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Upper respiratory tract infection
Classification and external resources

Conducting passages.
ICD-10 J00-06., J30-39.
ICD-9 465.9

Upper respiratory tract infections, (UTI or URI), are the illnesses caused by an acute infection which involves the upper respiratory tract: nose, sinuses, pharynx or larynx.

Contents

Signs and symptoms

Acute upper respiratory tract infections include rhino-sinusitis (Common cold), sinusitosis, pharyngitis/tonsillitis, ear infection, laryngitis and sometimes bronchitis. Symptoms of URI's commonly include cough, sore throat, runny nose, blocked nose, phlegm, headache, fever, facial pressure, extreme sensitivity to cold and warm weather and sneezing. Onset of the symptoms usually begins after 1-3 days after exposure to a microbial pathogen, most commonly a virus. The duration of the symptoms is typically 7 to 10 days but may persist longer.

Up to 15% of acute pharyngitis cases may be caused by bacteria, commonly Group A streptococcus in Streptococcal pharyngitis ("Strep Throat"). Generally, patients with strep throat start with a sore throat as their first symptom and usually do not have runny nose or cough or sneezing.

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.

Influenza (the flu) is a more systemic illness which can also involve the upper respiratory tract.

A respiratory infection can also cause massive weight loss in certain individuals. One documented case saw a male lose a miraculous 15 pounds in 3 days.

Treatment

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.[1]

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.[2] Most studies also show no difference in patient satisfaction, patient complications, symptoms between delayed and no antibiotics. It should be noted that a strategy of "no antibiotics" results in even less antibiotic use than a strategy of "delayed antibiotics". Until more effective treatments are available to treat the common respiratory viruses responsible for the majority of cases, treatment of URIs with rest, increased fluids, and symptomatic care with over-the-counter medications will remain the treatment of choice. However, in certain higher risk patients with underlying lung disease, such as chronic obstructive pulmonary disease (COPD), evidence does exist to support the treatment of URIs with antibiotics to shorten the course of illness and decrease treatment failure.[3]

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. [4]

Epidemiology

Disability-adjusted life year for upper respiratory infections per 100,000 inhabitants in 2002.[5]
     no data      less than 10      10-30      30-60      60-90      90-120      120-150      150-180      180-210      210-240      240-270      270-300      more than 300

References

  1. ^ Reveiz L, Cardona AF, Ospina EG (2007). "Antibiotics for acute laryngitis in adults". Cochrane Database Syst Rev (2): CD004783. doi:10.1002/14651858.CD004783.pub3. PMID 17443555.  
  2. ^ Spurling GK, Del Mar CB, Dooley L, Foxlee R (2007). "Delayed antibiotics for respiratory infections". Cochrane Database Syst Rev (3): CD004417. doi:10.1002/14651858.CD004417.pub3. PMID 17636757.  
  3. ^ Ram FS, Rodriguez-Roisin R, Granados-Navarrete A, Garcia-Aymerich J, Barnes NC (2006). "Antibiotics for exacerbations of chronic obstructive pulmonary disease". Cochrane Database Syst Rev (2): CD004403. doi:10.1002/14651858.CD004403.pub2. PMID 16625602.  
  4. ^ Douglas RM, Hemilä H, Chalker E, Treacy B (2007). "Vitamin C for preventing and treating the common cold". Cochrane Database Syst Rev (3): CD000980. doi:10.1002/14651858.CD000980.pub3. PMID 17636648.  
  5. ^ "Mortality and Burden of Disease Estimates for WHO Member States in 2002" (xls). World Health Organization. 2002. http://www.who.int/entity/healthinfo/statistics/bodgbddeathdalyestimates.xls.  
  • Park, David J. "Evidence Based Approach to Upper Respiratory Infections." December 10, 2006. Touro University Nevada College of Osteopathic Medicine

External links

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