ARVI is an "acute respiratory viral infection", the causative agent of this disease can only be a virus. The symptoms of acute respiratory viral infections in adults develop rapidly, and the faster the response to the invasion of infection is taken and treatment is started, the easier the immunity will cope with the disease.
The group of causative agents of respiratory infections includes more than 200 viruses, united by a common clinical picture of the disease and the localization of the focus of inflammation in the respiratory organs.
The clinical diagnosis must be accompanied by the identification of specific antibodies. It has no specific antiviral agent... They occur mainly in summer and autumn and are transmitted to humans through oral feces and to a lesser extent respiratory secretions.
They are scattered throughout the world and occur in annual outbreaks in which only a few serotypes occur. It has an incubation period of 3 to 6 days, during which there is low temperature, general malaise, abdominal pain or respiratory symptoms. Twelve to 24 hours later, lesions appear on the hard palate, tongue, and oral mucosa, which begin as maculae that rapidly progress to vesicles that are ulcerated, tender, yellowish gray, and with an erythematous halo.
ARVI refers to diseases caused by viruses, in contrast to the more general group of acute respiratory diseases ARI, which includes viral and bacterial infections.
The most common causative agents of ARVI, with the exception of influenza viruses, which are considered a special disease, include infections:
Skin vesicles appear at the same time or after several hours, mainly in the arms and legs. The image is resolved in 5-10 days. It has the same contagious mechanism and starts suddenly with fever, single phagia, dysphagia and general malaise. In the posterior palate, the uvula and tonsils are small grayish vesicles surrounded by an erythematous halo, 1 to 4 mm thick, which ulcerates rapidly. Systemic symptoms resolve within 4-5 days, and ulcers re-epithelialize within 1 week.
Viral isolation is also possible, but cumbersome and slow. Enteroviruses can be detected in nasopharins within 2 weeks and in sediments for weeks or months after infection. There is only one vaccine against polio viruses and antiviral drugs.
- parainfluenza - die at room temperature in 4 hours, destroyed in 30 minutes when heated to 50 0 С;
- respiratory syncytial (RS) - a virus - acutely infectious, but unstable, and at a temperature of 55 0 С dies after 3 minutes;
- adenovirus - remains for 2 weeks at a temperature of + 18 ... + 20 0 С, dies when exposed to ultraviolet radiation (UV), chlorine treatment;
- rhinovirus - is inactivated upon drying after 5 minutes, after 10 minutes it dies when kept at 50 0 С;
- coronavirus is unstable, dies at 56 0 С in 15 minutes.
Symptoms
Respiratory infections are more often affected and more severely than adults, children are sick.
They are common throughout the world, reaching a serum level of 90% in adults. This usually happens in spring and winter. It mainly affects erythroid precursor cells in the bone marrow, and the liver also exhibits liver infection due to extramedullary hematopoiesis. Other tissues and cells where this virus has been identified are myocardium, endothelial cells, granulocyte precursors, megakaryocytes and macrophages. It is a virus that is transmitted between people and direct contact with surfaces that are contaminated with contaminated secretions.
In adults, acute respiratory viral infections caused by adenovirus, parainfluenza, CP-virus, coronavirus, occurring not only as mono-infections, but also with signs of mixed diseases, posed a particular danger in the 2015-2016 epidemiological season.
Adenovirus
Respiratory organs, eyes, and lymph nodes are targets for 32 known types of adenoviruses. Infection with adenovirus, like most acute respiratory viral infections, occurs by airborne droplets, manifests itself in adults with symptoms:
Vertical transmission appears to occur in only 30% of maternal infections. The incubation period is estimated at 1 to 2 weeks and can be extended to three. Infectious erythema occurs with a malarial erythematous rash that appears as a slap and mesh or lace type rash in the trunk and limbs that lasts for several weeks. The rash can then appear in the face of certain irritants, such as temperature changes, sun exposure, or emotional stress. It is usually afebrile, but the patient may present with general symptoms 1-4 days before the rash.
