Acute Common Bacterial Diseases- Part 2

Acute Common Bacterial Diseases

Learn how to prevent these diseases and treat them if you get it

After learning about acute common viral diseases, it’s time now to dig into some Acute Common Bacterial Diseases. In this article, we are going to learn how these diseases present with real-time examples of patients that I have come across in my Clinic and how I have treated them.

What are Common Acute Bacterial Diseases?

Let us briefly learn what we are going to discuss here.

Bacterias are living organisms that have a cell with a nucleus and a cell wall. A virus has a cell wall but no nucleus.

Instead, virus has what we call RNA( ribosome nucleic acid) or DNA( deoxyribose nucleic acid) strand. This they use to cause disease after entering a healthy  cell.

To know more about the structure of a bacteria, read this short article.

How do the viruses and bacterias grow in our body?

The above two pictures depicts the difference between a Bacterial cell and a viral cell.

Both bacterias and viruses have a different way of multiplying in our body. Whereas the virus has the ability to replicate by releasing the RNA or DNA strands in the human cell, the bacterias multiply by a process called mitosis. In this the bacterias multiply by division of the cells.

I have explained how a viral disease is detected in the body in my recent article on COVID-19 infection.

Now let us proceed to learn about the Common Bacterial Diseases which may affect you.

The Acute Common Bacterial Diseases-

Broadly speaking, bacterial diseases affect almost all the important systems in our bodies. While there are many bacterial diseases out there-both acute and chronic- we will be focussing on acute ones.

I have designed a table system-wise for your better understanding and learning.

As you can see, the list is quite big. So we proceed one system at a time, article by article.

In this article, we will discuss all the common bacterial diseases affecting the uppermost part of our body i.e. the head. And in the head, we will learn about the face and in it, the most prominent part of the face-the NOSE.

Let us first try to know about the different bacterial infections of the different organs in the face. These are as shown below in the picture along with the terms used to describe them.

In this article and the subsequent ones, we will study common bacterial diseases concerned with-

• Nose
• Ears and
• Eyes

To begin with, this article will deal with the Nasal System which includes the nasal cavities, the different sinuses connected to the nose, and as we go downwards, the throat or the pharynx.

Acute Common Bacterial Diseases of the Nasal System-

1. The Nasal system-

The nasal system comprises parts of the nose such as

1.  nasal cavity,
2. the nasal septum,
3.  paranasal sinuses [as shown below] and
4. the throat( pharynx).

The above picture shows the parts of the nasal system which are prone to Acute Bacterial Diseases. The common cold is one of them, which presents itself as Acute Rhinitis.

What are the acute common nasal diseases we come across?

They can be broadly categorized as-

• Acute Rhinitis
• Acute sinusitis
• Acute Pharyngitis

We will discuss in detail the acute common bacterial diseases of these 3 conditions in this article.

Acute Common Bacterial diseases-Acute Rhinitis-Case study

Acute Rhinitis stands for inflammation of the nasal cavities, the nasal septum, and the turbinate [part of the nasal wall which covers the openings to the maxillary sinuses]. Let us study this ailment with an example-

Mr. MSK [name changed] visited my clinic with the following symptoms-

1. Runny nose with sneezing. If this is a thin watery fluid, then the likely cause is an allergy to either dust or pollen. This is mostly caused by viruses found in the common cold. This patient may have a history of allergy to dust.
2. The nasal discharge at the time of visit was a thick foul-smelling liquid. It is called phlegm, which can be greenish yellow in color. This is mostly caused by bacteria.  Click the link to know more about it from the Color of the Phlegm.
3. Pain in the nose. This was caused due to swelling of the turbinates[see the image showing a cross-section of the Nasal Cavity below⇓]. The turbinates are part of the nasal cavity which acts as a cover or a door to the openings of the maxillary sinuses, the bony chambers which form the part of the cheeks.

 

Acute Common Bacterial Disease of the Sinuses- Acute Sinusitis

After having a common cold, if the infection still lingers around,  it can affect our nasal sinuses. There is inflammation of the sinuses which is called Sinusitis. The picture below shows how the nasal sinuses look on a cross-section of our face. Out of the 4 types of sinuses shown, the sinuses that are most affected by bacterial diseases are the frontal and maxillary sinuses.

Case study of Acute Sinusitis-

Now let us study one more case who visited my clinic with cold and severe facial pain.

Mrs.SN reported to me with these symptoms-

• Fever
• Sneezing
• Blocked nose due to nasal congestion
• Facial pain, especially in the forehead( Frontal Sinusitis) and cheeks( Maxillary Sinusitis)

Signs–

On examination, she had

• Moderate to high body temperature-(100 to 102.5° F, as per history given by the patient)
• Tenderness( pain) on pressing the sinuses
• Throat congestion
• Nasal cavities appeared swollen and blocked by thick greenish-yellow phlegm

The two nasal cavities of our nose are separated by a cartilage called the septum. Sometimes, this septum gets deviated due to excessive growth. This deviated nasal septum, popularly referred to as DNS, blocks the fluid flowing from the upper or frontal sinuses causing Frontal Sinusitis.

Investigation-

X-Ray of Paranasal Sinuses

I advised this patient an X-ray of the paranasal sinuses, popularly known as the Water’s View[see below]-

In this picture, you can see the swollen turbinates in the left nasal cavity. This has blocked the opening of the left maxillary sinus, causing fluid or pus to accumulate in that sinus. This was causing pain and headache in the patient.

