Acute viral nasopharyngitis | definition of Acute viral nasopharyngitis by Medical dictionary Acute viral nasopharyngitis | definition of Acute viral nasopharyngitis by Medical dictionary Related to Acute viral nasopharyngitis: common cold , Common cold virus Common Cold Definition The common cold is a viral infection of the upper respiratory system, including the nose, throat, sinuses, eustachian tubes, trachea, larynx, and bronchial tubes. Although more than 200 different viruses can cause a cold, 30-50% are caused by a group known as rhinoviruses. Almost all colds clear up in less than two weeks without complications. Description Colds, sometimes called rhinovirus or coronavirus infections, are the most common illness to strike any part of the body. It is estimated that the average person has more than 50 colds during a lifetime. Anyone can get a cold, although pre-school and grade school children catch them more frequently than adolescents and adults. Repeated exposure to viruses causing colds creates partial immunity.

Although most colds resolve on their own without complications, they are a leading cause of visits to the doctor and of time lost from work and school. Treating symptoms of the common cold has given rise to a multi-million dollar industry in over-the-counter medications. Cold season in the United States begins in early autumn and extends through early spring. Although it is not true that getting wet or being in a draft causes a cold (a person has to come in contact with the virus to catch a cold), certain conditions may lead to increased susceptibility. These include: fatigue and overwork smoking living or working in crowded conditions Colds make the upper respiratory system less resistant to bacterial infection. Secondary bacterial infection may lead to middle ear infection, bronchitis , pneumonia, sinus infection, or strep throat . People with chronic lung disease, asthma , diabetes, or a weakened immune system are more likely to develop these complications. Causes and symptoms Colds are caused by more than 200 different viruses. The most common groups are rhinoviruses and coronaviruses. Different groups of viruses are more infectious at different seasons of the year, but knowing the exact virus causing the cold is not important in treatment.

People with colds are contagious during the first two to four days of the infection. Colds pass from person to person in several ways. When an infected person coughs, sneezes, or speaks, tiny fluid droplets containing the virus are expelled. If these are breathed in by other people, the virus may establish itself in their noses and airways. Colds may also be passed through direct contact. If a person with a cold touches his runny nose or watery eyes, then shakes hands with another person some of the virus is transferred to the uninfected person. If that person then touches his mouth, nose, or eyes, the virus is transferred to an environment where it can reproduce and cause a cold. Cold Remedies Rapid heart beat Stimulation Finally, cold viruses can be spread through inanimate objects (door knobs, telephones, toys) that become contaminated with the virus. This is a common method of transmission in child care centers. If a child with a cold touches her runny nose, then plays with a toy, some of the virus may be transferred to the toy. When another child plays with the toy a short time later, he may pick up some of the virus on his hands.

The second child then touches his contaminated hands to his eyes, nose, or mouth and transfers some of the cold virus to himself. Once acquired, the cold virus attaches itself to the lining of the nasal passages and sinuses. This causes the infected cells to release a chemical called histamine. Histamine increases the blood flow to the infected cells, causing swelling, congestion, and increased mucus production. Within one to three days the infected person begins to show cold symptoms. The first cold symptoms are a tickle in the throat, runny nose, and sneezing. The initial discharge from the nose is clear and thin. Later it changes to a thick yellow or greenish discharge. Most adults do not develop a fever when they catch a cold. Young children may develop a low fever of up to 102°F (38.9°C). In addition to a runny nose and fever, signs of a cold include coughing, sneezing, nasal congestion, headache , muscle ache, chills, sore throat , hoarseness, watery eyes, tiredness, and lack of appetite. The cough that accompanies a cold is usually intermittent and dry. Most people begin to feel better four to five days after their cold symptoms become noticeable.

All symptoms are generally gone within ten days, except for a dry cough that may linger for up to three weeks. Colds make people more susceptible to bacterial infections such as strep throat, middle ear infections, and sinus infections. A person whose cold does not begin to improve within a week; or who experiences chest pain , fever for more than a few days, difficulty breathing, bluish lips or fingernails, a cough that brings up greenish-yellow or grayish sputum, skin rash, swollen glands, or whitish spots on the tonsils or throat should consult a doctor to see if he or she has acquired a secondary bacterial infection that needs to be treated with an antibiotic. People who have emphysema , chronic lung disease, diabetes, or a weakened immune system—either from diseases such as AIDS or leukemia, or as the result of medications, ( corticosteroids , chemotherapy drugs)—should consult their doctor if they get a cold. People with these health problems are more likely to get a secondary infection. Diagnosis Colds are diagnosed by observing a person's symptoms. There are no laboratory tests readily available to detect the cold virus. However, a doctor may do a throat culture or blood test to rule out a secondary infection.

