in a sore throat and fever. Other symptoms may include a runny nose, cough, headache, and hoarseness. Determining the causative agent based on symptoms alone is difficult. Thus, a throat swab is often performed to rule out a bacterial cause. The mainstay of treatment is symptomatic and supportive, with bacterial causes requiring antibiotics.

Nonsteroidal antiinflammatory drugs (NSAIDs) are a class of medications consisting of aspirin, reversible NSAIDs, and selective NSAIDs. NSAIDs are used as antiplatelet, analgesic, antipyretic, and antiinflammatory agents. Common side effects include GI irritation, prolonged bleeding, and AKI.

The 4 pair of paranasal sinuses include the maxillary, ethmoid, sphenoid, and frontal sinuses. The sinuses are a group of air-filled cavities located within the facial and cranial skeleton; all are connected to the main nasal cavity and nasopharynx. Functions include contributing to voice resonance, reducing the skull weight to facilitate an upright head position, conditioning (warming and humidifying) inhaled air, and maximizing the surface of the nasal mucosa.

Acute otitis media is an infection in the middle ear characterized by mucosal inflammation and retention of fluid. The most common pathogens are Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. The condition can present with fever, otalgia, and diminished hearing. Diagnosis is made by history and otoscopic exam showing a bulging tympanic membrane with reduced mobility. Observation or antibiotics are the usual management approaches, but surgery for tympanostomy tubes may be required if there are recurrent infections. Potential complications include hearing loss, tympanic membrane perforation, and mastoiditis.

Streptococcus is one of the two medically important genera of gram-positive cocci, the other being Staphylococcus. Streptococci are identified as different species on blood agar on the basis of their hemolytic pattern and sensitivity to optochin and bacitracin. There are many pathogenic species of streptococci, including S. pyogenes, S. agalactiae, S. pneumoniae, and the viridans streptococci (e.g., S. mutans, S. mitis, and S. sanguinis). Streptococcal infections cause a wide array of clinical manifestations, including pharyngitis, pneumonia, skin and soft tissue infections, endocarditis, septicemia, meningitis, and streptococcal toxic shock syndrome. They are also responsible for the postinfectious syndromes of acute rheumatic fever and poststreptococcal glomerulonephritis. Most streptococci are sensitive to penicillin.