Upper respiratory tract infections are frequent illnesses in the general population. They are caused by either viruses or bacteria. A viral infection may become complicated subsequently by bacteria. The location of the disease dictates its gravity, as viral upper respiratory tract infections range from simple ones, like viral nasopharyngitis to more severe ones, like rhinosinusitis, epiglottitis, laryngotracheitis and otitis media.
In viral nasopharyngitis patients have profuse nasal discharge , fever, halitosis, mouth breathing leading to dry mouth, hyposmia, sneezing and odynophagia, symptoms that occur 2-3 days after inoculation and last for 7-14 days, depending on the age of the patient . Nasal secretions are initially clear and after 2-3 days turn green or yellow, which may signify a superimposed bacterial infection . Examination of the uvula and posterior pharynx reveals inflammation. Cough may result from postnasal drip. Conjunctivitis and photophobia may accompany ocular pain.
Viral rhinosinusitis  is also characterized by nasal discharge with mucopurulent secretion that does not improve with decongestants or antihistamines administration. Facial or dental pain related to the affected sinus raise rhinosinusitis suspicion. Other symptoms include sore throat, dry mouth, cough, posttussive emesis, hyposmia, and fatigability.
Epiglottitis may represent a potential lethal emergency . It is characterized by an acute onset of symptoms like fever, dyspnea, fatigability, odynophagia- as severe as to prevent saliva swallowing, leading to drooling, dysphonia or total voice loss . Severe episodes are accompanied by respiratory distress, manifested as tachypnea, tachycardia, perioral cyanosis and use of accessory respiratory muscles.
Acute viral otitis media also has a rapid onset , consisting of fever, otalgia, difficulty sleeping, irritability, headache, loss of appetite, fluid drainage from the ear and diminished hearing .
All viral upper respiratory tract infections can cause cervical lymphadenopathy. Specific etiologies lead to specific signs: mononucleosis is accompanied by splenomegaly and hepatomegaly, herpes virus infection causes palatal vesicles, vesicles located on the uvula, palate and anterior tonsillar pillars suggest herpangina. Tonsil hypertrophy is a common finding. Cough may be severe enough to produce conjunctival hemorrhages.
Entire Body System
We report the cases of eight military patients with fever ( 38 C) induced by viral upper respiratory tract infection (URTI) who requested treatment with acupuncture in the military medical service room. [ncbi.nlm.nih.gov]
These were ‘fever’ (P 0.01) and ‘low energy, tired’ (P 0.04). [academic.oup.com]
[…] upper respiratory tract infection, viral infection, sepsis and constipation en In children, the side effects seen in more than # % of patients were urinary tract infections, hypertrichosis (excess body hair), rhinitis (stuffy and runny nose), pyrexia (fever [da.glosbe.com]
- Sudden Infant Death Syndrome
These results are relevant to sudden infant death syndrome (SIDS). The combination of prone sleeping and URTI reproduces the nasopharyngeal flora seen in SIDS. [ncbi.nlm.nih.gov]
Carriage of Haemophilus influenzae and Streptococcus pneumoniae in healthy Chinese and Vietnamese children in Hong Kong. Acta paediatr (Oslo, Norway: 1992). 1995;84(11):1262–7. 19. Dhakal R, Sujatha S, Parija SC, Bhat BV. [bmcinfectdis.biomedcentral.com]
Two previous studies incorporating capsaicin cough challenge methodology have demonstrated that cough reflex sensitivity is transiently enhanced during URI. These studies used single measurements of cough reflex sensitivity during the URI period. [ncbi.nlm.nih.gov]
European Respiratory Journal 2011 38: p3510; DOI: Abstract One previous study has demonstrated that cough reflex sensitivity to inhaled capsaicin is transiently enhanced during acute viral respiratory tract infection (URI) by comparing single cough reflex [erj.ersjournals.com]
Measurement of cough reflex sensitivity Measurement of cough reflex sensitivity has allowed insight into the effects of viral URI on human cough reflex sensitivity. [jtd.amegroups.com]
- Sore Throat