Influenza is sometimes confused with a cold, but flu causes much more severe symptoms and generally a fever. Allergies to molds or pollens also can make the nose run. Allergies are usually more persistent than the common cold. An allergist can do tests to determine if the cold-like symptoms are being caused by an allergic reaction. Also, some people get a runny nose when they go outside in winter and breathe cold air. This type of runny nose is not a symptom of a cold. Treatment There are no medicines that will cure the common cold. Given time, the body's immune system will make antibodies to fight the infection, and the cold will be resolved without any intervention. Antibiotics are useless against a cold. However, a great deal of money is spent by pharmaceutical companies in the United States promoting products designed to relieve cold symptoms. These products usually contain antihistamines , decongestants, and/or pain relievers. Antihistamines block the action of the chemical histamine that is produced when the cold virus invades the cells lining the nasal passages. Histamine increases blood flow and causes the cells to swell.

Antihistamines are taken to relieve the symptoms of sneezing, runny nose, itchy eyes, and congestion. Side effects are dry mouth and drowsiness, especially with the first few doses. Antihistamines should not be taken by people who are driving or operating dangerous equipment. Some people have allergic reactions to antihistamines. Common over-the-counter antihistamines include Chlor-Trimeton, Dimetapp, Tavist, and Actifed. The generic name for two common antihistamines are chlorpheniramine and diphenhydramine. Decongestants work to constrict the blood flow to the vessels in the nose. This can shrink the tissue, reduce congestion, and open inflamed nasal passages, making breathing easier. Decongestants can make people feel jittery or keep them from sleeping. They should not be used by people with heart disease, high blood pressure, or glaucoma . Some common decongestants are Neo-Synepherine, Novafed, and Sudafed.

The generic names of common decongestants include phenylephrine, phenylpropanolamine, pseudoephedrine, and in nasal sprays naphazoline, oxymetazoline and xylometazoline. Many over-the-counter medications are combinations of both antihistamines and decongestants; an ache and pain reliever, such as acetaminophen (Datril, Tylenol, Panadol) or ibuprofen (Advil, Nuprin, Motrin, Medipren); and a cough suppressant (dextromethorphan). Common combination medications include Tylenol Cold and Flu, Triaminic, Sudafed Plus, and Tavist D. Aspirin should not be given to children with a cold because of its association with a risk of Reye's syndrome, a serious disease. Nasal sprays and nose drops are other products promoted for reducing nasal congestion. These usually contain a decongestant, but the decongestant can act more quickly and strongly than ones found in pills or liquids because it is applied directly in the nose. Congestion returns after a few hours. People can become dependent on nasal sprays and nose drops.

If used for a long time, users may suffer withdrawal symptoms when these products are discontinued. Nasal sprays and nose drops should not be used for more than a few days. The label lists recommendations on length and frequency of use. Scientists reported in 2004 the possibility of a new oral drug for use in relieving common cold symptoms. Called pleconaril, it inhibited viral replication in at least 90% of rhinoviruses if taken within 24 hours of onset. People react differently to different cold medications and may find some more helpful than others. A medication may be effective initially, then lose some of its effectiveness. Children sometimes react differently than adults. Over-the-counter cold remedies should not be given to infants without consulting a doctor first. Care should be taken not to exceed the recommended dosages, especially when combination medications or nasal sprays are taken. Individuals should determine whether they wish to use any of these drugs. None of them shorten or cure a cold. At best they help a person feel more comfortable. People who are confused about the drugs in any over-the-counter cold remedies should ask their pharmacist for an explanation.

In addition to the optional use of over the counter cold remedies, there are some self-care steps that people can take to ease their discomfort. These include: drinking plenty of fluids, but avoiding acidic juices, which may irritate the throat gargling with warm salt water—made by adding one teaspoon of salt to 8 oz of water—for a sore throat not smoking using a cool-mist room humidifier to ease congestion and sore throat rubbing Vaseline or other lubricant under the nose to prevent irritation from frequent nose blowing for babies too young to blow their noses, the mucus should be suctioned gently with an infant nasal aspirator. It may be necessary to soften the mucus first with a few drops of salt water. Alternative treatment Alternative practitioners emphasize that people get colds because their immune systems are weak. They point out that everyone is exposed to cold viruses, but not everyone gets every cold. The difference seems to be in the ability of the immune system to fight infection. Prevention focuses on strengthening the immune system by eating a healthy diet low in sugars and high in fresh fruits and vegetables, practicing meditation to reduce stress, and getting regular moderate exercise .

Once cold symptoms appear, some naturopathic practitioners believe the symptoms should be allowed to run their course without interference. Others suggest the following: Inhaling a steaming mixture of lemon oil, thyme oil, eucalyptus, and tea tree oil (Melaleuca spp.). ( Aromatherapy ) Gargling with a mixture of water, salt, and turmeric powder or astringents such as alum, sumac, sage, and bayberry to ease a sore throat. ( Ayurvedic medicine ) Taking coneflower or goldenseal (Hydrastis canadensis). Other useful herbs to reduce symptoms include yarrow (Achillea millefolium), eyebright (Euphrasia officinalis), garlic (Allium sativum), and onions (Allium cepa). (Herbal) Microdoses of Viscue album, Natrum muriaticum, Allium cepa, or Nux vomica. (Homeopathy) Taking yin chiao (sometimes transliterated as yinquiao) tablets that contain honeysuckle and forsythia when symptoms appear.

