Upper Respiratory Tract Infection Questions & Answers

Updated: Jun 21, 2018
  • Author: Anne Meneghetti, MD; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Questions & Answers

Overview

What is an upper respiratory tract infection (URI)?

How are common colds differentiated from more serious upper respiratory tract infections (URIs)?

What are the signs of viral nasopharyngitis?

What are the signs of group A streptococcal pharyngitis?

What are the signs of acute bacterial rhinosinusitis?

What are the symptoms of epiglottitis?

What are the symptoms of laryngotracheitis and laryngotracheobronchitis?

What are the features of whooping cough (pertussis)?

What are the phases of pertussis (whooping cough)?

What is the role of nasopharyngeal cultures in upper respiratory tract infections (URIs)?

How are the various upper respiratory tract infections (URIs) diagnosed?

When are blood cultures or imaging studies indicated in the diagnosis of an upper respiratory tract infection (URI)?

Which types of medications are used in the treatment of an upper respiratory tract infection (URI)?

What is the treatment protocol for epiglottitis?

How is laryngotracheitis treated?

What is the role of antibiotic therapy in the treatment of rhinosinusitis?

Which medications are used in the treatment of group A streptococcal upper respiratory tract infection (URI)?

What is an upper respiratory tract infection (URI)?

How are upper respiratory tract infections (URIs) managed?

Which specific conditions can be categorized as upper respiratory tract infections (URIs)?

What is rhinitis?

What is rhinosinusitis (sinusitis)?

What is nasopharyngitis (the common cold)?

What is pharyngitis?

What is epiglottitis (supraglottitis)?

What is laryngitis?

What is laryngotracheitis?

What is tracheitis?

How does someone contract a bacterial or viral upper respiratory tract infection (URI)?

What defense mechanisms does the body have against bacterial and viral upper respiratory tract infections (URIs)?

What is the role of the immune system in upper respiratory tract infections (URIs)?

What is the relationship between allergies and upper respiratory tract infections (URIs)?

How are upper respiratory tract infections (URIs) transmitted person to person?

How do viruses evade the immune system in upper respiratory tract infections (URIs)?

What are the incubation periods for upper respiratory tract infections (URIs)?

What causes symptoms of an upper respiratory tract infection (URI)?

Which complications may result from spread of a nasopharyngeal infection?

What threats are posed by inflammatory narrowing at the level of epiglottis and larynx?

What is the role of genetics in upper respiratory tract infection (URI)?

Which viruses cause rhinosinusitis?

Which pathogens cause most upper respiratory tract infections (URIs)?

Which viruses are the main causes of the common cold?

Which viruses are less common causes of the common cold?

Is pharyngitis usually viral or bacterial?

Which viruses cause pharyngitis?

Which bacteria cause pharyngitis?

Which bacteria cause rhinosinusitis?

What is the etiology of nosocomial sinusitis?

What causes noninvasive fungal sinusitis?

What is epiglottitis and how common is it?

What causes croup?

What causes pertussis (whooping cough)?

Which viruses cause laryngitis that is not associated with whooping cough (pertussis) or croup?

Which bacteria cause laryngitis?

What are the risk factors for contracting an upper respiratory tract infection (URI)?

How common are upper respiratory tract infections (URIs)?

What is the incidence of the common cold (nasopharyngitis)?

Which age group has the highest incidence of pharyngitis?

Is sinusitis most commonly associated with bacterial or viral upper respiratory tract infections (URIs)?

What is the incidence of epiglottitis, and which vaccine is credited with significantly reducing the incidence?

Which age group has the highest incidence of croup?

What is the incidence of pertussis (whooping cough) in the US?

What is the worldwide incidence of pertussis (whooping cough)?

Why is pertussis (whooping cough) likely underreported or misdiagnosed in the US?

What is the incidence of pharyngitis, and what percentage of infections are caused by group A streptococcal bacteria?

How common is influenza in the US?

How common is Epstein-Barr virus (EBV) infection in the US?

What is the prevalence of diphtheria in the US?

In which seasons do most upper respiratory tract infections (URIs) occur?

