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CONDITION/DISORDER SYNONYMS

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  • Epiglottitis

  • Laryngitis

  • Laryngotracheitis

  • Nasopharyngitis

  • Pharyngitis

  • Rhinitis

  • Rhinosinusitis

  • Sinusitis

  • Tracheitis

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ICD-9-CM CODES

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  • 465.9 Acute upper respiratory infections of unspecified site

  • PT diagnoses/treatment diagnoses that may be associated with respiratory disorders

    • 780.7 Malaise and fatigue

    • 786.0 Dyspnea and respiratory abnormalities

    • 786.05 Shortness of breath

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ICD-10-CM CODE

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  • J06.9 Acute upper respiratory infection, unspecified

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PREFERRED PRACTICE PATTERNS1

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  • 6C: Impaired Ventilation, Respiration/Gas Exchange, and Aerobic Capacity/Endurance Associated with Airway Clearance Dysfunction

  • 6F: Impaired Ventilation and Respiration/Gas Exchange Associated with Respiratory Failure

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FIGURE 78-1

Diagram of the anatomic relations of head and neck structures and distribution of the indigenous flora. (Reproduced with permission from Todd JK. Bacteriology and clinical relevance of nasopharyngeal and oropharyngeal cultures. Pediatr Infect Dis. 1984;3:159.)

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PATIENT PRESENTATION

A 10-year-old girl is brought to her pediatrician’s office complaining of headache for the past 2 weeks. Her mother had taken the girl to an optometrist, and her vision was normal. The patient states that she has been in good health and that she received a cat as a birthday present 1 month previously. On examination, she has a normal temperature, the tympanic membranes appear normal, and her throat is clear. There is some tenderness of the right cheek and over the right orbit.2

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KEY FEATURES

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Description
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  • Nonspecific term for acute infections in the nose, paranasal, sinuses, pharynx, larynx, trachea, and bronchi

  • Viruses are the main cause

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Essentials of Diagnosis
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  • Diagnosis is based upon clinical manifestation3

  • Sinusitis and acute bronchitis usually occur after a common cold

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General Considerations
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  • Influenza is a systemic illness involving the respiratory tract that is separate from upper respiratory tract infections (URI or UTI)

  • Spread by aerosol, droplet, hand-to-hand contact

  • Antibiotics have no-to-limited role in the treatment of the common cold or URI3

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FIGURE 78-2

Acute sinusitis with opacification of the maxillary sinus. (Reproduced with permission from Brunicardi FC, Andersen D, Billiar T, et al. Schwartz’s Principles of Surgery. 8th ed. New York, NY: McGraw-Hill; 2004.)

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Demographics
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  • Across the lifespan

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FIGURE 78-3

Algorithm for acute nasal congestion and rhinosinusitis. (From Hay WM et al. Current Diagnosis & Treatment: Pediatrics. 21st ed. www.accessmedicine.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)

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CLINICAL FINDINGS

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SIGNS AND SYMPTOMS4

  • Chest tightness

  • Cough

  • Edema

  • Fever

  • Headache

  • Local swelling

  • Nasal congestion

  • Shortness of breath

  • Shoulder raised to allow increased lung air ...

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