Natural herb loquat syrup for cough and sinus congestion and Chinese ephedra (ma-huang) for runny nose. (Chinese traditional medicine) The use of zinc lozenges every two hours along with high doses of vitamin C is suggested. Some practitioners also suggest eliminating dairy products for the duration of the cold. (Nutritional therapy). The use of zinc lozenges may be moving toward acceptance by practitioners of traditional medicine. In 1996 the Cleveland Clinic tested zinc gluconate lozenges and found using zinc in the first 24 hours after cold symptoms occurred shortened the duration of symptoms. The mechanism by which zinc worked was not clear, but additional studies are underway. At one time, the herb (Echinacea spp.) was touted as a remedy to relieve cold symptoms. However, a study published in 2004 reported that the herb failed to relieve cold symptoms in 400 children taking it and caused skin rashes in some children. Prognosis Given time, the body will make antibodies to cure itself of a cold. Most colds last a week to 10 days. Most people start feeling better within four or five days.

Occasionally a cold will lead to a secondary bacterial infection that causes strep throat, bronchitis, pneumonia, sinus infection, or a middle ear infection. These conditions usually clear up rapidly when treated with an antibiotic. Prevention It is not possible to prevent colds because the viruses that cause colds are common and highly infectious. However, there are some steps individuals can take to reduce their spread. These include: washing hands well and frequently, especially after touching the nose or before handling food covering the mouth and nose when sneezing disposing of used tissues properly avoiding close contact with someone who has a cold during the first two to four days of their infection not sharing food, eating utensils, or cups with anyone avoiding crowded places where cold germs can spread eating a healthy diet and getting adequate sleep Resources Periodicals "Study: Echinacea Is Ineffective." Chain Drug Review February 16, 2004: 25. Zepf, Bill. "Pleconaril for Treatment of the Common Cold?" American Family Physician February 1, 2004: 703.

Key terms Nasopharyngitis Symptoms, Diagnosis, Treatments and Causes - RightDiagnosis.com See full list of 12 symptoms of Nasopharyngitis Treatments for Nasopharyngitis There are no antiviral drugs approved to treat or cure the infection; all medications used are palliative and treat symptoms only Alternative treatments such as vitamin C, echinacea, and zinc have been proposed but none of them have been shown to decrease the duration of the illness Conservative treatment - plenty of rest, drinking fluids to maintain hydration, gargling with warm salt water, using cough drops, throat sprays, or over-the-counter pain or cold medicines. Saline nasal drops may help alleviate congestion.

Read more about treatments for Nasopharyngitis Home Diagnostic Testing Home medical testing related to Nasopharyngitis: Cold & Flu: Home Testing: 2014 ICD-9-CM Diagnosis Code 460 : Acute nasopharyngitis [common cold] 2014 ICD-9-CM Diagnosis Code 460 Acute nasopharyngitis [common cold] Non-Billable On/After Oct 1/2015 Short description: Acute nasopharyngitis. ICD-9-CM 460 is a billable medical code that can be used to indicate a diagnosis on a reimbursement claim, however, 460 should only be used for claims with a date of service on or before September 30, 2015. For claims with a date of service on or after October 1, 2015, use an equivalent ICD-10-CM code (or codes). You are viewing the 2014 version of ICD-9-CM 460. More recent version(s) of ICD-9-CM 460: 2015 .

Upper Respiratory Tract Infection Upper respiratory infection (URI) is the most common acute illness in the United States, the most common reason for absence from school or work, and the most common acute complaint seen in the ambulatory setting. URI is also the syndrome most consistently mismanaged by primary care providers. Variably described as homely, prosaic and plebian in the medical literature, the topic is rarely perceived as exciting or controversial. Nonetheless, it is clear that physicians continue to overuse antibiotics in the treatment of URI and that this "prescriptive promiscuity" has directly contributed to the widespread emergence of antibiotic resistance. This chapter will briefly address acute nasopharyngitis ("the common cold"), acute bronchitis, acute sinusitis, pharyngitis and influenza. Readers interested in further details ï¿½ or in allergic rhinitis, community-acquired pneumonia, chronic cough, or the evaluation of fever and cough in immunocompromised patients ï¿½ are encouraged to pursue the references at the end of the chapter. The vast majority of URIs are mild, self-diagnosed and self-treated at home. Americans spend more than $1 billion each year on over-the-counter medications for URI symptoms.

When patients do present for medical attention, however, you must efficiently and accurately be able to differentiate trivial from serious and potentially treatable infections. Is this an allergic or infectious problem? With acute infections, is there evidence for bacterial infection or superinfection? Have the symptoms lasted more than three weeks? Has a fever lasted longer than a week? Is there purulent nasal discharge with sinus pain, ear pain with discharge, severe odynophagia, chest pain, dyspnea, hemoptysis, stridor or difficulty breathing? These questions and others should give you clues with which to create a differential diagnosis. In addition, smokers with URI symptoms should be counseled that smoking cessation will reduce the incidence and severity of URIs. The Common Cold The term "common cold" refers to acute nasopharyngitis (sometimes called acute rhinosinusitis), a mild, self-limited syndrome caused by viral infection of the upper respiratory tract mucosa. Cardinal features include malaise, nasal discharge and obstruction, sneezing and sore or "scratchy" throat. Headache, mild conjunctivitis, hoarseness and cough may also be seen. High fever is uncommon.

