High altitude pharyngitis and bronchitis: Difference between revisions
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==Background== | ==Background== | ||
*One of the most common conditions at high altitude<ref>Basnyat B, Litch JA. Medical problems of porters and trekkers in the Nepal Himalaya. Wilderness Environ Med. 1997;8(2):78-81.</ref> | |||
*Possibly due to hyperventilation of altitude, dry & cold air of altitude | |||
== | ==Clinical Features== | ||
*Dry, hacking cough is common at | *Dry, hacking [[cough]] is common at > 8000ft (~2500m) | ||
*Purulent bronchitis/painful pharyngitis common | *Purulent [[bronchitis]]/painful [[pharyngitis]] common with prolonged periods at extreme altitude | ||
*Severe coughing spasms can result in cough | *Severe coughing spasms can result in cough [[rib fracture|fracture of ribs]] | ||
*May be confused with [[HAPE]] | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{High altitude DDX}} | {{High altitude DDX}} | ||
*[[Pneumonia]] | |||
*Viral etiology | |||
*[[CHF]] | |||
*[[COPD]] | |||
*[[Pneumonitis]] | |||
== | ==Evaluation== | ||
*[[ | *Clinical diagnosis after exclusion of other etiologies (e.g. infection) | ||
*Breathing steam, sucking on hard candies, forcing hydration | *Rule out [[HAPE]] | ||
{{Expected SpO2 at altitude}} | |||
==Management== | |||
*Symptomatic treatment | |||
*[[Albuterol]] | |||
*Breathing steam, wearing a face mask, sucking on hard candies, forcing hydration | |||
*[[Antibiotics]] are NOT helpful | *[[Antibiotics]] are NOT helpful | ||
==Disposition== | |||
*Generally treated as an outpatient as long as alternative etiologies are excluded | |||
==See Also== | ==See Also== | ||
*[[High Altitude Medicine]] | *[[High Altitude Medicine]] | ||
== | ==References== | ||
<references/> | |||
[[Category: | [[Category:Environmental]] | ||
[[Category: | [[Category:Pulmonary]] | ||
Latest revision as of 00:33, 23 May 2021
Background
- One of the most common conditions at high altitude[1]
- Possibly due to hyperventilation of altitude, dry & cold air of altitude
Clinical Features
- Dry, hacking cough is common at > 8000ft (~2500m)
- Purulent bronchitis/painful pharyngitis common with prolonged periods at extreme altitude
- Severe coughing spasms can result in cough fracture of ribs
- May be confused with HAPE
Differential Diagnosis
High Altitude Illnesses
- Acute mountain sickness
- Chronic mountain sickness
- High altitude cerebral edema
- High altitude pulmonary edema
- High altitude peripheral edema
- High altitude retinopathy
- High altitude pharyngitis and bronchitis
- Ultraviolet keratitis
- Pneumonia
- Viral etiology
- CHF
- COPD
- Pneumonitis
Evaluation
- Clinical diagnosis after exclusion of other etiologies (e.g. infection)
- Rule out HAPE
Expected SpO2 and PaO2 levels at altitude[2]
| Altitude | SpO2 | PaO2 (mm Hg) |
|---|---|---|
| 1,500 to 3,500 m (4,900 to 11,500 ft) | about 90% | 55-75 |
| 3,500 to 5,500 m (11,500 to 18,000 ft) | 75-85% | 40-60 |
| 5,500 to 8,850 m (18,000 to 29,000 ft) | 58-75% | 28-40 |
Management
- Symptomatic treatment
- Albuterol
- Breathing steam, wearing a face mask, sucking on hard candies, forcing hydration
- Antibiotics are NOT helpful
Disposition
- Generally treated as an outpatient as long as alternative etiologies are excluded