- , - early and characteristic signs;
- lacrimation, conjunctivitis - develop in 33% of patients;
- , - can proceed in isolation, like;
- enlarged lymph nodes - more often the lymph nodes in the neck, armpit, groin increase;
- chills, fever - the temperature lasts 4-14 days;
- headache;
- lack of appetite;
- muscle pain.
An increase in temperature with adenoviral ARVI does not cause intoxication of the body, as with the flu, and is more easily tolerated by the body. Sometimes the intestines are affected with the development of diarrhea, inflammation of the mesenteric lymph nodes.
Patients with infectious erythema are infected before the period of illness. Various types of rashes have been described to provoke: morbiliform, omnipresent, and purple. Puruluric knee syndrome is an exanthematic presentation characterized by petechiae and painful swelling in the arms and legs, extending slightly to the nearest. It has also been described as fever, lethargy, and arthralgia. In addition, cases of vesicles, bulls, conjunctivitis, cheek and perioral involvement have been reported.
An asymmetric peripheral rash begins as an eruption that appears initially in the flexor regions, with the axillary fold being the most common site. This may be accompanied by axillary lymphadenopathy. It spreads unilaterally asymmetrically, sometimes affecting the entire side of the body. This rash can be generalized to the rest of the body. Fully resolved within 2-6 weeks. In these cases, the immune status is not affected and can be detected from the first week of infection.
The virus can in isolation, without infecting the respiratory system, infect the eyes, causing inflammation of the cornea, keratoconjunctivitis.
Complications of adenovirus infection are caused by the addition of bacterial microflora to the process and the development of:
- – , .
A sign of the addition of pneumonia is a sharp deterioration in the patient's condition, an increase in temperature up to 39 0 С, appearance.
There is no specific antiviral vaccine or treatment for parvovirus infection. This virus is able to persist chronically in 10% of infected adults and in 90% of cases. Newborns infected vertically. It is transmitted through sexual contact, parenteral, organ transplant and mother-to-child transplant. This syndrome is characterized by maculopapular erythema with a diameter of 3 to 5 mm, symmetrically distributed over the face, buttocks and extremities, combined with a history of hepatitis and generalized lymphadenopathy.
It is believed that skin manifestations will be mediated by the formation of immune complexes. Very safe and effective recombinant vaccines are used to prevent chronic congenital infections. Corticosteroids are used for severe extrahepatic manifestations. Churchill Livingston Inc. Chilean Society of Infectious Diseases.
RS virus
The virus mainly affects the lower airwayscomplicating (in 25% of cases) pneumonia. caused by the RS virus can be fatal (0.5% of cases).
Adults become infected with the RS virus less often than children, since immunity after infection persists for life.
Typical symptoms of acute respiratory viral infection caused by the RS virus are:
The guidelines are based on scientific evidence. They intend to serve as a practical and easy-to-use tool for physicians in selecting appropriate diagnostic tests and effective methods treatment for their patients. Regular updates are proposed to incorporate new scientific knowledge.
These guidelines are based on scientific evidence and are intended to be a practical and user-friendly tool for the clinician in deciding the most effective diagnostic tests and treatments available to patients. These guidelines are developed primarily from the US guidelines for the treatment of opportunistic infections 1 and are adapted to local reality and experiences. We exclude drugs that are not available in Chile and are not installed on the first line of treatment, which, due to their high cost, are usually not used in routine clinical practice.
- paroxysmal - the leading symptom, the duration of such a painful cough can be up to 3 weeks;
- shortness of breath with difficulty breathing out;
- tightness in the chest;
- bluish lip color.
Signs of intoxication are less pronounced than with the flu. In adults, ARVI manifests itself with symptoms such as headache, weakness, a temperature of about 38 0 C, which is easy for an adult to treat at home on his own.
In the same direction, new relevant international and national publications will be included. The management of viral hepatitis is not included in these guidelines as a document has been prepared in this regard. The level of evidence for the therapy used in each case is included.