A prevalent myth among physicians is that the presence of purulent sputum ï¿½ or the color of sputum ï¿½ predicts bacterial infection and warrants antibiotics. This is clearly untrue. Discolored or purulent sputum or nasal discharge is consistent with the natural history of viral URI and is a normal and self-limited phase of the common cold. While two to three percent of colds may be complicated by secondary bacterial infection, including sinusitis and otitis media, these are usually evidenced by additional findings in the history and physical exam and are rarely subtle. Symptoms generally last one week, although 25 percent of patients (particularly smokers) may be ill for up to two weeks. The majority of colds are caused by four different families of viruses - rhinovirus, coronavirus, adenovirus and respiratory syncytial virus. While there is seasonal variation in infection rates of the different viruses, they produce clinically indistinguishable symptoms. Influenza and parainfluenza cause upper tract symptoms but are usually associated with lower tract and systemic symptoms as well.

The mechanisms of viral transmission are not well established, but most colds are thought to be spread by hand contamination with infectious secretions and subsequent auto-inoculation (nose-to-hand-to-hand-to-nose). Aerosol transmission and fomite transmission are also possible; prompt disposal of nasal secretions and handwashing are recommended interventions. Cold weather is not associated with more frequent or more severe upper respiratory infections. Unfortunately for most patients, the old saying that "the treated cold lasts seven days and the untreated cold lasts a week" is still a truism. There are no safe and effective antiviral medications for this syndrome. Symptomatic treatment may include decongestants, antihistamines, warm saline gargles, lozenges and/or cough suppression with dextromethorpan or codeine (Table 1). Intranasal ipratropium bromide can be used to ameliorate sneezing if this is a particularly bothersome symptom, although it may cause nasal dryness and blood-tinged sputum.

Inhaled cromolyn sodium was shown to improve symptoms of rhinorrhea, sore throat and cough when used within the first 24 hours of symptoms, but required q2 hour administration. Herbal and complementary medicines are widely used for URI treatment and prevention, but not well studied. Chicken soup increases the clearance of nasal mucous. Careful analysis of the available evidence does not support the use of high dose vitamin C. Zinc lozenges may have a minor beneficial effect ï¿½ the literature is conflicting ï¿½ but are associated with noxious taste and gastrointestinal side effects. Several randomized trials of Echinacea show no benefit on either prevention or treatment of URIs. We do not recommend the use of cromolyn, ipratropium, Echinacea, zinc or vitamin C at this time. There is no role for antibiotics in the treatment of the common cold ï¿½ or, in fact, for most upper respiratory infections. This should be an uncontroversial statement as the common cold is caused by viruses, against which antibiotics are, obviously, useless. Despite this fact, more than 50 percent of patients presenting with URI symptoms are given antibiotics.

This apparent paradox will be discussed at greater length below. TABLE 1: Numbs mouth, do not chew Adapted and modified from reference . Acute Bronchitis While acute bronchitis is technically a lower respiratory tract infection, it is mentioned in this chapter because of its reputation as "any cough for which the doctor has decided to prescribe antibiotics." In other words, bronchitis is often invoked as a rationale for giving antibiotics to patients with URI symptoms. In fact, acute bronchitis is an inflammatory condition of the tracheobronchial tree caused almost exclusively by viral agents. A recent randomized controlled trial of Azithromycin showed that it was no more effective than vitamin C in the treatment of adults with acute bronchitis and no underlying lung disease. In the absence of specific alarm signs (dyspnea, hemoptysis, pleuritic chest pain, prolonged course, high fever) which may signify bacterial superinfection or pneumonia, there is no role for antibiotics in the management of bronchitis. The diagnosis of acute bronchitis is a clinical one, and the syndrome does overlap with that of the common cold.

While some authors argue that URI and acute bronchitis are variant presentations of the same illness, many agree than bronchitis is characterized by a more prominent cough (productive or nonproductive) and by fever; rhinorrhea is less prominent and duration is longer, often up to two weeks. There is no specific finding on history and physical that can rule in pneumonia, but the alarm signs above or physical exam consistent with pulmonary consolidation should prompt a chest Xray. Acute Sinusitis The term "sinusitis" means inflammation of one or more of the paranasal sinuses associated with ostial obstruction and impaired drainage. Symptoms of less than four weeks duration are considered acute. Historically, "acute sinusitis" has been used to signify a bacterial infection, but we now know that most common colds involve the sinuses (which is why that viral syndrome can be called acute rhinosinusitis). A small percentage (0.5-2.0%) of colds are complicated by acute bacterial infection of the sinuses; this overlap has made sinusitis difficult to study and explains our lack of information about its epidemiology and natural history.

