Upper Respiratory Infection

Related Terms

 Acute Coryza
 Cold
 Common Cold
 Rhinitis
 Upper Respiratory Bacterial Infection
 Upper Respiratory Tract Infection
 URI
 URTI
 Viral Pharyngitis

Differential Diagnoses

 Acute Laryngitis
 Allergic and Environmental Asthma
 Allergic Fungal Sinusitis
 Apnea, Sleep
 Asthma
 Bronchiectasis
 Bronchiolitis
 Bronchitis
 Bronchitis, Acute and Chronic
 Chlamydial Pneumonias
 Chronic Bronchitis
 Disorders of Taste and Smell
 Drooling
 Farmer's Lung
 Gastroesophageal Reflux Disease
 Goiter
 Gonococcal Infections
 H1N1 Influenza (Swine Flu)
 Halitosis
 Herpes Simplex
 Histoplasmosis
 HIV Disease
 Hypersensitivity Pneumonitis
 Immunoglobulin A Deficiency
 Infectious Mononucleosis
 Influenza
 Kawasaki Disease
 Legionnaires Disease
 Mumps

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  Otitis Media
 Pneumococcal Infections
 Pneumonia
 Pneumonia, Bacterial
 Pneumonia, Community-Acquired
 Pneumonia, Viral
 Psittacosis
 Reflux Laryngitis
 Retropharyngeal Abscess
 Rhinitis Medicamentosa
 Rhinitis, Allergic
 Rhinitis, Nonallergic
 Sinusitis, Chronic
 Sinusitis, Fungal
 Toxoplasmosis
 Tracheal Tumors
 Vocal Cord Dysfunction

Acute upper respiratory tract infections include rhinitis, pharyngitis/tonsillitis

and laryngitis often referred to as a common cold, and their complications:
sinusitis, ear infection and sometimes bronchitis (though bronchi are
generally classified as part of the lower respiratory tract.)

Symptoms of URI's commonly include

 cough,
 sore throat,
 runny nose,
 nasal congestion,
 headache,
 low grade fever,
 facial pressure and
 sneezing.

Onset of symptoms usually begins 1–3 days after exposure.

Definition

An upper respiratory infection (URI) is a viral or bacterial infection that affects the nose,
throat (pharynx), sinuses, and voice box (larynx). These are the most common of all
illnesses. The most familiar upper respiratory infections include the common cold
(rhinopharyngitis), infection of the throat (pharyngitis), tonsils (tonsillitis), the maxillary
sinuses behind the nose (sinusitis), and the larynx (laryngitis). Ear infections (acute otitis
media) are another manifestation of URI. More serious upper respiratory infections
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include epiglottitis, an inflammation of the upper portion of the larynx and supraglottic
area.

Colds and influenza can affect the air passages in the head, neck, and chest (bronchi,
bronchioles, and alveoli). For more information, see Cold, Pharyngitis, Acute Sinusitis, or
Influenza.

Upper respiratory tract infection

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Not to be confused with Urinary tract infection (UTI)

Upper respiratory tract infection

Classification and external resources

Conducting passages.

ICD-10 J00-06, J30-39

ICD-9 465.9

Upper respiratory tract infections (URI or URTI) are the illnesses caused by an acute infection
which involves the upper respiratory tract: nose, sinuses, pharynx or larynx. This commonly includes:
tonsillitis, pharyngitis, laryngitis, sinusitis, otitis media, and the common cold.[1]
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Common URI terms are defined as follows:

 Rhinitis - Inflammation of the nasal mucosa

 Rhinosinusitis or sinusitis - Inflammation of the nares and paranasal sinuses, including
frontal, ethmoid, maxillary, and sphenoid
 Nasopharyngitis (rhinopharyngitis or the common cold) - Inflammation of the nares,
pharynx,hypopharynx, uvula, and tonsils
 Pharyngitis - Inflammation of the pharynx, hypopharynx, uvula, and tonsils
 Epiglottitis (supraglottitis) - Inflammation of the superior portion of the larynx and
supraglottic area
 Laryngitis - Inflammation of the larynx
 Laryngotracheitis - Inflammation of the larynx, trachea, and subglottic area
 Tracheitis - Inflammation of the trachea and subglottic area

Contents
[hide]

 1 Signs and symptoms

 2 Cause
 3 Prevention
 4 Treatment
o 4.1 Antibiotics
o 4.2 Decongestants
o 4.3 Alternative medicine
 5 Epidemiology
 6 See also
 7 References
 8 External links

[edit] Signs and symptoms

Acute upper respiratory tract infections include rhinitis, pharyngitis/tonsillitis and laryngitis often
referred to as a common cold, and their complications: sinusitis, ear infection and sometimes
bronchitis (though bronchi are generally classified as part of the lower respiratory tract.) Symptoms of
URI's commonly include cough, sore throat, runny nose, nasal congestion, headache, low grade fever,
facial pressure and sneezing. Onset of symptoms usually begins 1–3 days after exposure. The illness
usually lasts 7–10 days.