Pneumocystis pneumonia. This can only happen with a fever. The pulmonary physical examination is usually mild and sometimes there is no sign. Pneumothorax is a common complication associated with severe conditions. Enzymatic lactate dehydrogenase in the blood can be increased more than three times the normal value, which is highly sensitive but non-specific. 2. C-reactive protein is usually low when there is no co-infection with other infectious agents. rib cage shows bilateral interstitial infiltrates "in butterfly wings" but may have variable structures with nodules, pouch inserts, or any type of radiological pattern.
With ARVI, you can use drugs to strengthen the immune system and treat cold symptoms at home, as described in the article "".
Parainfluenza
Parainfluenza viruses are the cause of the disease in 20% of cases of ARVI in adults. Symptoms of parainfluenza appear with damage to the nasal cavity and larynx.
From the introduction of the virus to recovery in adults, in the absence of complications in the form of pneumonia, it takes 10-14 days, the characteristic symptoms are:
The classic diagnostic method is by means of induced sputum or bronchoalveolar lavage. Direct immunofluorescence is a more sensitive technique and does not depend on the operator. In severe cases with respiratory failure, the use of corticosteroids, which in some cases may represent the most important therapeutic effect for patient recovery, is mandatory.13 It manifests itself mainly as meningitis or meningoencephalitis and is characterized by fever, headache and general condition compromise.
- runny nose;
- nasal congestion;
- sore throat;
- dry cough.
Rhinovirus
Symptoms of rhinovirus infection are manifested by a runny nose, cough, tickling, weakness, muscle pain, and heaviness in the head. The disease lasts up to 2 weeks, the temperature usually does not rise above subfebrile values \u200b\u200b(37.5 0 С).
In adults, ARVI caused by rhinovirus occurs more often without complications, and the most unpleasant symptoms are dry cough, hearing loss, heaviness in the maxillary sinuses, and lack of smell.
The classic signs of occipital stiffness and photophobia are less common than in acute bacterial meningitis. The commitment of higher mental functions and the level of consciousness are rare and are seen quite late in illness. The crop has a high yield, but is usually positive only after three to four days of incubation.
Amphotericin B in lipids and 5-flucytosine associated with amphotericin are options but were not included given the high cost of the former and the lack of the latter in Chile. Recurrent vulvovaginal candidiasis also occurs in women. It is characterized by dysphagia, odonophagia, and weight loss. It is not associated with fever and generally does not represent a systemic compromise, although, in exceptional cases, it is associated with candidemia in patients contracting infections with fluconazole-resistant strains 20.
Complicated rhinovirus infection with sinusitis,.
Treatment
The treatment regimen for ARVI in adults depends on the type of infection that caused the disease. For all types of viral infections, it is important to start treatment in the first hours of the illness.
From the first hours of the onset of ARVI symptoms, no later than 48 hours later, they begin to take one of the drugs 2 times a day:
Diagnosis is by direct vision of multiple appetizing whitish lesions in the oropharynx; They may also present as non-ulcer erythematous lesions or angular cheilitis. Esophageal candidiasis is manifested with dysphagia, onunophagia, burning and chest pain and is confirmed by vision lesions of the upper digestive endoscopy.
The drug of choice is fluconazole 21. Vulvovaginal candidiasis can be treated with topical azole or an oral dose of fluconazole. Invasive aspergillosis is no less common problem than in other groups of immunocompromised patients, such as neutropenic patients, organ transplant patients, or chemotherapy patients. The most common site is mild and presents clinically as necrotizing pneumonia or bronchitis 24. There is tracheobronchial fever, shortness of breath, chest pain, cough, hemoptysis, and hypoxemia.
- rimantadine or amantadine - 0.1 g each;
- oseltamivir (Tamiflu) - 0.075-0.15 g;
- zanamivir (Relenza).
Take antiviral drugs need 5 days. For adults after 65 years of age, the daily dosage for treatment with amantadine should not exceed 0.1 g.
Taking interferon drugs enhances the phagocytic activity of the immune system, stimulates the production of specific antibodies to viruses. Against acute respiratory viral infections in adults, interferons Grippferon, Alfaron, Viferon, Ingaron are used.
