Common acute respiratory diseases

Acute respiratory diseases

An acute disease is a disease that has a severe, sudden onset. There are many acute respiratory diseases. The following sections examine common acute respiratory diseases.

Acute bronchitis

Acute bronchitis is an inflammation of the lining of the bronchial tubes. The bronchial tubes become irritated and swollen, narrowing the airway. Excessive mucus is produced, leading to increased coughing.

Acute bronchitis is usually caused by a lower respiratory viral infection. Viral conditions, such as the common cold, influenza, and pertussis (whooping cough), can also cause acute bronchitis. In rare cases, a bacterial infection causes the disease. In addition, breathing in irritants or inhaling food or vomit can cause acute bronchitis. Acute bronchitis can cause a dry, hacking cough that can turn into a productive cough. The patient may also experience a low-grade fever, fatigue, and weakness.

After obtaining a medical history and performing an examination, the provider may order a chest x-ray. Pulse oximetry, which determines the oxygen saturation in the blood, may also be performed. In most cases, acute bronchitis is viral, so no antibiotics are prescribed. At-home treatments include using cough drops and a humidifier to soothe a dry throat. Patients are encouraged to drink plenty of fluids and get adequate rest. Over-the-counter (OTC) medications are used for fevers and body aches. Patients are encouraged to stop smoking and using e-cigarettes.

COVID-19

COVID-19 is also called coronavirus disease 2019 and SARS-CoV-2. This disease originated in China in 2019 and created a worldwide pandemic. Several vaccines have been approved and can prevent or decrease the severity of the illness should a person get COVID-19. Because this is a new disease, new information is being learned all the time.

COVID-19 is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Coronaviruses are a group of viruses that cause several illnesses, including the common cold and severe acute respiratory syndrome (SARS).

The following factors put people at a higher risk of serious illness with COVID-19:

• Age over 65
• Lung disease, such as COPD, asthma, and cystic fibrosis
• Weakened immune system, from cancer treatments, transplants (e.g., bone marrow, solid organ), and chronic diseases
• Type 1 or type 2 diabetes mellitus, chronic kidney disease, liver disease, sickle cell disease, high blood pressure, heart disease, severe obesity, and nervous system conditions

The severity of the signs and symptoms can vary and can appear 2 to 14 days after exposure to the virus.

COVID-19 can cause the following reactions:

• Fever, chills, muscle aches, and fatigue
• New loss of taste or smell, headache
• Rhinorrhea, sore throat, cough, shortness of breath, and chest pain
• Nausea, vomiting, and diarrhea
• Emergency warning signs: dyspnea, persistent chest pressure or pain, new confusion, inability to wake or stay awake, and cyanosis

A viral test is performed to diagnose a current infection. A nasal or throat specimen is obtained, and viral tests can be used to check for SARS-CoV-2, the virus that causes COVID-19. Nucleic acid amplification tests (NAATs) detect the virus’s genetic material. NAATs are more accurate but take longer to process than the antigen test. Antigen tests detect viral proteins and are less sensitive; thus the test result may need to be confirmed with a NAAT. The antibody (serology) test is used to test for COVID-19 antibodies, indicating a past infection.

Treatments depend on the severity of the illness. Home care treatments include analgesics, cough medication, rest, and fluid intake. Quarantining helps to minimize the spread of the disease. Severe cases can lead to hospitalization and oxygen therapy. Many clinical studies are underway, and additional treatments are being researched. COVID vaccines are available.

Most people return to normal health, but some people may have post-COVID conditions (or long COVID). They may experience many symptoms for weeks to months after the infection. Post-COVID signs and symptoms can include:

• Tiredness, fatigue, and fever
• Heart palpitations, difficulty breathing, cough, and chest pain
• Difficulty concentrating or thinking (“brain fog”), headache, sleep issues, lightheadedness, change in smell or taste, and depression
• Diarrhea and stomach pain
• Joint or muscle pain, rash, and changes in menstrual cycles

Croup

Croup is caused by inflammation of the trachea and larynx. It usually affects children ages 3 months to 5 years but can occur at any age. Croup is caused by bacteria and viruses, such as parainfluenza RSV, adenovirus, and influenza. Bacterial croup is more severe than viral croup. Usually, the person has a mild cold and low-grade fever for several days before the barking cough and hoarseness occur. As croup worsens, the child may have trouble breathing, such as inspiratory stridor, wheezing, and chest retractions.

The provider will complete a history and physical examination. Additional tests and chest x-rays may be completed. Treatment includes antipyretics, humidifier, bed rest, and increased fluid intake. Sitting up may help the person breathe easier. In severe cases, hospitalization with antibiotics and oxygen therapy may be necessary.

Epiglottis

Epiglottis, an upper respiratory system disease, is a life-threatening inflammation of the epiglottis. Haemophilus influenzae type b (Hib), Streptococcus pneumoniae, and viruses cause epiglottitis. Signs and symptoms include a high fever, pharyngitis, stridor, cyanosis, drooling, difficulty breathing and swallowing, and hoarseness.

The provider will complete a history and physical examination. Blood and throat cultures, a complete blood count (CBC), and a neck x-ray may be ordered. Treatments for epiglottitis include hospitalization, humidified oxygen, antibiotics, and corticosteroids.

Influenza

Influenza, also called the flu, is an acute, contagious respiratory viral infection. Two main types of influenza include Types A and B. Influenza is spread mainly by droplets from coughing, sneezing, or talking. Signs and symptoms include a fever, cough, sore throat, nasal congestion, body aches, headache, and fatigue. Children may experience vomiting and diarrhea.

The provider will complete a history and physical examination. A nasopharyngeal swab is used to collect a specimen, and a rapid influenza diagnostic test (waived by the Clinical Laboratory Improvement Amendments [CLIA]) is done. Treatment involves bed rest, increased fluids, antiviral medications, and over-the-counter analgesics. A yearly vaccine is available for influenza.

Laryngitis

Laryngitis is an inflammation of the voice box (larynx) and an upper respiratory system disease. The cause of laryngitis is overuse of the voice, irritation, or infection. Signs and symptoms include hoarseness, weakened (or loss of) voice, tickling sensation, sore or dry throat, and cough.

The provider will complete a history and physical examination. With chronic laryngitis, a laryngoscopy and biopsy may be done. Treatment consists of antibiotics and corticosteroids. The patient is encouraged to increase fluid intake, rest the voice, and breathe moist air,