The fact that a clinical diagnosis of "acute sinusitis" is more likely to be associated with a viral infection than a bacterial one may also explain our failure to prove that antibiotics are indicated for this syndrome. The diagnosis of acute sinusitis is initially a clinical one. No single symptom or sign is an accurate predictor. Prolonged rhinitis is usually the first clue, but there are five clinical indicators that have been shown to predict the syndrome: maxillary toothache, patient report of colored nasal discharge, mucopurulent discharge on examination, poor response to decongestants and inability to transilluminate the sinus. In a study of men with nasal symptoms, the presence of sinusitis when all five features were present was 92 percent. Headache and fever are also common. Radiologic confirmation is required only if the patient does not improve with empiric therapy or if s/he appears extremely ill. Sinus films (particularly the Waters occipitomeatal view) are most appropriate; CT scanning is sensitive but not specific. Sinus tap and culture are reserved for patients who appear toxic at presentation, those with severe facial pain, those with underlying immunocompromise, and those with recalcitrant infection.

Treatment of sinusitis is governed by how sick and/or uncomfortable the patient appears. Toxic patients or those with complicated sinusitis (periorbital cellulitis, dental abscess, intracranial extension) should be admitted to the hospital and treated with parenteral antibiotics under the supervision of an otolaryngologist. The vast majority of patients, however, have uncomplicated disease and can be effectively treated by primary care providers in the ambulatory setting. Decongestants are clearly indicated and should be offered to all patients; antibiotics are controversial. There are many clinical trials of antibiotics for acute sinusitis, but most compare one drug to another. Although cultures obtained via sinus puncture demonstrate S. pneumonia, H. influenza, S. pyogenes and S. aureus are the most common bacterial pathogens, there have been trials of penicillins, cephalosporins, sulfonamides, quinolones and macrolides. These head-to-head drug studies do not help us to determine whether antibiotic therapy is indicated. A randomized, placebo-controlled trial of amoxicillin and decongestants vs.

placebo and decongestants showed no improvement among those who received amoxicillin; these patients did, however, have a higher incidence of side effects. In older placebo-controlled trials, there was a 60 percent placebo response rate, suggesting that acute sinusitis has a high rate of spontaneous resolution;23 antibiotics were superior to placebo in some of these trials. In spite of this underwhelming data, most guidelines recommend antibiotic treatment of acute sinusitis. Although the authors conclude that symptoms resolve in two-thirds of untreated patients within two weeks, the most recent (1999) AHCPR guideline recommends the use of amoxicillin or bactrim for acute uncomplicated sinusitis, stressing that patients are more likely to be cured and to be cured more quickly if they receive antibiotics. They agree that a 7 to 10 day period of watchful waiting before antibiotics are prescribed is a reasonable course of action, since most patients will recover without antibiotics and complications are rare. Figure 1: Influenza The flu syndrome is a severe illness, lasting from three days to two weeks with convalescence over one to four weeks.

Symptoms include the abrupt onset of malaise, prominent myalgia, headache and high fever (up to 106F, lasting three to seven days), followed by cough, rhinorrhea, pharyngitis and weakness. Complications include prolonged airway hyperreactivity, particularly in patients with asthma and chronic bronchitis. Secondary bacterial bronchitis and pneumonia are seen in up to ten percent of patients, and usually present as purulent or bloody sputum and increased fever after a few days of apparent clinical improvement. The most common cause is S. pneumoniae, although H. influenza and S. aureus infections (associated with a 50 percent mortality) are also seen. Rare nonpulmonary complications include myositis (with or without myoglobinuria and acute renal failure), Guillain-Barre syndrome, encephalitis, transverse myelitis and Reyeï¿½s syndrome. Since the flu syndrome can be severe, patients who are elderly, debilitated by chronic disease, immunocompromised or who have severe dehydration or secondary complications may require hospitalization.

While may viruses can cause "flu," including parainfluenza, respiratory syncytial virus and adenovirus, 85 percent of cases are caused by influenza A or B. Epidemic spread of the influenza virus is due to the appearance of new antigenic variations of the virus in nonimmune populations. Viral transmission takes place through the aerosol route, by sneezing, coughing and talking; the virus has an extremely high attack rate. Major antigenic variations lead to pandemics, such as the influenza A pandemic of 1918, which killed 25 million people worldwide. Minor antigenic changes cause near-annual winter epidemics; 20,000 deaths a year in the United States are attributed to influenza. The CDC follow national and global influenza epidemiology extremely closely, and maintain an extensive website at . Diagnosis is typically made clinically outside of research settings, although rapid diagnostic tests are available. Treatment of the flu consists of symptomatic and supportive care, including bed rest, hydration, analgesics, antipyretic agents and antibiotics for secondary bacterial infection.

