FCAAIA Notes: So if it looks like a sinus infection, smells like a sinus infection, and eels like a sinus infection, it must be a sinus infection, right? Well, not necessarily. Every summary of chronic nasal and sinus disease will tell you that and that the overuse and abuse of antibiotics is common (Diagnosis and management of rhinosinusitis: A practice parameter update. Ann Allergy Asthma Immunol 2014; 113:347–385). If your symptoms do not clear with antibiotics, you have to start to wonder if there is something else going on. Continue reading “MANAGEMENT OF RHINOSINUSITIS: AN EVIDENCE BASED APPROACH”
FCAAIA Notes: It often takes a while before common variable immunodeficiency (CVID) is diagnosed after the onset of symptoms. Early on, its presentation can mimic asthma and allergic rhinitis with complications of recurrent infections. It can evolve insidiously, so seeing the same physician regularly might result in earlier diagnosis. But as also noted in this article, patients with allergic airway disease can develop CVID later.
Physicians need to be aware of CVID, know when to suspect it, and know how to make the diagnosis. Continue reading “IMMUNODEFICIENCY MAY BE COMPLICATED BY ASTHMA, ALLERGIES”
FCAAIA Notes: I think EVERY doctor (myself included) is guilty from time to time of prescribing antibiotics when they are not necessary. This study shows that about 1/3 of those prescriptions are unnecessary.
Frequently, it is best to let new-onset symptoms run their course. Continue reading “HOW MANY OF THE ANTIBIOTICS PRESCRIBED IN THE U.S. ARE ACTUALLY NECESSARY?”
FCAAIA Notes: Patients with immune deficiency disease do get any more viral upper respiratory tract infections than anyone else. What they do get, is more frequent complications of those infections (ear and sinus infections and pneumonia). Most patients with recurrent ear, sinus, and lung infections do not have immune deficiency, but it is always a consideration. Those infections are often “over-treated” and are not bacterial at all or are complications of allergic rhinitis or asthma. So, other factors as described below need to be considered. Continue reading “IN RECURRENT UPPER RESPIRATORY INFECTIONS, DON’T ORDER THAT IMMUNE TEST JUST YET”