Group A beta hemolytic streptococcal pharyngitis/tonsillitis(strep throat) typically presents with a

sudden onset of sore throat, pain with swallowing and fever. Strep throat does not usually cause runny
nose, voice changes or cough.

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Pain and pressure of the ear caused by a middle ear infection (Otitis media) and the reddening of the
eye caused by viral Conjunctivitis are often associated with upper respiratory infections.

URI, seasonal allergies, influenza: symptom comparison

Allergy
Symptoms URI Influenza

Itchy, watery Rare (conjunctivitis may Soreness behind eyes, sometimes

Common
eyes occur with adenovirus) conjunctivitis

Nasal
Common Common Common
discharge

Nasal
Common Common Sometimes
congestion

Sneezing Very common Very common Sometimes

Sometimes
Sore throat Very common Sometimes
(postnasal drip)

Common (mild to
Cough Sometimes Common (dry cough, can be severe)
moderate, hacking)

Sometimes (sinus
Headache Uncommon Common
pressure headache)

Very common (100-102°F (or higher in

Rare in adults, possible in
Fever Never young children), lasting 3–4 days; may
children
have chills)

Malaise Sometimes Sometimes Very common

Fatigue, Very common, can last for weeks,

Sometimes Sometimes
weakness extreme exhaustion early in course

Muscle pain Never Slight Very common, often severe

[edit] Cause

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Over 200 different viruses have been isolated in patients with URIs. The most common virus is called
the rhinovirus. Other viruses include the coronavirus, parainfluenza virus, adenovirus, enterovirus, and
respiratory syncytial virus.[2]

Up to 15% of acute pharyngitis cases may be caused by bacteria, most commonly Streptococcus
pyogenes a Group A streptococcus in Streptococcal pharyngitis ("Strep Throat").[3]

Influenza (the flu) is a more severe systemic illness which typically involves the upper respiratory
tract. Influenza is a relatively uncommon cause of influenza-like illness.

[edit] Prevention

Probiotics may be useful in preventing URTIs.[4]

[edit] Treatment

Treatment depends on the underlying cause. There are currently no medications or herbal remedies
which have been conclusively demonstrated to shorten the duration of the illness. [5] Treatment
comprises symptomatic support usually via analgesics for headache, sore throat and muscle aches.[6]

There is no evidence to support the age-old advice to rest when you are sick with an upper respiratory
illness. Moderate exercise in sedentary subjects with a URI has been shown to have no effect on the
overall severity and duration of the illness. Based on these findings, it was concluded that previously
sedentary people who have acquired a URI and who have initiated an exercise program may continue
to exercise.[7] Getting plenty of sleep; however, is advisable since even mild sleep deprivation has been
shown to be associated with increased susceptibility to infection.[8][9] Increasing fluid intake, or
"drinking plenty of fluids" during a cold is not supported by medical evidence, according to a
literature review published in the British Medical Journal.[10]

[edit] Antibiotics

Judicious use of antibiotics can decrease unnecessary adverse effects of antibiotics as well as out-of-
pocket costs to the patient. But more importantly, decreased antibiotic usage will prevent the rise of
drug resistant bacteria, which is now a growing problem in the world. Health authorities have been
strongly encouraging physicians to decrease the prescribing of antibiotics to treat common upper
respiratory tract infections because antibiotic usage does not significantly reduce recovery time for
these viral illnesses.[11] Some have advocated a delayed antibiotic approach to treating URIs which
seeks to reduce the consumption of antibiotics while attempting to maintain patient satisfaction. Most
studies show no difference in improvement of symptoms between those treated with antibiotics right
away and those with delayed prescriptions.[12] Most studies also show no difference in patient
satisfaction, patient complications, symptoms between delayed and no antibiotics. A strategy of "no
antibiotics" results in even less antibiotic use than a strategy of "delayed antibiotics". However, in

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certain higher risk patients with underlying lung disease, such as chronic obstructive pulmonary
disease (COPD), evidence does exist to support the treatment of bronchitis with antibiotics to shorten
the course of the illness and decrease treatment failure.[13]

[edit] Decongestants

According to a Cochrane review single oral dose of nasal decongestant in the common cold is
modestly effective for the short term relief of congestion in adults; however, "there is insufficient data
on the use of decongestants in children." Therefore decongestants are not recommended for use in
children under 12 years of age with the common cold.[14] Oral decongestants are also contraindicated
in patients with hypertension, coronary artery disease, and history of bleeding strokes. [15][16]

[edit] Alternative medicine

The use of Vitamin C in the inhibition and treatment of upper respiratory infections has been
suggested since the initial isolation of vitamin C in the 1930s. Some evidence exists to indicate that it
could be justified in persons exposed to brief periods of severe physical exercise and/or cold
environments.[17]

The benefits versus risk of nasal irrigation are currently unclear and therefore is not recommended.[18]

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