Prevention–

It is not so easy to prevent sinusitis as it is a postlude to the common cold. Avoiding coming in contact with a person who is sneezing around is the best course. Other than that

• wearing warm clothes in the winter season, especially a woolen cap
• having hot soups like tomato soup or chicken-stock soup will help overcome symptoms of acute sinusitis,
• Steam inhalation if you are having a stuffy nose

Here is a short article that will help you prevent or treat sinusitis at home on this link-timesofindia.indiatimes.com

Treatment of Acute Rhinitis and Sinusitis

I have discussed the treatment of Acute Rhinitis in my previous article.

The treatment of Acute Sinusitis includes all that for acute rhinitis plus these medications-

1.Nasal decongestant-

This includes nasal sprays like

• oxymetazoline hydrochloride (Nasivion),
• Saline nasal solution (Nasivion S).

These medicines when used as a spray or drops can relieve one from nasal congestion. This helps to breathe through the nose easier.

2. Anti-inflammatory drugs

Anti-inflammatory medicines help in reducing the congestion and swelling inside the sinuses. This reduces the pain and headaches experienced in acute sinusitis. The common medicines which I prescribe to my patients are-

• Diclofenac+ Serratiopeptidase ( Emanzen-D, Flanzen-D)
• Trypsin- Chymotrypsin ( Chymoral) plus either Diclofenac sodium ( Voveran, Diclogem) or ibuprofen( Brufen, Ibugesic)

3.Antibiotics-

There are many antibiotics 💊 that I prescribe depending upon the severity of sinusitis. These are-

•  Amoxycillin( Almox, Mox) of 250mg or 500mg strength depending upon the severity of infection
• Doxycycline( Doxy-1L)
• Azithromycin( Zithromax, Azee) of 250mg or 500mg strength depending upon the age of the patient.

4. Vapocaps-

Vapocaps are solutions used as a steam inhalation or by spray on a handkerchief that can help in relieving nasal congestion. A few names that I use are

•  Karvol plus,
• Sinarest vapocaps

If the sinusitis is very severe, the patient is referred to an ENT surgeon for draining the accumulated fluid or pus in the sinus[as shown above in the X-Ray]. This is quite common in the maxillary sinuses.

Now let us proceed ahead with the next common bacterial disease of the nasal system-Acute Pharyngitis.

Acute Common Bacterial Infection-Pharyngitis

What is the pharynx? The pharynx is the part of the mouth that is behind the tongue. It forms the part of the ear-nose-throat triangle of the face. The picture below shows a cross-section of the head and face and the location of the pharynx in it-

The Pharynx is connected to the nose above and the ear by its side through the Eustachian tube. So, whenever there is an infection of the nose, there are equal chances of the pharynx getting swollen or inflamed. This is termed Pharyngitis or simply put, sore-throat.

It should be noted that the pharynx contains glands called the Tonsils. There is a circle of these tonsils that surround the nasal cavity from inside. Collectively, these are referred to as Adenoids. When these are also inflamed it is called Tonsillitis[see picture below]. 

Sometimes these tonsils block the tube extending from the pharynx to the middle ear, the Eustachian Tube. There may be inflammation here also which may give rise to pain in the ears and sometimes, discharge from the ears[will be covered in the next article].

Now that we know what a pharynx looks like, let me discuss a case having the symptoms and signs of Acute Bacterial Pharyngitis and Tonsillitis.

Acute Bacterial Pharyngitis-a Case Study

Sixteen-year-old NK visited my clinic in September 2019 with the following signs and symptoms-

1. Fever off and on for last 3 days.
2. Stuffy nose.
3. Severe sore throat.
4. Hacking dry cough which gave him pain in the throat and both ears.

On physical examination-

1. His pulse rate was high(> than 100).
2. Throat was severely congested and showed a whitish patch on the tonsils.
3. Chest examination- normal breath sounds. No signs of lung infection.

Investigations of Acute Severe Pharyngitis-

• CBC- This showed a high white cell count.
• A throat swab was also taken- this revealed streptococcus bacteria on culture.
• This bacteria was sensitive to these antibiotics-Amoxycillin, Doxycycline, Erythromycin, Gentamycin, and Amikacin.
• X-ray paranasal sinuses showed signs of both Frontal and Maxillary Sinusitis.

Treatment of Acute Bacterial Pharyngitis-

• Paracetamol ( Pacimol 500) for fever;
• Diclofenac sodium + Serratiopeptidase( Emanzen-D)combination for throat pain and swelling;
• Amoxycillin ( Almox 250) + metronidazole ( Metrogyl 400) for infection;
• povidone-iodine ( Betadine gargle) solution for gargling; cough suppressant  ( Corex Dx) for the dry cough.

All these medicines were prescribed for 5 days. NK recovered fully. However, he was advised to continue gargling for 3 more days.

Prevention of Acute Bacterial Pharyngitis-

All the preventive measures taken for acute sinusitis and rhinitis along with regular gargling with warm salt water(at least once at bedtime) are advised for those having recurring pharyngitis.

Conclusion-

I hope this article has helped you understand almost everything about the acute common bacterial disease of the upper respiratory tract. In my next article, I  will be discussing cases related to others parts of the head, namely the eyes and the ears.

Until then, wishing you all a healthy life free from any sort of disease. If you have found this article useful, be sure to share this knowledge with your friends and near and dear ones.

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If you have any queries on the subject discussed in this article, kindly post them in the comments section at the end of this article.

Till then, Adios.

Disclaimer:-

The medicines mentioned in this article is for information purpose only and that which I prescribe to my patients on consultation. Drugs mentioned in this article should be consumed only after consulting your family physician or health care personal.