Clinical and psychosocial predictors of illness duration from randomised controlled trial of prescribing strategies for sore throat. Br Med J 1999 ; 319 (7212): 736 –737. 6 Hay AD, Wilson A, Fahey T, Peters TJ. [academic.oup.com]
Pharyngitis Pharyngitis is more commonly known as a sore throat. Sometimes a sore throat is a symptom of a wider respiratory illness such as the common cold, but it can also be due to an infection only in your pharynx (throat). [gleneagles.com.sg]
throat, conjunctivitis–with adenovirus infections; sore throat with pain on swallowing, fever, absence of cough, and exposure to a person with streptococcal pharyngitis in the prior 2 wks support Dx of GABHS-related pharyngitis; Pts with acute sinusitis [medical-dictionary.thefreedictionary.com]
[…] of the throat that often worsens during swallowing Causes The virus or bacteria can cause a sore throat You can catch a sore throat after a viral infection like a cold A sore throat caused due to bacterial infection is called strep throat that is less [beingtheparent.com]
[…] angiotensin I og angiotensin en Adverse Drug Reaction acarodermatitis, bronchitis, bronchopneumonia, cellulitis, cystitis, ear infection, eye infection, influenza, localised infection, nasopharyngitis, onychomycosis, otitis media, otitis media chronic, pharyngitis [da.glosbe.com]
[…] lesions,” tender anterior cervical lymphadenopathy, and occasionally a scarlatiniform rash; pharyngeal or palatal vesicles and ulcers (herpangina) suggest enteroviral or herpetic pharyngitis; pharyngeal exudates are most common in GABHS-related pharyngitis [medical-dictionary.thefreedictionary.com]
Acute Pharyngitis MicrobiologyAcute Pharyngitis Microbiology Commonest bacterial etiology: GAS: 5 – 15 % of sore throat visits in adults (20 – 30 % in children). 27. [slideshare.net]
Acute pharyngitis. N Engl J Med. 2001;344(3):205–11. PubMed CrossRef Google Scholar 121. Choby BA. Diagnosis and treatment of streptococcal pharyngitis. Am Fam Physician. 2009;79(5):383–90. PubMed Google Scholar 122. Shulman ST, et al. [link.springer.com]
Patients with adenoviral pharyngitis often have pharyngeal exudate, so the disease can mimic streptococcal pharyngitis. [microbiologybook.org]
- Nasal Congestion
Because newborns and young infants prefer to breathe through their nose, even moderate nasal congestion can create difficulty breathing. [merckmanuals.com]
The majority of patients in health care settings that present with complaints of runny nose, nasal congestion, cough and headache have a viral upper respiratory infection (the common cold). [healthcentral.com]
Often, the first 2 to 3 days are marked by nasal congestion and stuffiness, followed by several days of sniffling and a runny nose. [care.american-rhinologic.org]
To find relief from nasal congestion, try some extra humidity. Use a humidifier in your room. You can also use a neti pot or saline water for some relief. [ Read: Nasal Congestion Relief During Pregnancy ] 5. [momjunction.com]
- Nasal Discharge
The absence of green nasal discharge, the absence of disturbed sleep and mild symptoms were associated with a diagnosis of URI. [ncbi.nlm.nih.gov]
In viral nasopharyngitis patients have profuse nasal discharge, fever, halitosis, mouth breathing leading to dry mouth, hyposmia, sneezing and odynophagia, symptoms that occur 2-3 days after inoculation and last for 7-14 days, depending on the age of [symptoma.com]
Symptoms & Signs In infants :fever, nasal discharge, difficulty feeding, decreased appetite, and difficulty sleeping. In school-aged children:nasal congestion, sneeze, fever, nasal discharge, headache, sore throat, hoarseness and cough 10. [slideshare.net]
Ciprofloxacin 500 mg BD for 7 days If nasal discharge headache or cough persisit antibiotics are indicated. [speciality.medicaldialogues.in]
Accompanying symptoms such as headache, myalgia and nasal obstruction also showed a tendency to decrease. Within 3 days of treatment, six of the eight patients had recovered from the URTI. No adverse effects of acupuncture treatment were reported. [ncbi.nlm.nih.gov]
