Upper respiratory tract infection

Upper respiratory tract infections (URTI) affect the components of the upper respiratory tract, including the nasal passages, pharynx, and larynx.

• Viruses: Rhinovirus, coronavirus, adenovirus, influenza virus, parainfluenza virus, respiratory syncytial virus.
• Bacteria: Less common, includes Streptococcus pyogenes.

• Rhinorrhoea (runny nose) or nasal congestion.
• Sore throat.
• Cough (typically dry).
• Fever and malaise (more common in children).
• Hoarseness or loss of voice (laryngitis).

• Influenza: Sudden onset, higher fever, muscle aches.
• Epiglottitis: Rapid onset, high fever, drooling, difficulty swallowing.
• Tonsillitis: Throat pain, swollen tonsils, possible exudates.
• Mononucleosis: Fatigue, lymphadenopathy, atypical lymphocytes.

• Mostly clinical diagnosis; investigations not routinely needed.
• Combined nose and throat swab: PCR for virus detection if influenza suspected.
• FBC: Atypical lymphocytes, lymphocytosis if mononucleosis suspected.

• Primarily symptomatic: Rest, hydration, and over-the-counter pain relievers (e.g., paracetamol).
• Antibiotics are generally not indicated unless bacterial aetiology is confirmed or suspected.
• Nasal decongestants can be used for short-term relief.
• Avoid antibiotics to prevent resistance and unnecessary side effects unless specifically indicated.

• Hand hygiene and respiratory etiquette (e.g., covering mouth/nose during coughing/sneezing).
• Avoidance of close contact with sick individuals.
• Regular cleaning of surfaces.

• Most URTIs are self-limiting and resolve within 7-10 days.
• Seek medical attention for severe symptoms or if symptoms persist beyond expected duration.

• Otitis media (middle ear infection).
• Sinusitis.
• Laryngitis.
• Lower respiratory tract infections such as bronchitis or pneumonia, especially in immunocompromised individuals.

• URTIs are commonly caused by viral infection and are generally self-limiting.
• They are characterised by a runny or congested nose, cough and sore throat.
• Diagnosis is primarily through clinical judgement, and it is important to be aware of the differential diagnoses.
• Management is supportive with symptomatic treatment and antibiotics are often not required.