In addition, four antiviral agents are approved for the treatment of influenza: amantadine, rimantadine, zanamivir and oseltamivir. Amantadine and rimantadine are approved for the treatment of influenza A infections; they inhibit viral uncoating after cell entry. Rimantadine has fewer CNS symptoms than amantadine but is more expensive. Zanamivir (inhaled) and oseltamivir (oral), both approved in 1999, are neuraminidase inhibitors which are effective against both influenza A and B. All four agents must be used within 24 to 48 hours of initial symptoms if they are to have any effect at all; they are not curative but shorten the duration of illness by one to two days. There are limited clinical data with which to assess the efficacy of zanamivir and oseltamivir and no trials comparing the four agents to each other. They are thought to be roughly comparable in terms of their palliative effects on flu symptoms; data suggest that zanamivir and oseltamivir may have fewer adverse effects.

Although heavily marketed, these antiviral agents have limited efficacy in the treatment of influenza and have no effect in patients with symptoms of more than 36-48 hours duration. It is reasonable to treat patients at high risk for morbidity and mortality who have the "flu syndrome" and who present within 48 hours of symptom onset ï¿½ such patients might include unvaccinated persons with chronic pulmonary, cardiovascular, neuromuscular, metabolic and immunodeficiency diseases. These agents should not be prescribed for patients with simple URI symptoms ï¿½ remember that severe fatigue, myalgia and high fever are characteristic of influenza. Given the potential severity of illness, prophylactic measures are recommended for select patients. Vaccination guidelines are discussed in Chapter 2. Amantadine prophylaxis prevents clinical disease in 70 to 90 percent of patients; oseltamivir has also been shown to work as prophylactically. These agents may be considered for the same high risk groups outlined above, particularly those in closed settings such as nursing homes. Chemoprophylaxis is not a substitute for vaccination!

Pharyngitis Acute pharyngitis is an inflammatory syndrome of the pharynx, usually caused by a virus but occasionally bacterial in origin. The main challenge for the primary care provider is to identify those patients with group A beta-hemolytic streptococcus (S. pyogenes) which can be associated with scarlet fever, acute rheumatic fever and acute glomerulonephritis. Streptococcal pharyngitis should be treated with antibiotics, but its low prevalence makes empiric antibiotic treatment of all adults with pharyngitis an extremely bad idea. In fact, Little et al. have demonstrated that this strategy ï¿½ giving penicillin to all adults with sore throats ï¿½ has the same probability of preventing one case of rheumatic fever or acute nephritis as it does of causing one death from penicillin-induced anaphylaxis. Most cases of pharyngitis occur in the colder months, with the peak incidence of streptococcal pharyngitis in late winter to early spring. The severity of illness varies greatly, but cardinal features include sore throat, odynophagia, malaise, fever and headache.

Signs of "strep throat" may include an exudative pharyngitis, tender tonsillar lymph nodes and a rare scarletiniform rash. Because these symptoms and signs are not specific, the formal diagnosis of strep throat requires a throat culture. Rapid strep antigen tests have good specificity but lack adequate sensitivity; negative antigen tests should be followed by a throat culture. Occasionally, bacterial pharyngitis is complicated by a retropharyngeal or peritonsillar abscess or epiglottitis, which are medical emergencies. Treatment of viral pharyngitis is mainly symptomatic. Since acute rheumatic fever is very rare in adults, the principle goals of treatment are the amelioration of symptoms and the prevention of local suppurative complications and spread. Symptoms in the untreated patient may last up to five days, and early therapy (in the first 48 hours) is required for moderate symptomatic relief. The question facing the primary care physician is to decide which patients to culture and which patients to treat with antibiotics.

One strategy is to use the clinical prediction rule generated by a large multicenter prospective study which compared the results of throat cultures in patients using three clinical findings; tonsillar exudate, temperature greater than 100 F and tender anterior cervical lymphadenopathy. Of the patients with all three findings, 42 percent had positive throat cultures. Fourteen percent of patients with one finding and three percent of patients with none of these signs had positive throat cultures. Based on these data, it is reasonable to empirically treat patients with all three signs, to culture patients with only one sign and treat based on the results and to neither culture nor treat (with antibiotics) patients with no signs. All patients with a sore throat and a history of acute rheumatic fever (ARF), or young patients with a sore throat and a strong family history of ARF should be cultured and treated before the culture results are known. Treatment consists of parenteral benzathine penicillin 1.2 million units IM x 1 (preferably) or oral penicillin V 250 mg tid for 10 days. For patients allergic to penicillin, erythromycin 250 mg qid for 10 days is adequate.

Other antibiotics, including cephalosporins, macrolides and clindamycin are effective, but penicillin is preferred because of its "proven efficacy, narrow spectrum and low cost." Overuse of antibiotics It is clear that there is no role for antibiotics in the management of simple upper respiratory infection and bronchitis. This statement is data-based, uncontroversial, and supported by every expert panel and management guideline. Why then do physicians continue to prescribe antibiotics ï¿½ of wider and wider spectrum ï¿½ for these syndromes? The scope of the problem is immense. A large 1997 survey indicated that antibiotics were prescribed for 52 percent of patients with URIs and 66 percent of patients with bronchitis;19 this practice did not vary by geographical area, physician specialty or patient sociodemographic or insurance status. These data are consistent with other U.S. surveys and with data collected in other industrialized countries. Antibiotics unnecessarily prescribed for URIs and bronchitis represent 31 percent of total antibiotic prescriptions in the U.S. The cost of such overuse of antibiotics is profound.

