MI7.{1,4} | Upper Respiratory Tract Infections — Summary & Reflection

REFLECT

Think about a febrile child with sore throat presenting to your outpatient clinic. What clinical signs would make you request a throat swab before prescribing antibiotics? When would you give antitoxin before culture results return? How would you counsel a parent about why antibiotics are not needed for a viral sore throat?

KEY TAKEAWAYS

Upper respiratory tract infections are caused by a diverse range of bacterial (GAS, C. diphtheriae, H. influenzae), viral (Rhinovirus, EBV, Influenza, Parainfluenza), fungal (Candida, Mucor) and parasitic agents. GAS pharyngitis is the commonest bacterial cause — diagnose with RADT/culture, treat with penicillin to prevent rheumatic fever. Diphtheria presents with an adherent pseudomembrane; Albert stain shows metachromatic granules; Elek's test confirms toxigenicity; give DAT immediately in suspected cases. Viruses cause most URTIs — antibiotics are not indicated. Laboratory diagnosis pivots on proper throat swab collection and interpretation of Gram stain versus Albert stain versus KOH mount. Vaccination (DPT, Hib, PCV) remains the cornerstone of prevention.