How does climate affect the prevalence of upper respiratory tract infections (URIs)?

What are the seasonal patterns of rhinoviral, coronaviral, enteroviral, and adenoviral upper respiratory tract infections (URIs)?

What are the seasonal patterns of human parainfluenza viruses (PIVs)?

Are upper respiratory tract infections (URI) more prevalent in certain racial groups?

How does rhinitis affect men and women differently?

Is nasopharyngitis more common in males or females?

Is epiglottitis more common in males or females?

Is croup more common in males or females?

In what age group is the common cold most common?

In what age group are viral and bacterial pharyngitis most common?

Which age groups are most at risk for epiglottitis?

Which age groups are most at risk for croup?

What are the potential complications of upper respiratory tract infection (URI)?

How long do symptoms of the common cold last?

What is the role of daycare in the duration of upper respiratory tract infection (URI) symptoms in children?

What is the typical duration of influenza symptoms?

How often is influenza severe or fatal?

What is the typical duration of viral pharyngitis?

What are the potential complications of untreated group A streptococcal pharyngitis?

What morbidity or mortality risks are associated with streptococcal pharyngitis?

What is the prognosis of penicillin-sensitive streptococcal pharyngitis?

What is the prognosis of a chronic carrier of group A streptococci?

What is the prognosis of Epstein-Barr virus (EBV) mononucleosis?

What is the prognosis of acute rhinosinusitis?

Which serious complications are associated with sinusitis?

What is the prognosis of epiglottitis?

What is the prognosis of croup?

What is the prognosis of pertussis (whooping cough)?

What are the potential complications of upper respiratory tract infections (URIs)?

What is the role of upper respiratory tract infections (URIs) in asthma?

What is a postinfectious cough associated with upper respiratory tract infections (URIs), and how does it develop?

Which symptoms of upper respiratory tract infections (URIs) may indicate lower respiratory tract disease and sepsis?

Which infections and superinfections are associated with upper respiratory tract infections (URIs)?

What are the potential complications of laryngitis and laryngotracheitis?

What are the potential complications of pharyngitis?

What are the potential complications of sinusitis?

Which symptoms of upper respiratory tract infection (URI) are associated with ophthalmologic deep tissue infection or intracranial involvement?

Which bone and brain complications are associated with upper respiratory tract infection (URI)?

What is the role of upper respiratory tract infection (URI) in lymphadenitis, Guillain-Barré syndrome, and Reye syndrome?

Which cardiovascular complications are associated with upper respiratory tract infection (URI)?

Which patients are at risk for hyperglycemia during an upper respiratory tract infection (URI)?

Why are rib fractures and hernias associated with upper respiratory tract infection (URI)?

Which cutaneous complications are associated with group A streptococcal upper respiratory tract infection (URI)?

What does hemoptysis indicate in a patient with an upper respiratory tract infection (URI)?

What serious complications are associated with group A streptococcal pharyngitis?

What is the incidence and typical course of acute rheumatic fever (ARF) as a complication of strep throat?

What are signs of acute rheumatic fever (ARF) in group A streptococcal infections?

Which age group is most commonly affected by poststreptococcal glomerulonephritis?

What are the signs and symptoms of poststreptococcal glomerulonephritis?

How does scarlet fever manifest as a complication of group A streptococcal infection?

What is the PANDAS complication of streptococcal infection in children?

What are the potential complications of mononucleosis?

What are the potential complications of diphtheria?

What are the potential complications of pertussis in hospitalized infants?

What are the potential complications of influenza?

What information should be provided to patients about antibiotic therapy for upper respiratory tract infection (URI)?

What information about managing symptoms should be provided to patients with upper respiratory tract infection (URI)?

What is the most effective way to reassure patients with upper respiratory tract infections (URIs)?

What behavioral recommendations can be made to patients with upper respiratory tract infections (URIs)?

When is follow-up indicated in patients with an upper respiratory tract infection (URI)?

Presentation

How is the common cold differentiated from upper respiratory tract infections (URIs) that require targeted therapy?

How long does the common cold last?

