Differentiating acute viral nasopharyngitis from other diseases: Difference between revisions

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* [[PCR]] is rapid and accurate test but done only in [[immunocompromised]] patients when the [[virus]] strain needs to be known
* [[PCR]] is rapid and accurate test but done only in [[immunocompromised]] patients when the [[virus]] strain needs to be known
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| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |  Allergic rhinitis<ref name="pmid20232579">{{cite journal |vauthors=Pawankar R, Bunnag C, Chen Y, Fukuda T, Kim YY, Le LT, Huong le TT, O'Hehir RE, Ohta K, Vichyanond P, Wang DY, Zhong N, Khaltaev N, Bousquet J |title=Allergic rhinitis and its impact on asthma update (ARIA 2008)--western and Asian-Pacific perspective |journal=Asian Pac. J. Allergy Immunol. |volume=27 |issue=4 |pages=237–43 |year=2009 |pmid=20232579 |doi= |url=}}</ref>
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |  [[Allergic rhinitis]]<ref name="pmid20232579">{{cite journal |vauthors=Pawankar R, Bunnag C, Chen Y, Fukuda T, Kim YY, Le LT, Huong le TT, O'Hehir RE, Ohta K, Vichyanond P, Wang DY, Zhong N, Khaltaev N, Bousquet J |title=Allergic rhinitis and its impact on asthma update (ARIA 2008)--western and Asian-Pacific perspective |journal=Asian Pac. J. Allergy Immunol. |volume=27 |issue=4 |pages=237–43 |year=2009 |pmid=20232579 |doi= |url=}}</ref>
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* Characterized by repeated paroxysms of [[rhinorrhea]], [[sneezing]] and [[cough]].
* Characterized by repeated paroxysms of [[rhinorrhea]], [[sneezing]] and [[cough]].
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* Serum immune assays to determine [[IgE|IgE levels]] in the [[serum]].
* Serum immune assays to determine [[IgE|IgE levels]] in the [[serum]].
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| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |  Acute sinusitis<ref name="pmid9347786">{{cite journal |vauthors=Low DE, Desrosiers M, McSherry J, Garber G, Williams JW, Remy H, Fenton RS, Forte V, Balter M, Rotstein C, Craft C, Dubois J, Harding G, Schloss M, Miller M, McIvor RA, Davidson RJ |title=A practical guide for the diagnosis and treatment of acute sinusitis |journal=CMAJ |volume=156 Suppl 6 |issue= |pages=S1–14 |year=1997 |pmid=9347786 |doi= |url=}}</ref>
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |  [[Acute sinusitis]]<ref name="pmid9347786">{{cite journal |vauthors=Low DE, Desrosiers M, McSherry J, Garber G, Williams JW, Remy H, Fenton RS, Forte V, Balter M, Rotstein C, Craft C, Dubois J, Harding G, Schloss M, Miller M, McIvor RA, Davidson RJ |title=A practical guide for the diagnosis and treatment of acute sinusitis |journal=CMAJ |volume=156 Suppl 6 |issue= |pages=S1–14 |year=1997 |pmid=9347786 |doi= |url=}}</ref>
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* Presents with symptoms similar to [[URTI|URTIs]] ([[sneezing]], [[cough]] and [[runny nose]])
* Presents with symptoms similar to [[URTI|URTIs]] ([[sneezing]], [[cough]] and [[runny nose]])
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* [[Culture medium|Culture]] of the nasal secretions is of limited use in [[acute sinusitis]] as nasal secretions may be contaminated by [[Flora|nasal flora]].
* [[Culture medium|Culture]] of the nasal secretions is of limited use in [[acute sinusitis]] as nasal secretions may be contaminated by [[Flora|nasal flora]].
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| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | Infectious mononucleosis<ref name="pmid4864269">{{cite journal |vauthors=Niederman JC, McCollum RW, Henle G, Henle W |title=Infectious mononucleosis. Clinical manifestations in relation to EB virus antibodies |journal=JAMA |volume=203 |issue=3 |pages=205–9 |year=1968 |pmid=4864269 |doi= |url=}}</ref>
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | [[Infectious mononucleosis]]<ref name="pmid4864269">{{cite journal |vauthors=Niederman JC, McCollum RW, Henle G, Henle W |title=Infectious mononucleosis. Clinical manifestations in relation to EB virus antibodies |journal=JAMA |volume=203 |issue=3 |pages=205–9 |year=1968 |pmid=4864269 |doi= |url=}}</ref>
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* Symptoms of [[pharyngitis]]: [[sore throat]] and [[Dysphagia|difficult swallowing]]
* Symptoms of [[pharyngitis]]: [[sore throat]] and [[Dysphagia|difficult swallowing]]