Radiographic images are variable, and fine-measure pulmonary tomography can be found with a halo or crescent sign. The diagnosis is confirmed by histology showing invasion of hyphae into the lung parenchyma. The drug of choice for this person is voriconazole 1, 27. They are also effective for the treatment of aspergillosis: itraconazole, whose performance Parenteral use is not available in Chile, posaconazole, echinocandins and amphotericin in lipids. In patients with more immunosuppression, chest radiographs can be of any type, including interstitial, miliary, and even normal images, requiring differential diagnosis with atypical mycobacteria.
Interferon inducers - Cycloferon, Neovir, Kagocel, Tiloron - are distinguished by their antiviral properties, immunomodulatory effect.
Features of the treatment of adenovirus, MS infection
In severe forms of ARVI caused by adenovirus, adults are treated in infectious diseases wards due to the high infectiousness of the disease.
Active tuberculosis: for its diagnosis, it is necessary to obtain a sample of the infection site for acid-fast staining, culture in automated media, the result of which is from one to three weeks, and culture in a classical medium, which takes three to eight weeks. The expectoration specimen should be obtained three times, ideally in the morning, on alternate days, and processed using the concentration method, which significantly increases the sensitivity of sputum smear microscopy 32. A positive result prompts us to initiate appropriate processing 36.
In a hospital, patients are administered drugs:
- normal immunoglobulin with specific antibodies to adenovirus intramuscularly;
- intravenously treated with detoxification solutions - hemodez, glucose with ascorbic acid are injected.
When symptoms of conjunctivitis appear, immunoglobulins drip into the corner of the eye. And when the condition worsens, wash with 2% boric acid, instillation of albucide, 0.2% deoxyribonuclease enzyme solution are added. They also use tebrofen 0.25% ointment, placing it behind the eyelid.
And a detailed list of drugs for the treatment of influenza and ARVI can be found on the page "", where it is indicated how you can inexpensively treat a respiratory infection in adults.
Symptomatic treatment
To improve well-being, patients are prescribed drugs:
- antipyretic;
- anti-inflammatory;
- pain relievers.
When the temperature rises above 38 0 С Paracetamol is prescribed, which not only lowers the temperature, but has anti-inflammatory and analgesic effects, reducing headaches.
With ARVI with a strong dry cough adults are advised to take the combined antitussive agent Bronholitin, which reduces the intensity of attacks. What else can you treat dry cough in adults with ARVI, is described in the article "".
To relieve sore throat in adults with SARS you can dissolve tablets Faringosept, Hexoral Tabs, drink warm milk with honey, gargle, do oil inhalations, which is described in detail in the section "".
Against nasal congestion and runny nose for acute respiratory viral infections in adults use vasoconstrictor drops in the nose Vibrocil, Nazivin, Otrivin, Sanorin.
Prevention
Preventive measures in the cold season for adults are personal hygiene, flu vaccination, a full diet and strengthening immunity. The body of an adult is quite capable of resisting the invasion of any respiratory virus, provided the immune system is effective.
Continuing the topic, read about one of the most popular preventive measures during the cold season - vaccinations - in our article.
ARVI (acute respiratory viral infection) is a huge group of diseases that are caused by various DNA and RNA viruses (there are about 200 of them).
They affect the respiratory system and are easily transmitted by airborne droplets. The disease always occurs acutely and proceeds with pronounced symptoms of a cold.
This is one of the most common diseases: schoolchildren in 80% of cases miss classes due to the incidence of ARVI, and adults, for the same reason, lose almost half of their working time. Today we will discuss ARVI - the symptoms and treatment of this infection.
Causes
The main reasons for the development of viral respiratory infection there are about two hundred different viruses:
- influenza and parainfluenza, avian and swine flu;
- adenovirus, RS virus;
- rhinovirus, picornavirus;
- coronavirus, bocaruvirus, etc.
