Symptoms >10 days without clinical improvement • Onset with severe symptoms (fever, purulent
drainage) lasting at least 3 consecutive days at the beginning of the illness • Symptoms worsened
after initial improvement
Relieve symptoms (nasal stuffiness, rhinorrhea) Promote drainage!!!! or give amoxicillin 5 to 7 days.
remember it is bacterial infection. - ✔✔Inflammation of the paranasal sinuses due to bacterial, viral,
or fungal infection, or allergic reaction
sx:
tx:
• Age >65 years • Hospitalization in last 5 days • Antibiotic use in previous month •
Immunocompromised people • Presence of multiple comorbidities • Severe infection (temp >102F,
severe headache) - ✔✔Who is at risk for pneumococcal resistance (acute bacterial infection)?
CT Scan with contrast• Demonstrates: Almost always diagnostic! Air fluid levels Mucosal edema Air
bubbles
With contrast: helpful for a suppurative complication like cellulitis, intracranial infection -
✔✔periorbital cellulitis. What is the imaging study of choice?
Pharyngitis/Tonsillitis - ✔✔• An acute inflammation of the pharynx/tonsils
Most important and treatable is Group A Strep (accounts for 5-15% of adults with pharyngitis)
at 1 point for each symptom. if greater than 2 then may have strep - ✔✔strep throat sx center
criteria?
Consider screening if Centor score 2 or >
• Screen adults with Centor score ≥3 with RADT
• Adults at high risk for infections (chronic steroid use, DM poorly controlled, immunocompromised,
etc.), throat culture if RADT negative - ✔✔screening for strep throat if points are greater than 2?
penicillin. - ✔✔group a streptococcus treatment?
infectious mononucleosis - ✔✔Viral infection caused by Epstein-Barr virus (EBV) of the herpes family
of viruses and is characterized by malaise and fatigue
Tetrad 3's and an L
Fatigue can last days to weeks
Fever
Pharyngitis can be painful, severe, exudative
Lymphadenopathy: posterior cervical nodes most commonly
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