1. Upper respiratory tract infection
Dr. Eyad Obeidat
Consultant of Pediatric

2. Upper respiratory tract infection
Upper respiratory infections are one of the most common reasons for doctor visits.
Upper respiratory infections are the most common illness resulting in missed work or school.
Upper respiratory infections can happen at any time, but are most common in the fall and winter.
The vast majority of upper respiratory infections are caused by viruses and are self-limited.

3. Upper respiratory tract infection
Symptoms of upper respiratory infection include
cough,
sneezing,
nasal discharge,
nasal congestion,
runny nose,
fever,
scratchy or sore throat, and
nasal breathing.

4. Upper respiratory tract infection
Antibiotics are rarely needed to treat upper respiratory infections and generally should be avoided, unless the doctor suspects a bacterial infection.
Simple techniques, such as, proper hand washing and covering face while coughing or sneezing, may reduce the spread of upper respiratory infections.
General outlook for upper respiratory infections is favorable, although, sometimes complication can occur.

5. Upper respiratory tract infection
The upper respiratory tract includes the sinuses, nasal passages, pharynx, and larynx. These structures direct the air we breathe from the outside to the trachea and eventually to the lungs for respiration to take place.
An upper respiratory tract infection, or upper respiratory infection, is an infectious process of any of the components of the upper airway.

6. What is an upper respiratory infection?
Infection of the specific areas of the upper respiratory tract can be named specifically. Examples of these may include rhinitis (inflammation of the nasal cavity), sinus infection (sinusitis or rhinosinusitis) - inflammation of the sinuses located around the nose, common cold (nasopharyngitis) - inflammation of the nares, pharynx, hypopharynx, uvula, and tonsils, pharyngitis (inflammation of the pharynx, uvula, and tonsils), epiglottitis (inflammation of the upper portion of the larynx or the epiglottis), laryngitis (inflammation of the upper portion of the larynx or the epiglottis), laryngitis (inflammation of the larynx), laryngotracheitis (inflammation of the larynx and the trachea), and tracheitis (inflammation of the trachea).

7. What is an upper respiratory infection?
Upper respiratory infections are one of the most frequent causes for a doctor visit with varying symptoms ranging from runny nose, sore throat, cough, to breathing difficulty, and lethargy. In the United States, upper respiratory infections are the most common illness leading to missing school or work. Although upper respiratory infections can happen at any time, they are most common in the fall and winter months, from September until March. This may be explained because these are the usual school months when children and adolescents spend a lot of time in groups and inside closed doors. Furthermore, many viruses of upper respiratory infection thrive in the low humidity of the winter.

8. Is an upper respiratory infection contagious?
A majority of upper respiratory infections are due to self-limited viral infections. Occasionally, bacterial infections may cause upper respiratory infections. Most often, upper respiratory infection is contagious and can spread from person to person by inhaling respiratory droplets from coughing or sneezing. The transmission can also occur by touching the nose or mouth by hand or other object exposed to the virus.

9. What are the causes of upper respiratory infection?
Common pathogens for upper respiratory infection and their respective incubation times are the following:
Thinoviruses, 1-5 days;
Group A streptococci, 1-5 days;
Influenza and parainfluenza viruses, 1-4 days;
Respiratory syncytial virus (RSV), 7 days;
Whooping cough (pertussis), 7-21 days;
Diphtheria, 1-10 days; and
Epstein-Barr virus (EBV), 4-6 weeks.

10. What are the symptoms of upper respiratory infection?
Generally, the symptoms of upper respiratory infection result from the toxins released by the pathogens as well as the inflammatory response mounted by the immune system to fight the infection.
Common symptoms of upper respiratory infection generally include:
nasal congestion,
runny nose (rhinorrhea),
nasal discharge (may change from clear to white to green)
nasal breathing,
sneezing,

11. What are the symptoms of upper respiratory infection?
sore or scratchy throat,
painful swallowing (odynophagia),
cough (from laryngeal swelling and post nasal drip),
malaise, and
fever (more common in children).

12. What are the symptoms of upper respiratory infection?
Other less common symptoms may include
foul breath,
reduced ability to smell (hyposmia),
headache,
shortness of breath,
sinus pain,
itchy and watery eye (conjunctivitis),
nausea,
vomiting
diarrhea, and
body aches.

13. What are the symptoms of upper respiratory infection?
The symptoms of upper respiratory infection usually last between 3-14 days; if symptoms last longer than 14 days, an alternative diagnosis can be considered such as, sinusitis, allergy, pneumonia, or bronchitis. Bacterial pharyngitis (strep throat due to group A Streptococcus) may be considered if symptoms continue to worsen after the first week in the absence of runny nose, cough, or conjunctivitis. Prompt testing and initiation of appropriate antibiotics is important due to the risk of developing rheumatic fever, especially in children.

14. What are the symptoms of upper respiratory infection?
Epiglottitis is an upper respiratory infection in children that may have a more sudden onset of sore throat, feeling of a lump in the throat, muffled voice, dry cough, very painful swallowing, and drooling. Upper respiratory infections in the lower part of the upper respiratory tract, such as, laryngotracheitis, are more commonly featured with dry cough and hoarseness or loss of voice. Barking or whooping cough, gagging, rib pain (from severe cough) are other symptoms and signs.

15. When should you seek medical care for upper respiratory infection?a
Most people tend to diagnose and treat their symptoms at home without seeking professional medical care. A great majority of cases of upper respiratory infection are caused by viruses and are self-limited, meaning they resolve on their own spontaneously.
Visiting a doctor may be advisable if:
symptoms last more than a couple of weeks,
symptoms are severe and worsening,
there is difficulty breathing,
swallowing is impaired, and
upper respiratory infection is recurring.

