Upper Respiratory Infection

Question 1

Essentials of Diagnosis:

• Clear rhinorrhea, hyposmia, and nasal congestion
• Associated Symptoms: Malaise, headache, and cough
• Erythematous, engorged nasal mucosa on examination without intranasal purulence.
• Symptoms last <4 weeks and typically < 10 days
• Symptoms are self-limited

Answer 1

Upper Respiratory Infection

Question 2

General Considerations:

• Self-limited syndrome representing a group of diseases caused by members of several families of viruses.
• Most frequent acute illness in the United States and the industrialized world.
• “common cold” refers to a mild upper respiratory viral infection involving, to variable degrees, nasal congestion and discharge (rhinorrhea), sneezing, sore throat, cough, low grade fever, headache, and malaise.

Answer 2

Upper Respiratory Infection

Question 3

Physical Findings:

• Presentation can be Normal
• The most common and characteristic initial symptoms are nasal discharge, nasal obstruction, and a dry or “scratchy throat”. Cough is common and tends to appear after the onset of nasal discharge and obstruction.
• Cough may be prominent and prolonged in some patients, rales and signs of lower respiratory tract involvement typically are not present in adults. Fever, when present, tends to be low grade.
• Incubation period for most common cold viruses is 24 to 72 hours
• Symptom onset can occur as early as 10 to 12 hours after exposure
• Colds usually persist for 3 to 10 days in the normal host, although clinical illness may last as long as two weeks in up to 25 percent of patients, particularly smokers

Answer 3

Upper Respiratory Infection

Question 4

Lab/Imaging/Other:

Not indicated for this Dx

Answer 4

Upper Respiratory Infection

Question 5

Differential Diagnosis:

• Bronchitis
• Pneumonia
• Allergic or seasonal rhinitis
• Pertussis
• Influenza
• Aspiration

Answer 5

Upper Respiratory Infection

Question 6

Treatment:

You treat based on symptoms* Self treatement
* Acetaminophen: 325mg 1-2 tablets by mouth every 4-6 hours
* Pseudoephedrine: Immediate release: 60 mg every 4 to 6 hours; Extended release: 120 mg every 12 hours
* Oxymetazoline: 12 Hour Nasal Relief Spray: 0.05% (15 mL, 30 mL)
* Gufentison 100mg every 8 hrs don’t chew

Answer 6

Upper Respiratory Infection