Revision as of 18:56, 24 July 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Ahmed Younes M.B.B.CH [2]

Overview

Acute viral nasopharyngitis should be differentiated from other diseases that cause runny nose, cough and constitutional symptoms such as influenza, allergic rhinitis and acute sinusitis.

Differentiating acute viral nasopharyngitis from other diseases

Acute viral nasopharyngitis should be differentiated from other diseases that cause runny nose, cough and constitutional symptoms.

Disease History Physical examination Laboratory or radiological findings
Acute viral nasopharyngitis[1]
  • Diagnosis is usually clinical and lab tests are rarely needed
  • The virus can be cultured on human lung cells but results take time
  • PCR is rapid and accurate test but done only in immunocompromised patients when the virus strain needs to be known
Allergic rhinitis[2]
  • Characterized by repeated paroxysms of rhinorrhea, sneezing and cough.
  • Symptoms may be related to a specific season of the year, hence the name “seasonal allergies”.
  • Rhinorrhea fluid is usually clear and watery.
  • Examination of the nose reveals a crease below the nasal bridge from repeated pulling of the nose secondary to irritation.
  • Edema in the area below the eye if associated conjunctivitis is present.[3]
Acute sinusitis[4]
Infectious mononucleosis[6]

Differentiating Flu and Common Cold
Symptoms Flu Common Cold
Fever High fever (100-102° F) Rare
Headache Common Rare
Cough Common, moderate to severe Mild to moderate
Body aches Common, may be severe Slight
Fatigue Usual, can last up to 2-3 weeks Sometimes
Nasal congestion Sometimes Common
Sneezing Sometimes Common
Sore throat Sometimes Common
Adapted from the National Institute of Allergy and Infectious Diseases (NIAID) [7]

References

  1. ↑ Heikkinen T, Järvinen A (2003). "The common cold". Lancet. 361 (9351): 51–9. doi:10.1016/S0140-6736(03)12162-9. PMID 12517470.
  2. ↑ Pawankar R, Bunnag C, Chen Y, Fukuda T, Kim YY, Le LT, Huong le TT, O'Hehir RE, Ohta K, Vichyanond P, Wang DY, Zhong N, Khaltaev N, Bousquet J (2009). "Allergic rhinitis and its impact on asthma update (ARIA 2008)--western and Asian-Pacific perspective". Asian Pac. J. Allergy Immunol. 27 (4): 237–43. PMID 20232579.
  3. ↑ Skoner DP (2001). "Allergic rhinitis: definition, epidemiology, pathophysiology, detection, and diagnosis". J. Allergy Clin. Immunol. 108 (1 Suppl): S2–8. PMID 11449200.
  4. ↑ Low DE, Desrosiers M, McSherry J, Garber G, Williams JW, Remy H, Fenton RS, Forte V, Balter M, Rotstein C, Craft C, Dubois J, Harding G, Schloss M, Miller M, McIvor RA, Davidson RJ (1997). "A practical guide for the diagnosis and treatment of acute sinusitis". CMAJ. 156 Suppl 6: S1–14. PMID 9347786.
  5. ↑ "Acute maxillary sinusitis". N. Engl. J. Med. 305 (4): 226–7. 1981. doi:10.1056/NEJM198107233050419. PMID 7242607.
  6. ↑ Niederman JC, McCollum RW, Henle G, Henle W (1968). "Infectious mononucleosis. Clinical manifestations in relation to EB virus antibodies". JAMA. 203 (3): 205–9. PMID 4864269.
  7. ↑ "National Institute of Allergy and Infectious Diseases (NIAID)- Flu (Influenza)".
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