Upper Respiratory Infection (cont.)
Siamak T. Nabili, MD, MPH
Dr. Nabili received his undergraduate degree from the University of California, San Diego (UCSD), majoring in chemistry and biochemistry. He then completed his graduate degree at the University of California, Los Angeles (UCLA). His graduate training included a specialized fellowship in public health where his research focused on environmental health and health-care delivery and management.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Upper respiratory infection facts
- What is an upper respiratory infection?
- Is an upper respiratory infection contagious?
- What are the causes of upper respiratory infection?
- What are the risk factors for upper respiratory infection?
- What are the symptoms of upper respiratory infection?
- When should you seek medical care for upper respiratory infection?
- How is an upper respiratory infection diagnosed?
- What is the treatment for upper respiratory infection?
- What are some of the home remedies for upper respiratory infection?
- What are some data on alternative therapies in treating upper respiratory infections?
- What are the complications of an upper respiratory infection?
- Can an upper respiratory infection be prevented?
- What is the outlook for a patient suffering from an upper respiratory infection?
- Find a local Family Physician in your town
When should you seek medical care for upper respiratory infection?
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.
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).
How is an upper respiratory infection diagnosed?
In evaluating people with suspected upper respiratory infection, other alternative diagnoses need to be considered. Some of the common and important diagnoses that can resemble upper respiratory infection are:
- H1N1 (swine) flu,
- allergic reactions,
- seasonal allergies,
- chronic (long standing) sinusitis,
- acute HIV infection, and
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.
Laboratory testing is generally not recommended in the evaluation of upper respiratory infection. 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.
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).
- 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.
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).
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