[…] nasal discharge; hoarseness suggests laryngitis; difficulty in swallowing oral secretions and stridor should raise suspicion for epiglottitis or pharyngeal abscess; influenza presents as a sudden illness characterized by high fever, severe headache, myalgia [medical-dictionary.thefreedictionary.com]
More severe viral upper respiratory infections also cause vomiting, nausea, diarrhea and abdominal pain, as well as myalgia, fatigue or malaise- more frequent in influenza virus infection. [symptoma.com]
Some Infectious Agents that Cause the Common Cold Agents* Human Serotypes Other unique symptoms in addition to coryza Myxoviruses Influenza A, B, C Myalgia and fatigue Parainfluenza 1, 2, 3, 4 Myalgia and fatigue Respiratory syncytial virus 1 (possibly [atsu.edu]
She denies myalgias, shortness of breath, and ear pain, but does admit to mild headache. On physical exam, the nasal mucosa is swollen and erythematous. There is a small amount of whitish discharge inside the left naris. [medicine.uiowa.edu]
The diagnosis of viral upper respiratory tract infection is mostly clinical, but several tests may also be helpful. For instance, the physician may order influenza rapid test, Epstein-Barr heterophile antibody test, cell culture for herpes simplex virus identification  or polymerase chain reaction in order to detect the same type of infection. Epiglottitis can be diagnosed by direct visualization during laryngoscopy, provided that the patient's clinical status allows it. The microbiological specimen is obtained from throat or nasal swabs or washes; they are cultured on special media in order to identify respiratory syncytial virus, influenza and parainfluenza virus and adenovirus. Antibody titers should be observed in a dynamic manner.
The complete blood cell count shows lymphocytosis in acute viral infections, but lymphopenia may also be noticed in some cases. A high white blood cell number is not unusual. In case dyspnea is noticed, foreign body inhalation should be excluded using imaging methods. In croup, the steeple sign representing subglottic stenosis may be noticed . In acute viral otitis media, tympanometry may be useful.
Within 3 days of treatment, six of the eight patients had recovered from the URTI. No adverse effects of acupuncture treatment were reported. [ncbi.nlm.nih.gov]
Gregory DeMuri and Ellen Wald at the University of Wisconsin, antibiotic therapy is recommended, and amoxicillin–clavulanate is generally the first-line treatment. [blogs.nejm.org]
This study does not address the issue whether a subgroup of children with SAVURTI might benefit from antibiotic treatment. [academic.oup.com]
Rhinosinusitis The prognosis is generally favorable for acute rhinosinusitis, and many cases appear to resolve even without antibiotic therapy. [emedicine.medscape.com]
Hillary Clinton's Pneumonia: How Serious, the Prognosis Posted 12 Sep 2016 by Drugs.com MONDAY, Sept. 12, 2016 – Democratic presidential candidate Hillary Clinton's pneumonia may have heightened questions about her overall health, but doctors say pneumonia [drugs.com]
[…] high-risk persons with influenza exposures.  Differential Diagnosis Common Cold Allergic rhinitis Sinusitis Tracheobronchitis Pneumonia Influenza Atypical Pneumonia Pertussis Epiglottitis Streptococcal Pharyngitis/Tonsillitis Infectious Mononucleosis Prognosis [ncbi.nlm.nih.gov]
Bacterial infections, people with weak immune systems, and those with complications of upper respiratory infections (listed above) may have less favorable prognosis. Medically Reviewed on 7/19/2019 References Meneghetti, A. [medicinenet.com]
A viral etiology was identified in 62 of 108 (57.4%) samples. Symptom measures that best differentiated children with a viral etiology from those without were significant runny nose and significant cough on days 1-4 of the illness. [ncbi.nlm.nih.gov]
Specific etiologies lead to specific signs: mononucleosis is accompanied by splenomegaly and hepatomegaly, herpes virus infection causes palatal vesicles, vesicles located on the uvula, palate and anterior tonsillar pillars suggest herpangina. [symptoma.com]
Bacterial etiology is same as in otitis media. [speciality.medicaldialogues.in]
Bacterial etiologies of some of the common upper respiratory tract infections may be primary or superinfections of the original viral processes and are amenable to treatment (Table 75–1). [accessmedicine.mhmedical.com]