What are the typical nasal symptoms of a common cold?

Which common cold symptoms may indicate bacterial infection?

What is the progression of pharyngeal (throat) symptoms in the common cold?

What symptoms, other than nasal congestion, sore throat, and cough, are associated with the common cold?

How are viral and bacterial pharyngitis differentiated?

What features of the patient history may suggest group A streptococcal upper respiratory tract infection (URI)?

Which pharyngeal symptoms differentiate group A streptococcal infection from viral illness?

What nonpharyngeal symptoms are associated with group A streptococcal infection?

Which pharyngeal infections should be considered in patients with a history of recent orogenital contact?

Which features of patient presentation can be used to differentiate viral and bacterial rhinosinusitis?

What are the most common signs of bacterial sinusitis in children?

How do the AAP guidelines define acute bacterial sinusitis in children?

What is the difference between viral and bacterial rhinosinusitis nasal symptoms?

Can acute rhinosinusitis cause facial or dental pressure or pain?

Can acute rhinosinusitis cause sore throat?

What are the features of rhinosinusitis-related cough, and when do they suggest a more serious condition?

Is the sense of smell affected by an upper respiratory tract infection (URI)?

What are the symptoms of epiglottitis, and which age group is most often affected?

What are the signs and symptoms of laryngotracheal infection?

What are the features of the cough in whooping cough (pertussis)?

What are the phases of whooping cough (pertussis)?

What are the posttussive symptoms of whooping cough (pertussis)?

Which physical findings indicate viral nasopharyngitis (the common cold)?

Which type of infection is most commonly associated with pharyngeal erythema in upper respiratory tract infection (URI)?

What do exudates indicate in upper respiratory tract infections (URIs)?

Which upper respiratory tract infection (URI) may present with oral vesicles or ulcers?

Is profuse nasal discharge characteristic in bacterial or viral infections?

Which conditions are associated with lymphadenopathy in upper respiratory tract infection (URI)?

What does conjunctivitis indicate in upper respiratory tract infection (URI)?

What signs may be present in viral pharyngitis?

Which physical findings suggest a high risk for group A streptococcal upper respiratory tract infection (URI)?

How do exudates manifest in bacterial pharyngitis?

Which upper respiratory tract infection (URI) is associated with a whitish or colored adherent membrane on the nasal septum?

What are the physical findings of peritonsillar and retropharyngeal abscesses?

Which upper respiratory tract infections (URIs) are associated with anterior cervical adenopathy?

Which upper respiratory tract infection (URI) is most commonly associated with fever?

Which upper respiratory tract infections (URI) are associated with a rash?

Which unusual findings may be seen in bacterial pharyngitis?

When should cardiac murmurs be documented in cases of pharyngitis?

How is acute viral rhinosinusitis differentiated from bacterial rhinosinusitis?

At what age do children develop sinuses?

How do exudates manifest in acute rhinosinusitis?

Which physical findings are consistent with rhinitis?

What is the role of preexisting nasal obstructions in sinusitis?

How are the sinuses evaluated during a physical exam for acute rhinosinusitis?

How are the sinuses evaluated during a physical exam for acute rhinosinusitis?

Which physical findings may indicate intracranial suppurative complications of acute rhinosinusitis?

How is a physical exam conducted for suspected epiglottitis?

Which physical findings are associated with epiglottitis?

Which vocal symptoms are associated with laryngitis and laryngotracheitis?

Which types of cough are associated with laryngeal involvement in upper respiratory tract infection (URI)?

Which conditions are associated with laryngitis with inspiratory stridor?

Is hemoptysis associated with laryngitis?

How does respiratory compromise manifest in laryngitis and laryngotracheitis?

Can laryngitis cause hemorrhages?

Are lymphadenopathy and fever manifestations of laryngitis?

DDX

What are the differential diagnoses for Upper Respiratory Tract Infection?

Workup

When are bacterial and viral testing indicated in upper respiratory tract infection (URI)?

When is viral testing indicated in upper respiratory tract infection (URI)?

How are samples collected for testing to confirm bacterial upper respiratory tract infection (URI) pathogens?

