*Acute Bronchitis: Manifested by cough, fever, phlegm production ( clear or purulent ).
In the non-smoking population, it is primarily viral, therefore no antibiotics. Mucous thinners,
decongestants, cough suppressants and bronchodilator inhalers usually suffice. Symptoms lasting more than a week may warrant antibiotics. Persistant post treatment cough in the absence of infection is often a result of irritated airways and can be treated with a 5 days course of oral prednisone.

         *Pneumonia:  Could be viral or bacterial, but Strep. Pneumococcus a potentially deadly bacteria
causes a significant number of Pneumonias in the community. Antibiotics, therefore are the norm. Hospitalization is sometimes needed.

        *AECB ( Acute exacerbation of Chronic Bronchitis ): This is primarily a smokers' disease.
Symptoms are similar to Acute Bronchitis, but the history is that of recurring episodes, coupled
with thick purulent mucous, which may not differ from the daily variety in a smoker's life. Antibiotics
are often needed, along with the above remedies.

       *Acute sinusitis: Manifested by tenderness to pressure in the cheecks, purulent nasal discharge
fever, nasopharyngeal drainage, and sore throat. A good percentage is bacterial and therefore antibiotics
are needed.

         *Chronic Sinusitis: More than 2 month duration of nasal and sinus congestion, with or without
purulent or nonpurulent mucous. Fever and sore throat are usually absent. Antibiotics are usually not needed unless there is an acute exacerbation. Mucous thinners, decongestants and intranasal steroid
sprays are the treatment of choice. Severe cases are referred to the Otolaryngolygists for surgical intervention, such as removal of polyps or surgical toilet of sinus cavities.

          *External Otitis: Infection of the ear canal outside the ear drum. Antibiotic ear drops.
 

           *Otitis Media:  Manifests by ear pain, red ear drum, decreased hearing, fever. A significant
portion of these are bacterial. Antibiotics. Ear drops alone can be effective in some cases.

           *Sore Throat: More than 2 dozen organisms, mostly viruses cause this. Strep Group A is worrisome because of potential for Rheumatic fever which may go on to damage the heart valves.
A sore throat less than 48 hours is best tested by a 16 hour culture, while a longer duration sore throat renders a more reliable in office 5 minute rapid strep test. While waiting for the culture, a parent has the option of initiating the antibiotics then stopping when the culture is negative for strep, or waiting till the culture result is known. The choice depends on how sick the child looks and how nervous the parent is.
The child usually misses one to two school days in cases of confirmed strep, for the good of the classroom usually rather than the child.