16. When should you seek medical care for upper respiratory infection?a
Sometimes hospitalization may be necessary if upper respiratory infection is severe and causes significant dehydration, respiratory difficulty with poor oxygenation (hypoxia), significant confusion, lethargy, and worsening of shortness of breath in chronic lung and heart disease (chronic obstructive pulmonary disease or COPD, congestive heart failure). Hospitalizations are much more common in children less than 2 years of age, elderly people (especially those with dementia), and immunocompromised individuals (weak immune system).

17. How is an upper respiratory infection diagnosed?
The diagnosis of upper respiratory infection is typically made based on review of symptoms, physical examination, and occasionally, laboratory tests. In physical examination of an individual with upper respiratory infection, a doctor may look for swollen and redness inside wall of the nasal cavity (sign of inflammation), redness of the throat, enlargement of the tonsils, white secretions on the tonsils (exudates), enlarged lymph nodes around the head and neck, redness of the eyes, and facial tenderness (sinusitis). Other signs may include bad breath (halitosis), cough, voice hoarseness, and fever.

18. How is an upper respiratory infection diagnosed?
Laboratory testing is generally not recommended in the evaluation of upper respiratory infections. Because most upper respiratory infections are caused by viruses, specific testing is not required as there is typically no specific treatment for different types of viral upper respiratory infections.

19. How is an upper respiratory infection diagnosed?
Some important situations where specific testing may be important include:
Suspected strep throat (fever, lymph nodes in the neck, whitish tonsils, absence of cough), necessitating rapid antigen testing (rapid strep test) to rule in or rule out the condition given possible severe sequelae if untreated.
Possible bacterial infection by taking bacterial cultures with nasal swab, throat swab, or sputum.
Prolonged symptoms, as finding a specific virus can prevent unnecessary use of antibiotics (for example, rapid testing for the influenza virus from nasal or pharyngeal swabs).

20. How is an upper respiratory infection diagnosed?
Evaluation of allergies and asthma which can cause long lasting or unusual symptoms.
Enlarged lymph node and sore throat as the primary symptoms that may be caused by Ebstein-Barr virus (mononucleosis) with expected longer time course (by using the monospot test).
Testing for the H1N1 (swine) flu if suspected.

21. How is an upper respiratory infection diagnosed?
Blood work and imaging tests are rarely necessary in the valuation of upper respiratory infection. X-rays of the neck may be done if suspected case of epiglottitis. Although the finding of swollen epiglottis may not be diagnostic, its absence can rule out the condition. CT scans can sometimes be useful if symptoms suggestive of sinusitis last longer than 4 weeks or are associated with visual changes, copious nasal discharge, or protrusion of the eye. CT scan can determine the extent of sinus inflammation, formation of abscess, or the spread of infection into adjacent structures (cavity of the eye or the brain).

22. What is the treatment for upper respiratory infection?
As described above, most cases of upper respiratory infection are caused by viruses and therefore, require no specific treatment and are self-limited. People with upper respiratory infections typically diagnose themselves and treat their symptoms at home without requiring doctor's visit or prescription medications. Rest is an important step in treating upper respiratory infections. Usual activities, such as, working and light exercising may be continued as much as tolerated.

23. What is the treatment for upper respiratory infection?
Increased intake of oral fluids is also generally advised to keep up with the fluid loss from runny nose, fevers, and poor appetite associated with upper respiratory infections. Treatment of the symptoms of upper respiratory infection is usually continued until the infection has resolved.

24. What is the treatment for upper respiratory infection?
Some of the most common upper respiratory infection or cold medications used to treat these symptoms are the following:
Acetaminophen (Tylenol) can be used to reduce fever and body aches.
Nonsteroidal antiinflammatory drugs such as ibuprofen (Motrin, Advil) can be used for body aches and fever.
Antihistamines such as diphenhydramine (Benadryl) are helpful in decreasing nasal secretions and congestions.
Nasal ipratropium (topical) can be used to diminish nasal secretions.
Cough medications (antitussives) can be used to reduce cough. Many cough medications are commercially available such as dextromethorphan, guaifenesin (Robitussin), and codeine all have shown benefits in reducing cough in upper respiratory infections.

25. What is the treatment for upper respiratory infection?
Honey can be used in reducing cough.
Steroids such as dexamethasone (Decadron) and prednisone orally (and nasally) are sometimes used reduce inflammation of the airway passage and decrease swelling and congestion.
Decongestants such as pseudoephedrine (Sudafed) Actifed oral, phenylephrine (Neo-synephrine nasal) can be used to reduce nasal congestion (generally not recommended in children less than 2 years of age and not recommended for individuals with high blood pressure).
Oxymetazoline (Afrin) nasal solution is a decongestant, but should only be used for short-term.
Combination medications containing many of these components are also widely available over the counter.

26. What is the treatment for upper respiratory infection?
Some cough and cold medicines can cause excessive drowsiness need to be used with caution in children younger than 4 years of age and the elderly. Antibiotics are sometimes used to treat upper respiratory infections if a bacterial infection is suspected or diagnosed. These conditions may include strep throat, bacterial sinusitis, or epiglottitis. Antivirals may occasionally be recommended by doctors in patients who are immunocompromised (poor immune system). The treating doctor can determine which antibiotic would be the best option for a particular infection.

27. What is the treatment for upper respiratory infection?
Because antibiotics are associated with many side effects and can promote bacterial resistance and secondary infections, they need to be used very cautiously and only under the direction of a treating physician. Inhaled epinephrine is sometimes used in children with severe spasm of the airways (bronchospasm) and in croup to reduce spasm. Rarely, surgical procedures may be necessary in cases of complicated sinus infections, compromised airway with difficulty breathing, formation of abscesses behind the throat, or abscess formation of the tonsils (peritonsillar abscess).