In addition to wasting money on the agents themselves, over-prescription promotes subsequent unnecessary office visits. More worrisome is the fact that widespread use of antibiotics has clearly contributed to the emergence of drug-resistant pathogens, what Neu has called "the crisis in antibiotic resistance." Twenty years ago, more than 99 percent of all pneumococcus isolates in the U.S. were sensitive to penicillin; resistance rates in some studies now approach 30 percent. Prior antibiotic use is the single most powerful predictor of antibiotic resistance. Data from other countries demonstrate that changing prescription patterns can decrease rates of antibiotic resistance, providing a powerful motivation to reform our criteria for antibiotic use. Why do physicians prescribe antibiotics for patients with viral infections? Although the reason is probably a complex interaction of doctor and patient expectations, two answers are usually offered in the medical literature: "it might help the patient" and "the patient expects antibiotics." A third, less acknowledged reason, is that it is usually faster and easier for the physician to write a prescription than to explain to the patient why antibiotics are inappropriate. Some physicians argue that the use of antibiotics may provide a benefit to patients. In essence, these doctors do not believe the outcomes research that demonstrates the converse.

While one author has noted that "trying to determine the clinical predictors of antibiotic-responsive URIs may be like looking for the Holy Grail," these clinicians believe otherwise. I would emphasize that this is poor science and poor medicine. Side effects of antibiotics are not rare and drug-resistance is not merely a theoretical concern. The second proffered reason is that patients "expect" antibiotics - when physicians perceive that patients desire antibiotics, they are 10 times more likely to be prescribed. An interview study of patients presenting with URI symptoms challenges this approach. While 50 percent of patients did expect antibiotics, all stated that they would have been satisfied with a "nonantibiotic medicine to relieve symptoms." The only variable associated with desire for antibiotics was past experience, including previous receipt of antibiotics for URI. Another survey showed that patient satisfaction was not associated with receipt of antibiotics but understanding the illness and with the perception of having adequate time with their care provider. Thus, a complex cycle of expectations is created as we teach patients to expect antibiotics by prescribing antibiotics. The responsible approach is to spend the time to educate patients about cold care, to emphasize that non-use of antibiotics is not the same thing as non-care, and to strictly adhere to practice guidelines.

Excluding patients with underlying illnesses such as chronic obstructive pulmonary disease, cystic fibrosis, HIV, chronic sinusitis, chronic bronchitis and bronchiectasis, we recommend the following strategy: Never prescribe antibiotics for simple coughs and colds. Never prescribe antibiotics for viral sore throat. Limit prescribing antibiotics over the phone to exceptional cases. Educate patients about the indications for antibiotic use and the risks to them of inappropriate antibiotic use. Pharyngitis - sore throat: MedlinePlus Medical Encyclopedia Swollen lymph nodes (glands) in the neck Exams and Tests Your health care provider will perform a physical exam and look at your throat. A rapid test or throat culture to test for strep throat may be done. Other laboratory tests may be done, depending on the suspected cause. Treatment Most sore throats are caused by viruses. Antibiotics do not help viral sore throats. Using these medicines when they are not needed leads to antibiotics not working as well when they are needed. Sore throat is treated with antibiotics if: A strep test or culture is positive. Your provider cannot diagnose strep throat by symptoms or a physical exam alone. A culture for chlamydia or gonorrhea is positive.

Sore throat caused by the flu (influenza) may be helped by antiviral medicines. The following tips may help your sore throat feel better: Drink soothing liquids. You can either drink warm liquids, such as lemon tea with honey, or cold liquids, such as ice water. You could also suck on a fruit-flavored ice pop. Gargle several times a day with warm salt water (1/2 tsp or 3 grams of salt in 1 cup or 240 milliliters of water). Suck on hard candies or throat lozenges. Young children should not be given these products because they can choke on them. Use of a cool-mist vaporizer or humidifier can moisten the air and soothe a dry and painful throat. Try over-the-counter pain medicines, such as acetaminophen. Possible Complications Throat anatomy References Flores AR, Caserta MT. Pharyngitis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 59.

Frye R, Bailey J, Blevins AE. Clinical inquiries. Which treatments provide the most relief for pharyngitis pain? J Fam Pract. 2011;60(5):293-294. PMID: 21544279 . Shulman ST, Bisno AL, Clegg HW, et al. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. Clin Infect Dis. 2012;55(10):e86-e102. PMID: 22965026 . Tanz RR. Acute pharyngitis. In: Kliegman RM, Stanton BF, St Geme JW III, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 381. van Driel ML, De Sutter AIM, Keber N, Habraken H, Christiaens T. Different antibiotic treatments for group A streptococcal pharyngitis.