Which lab tests are used for suspected pertussis?

How is viral nasopharyngeal infection confirmed?

How are rapid tests used for the diagnosis of viral upper respiratory tract infection (URI)?

Which assays are used in the workup of viral upper respiratory tract infection (URI)?

How are pathogens of upper respiratory tract infection (URI) identified in immunocompetent patients?

How are CBC count and cultures used in the workup for upper respiratory tract infection (URI)?

When are imaging studies indicated in the workup for upper respiratory tract infection (URI)?

When should group A streptococcal infection be suspected in patients with upper respiratory tract infection (URI)?

What are the IDSA guidelines for group A streptococcal pharyngitis testing?

When is a backup culture indicated in group A streptococcal pharyngitis testing?

When is testing for group A streptococcal pharyngitis most accurate?

Are lab studies indicated in suspected acute bacterial rhinosinusitis?

Why are imaging studies not typically used in acute rhinosinusitis?

When is CT scanning indicated in rhinosinusitis?

Why is CT scanning preferred over plain radiography when imaging is indicated in rhinosinusitis?

Which imaging studies can be used in rhinosinusitis if CT scanning is not an option?

What is the role of sinus puncture and aspiration in patients with rhinosinusitis?

Which lab tests may be useful in suspected influenza?

What is the indicated workup for suspected mononucleosis?

Which lab tests are used in the workup for suspected herpes simplex virus (HSV) infection?

Which lab tests are available for the workup of suspected pertussis (whooping cough)?

What is the indicated workup for suspected epiglottitis?

What is the role of imaging in suspected epiglottitis?

Is radiography an effective tool for identifying epiglottitis?

Does CT scanning have a role in suspected epiglottitis?

Treatment

How are most upper respiratory tract infections (UTI) diagnosed and treated?

How are upper respiratory tract infections (URIs) treated?

What are the basic principles of antibiotic therapy in the treatment of pediatric upper respiratory tract infections (URIs)?

Are delayed antibiotic prescribing strategies as effective as immediate antibiotic prescriptions in the treatment of upper respiratory tract infections (URIs)?

When should patients with epiglottitis be hospitalized?

Which specialists should be involved in the treatment of adults with epiglottitis?

How is suspected epiglottitis examined?

What complications are associated with epiglottitis, and how should patients be monitored?

How is oxygen used in the treatment of patients with epiglottitis?

Which medications are used to treat epiglottitis?

When is hospitalization indicated for laryngotracheitis?

How are hospitalized patients with laryngotracheitis monitored?

Which medications are used to treat laryngotracheitis?

Are antibiotics indicated in the treatment of rhinosinusitis?

According to the IDSA guidelines and the AAP guidelines, when is antibiotic treatment indicated in sinusitis?

What are the IDSA guidelines for the recommended duration of antibiotic therapy for sinusitis?

What is the recommended antibiotic regimen for the treatment of sinusitis?

Which medications are recommended in the IDSA guidelines for the treatment of sinusitis in patients with penicillin allergy?

What are the guidelines for patients whose sinusitis is unresponsive to or worsens with empiric therapy?

Which medications are appropriate adjunctive therapy for sinusitis?

Should treatment for group A streptococcal infection begin before the diagnosis is confirmed?

What is the recommended antibiotic therapy for group A streptococcal pharyngitis?

Which antibiotics are recommended for penicillin-allergic patients with group A streptococcal upper respiratory tract infection (URI)?

What is the recommended treatment for chronic group A streptococcal upper respiratory tract infection (URI)?

Should close contacts of group A Streptococcus carriers be identified for treatment?

Which medications are appropriate for adjunctive therapy in streptococcal pharyngitis?

How are gonococcal and herpes simplex virus (HSV) pharyngitis treated?

How is pertussis (whooping cough) treated?

How is diphtheria treated?

Which causes of immunocompromise warrant special attention for treatment of upper respiratory tract infections (URIs)?

Is hospitalization indicated in immunocompromised patients with upper respiratory tract infection (URI)?