The patient becomes the source of infection during the incubation period and in the prodromal period, when the concentration of viruses in his biological secrets is maximum. The route of transmission of infection is airborne, when sneezing, coughing, talking, screaming with small particles of mucus and saliva.
There may be infection through common dishes and household items, through dirty hands in children and through food contaminated with viruses. Susceptibility to a viral infection is different - people with strong immunity may not become infected or suffer a mild disease.
Promote development respiratory infection factors such as:
- stress;
- poor nutrition;
- hypothermia;
- chronic infections;
- unfavorable ecology.
Signs of the disease
The first signs of ARVI in adults and children include:
- temperature rise;
- headache;
- sneezing;
- weakness, malaise;
- and / or.
SARS symptoms in adults
SARS usually proceed in stages, the incubation period from the moment of infection to the manifestation of the first symptoms is different, ranging from several hours to 3-7 days.
During clinical manifestations all acute respiratory viral infections have similar manifestations of one degree or another:
- nasal congestion, runny nose, scanty to profuse and watery nasal discharge, sneezing and itching in the nose,
- sore throat, discomfort, soreness when swallowing, redness in the throat,
- (dry or wet),
- fever from moderate (37.5-38 degrees) to severe (38.5-40 degrees),
- general malaise, refusal to eat, headaches, drowsiness,
- redness of the eyes, burning sensation, lacrimation,
- digestive disorders with loose stools,
- there is rarely a reaction of the lymph nodes in the jaw and neck, in the form of enlargement with slight pain.
Symptoms of SARS in adults depend on the specific type of virus, and can range from a mild runny nose and coughing to severe febrile and toxic manifestations. On average, manifestations last from 2-3 to seven or more days, the febrile period lasts up to 2-3 days.
The main symptom of ARVI is high infectivity for others, the timing of which depends on the type of virus. On average, an infectious patient is the last days of the incubation period and the first 2-3 days of clinical manifestations, gradually the number of viruses decreases and the patient becomes not dangerous in terms of the spread of infection.
In young children, a symptom of ARVI is often a stool disorder - diarrhea. Babies often complain of pains appearing in the abdomen at the first stage of the disease, then a disorder and after that it is possible sharp rise temperature. A rash may appear on the child's body. Cough and runny nose may appear later - sometimes even every other day. Therefore, you need to very carefully monitor the condition of the babies, and monitor the appearance of new signs.
How and how to treat ARVI when the first symptoms appear, we will consider a little below.
How many days does the temperature last for ARVI?
Sore throat and sneezing appear early in the development of the disease. And they usually go away in 3-6 days.
- Subfebrile temperature (a mild manifestation of fever) and muscle pain usually accompany the initial symptoms, the temperature in ARVI stays around a week, says Dr. Komarovsky.
- Nasal congestion, sinus congestion, sinus congestion – general symptomsusually persist for the first week. In about 30% of all patients, these symptoms persist for two weeks, although all these symptoms usually go away on their own after 7-10 days.
- Usually the first few days, the nasal sinuses are not clogged, abundant watery mucus is released from the nose, but over time the mucus becomes thicker, acquires a color (green or yellow). A change in the color of the discharge does not automatically indicate the presence of a bacterial infection; in most cases, the condition disappears in 5-7 days.
- A cough occurs in most cases of SARS, and is usually more productive than a flu. The sputum ranges from clear to yellow-green and usually clears up in 2 to 3 weeks.
Although, a lingering dry cough can persist for 4 weeks in 25% of all infectious diseases.
Flu symptoms
The influenza virus is not in vain excluded by most specialists from the ARI group. Its differences from common colds are lightning-fast development, increased severity of the disease, as well as complex treatment and an increased mortality rate.
- comes unexpectedly and completely captures your body in a matter of hours;
- Influenza is characterized by a sharp increase in temperature (in some cases up to 40.5 degrees), increased sensitivity to light, aches throughout the body, as well as pain: headaches and muscle pains;
- On the first day of the flu, you are protected from a cold, which is characteristic only of this virus;
- The most active phase of influenza falls on the third or fifth day of illness, and the final recovery falls on the 8-10th day.