The prevalence, clinical profile, and epidemiology of respiratory virus in adults are different from those in young people. [hindawi.com]
Molecular epidemiology of human rhinovirus in children with acute respiratory diseases in Chongqing, China. Sci Rep. 2014;4:6686. PubMed PubMedCentral CrossRef Google Scholar 75. Linder JE, et al. [link.springer.com]
Epidemiology of acute respiratory infections in children in Guangzhou: a three-year study. PLoS One. 2014;9(5):e96674. 18. Liu J, Ai H, Xiong Y, Li F, Wen Z, Liu W, Li T, Qin K, Wu J, Liu Y. [bmcinfectdis.biomedcentral.com]
[…] recommended; a rapid antigen detection test is also available for adenovirus, RSV, and parainfluenza virus; serologic tests for viruses that can cause a mononucleosis-type illness should be done in the correct clinical setting; influenza serologies have only epidemiologic [medical-dictionary.thefreedictionary.com]
Analyses of routinely collected administrative healthcare data can provide valuable information on the number of URTIs, antibiotic use and bacterial complications to patients, prescribers and policy-makers. epidemiology epidemiology infection control [bmjopen.bmj.com]
PATHOPHYSIOLOGY innate immune response to infection viral replication occurs in only a small number of nasal epithelial cells The infected cells release cytokines, including interleukin (IL)-8 6. [slideshare.net]
Upper respiratory tract infections are accountable for greater than 20 million missed days of school and greater than 20 million days of work lost, thus generating a large economic burden.  Pathophysiology A URTI usually involves direct invasion of [ncbi.nlm.nih.gov]
Mouth Small round red lesions may occur on the soft palate. Decongestants may also cause decreased saliva. Cause In terms of pathophysiology, rhinovirus infection resembles the immune response. [en.wikipedia.org]
While Sphingobium may play a role in preventing AOM complicating URI, the commonly used probiotic Bifidobacterium did not play a significant role during URI or AOM. [ncbi.nlm.nih.gov]
Their enormous prevalence also indicates that rigorous research should be undertaken in order to tackle them, in both the prevention and treatment field. [link.springer.com]
Raina MacIntyre The Beijing Centre for Disease Prevention and Control, Beijing, China Yi Zhang, Peng Yang, Yang Pan, Daitao Zhang & Quanyi Wang Authors C. [bmcinfectdis.biomedcentral.com]
Take Anti-Flu Medications Two medicines are approved for prevention of influenza viral infection. [med.uth.edu]
- Winther B. Rhinovirus infections in the upper airway. Proc Am Thorac Soc. 2011;8(1):79–89.
- Heikkinen T, Järvinen A. The common cold. Lancet. 2003;361(9351):51–59.
- Chow AW, Benninger MS, Brook I, et al. IDSA clinical practice guideline for acute bacterial rhinosinusitis in children and adults. Clin Infect Dis. 2012;54(8):e72-e112.
- Thomas M, Yawn BP, Price D, et al. European Position Paper on Rhinosinusitis and Nasal Polyps Group. EPOS primary care guidelines: European position paper on the primary care diagnosis and management of rhinosinusitis and nasal polyps 2007—a summary. Prim Care Respir J. 2008;17(2):79–89.
- Reveiz L, Cardona AF, Ospina EG. Antibiotics for acute laryngitis in adults Cochrane Database Syst Rev. 2007;(2): CD004783.
- Rafei K, Lichenstein R. Airway infectious disease emergencies. Pediatr Clin North Am. 2006;53(2):215–242.
- Guldfred LA, Lyhne D, Becker BC. Acute epiglottitis: epidemiology, clinical presentation, management and outcome. J Laryngol Otol. 2008;122(8):818–823.
- Heikkinen T, Thint M, Chonmaitree T. Prevalence of various respiratory viruses in the middle ear during acute otitis media. N Engl J Med. 1999;340(4):260–264.
- Chonmaitree T. Viral and bacterial interaction in acute otitis media. Pediatr Infect Dis J. 2000;19(5 suppl):S24–S30.
- Workowski KA, Berman SM. Sexually transmitted diseases treatment guidelines, 2006. MMWR Recomm Rep. 2006; 4(55):1-94.
- Ragosta KG, Orr R, Detweiler MJ. Revisiting epiglottitis: a protocol--the value of lateral neck radiographs. J Am Osteopath Assoc. 1997;97(4):227-229.