Upper respiratory tract infection
Upper respiratory tract infection | |
---|---|
Infectious disease | |
Frequency | (2015)[1] |
Deaths | 3,100[2] |
An upper respiratory tract infection (URTI) is an illness caused by an acute
In 2015, 17.2 billion cases of URTIs are estimated to have occurred.[1] As of 2016, they caused about 3,000 deaths, down from 4,000 in 1990.[8]
Signs and symptoms
In uncomplicated colds, coughing and nasal discharge may persist for 14 days or more even after other symptoms have resolved.[6] Acute URTIs include
Symptoms of rhinovirus in children usually begin 1–3 days after exposure. The illness usually lasts 7–10 more days.[6]
Color or consistency changes in
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 a runny nose, voice changes, or cough.[citation needed]
Pain and pressure of the ear caused by a middle-ear infection (otitis media) and the reddening of the eye caused by viral conjunctivitis[10] are often associated with URTIs.
Cause
In terms of pathophysiology, rhinovirus infection resembles the immune response. The viruses do not cause damage to the cells of the upper respiratory tract, but rather cause changes in the tight junctions of epithelial cells. This allows the virus to gain access to tissues under the epithelial cells and initiate the innate and adaptive immune responses.[5]: 27
Up to 15% of acute pharyngitis cases may be caused by bacteria, most commonly
Sexually transmitted infections have emerged as causes of oral and pharyngeal infections.[12]
Diagnosis
Symptoms | Allergy | URI (Common Cold) | Influenza (Flu) |
---|---|---|---|
Itchy, watery eyes | Common | Rare (conjunctivitis may occur with adenovirus) | Soreness behind eyes, sometimes conjunctivitis |
Nasal discharge | Common | Common[6] | Common |
Nasal congestion | Common | Common | Sometimes |
Sneezing | Very common | Very common[6] | Sometimes |
Sore throat | Sometimes (post-nasal drip) | Very common[6] | Sometimes |
Cough | Sometimes | Common (mild to moderate, hacking)[6] | Common (dry cough, can be severe) |
Headache | Uncommon | Rare | Common |
Fever | Never | Rare in adults, possible in children[6] | Very common 37.8–38.9 °C (100–102 °F)(or higher in young children), lasting 3–4 days; may have chills |
Malaise | Sometimes | Sometimes | Very common |
Fatigue, weakness | Sometimes | Sometimes | Very common (can last for weeks, extreme exhaustion early in course) |
Muscle pain | Never | Slight[6] | Very common (often severe) |
Classification
A URTI may be classified by the area inflamed.
Prevention
Vaccination against
Treatment
Treatment comprises symptomatic support usually via
Antibiotics
Prescribing antibiotics for laryngitis is not a suggested practice.
For sinusitis while at the same time discouraging overuse of antibiotics the CDC recommends:
- Target likely organisms with first-line medications: amoxicillin/clavulanate
- Use the shortest effective course; should see improvement in 2–3 days. Continue treatment for 7 days after symptoms improve or resolve (usually a 10–14 day course).
- Consider imaging studies in recurrent or unclear cases; some sinus involvement is frequent early in the course of uncomplicated viral URI[6]
Cough medicine
No good evidence exists for or against the effectiveness of over-the-counter
Decongestants
According to a Cochrane review, a single oral dose of nasal decongestant in the common cold is modestly effective for the short-term relief of congestion in adults; however, data on the use of decongestants in children are insufficient. Therefore, decongestants are not recommended for use in children under 12 years of age with the common cold.[19] Oral decongestants are also contraindicated in patients with hypertension, coronary artery disease, and history of bleeding strokes.[26][27]
Mucolytics
Mucolytics such as acetylcysteine and carbocystine are widely prescribed for upper and lower respiratory tract infection without chronic broncho-pulmonary disease. However, in 2013 a Cochrane review reported their efficacy to be limited.[28] Acetylcystine is considered to be safe for the children older than 2 years.[28]
Alternative medicine
Routine supplementation with vitamin C is not justified, as it does not appear to be effective in reducing the incidence of common colds in the general population.[29] 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.[29] Given that vitamin C supplements are inexpensive and safe, people with common colds may consider trying vitamin C supplements to assess whether they are therapeutically beneficial in their case.[29]
Some low-quality evidence indicates the use of
Epidemiology
Children typically have two to nine viral respiratory illnesses per year.[6] In 2013, 18.8 billion cases of URTIs were reported.[31] As of 2014, they caused about 3,000 deaths, down from 4,000 in 1990.[8] In the United States, URTIs are the most common infectious illness in the general population, and are the leading reasons for people missing work and school.[citation needed]
Dietary research
Weak evidence suggests that probiotics may be better than a placebo treatment or no treatment for preventing upper respiratory tract infections.[32]
See also
References
- ^ PMID 27733282.
- PMID 27733281.
- PMC 7121526.
- ISBN 978-0-521-40554-6.
- ^ ISBN 978-3-319-17458-7.
- ^ a b c d e f g h i j k l "Rhinitis Versus Sinusitis in Children" (PDF). Centers for Disease Control and Prevention. Archived (PDF) from the original on 16 February 2017. Retrieved 19 December 2016. This article incorporates text from this source, which is in the public domain.
- ISBN 978-0-87553-018-5.
- ^ S2CID 1541253.
- PMID 21413304. Retrieved 10 July 2021 – via National Center for Biotechnology Information, U.S. National Library of Medicine.
- ^ "Conjunctivitis". The Lecturio Medical Concept Library. 23 July 2020. Retrieved 10 July 2021.
- PMID 11172144.
- ^ "Human papillomavirus (HPV) and Oropharyngeal Cancer, Sexually Transmitted Diseases". Centers for Disease Control and Prevention. 4 November 2016. Archived from the original on 16 December 2016. Retrieved 19 December 2016.
- ^ "Common Cold: Treatments and Drugs". Mayo Clinic. Archived from the original on 12 February 2010. Retrieved 9 January 2010.
- PMID 12893713.
- PMID 14988184.
- ^ PMID 26002823.
- PMID 28881002.
- PMID 29260224.
- ^ PMID 37791590.
- PMID 37436003.
- .
- PMID 25420096.
- ^ Center for Drug Evaluation and Research. "Special Features – Use Caution When Giving Cough and Cold Products to Kids". Food and Drug Administration. Archived from the original on 12 January 2017. Retrieved 23 January 2017.
- PMID 20176183.
- ^ "Mortality and Burden of Disease Estimates for WHO Member States in 2002" (xls). World Health Organization. 2002. Archived from the original on 16 January 2013.
- OCLC 56446842.
- OCLC 52895543.
- ^ PMID 23728642.
- ^ PMID 23440782.
- PMID 25892369.
- PMID 26063472.
- PMID 36001877.
External links
- Upper Respiratory Tract Infection from Cleveland Clinic Online Medical Reference