When are antivirals indicated in the treatment of viral upper respiratory tract infection (URI) in immunocompromised patients?

Which medications are used in the treatment of immunocompromised patients with HSV, (CMV, or RSV upper respiratory tract infections (URI)?

Which deep tissue infections associated with upper respiratory tract infections (URIs) require hospitalization?

When is surgery indicated in patients with streptococcal upper respiratory tract infections (URIs)?

What is the role of adenoidectomy in upper respiratory tract infection (URI)?

When is surgery indicated in acute rhinosinusitis?

How is sinus drainage altered in functional endoscopic sinus surgery?

What can be done at home to help relieve nasal and sinus symptoms associated with upper respiratory tract infections (URIs)?

What are some self-care strategies to relieve nasal and sinus symptoms associated with dry air?

What is the role of nasal saline in the treatment of sinus and nasal symptoms associated with upper respiratory tract infections (URIs)?

Does drinking water relieve sinus and nasal symptoms associated with upper respiratory tract infections (URIs)?

Do warm facial cloths or packs relieve sinus and nasal symptoms associated with upper respiratory tract infections (URIs)?

How are bulb syringes used for infant nasal symptoms associated with upper respiratory tract infections (URIs)?

What are common home remedies for a sore throat and cough associated with upper respiratory tract infections (URIs)?

What are common home remedies for improving sleep with an upper respiratory tract infection (URI)?

Which treatments effectively reduce symptoms in uncomplicated upper respiratory tract infection (URI)?

Are oral decongestants effective in the treatment of acute sinusitis?

What are the possible adverse effects of oral decongestants?

Should cough and cold medicines be used in children younger than 2 years?

Are topical decongestants an effective treatment for sinusitis?

Is ipratropium bromide effective in treating upper respiratory tract infections (URI)?

Which antihistamines are effective in treating upper respiratory tract infection (URI)?

What is the role of steroids in the treatment of upper respiratory tract infections (URIs)?

Is nasal saline effective in treating sinusitis symptoms in upper respiratory tract infections (URIs)?

Is guaifenesin effective in the treatment of upper respiratory tract infection (URI)?

Is topical phenol effective in the treatment of upper respiratory tract infection (URI)?

Is lidocaine effective in the treatment of upper respiratory tract infection (URI)?

Is intranasal cromolyn sodium effective in the treatment of nasal symptoms in upper respiratory tract infection (URI)?

Can children younger than 2 years use cough medicine?

How is a cough associated with the common cold treated?

What are the treatment options for postinfectious cough due to upper respiratory tract infection (URI)?

Which drugs are effective in treating cough symptoms in upper respiratory tract infection (URI)?

What is the role of cough suppressants in the treatment of upper respiratory tract infection (URI)?

Are over-the-counter cough suppressants indicated in the treatment of children with upper respiratory tract infection (URI)?

What is the role of codeine in the treatment of cough symptoms in upper respiratory tract infection (URI)?

What is the role of beta agonists in the treatment of upper respiratory tract infection (URI) cough?

What is the role of NSAIDs in the treatment of cough in upper respiratory tract infection (URI)?

What is the role of inhaled cromolyn sodium in the treatment of upper respiratory tract infection (URI) cough?

Does fever associated with an upper respiratory tract infection (URI) pose any risks?

Which medications can be used to treat pain and fever in upper respiratory tract infection (URI)?

Are alternative and complementary therapies effective in the treatment of upper respiratory tract infection (URI)?

Is nasal zinc gel safe and effective in the treatment of the common cold symptoms?

What is the role of oral zinc in the treatment of upper respiratory tract infection (URI)?

Is echinacea effective in treating common cold symptoms?

Is vitamin C effective in treating symptoms of upper respiratory tract infection (URI)?

Which folk remedies may be useful for relieving common cold symptoms?

What dietary changes should be considered for a patient with upper respiratory tract infection (URI)?

Should patients with the common cold restrict their physical activity?

Should patients with infectious mononucleosis restrict their physical activity?

Can patients with an upper respiratory tract infection (URI) travel on airplanes?

