B. Common cold
1.
Cause
(1) M/C cause : Rhinovirus
(2) Adenovirus, parainfluenza virus, RSV, Corona virus
2.
Clinical features
(1) Nasal congestion, rhinorrhea, sneezing
(2) 7~10일부터 3주 정도
(3) Rhinovirus infection의 특징은 nasal discharge, hoarse voice임.
fever는 소아에게 흔히 동반되나 성인은 드물며, 소아의 20% 정도는 acute otitis media를 고려
3.
Diagnosis : 임상증상으로 다른 검사가 필요하지 않다.
4.
Treatment
(1) Symptom relief (anti-histamine+decongestant)
(2) Vit C, zinc가 도움이 될 수 있다고 한다.
C. Influenza
1.
Clinical features
(1) 잠기 1~4일
(2) Fever (common cold와의 차이), headache, dry cough
2.
Diagnosis
(1) Clinically. direct contact and droplet transfer
(2) Diagnostic test는 nasal swab, nasal aspirate를 소아, 성인 모두에서 권장
3.
Treatment
(1) Symptom <48hr인 경우 oseltamivir 75mg BID X 5days.
(2) 임부나 high-risk 환자에서는 48시간 이후에도 항바이러스제 치료를 권장
(3) 그 외에는 모두 Symptomatic treatment 한다.
4.
SARS
(1) Most common cause : Corona virus
(2) Treatment : Supportive / Ribavirin / Lopinavir
5.
MERS
(1) Most common cause : Corona virus from bats
(2) Treatment
① Supportive : frequently requires mechanical ventilation, dialysis, and ECMO
② Antiviral drugs : ribavirin, lopinavir, and type I interferon → Efficiency unknown
③ Should be isolated in an airborne infection isolation room
D. 백일해 Pertussis (Whooping cough)
1.
Cause : Aerobic gram-negative rod, B. pertussis
2.
Clinical features
(1) Cyclical outbreaks occur every 3 to 5 years
(2) Pertussis pneumonia can occur in children but in shool-age children, adolesents, and
adults, upper respiratory infection are the rule
(3) 2주 이상의 cough, whooping cough는 성인에서 드물다.
3.
Immunization
(1) 2 types of vaccines
(Whole-cell ~10 years / Acellular ~at 2, 4, 6, 18 months of age and a booster at age 5)
(2) 임산부는 반드시 DtaP booster 접종해야 함.
4.
Treatment
(1) Azithromycin 500mg PO on day 1 and 250mg PO days 2~5
(2) Trimethoprim-sulfamethoxazole, 160 milligrams/800 milligrams twice a day for 14 days