Cochrane Database Syst Rev. 2013;4:CD004406. PMID: 23633318 . Read More Strep throat Review Date 11/1/2015 Updated by: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Related MedlinePlus Health Topics Nasopharyngitis | definition of nasopharyngitis by Medical dictionary Nasopharyngitis | definition of nasopharyngitis by Medical dictionary /na·so·phar·yn·gi·tis/ (-far″in-ji´tis) inflammation of the nasopharynx. nasopharyngitis Infectious disease Acute nasopharyngeal inflammation, often with keratoconjunctivitis; both occur in common cold and are attributed to viruses. see Common cold .

nasopharyngitis inflammation of the nasopharynx. Want to thank TFD for its existence? Tell a friend about us , add a link to this page, or visit the webmaster's page for free fun content . Link to this page: certolizumab pegol References in periodicals archive ? A review of the Nasopharyngitis (Common Cold) products under development by companies and universities/research institutes based on information derived from company and industry-specific sources. Valacyclovir proves safe for HSV-2 suppressive therapy of up to 20 months Headache and nasopharyngitis were the most frequently reported adverse events across treatment groups with no notable changes in any cardiovascular parameters measured by 24 hour ambulatory blood pressure, clinical chemistry, hematology, or ECG parameters. United States : FDA approves Striverdi Respimat to treat chronic obstructive pulmonary disease The most commonly reported (>=5% of patients) TEAEs in patients taking Concerta included decreased appetite, headache, insomnia, irritability, weight decreased, dizziness, nausea, and nasopharyngitis.

Shire Reports Top-Line Results From Two Head-to-Head Studies Comparing Vyvanse (lisdexamfetamine dimesylate), CII, With Concerta (methylphenidate HCl), CII, in Adolescents with ADHD The linagliptin adverse reactions label notes that side effects reported in more than 5% or more patients treated with the drug include nasopharyngitis and that hypoglycemia was more commonly reported in patients treated with linagliptin and sulfonylurea compared with placebo and sulfonylurea. FDA panel backs valtrex to cut HSV-2 transmission: transmission down 75% in partners. (Monogamous, Heterosexual Couples) The most commonly reported TEAEs in patients taking Vyvanse (reported in 5% or more of patients) included dry mouth, headache, insomnia, upper respiratory tract infection, nasopharyngitis, constipation, nausea, decreased appetite, irritability, bruxism, sinusitis, anxiety and feeling jittery.

Vyvanse (lisdexamfetamine dimesylate) Positive Top-Line Results in Maintenance of Efficacy Study in Adults with Moderate to Severe Binge Eating Disorder 1 letters from baseline, compared to a loss of 2 letters in patients receiving sham injections (p5%, and which have a higher incidence than sham, include nasopharyngitis, conjunctival hemorrhage, dry eye, eye pain, nausea, dizziness, headache. common cold - Wikidata common cold Cite this page This page was last modified on 13 December 2016, at 10:16. All structured data from the main and property namespace is available under the Creative Commons CC0 License ; text in the other namespaces is available under the Creative Commons Attribution-ShareAlike License ; additional terms may apply. By using this site, you agree to the Terms of Use and Privacy Policy. Overview - Acute sinusitis - Mayo Clinic Acute sinusitis Print Acute sinusitis (acute rhinosinusitis) causes the cavities around your nasal passages (sinuses) to become inflamed and swollen. This interferes with drainage and causes mucus to build up.

With acute sinusitis, it might be difficult to breathe through your nose. The area around your eyes and face might feel swollen, and you might have throbbing facial pain or a headache. Acute sinusitis is mostly caused by the common cold. Unless a bacterial infection develops, most cases resolve within a week to 10 days. In most cases, home remedies are all that's needed to treat acute sinusitis. However, persistent sinusitis can lead to serious infections and other complications. Sinusitis that lasts more than 12 weeks despite medical treatment is called chronic sinusitis. References Sinusitis. American Academy of Allergy, Asthma & Immunology. Accessed Jan. 11, 2016. Hwang PH, et al. Acute sinusitis and rhinosinusitis in adults: Clinical manifestations and diagnosis. Accessed Jan. 14, 2016. Hwang PH, et al. Acute sinusitis and rhinosinusitis in adults: Treatment. Accessed Jan. 14, 2016. Sinusitis (sinus infection). National Institute of Allergy and Infectious Disease. Accessed Jan. 14, 2016. Adult sinusitis.

American Rhinologic Association. Accessed Jan. 15, 2016. Complications of sinusitis. American Rhinologic Association. Accessed Jan. 14, 2016. Meltzer EO, et al. Rhinosinusitis diagnosis and management for the clinician: A synopsis of recent consensus guidelines. Mayo Clinic Proceedings. 2011;86:427. Sinupret+. Natural Medicines Comprehensive Database. Accessed Jan. 15, 2016. SinuGuard. Natural Medicines Comprehensive Database. Accessed Jan. 15, 2016. Related

Question: Acute viral nasopharyngitis is a medical term for which common ailment?
Answer: The common cold