Respiratory tract infection

Respiratory tract infections (RTIs) are infectious

Respiratory tract infection
diseases involving the respiratory tract.[1] An infection
of this type usually is further classified as an upper
respiratory tract infection (URI or URTI) or a lower
respiratory tract infection (LRI or LRTI). Lower
respiratory infections, such as pneumonia, tend to be
far more severe than upper respiratory infections, such
as the common cold.

Contents
Types
Upper respiratory tract infection
Lower respiratory tract infection
Diagnosis
Antibiotics
Prevention
Epidemiology
References
Conducting passages
External links
Specialty Infectious disease

Types

Upper respiratory tract infection

The upper respiratory tract is considered the airway above the glottis or vocal cords; sometimes, it is taken
as the tract above the cricoid cartilage. This part of the tract includes the nose, sinuses, pharynx, and larynx.

Typical infections of the upper respiratory tract include tonsillitis, pharyngitis, laryngitis, sinusitis, otitis
media, certain influenza types, and the common cold.[2] Symptoms of URIs can include cough, sore throat,
runny nose, nasal congestion, headache, low-grade fever, facial pressure, and sneezing.

Lower respiratory tract infection

The lower respiratory tract consists of the trachea (windpipe), bronchial tubes, bronchioles, and the lungs.

Lower respiratory tract infections are generally more severe than upper respiratory infections. LRIs are the
leading cause of death among all infectious diseases.[3] The two most common LRIs are bronchitis and
pneumonia.[4] Influenza affects both the upper and lower respiratory tracts, but more dangerous strains such
as the highly pernicious H5N1 tend to bind to receptors deep in the lungs.[5]
 Diagnosis
Pulmonary Function Testing
(PFT) allows for the evaluation
and assessment of airways,
lung function, as well as
specific benchmarks to
diagnose an array of
respiratory tract infections.[6]
Methods such as gas dilution
techniques and
plethysmography help
determine the functional
residual capacity and total lung
capacity.[6] To discover
whether or not to perform a set
of advanced Pulmonary
Function Testing will be based
on abnormally high values in
previous test results.[6] A 2014
systematic review of clinical
trials does not support routine
rapid viral testing to decrease
antibiotic use for children in
emergency departments.[7] It is
unclear if rapid viral testing in
Respiratory System Anatomy
the emergency department for
children with acute febrile
respiratory infections reduces the rates of antibiotic use,
blood testing, or urine testing.[7] The relative risk
reduction of chest x-ray utilization in children screened
with rapid viral testing is 77% compared with
controls.[7] In 2013 researchers developed a breath
tester that can promptly diagnose lung infections.[8][9]

Antibiotics Deaths from respiratory infections per million

persons in 2012

Bacteria are unicellular organisms present on Earth can 24-120 245-346 867-1,209
thrive in various environments, including the human 121-151 347-445 1,210-
body.[10] Antibiotics are a medicine designed to treat 152-200 446-675 2,090
bacterial infections that need a more severe treatment 201-244 676-866
course; antibiotic use is not recommended for common
bacterial infections because the body is likely to treat
them.[11] This medicine does not effectively treat a viral
infection like sore throats, influenza, bronchitis, and sinusitis, common respiratory tract infections.[12] This
is due to antibiotic properties that only allow bacteria's termination; antibiotics were not created to treat
viruses.[13]
The CDC has reported that antibiotic prescription is high; 47 million prescriptions in the United States in
2018 were made for infections that do not need antibiotics to be treated with.[14] It is recommended to
avoid antibiotic use unless bacterial infections are severe, transmissible, or have a high risk of further
complications if left untreated.[15] Unnecessary use of antibiotics could increase antibiotic-resistant
infections, affect the digestive system, create allergic reactions, and other intense side effects.[16] A study
published in JAMA found that narrow-spectrum antibiotics, such as amoxicillin, are just as effective as
broad-spectrum alternatives for treating acute respiratory tract infections in children, but have a lower risk
of side effects.[17]

Prevention
Despite the superior filtration capability of N95 filtering facepiece respirators measured in vitro, insufficient
clinical evidence has been published to determine whether standard surgical masks and N95 filtering
facepiece respirators are equivalent to preventing respiratory infections in healthcare workers.[18]

Adults in intensive care units (ICU) have a higher risk of acquiring an RTI.[19] A combination of topical
and systematic antibiotics taken prophylactically can prevent infection and improve adults' overall mortality
in the ICU for adult patients receiving mechanical ventilation for at least 48 hours, and topical antibiotic
prophylaxis probably reduces respiratory infections but not mortality.[19] However, the combination of
treatments cannot rule out the relevant contribution in the systemic component of the observed reduction of
mortality.[19] There is no sufficient evidence to recommend that antibiotics be used to prevent complications
from an RTI of unknown cause in children under the age of 5 years old.[20] High-quality clinical research
in the form of randomized controlled trials assessed the effectiveness of Vitamin D,[21] another review of
poorer quality RCTs addressed the effectiveness of immunostimulants for preventing respiratory tract
infections.[22] Despite some uncertainty due to small study sizes, there is some evidence that exercise may
reduce severity of symptoms but had no impact on number of episodes or number of symptom days per
episode.[23]

Viruses that cause RTI are more transmissible at very high or low relative humidity; ideal humidity for
indoor spaces is between 40–60%. Therefore relative humidity in this range can help lessen the risk of
aerosol transmission.[24]

Epidemiology
Respiratory infections often have strong seasonal patterns, with temperate climates more affected during the
winter. Several factors explain winter peaks in respiratory infections, including environmental conditions
and changes in human behaviors. Viruses that cause respiratory infections are affected by environmental
conditions like relative humidity and temperature. Temperate climate winters have lower relative humidity,
which is known to increase the transmission of influenza.[24]

Of the viruses that cause respiratory infections in humans, most have seasonal variation in prevalence.
Influenza, Human orthopneumovirus (RSV), and human coronaviruses are more prevalent in the winter.
Human bocavirus and Human metapneumovirus occur year-round, rhinoviruses (which cause the common
cold) occur mostly in the spring and fall, and human parainfluenza viruses have variable peaks depending
on the specific strain. Enteroviruses, with the exception of rhinoviruses, tend to peak in the summer.[24]

References
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External links
Classification MeSH: D012141 D
(https://www.nlm.ni
h.gov/cgi/mesh/201
5/MB_cgi?field=uid
&term=D012141)

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