Upper and lower respiratory tract infection

Pneumonia and common cold are two different conditions affecting our respiratory system. Though they have a few similar symptoms there are a number of factors that differentiate pneumonia from common cold. They vary in their causitive organism, clinical manifestation, treatment, prevention and prognosis.

Let's compare pneumonia and common cold and learn the difference!

PNEUMONIA: Pneumonia is the inflammation of the lung parenchyma (lower respiratory tract infection) caused by infectious agents.

Causative agents: The causative agent varies with each type of pneumonia. Atypical pneumonia and bacterial pneumonia are the major classification which inturn has various subdivisions.

Bacterial pneumonia:
Streptococcal pneumonia - streptococcus pneumoniae
staphylococcal pneumonia - staphylococcus aureus
Klebsiella pneumonia - klebsiella pneumoniae
pseudomonas pneumonia - pseudomonas aeruginosa
Haemophilus influenza - haemophilus influenzae

Atypical pneumonia:
Legionnaires disease - legionella pneumophila
Mycoplasma pneumonia - mycoplasma pneumoniae
viral pneumonia - influenza virus types A, B, C
Pneumocystis carinii pneumonia - pneumocystis carinii
Fungal pneumonia - aspergillus fumigatus
Chlamydial pneumonia - cipittaci
tuberculosis - mycobacterium tuberculosis

Clinical manifestation: It typically starts with the sudden onset of fever usually above 100F, shaking chills, chest pain (pleuritic pain) aggrevated by coughing and breathing, nasal flaring, grunts, use of accessory muscles for respiration, head ache, myalgia and tachypnea. Bacterial pneumonia's manifestation varies with the organism which may include rash, pharyngitis, sore throat and nasal congestion.

Diagnosis: Pneumonia is diagnosed with history (recurrent, recent and untreated RTI's), physical examination(bronchial breath sounds will be heard on auscultation, increased fremitus on palpation, dullness on percussion), chest X ray and scans showing consolidation and dense areas, blood culture and sputum culture.

Treatment: Antibiotics is the first main treatment of choice which includes penicillin G, erythromycin, clindamycin, 2nd generation cephalosporins and bactrim.
Steam or moist inhalations with effective chest physio are effective to bring out the thickened secretions from the lungs.
Hospitalisation will be necessary for oxygen therapy and initial stabilisation. Some may need ventilatory support if it affects breathing.
Surgical measures like lobar pneumonectamy are also considered if they are attached to one particular lobe.

Prevention:
1.Treating upper respiratory condition is the best way to prevent pneumonia.
2.Do deep breathing and effective coughing exercises to bring out the secretions.
3.Take steam inhalation every week though you dont have any symptoms.
4.Avoid contact with infectious people.
5.Stop smoking.
6.Do not lie down in a particular position for a long time after surgery and older patients.
7.Promote oral hygiene.
8.Reduce alcohol intake.
9.Take nutritious diet.
10.Take vaccination against pneumococcal and influenza viral infections.

Prognosis: Prognosis is very poor with pneumonia especially if untreated. It is the fourth common cause of death in United States.

COMMON COLD: Common cold is as common as it's name denotes. It usually refers to the upper respiratory tract infection which affects the nose and throat.

Causitive agents: They are caused by contagious virus which sheds and spreads from person to person. The common viruses that causes this common cold are picornaviruses, cornaviruses, myxoviruses, paraviruses and adenovirus.

Clinical manifestation: Nasal congestion, sore throat, sneezing, mild chills with fever, stuffy nose, head ache, musle ache, malaise and cough are the common symptoms.

Diagnosis: They are confirmed usually with the presenting history and further investigations are done if the symptoms do not vanish in 2 weeks.

Treatment: There is no specific treatment for common cold. It is usually treated symptomatically. Increased fluid intake, adequate rest, taking vitamin and protein supplements, saline gargle, using analgesics, decongestants and cough expectorants.

Prevention:
1. Avoid contact with people affected with cold. Even a single droplet will cause infection.
2. Break the chain of infection by proper handwashing, proper disposal of tissues and covering the mouth and nose while coughing, sneezing etc.
3. Eat healthy food which includes fruits and vegetables.
4. Protect yourself in cold weather.
5. Avoid crowded areas.

Prognosis: There is no reported deaths due to common cold. Prognosis is usually good when you take measures.

Now you might have understood how critical and different is pneumonia from a common cold. Prevent yourself from both upper and lower respiratory tract infections and have a long life.