- Considering that influenza infection affects blood vessels, it is for this reason that hemorrhages are possible: gingival and nasal;
- After suffering the flu, you can catch another illness within the next 3 weeks, such diseases are most often very painful and can be fatal.
ARVI prevention
Until today, there are no really effective measures for specific prevention of ARVI. Strict adherence to the sanitary and hygienic regime in the outbreak is recommended. This is regular wet cleaning and airing of premises, thorough washing of dishes and personal hygiene products for patients, wearing cotton-gauze bandages, frequent hand washing, etc.
It is important to increase the resistance of children to the virus by hardening, taking immunomodulators. Vaccination against influenza is also considered a preventive method.
During an epidemic, one should avoid crowded places, walk more often in the fresh air, take multivitamin complexes or ascorbic acid preparations. It is recommended to eat onions and garlic every day at home.
How to treat ARVI?
ARVI treatment in adults with a standard course of the disease is usually carried out at the patient's home. Bed rest, plenty of drink, drugs to combat symptoms of the disease, light but healthy and nutrient-rich nutrition, warming procedures and inhalations, and taking vitamins are required.
Many of us know that temperature is good, because this is how the body “fights” against invaders. It is possible to bring down the temperature only if it has risen above 38 degrees, because after this mark there is a threat to the state of the patient's brain and heart.
It must also be remembered that antibiotics are not used for ARVI, since they are indicated for ARI exclusively bacterial origin (for example), and ARVI is caused by viruses.
- For direct control of the causative agent of the disease, appoint: Remantadin (age limit from the age of seven), Amantadine, Oseltamivir, Amizon, Arbidol (age limit from two years), Amix
- : paracetamol, ibuprofen, diclofenac. These drugs have anti-inflammatory effects, lower body temperature, and relieve pain. It is possible to take these drugs as part of medicinal powders such as Coldrex, Tera - flu, etc. It should be remembered that it is not worth lowering the temperature below 38 ° C, since it is at this body temperature that the body's defense mechanisms against infection are activated. Exceptions are patients prone to seizures and small children.
- ... The main goal of cough treatment is to make the phlegm thin enough to cough up. The drinking regimen helps greatly in this, since the consumption of warm liquids dilutes the phlegm. If there are difficulties in expectoration, you can use the expectorant drugs mukaltin, ACC, bronchodilator, etc. You should not prescribe yourself drugs that reduce the cough reflex on your own, as this can lead to dangerous consequences.
- Taking vitamin C can accelerate recovery from SARS and alleviate the condition, but does not prevent the development of the disease.
- For cold treatment and improvements in nasal breathing are shown vasoconstrictor drugs (Phenylephrine, Oxymethasone, Xylometazoline, Naphazoline, Indanazolamine, Tetrizolin, etc.) and if longer use is required, drugs containing essential oils are recommended (Pinosol, Cameton, Evkazolin, etc.).
- A good help in the body's fight against infection will be taking immunomodulators, for example the drug Imupret. It enhances immunity and has an anti-inflammatory effect, significantly shortening the period of ARVI. This is exactly the remedy that is indicated for both the prevention and treatment of colds.
- For significant pain and sore throat, it is recommended rinsing with antiseptic solutions, for example furacilin (1: 5000) or herbal infusions (calendula, chamomile, etc.).
Be sure to call a doctor if you or your child has any of the following symptoms: temperature higher than 38.5 C; Strong headache; pain in the eyes from the light; chest pain; shortness of breath, noisy or rapid breathing, difficulty breathing; rash on the skin; pallor of the skin or the appearance of spots on it; vomiting; difficulty waking up in the morning, or unusual sleepiness; persistent cough or muscle aches.
Antibiotics for ARVI
ARVI is not treated with antibiotics. They are completely powerless against viruses, they are used only when bacterial complications occur.
Therefore, antibiotics should not be used without a doctor's prescription. These are drugs that are unsafe for the body. In addition, the uncontrolled intake of antibiotics leads to the emergence of forms of bacteria resistant to them.