Presents with fever and pain in young children. In older children, ear pain may be localised. A purulent middle ear effusion and a tympanic membrane with a loss of landmarks and characteristic bagel or doughnut appearance (evidence of positive pressure) is pathognomonic. Antibiotics may be given for confirmed infection.
asthma, acute exacerbation
Progressive worsening of symptoms, such as SOB, wheezing, cough, and chest tightness.
Administration of bronchodilators and corticosteroids relieves airflow obstruction.
Bacterial sinusitis is suspected following 2 weeks of nasal congestion, post-nasal drainage, cough, headache, or facial pain; treatment is symptomatic and includes topical corticosteroids and oral decongestants.
Facial tenderness is a rare and unreliable sign; however, reproducible pain on percussion of frontal and maxillary sinuses, dental pain, and failure of topical and oral decongestants is highly suggestive of acute bacterial sinusitis.
Dyspnoea, wheezing, cyanosis, and cough are the presenting features. The patient may be too breathless to speak; a silent chest with a tachycardia may be present in severe cases.
Antibiotics are not recommended. Oxygen and nebulised beta-agonists may be required in severe cases.
In older or immunocompromised individuals, spread from the upper respiratory tract may lead to life-threatening illness.
COPD, acute exacerbation
Acute exacerbations of COPD are commonly triggered by bacterial or viral pathogens or pollutants and present with an acute, sustained worsening of respiratory symptoms and functional status.
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