General Principles of Management - Upper Respiratory Tract Infections and Stomatitis

GENERAL PRINCIPLES OF MANAGEMENT

Viral infections of the upper respiratory tract can only be treated symptomatically. If S.pyogenes is the cause, penicillin therapy is required; if the patient is allergic to peni-cillin, an alternative is chosen (eg, erythromycin or a cephalosporin). Such treatment prevents suppurative or toxigenic complications (eg, pharyngeal abscess, cervical adeni-tis, and scarlet fever) and the development of acute rheumatic fever. The latter, a serious complication, may occur in 1 to 3% of patients in certain population groups if they are not adequately treated. In addition, treatment of acute streptococcal infections can aid in reducing spread of the organisms to other persons.

C. diphtheriae infections involve more complex management, which includes anti-toxin as well as antimicrobic treatment . Infections caused by N. gonor-rhoeae are treated with appropriate antimicrobics . The management ofstomatitis includes maintenance of adequate oral hygiene. If invasive Candida infection is present, topical and/or systemic antifungal therapy is sometimes necessary. Vincent’s angina and other fusospirochetal infections are usually treated with systemic penicillin therapy as well as with appropriate dental and periodontal care. There is no specific, widely accepted treatment for aphthous stomatitis. Peritonsillar and retropharyngeal ab-scesses are treated aggressively with antimicrobics and often require surgical drainage, taking care to prevent accidental aspiration of the abscess contents into the lower respira-tory tract.