Can patients with an upper respiratory tract infection (URI) swim in pools?

What is the role of breastfeeding in the prevention of upper respiratory tract infections (URIs) in infants?

How can upper respiratory tract infections (URIs) be prevented?

What is the best method of handwashing to prevent the spread of upper respiratory tract infection (URI)?

Is hand sanitizer effective in preventing the spread of upper respiratory tract infections (URIs)?

How long can rhinoviruses survive on skin and inanimate surfaces?

How long are adults and children with upper respiratory tract infection (URI) contagious?

How long are patients with pertussis (whooping cough) contagious?

How long are patients with group A streptococcal pharyngitis contagious?

When should household contacts of patients with group A streptococcal pharyngitis be tested for infection?

How long are patients with influenza contagious?

What prophylaxis is indicated for close contacts of patients with epiglottitis?

How can the spread of pertussis (whooping cough) be prevented?

How can the spread of diphtheria be prevented?

How is the spread of orogenitally transmitted infections prevented in close contacts of infected patients?

Which immunizations and immunoprophylaxes are recommended for upper respiratory tract infections (URIs)?

Do complementary and alternative therapies prevent upper respiratory tract infections (URIs)?

When is surgical consultation indicated in upper respiratory tract infection (URI)?

When is consultation with an infectious disease specialist indicated in upper respiratory tract infection (URI)?

When is consultation with a pulmonologist or otorhinolaryngologist (ENT) indicated in upper respiratory tract infection (URI)?

What follow-up care is indicated in upper respiratory tract infection (URI)?

Medications

What is the goal of medication therapy in upper respiratory tract infections (URIs)?

When is antibacterial therapy indicated for the treatment of upper respiratory tract infections (URIs)?

Which antibiotics are used to treat group A streptococcal upper respiratory tract infections (URIs)?

Which antibiotics are used to treat epiglottitis?

Which antibiotics are used to treat pertussis (whooping cough)?

Which antibiotics are used to treat acute bacterial rhinosinusitis?

Which patients are at risk for adverse events associated with azithromycin?

Which upper respiratory tract infections (URIs) have specific treatments other than strep throat, epiglottitis, and pertussis (whooping cough)?

What is the role of antivirals in the treatment of upper respiratory tract infections (URIs)?

Are cough and cold medicines safe for use in children?

Which medications in the drug class Decongestants, Intranasal are used in the treatment of Upper Respiratory Tract Infection?

Which medications in the drug class Decongestants, Systemic are used in the treatment of Upper Respiratory Tract Infection?

Which medications in the drug class Corticosteroids are used in the treatment of Upper Respiratory Tract Infection?

Which medications in the drug class Alpha/Beta-Adrenergic Agonists are used in the treatment of Upper Respiratory Tract Infection?

Which medications in the drug class Antitussives, Opioid Analgesics are used in the treatment of Upper Respiratory Tract Infection?

Which medications in the drug class Antitussives, Non-Narcotic Combos are used in the treatment of Upper Respiratory Tract Infection?

Which medications in the drug class Antihistamines, First Generation are used in the treatment of Upper Respiratory Tract Infection?

Which medications in the drug class Anticholinergics, Respiratory are used in the treatment of Upper Respiratory Tract Infection?

Which medications in the drug class NSAIDs are used in the treatment of Upper Respiratory Tract Infection?

Which medications in the drug class Analgesics, Other are used in the treatment of Upper Respiratory Tract Infection?

Which medications in the drug class Macrolides are used in the treatment of Upper Respiratory Tract Infection?

Which medications in the drug class Cephalosporins, Third Generation are used in the treatment of Upper Respiratory Tract Infection?

Which medications in the drug class Cephalosporins, Second Generation are used in the treatment of Upper Respiratory Tract Infection?

Which medications in the drug class Cephalosporins, First Generation are used in the treatment of Upper Respiratory Tract Infection?

Which medications in the drug class Penicillins, Amino are used in the treatment of Upper Respiratory Tract Infection?

Which medications in the drug class Penicillins, Natural are used in the treatment of Upper Respiratory Tract Infection?