Sinus headaches and migraine headaches

Headaches are terrible and they make the day miserable. Sinus headaches and migraine are two different types of headaches and they vary in their manifestation, pathophysiology and treatment. However, both are painful and can be eased by various techniques.

Sinus headaches: They are characterized by pain around the eyes (periorbital area) and facial parts especially in the mornings while awakening. They are sometimes confused with the migraine headaches, if the headache is single sided where only left or right sinus is infected. A careful history and diagnostic assessment will confirm the diagnosis.

Easing sinus headaches:

1. Sinus headaches are usually followed by common cold where the sinuses are blocked by thick mucus and are infected when left untreated. In order to loosen this thick secretion steam inhalation is the best treatment of choice. Boil water in a wide mouth vessel, remove them from the stove, add few drops of eucalyptus oil or vicks, place them in a comfortable and safe place, cover yourself with a blanket and start inhaling the steam through nose and exhale through mouth. This process will loosen secretion and relieve sinus pressure which directly will ease your headache. Hot shower, facial sauna and steam bath also works under the same mechanism to relieve pain.

2. Giving slight pressure over the painful eyebrows or cheek bone or teeth or even some parts of skull which are involved can relieve headache. Some try tieing towel or ribbon around the head to apply pressure but this is not advisable because it may interfere with blood supply.

3. Ice packs or ice compress can be applied to the temporal region which will cause vaso-constriction and there by relieve headache and reduce temperature (because they are accompanied with fever). Hot wet packs also soothe the affected area.

4. Gentle massages with vicks or tiger balm or axe oil do help.

5. Humidifier makes the air moist and when inhaled can thin the secretion which plugs the sinuses to certain extent and relieve pressure that causes headache.

6. Antihistamines like citrizine act as decongestant and sedative to relieve pressure and induce sleep.

7. Antibiotics like amoxicillin, ampicillin, septran DS or bactrim DS are used to treat the infection which in turn relieves headache.

8. Oral and topical decongestants like afrin or otrivin are prefered to loosen and drain out secretions.

9. Irrigating the sinuses also alleviates pain and infection.

10. If the above mentioned tips does not work and if the headache becomes a chronic problem, the exact cause is identified and surgery may be advised.

Migraine headache: This headache is preceded by a phase called aura where the person experiences visual disturbances (light flashes), some experience numb and tingling sensation over the hands or face, mild confusion, slight weakness of extremities and dizziness. The headache is throbbing and severe, usually associated with photophobia, nausea and vomiting. The person recovers from this headache after long hours of sleep with muscle contraction and muscle ache in the neck and scalp.

Migraine headaches can attack at any part of the day. It has a strong family history and usually affects the female gender.

Easing migraine headache:

1. If diet is the reason for this kind of headache, foods containing tyramine, monosodium glutamate, nitrates or milk products like cheese, chocolates and other processed foods should be avoided.

2. Oral contraceptives are believed to cause migraine headaches in some women. In such case, it can be discussed with your physician and proper decision can be taken.

3. Stress is considered the main reason reason for migraine headaches. A change in job or environment is advisable.

4. If habits like smoking or drinking is bringing about this headache, a lifestyle modification should be considered.

5. Certain medications like antihypertensives (hydralazine, diuretics), anti-inflammatory and monoamine oxidase inhibitors can provoke a migraine headache. If you are on such medications, it can be discussed with your doctor and appropriate decisions can be taken.

6. Having a regular sleep and meal pattern will definitely prevent and relieve this kind of headaches.

7. Ergotamine tartrate is the drug prescribed for migraine headaches which can be used orally, sublingually, intra-muscularly, sub-cutaneously, per rectum or by inhalation as well. It has its own side-effects and hence it has to be taken only with doctor's knowledge.

8. Sumatriptan is said to relieve moderate to severe migraine and is available in the form of subcutaneous injection which could be taken by the person himself.

9. Lying down quietly in a dark room with the head kept slightly elevated (30 degrees) can relieve an acute attack more easily.

10. Caffeine is said to arrest or reduce the severity of headache in 90% of migraine sufferers. Black coffee works good for many.

11. Different medication helps for different people. Analgesics, sedatives, antianxiety agents and antiemetics are wide range of medications that are administered to relieve headaches.

12. Propranolol, beta-blocker which halts the dilation of blood vessels in brain is believed to have antimigraine action.

Though headaches are the most common of all human physical complaints, it should be taken seriously. Headache is actually a symptom rather than a disease entity that may indicate other dreadful diseases. Seek treatment at the earliest because prevention is always better than cure.