Upper respiratory tract infection

Question 1

What is meant by upper resp tract infection?

Answer 1

• Upper Respiratory Tract Infections (URTI) are infections that affect the airways (above the level of the larynx) mainly affecting the sinuses and throat.

(Lower respiratory infections affect your airways and lungs.)

Question 2

What are the different types of URTI’s? what are the different causes of each one?

Answer 2

1. Rhinitis - infection of the nasal cavity.  
   - Caused by a virus - rhinovirus, influenza virus, respiratory syncytial virus, parainfluenza virus, adenovirus. 
   - Caused by bacteria - streptocreoccus pneumonia, haemophilus influenzae, Moraxella catarrhalis, staphylococcus aureus  
2. Rhinosinusitis - infection of nose and sinuses 
3. Pharyngitis - infection of the pharynx.
   - Caused be bacteria - group A streptococcus 
4. Tonsilitis - CENTOR CRITERIA OR FEVERPAIN SCORE 
5. Laryngitis - infection of larynx 
   - Caused by bacteria - group A streptococcus, streptococcus pneumoniae, haemophilus influenzae 

Question 3

What are the risk factors for URTI?

Answer 3

• Smoking 
• Poor hygiene  
• Crowded populations 
• Medical conditions 
• Age 
• Disability 
• Stress and other mental health factors 

Question 4

What are the presenting symptoms of an URTI?

Answer 4

• Fatigue 
• Loss of appetite 
• Fever 
• Sore throat 
• Sneezing 
• Cough 
• Post-nasal drainage/drip 
• Acute onset 
• In Rhinitis - runny/stuffy nose and sneezing 
• In Rhinosinusitis - pain/pressure on face, change in voice 
• Pharyngitis - sore throat 
• Tonsilitis-  painful swollen tonsils 
• Laryngitis - hoarse voice and dry cough 
• Epiglottis - trouble breathing; they would tripod 

Question 5

What investigations are used to diagnose/ monitor URTI?

Answer 5

1. Based on symptoms 
2. Could do rapid testing for group A Streptococcus, EBV and influenza. 
3. No investigations 
4. Consider: FBC, throat swab, sputum culture, heterophile antibody test, CRP, CXR 

Question 6

How are URTI’s managed?

Answer 6

• For viral infection - rest, fluid and pain medication 
• For bacterial infection - give antibiotics 

Question 7

What complications may arise from an URTI?

Answer 7

• Acute sinusitis 
• Bronchospasm 
• Pneumonia 
• Asthma or COPD exacerbation 

Question 8

Describe the prognosis of an URTI

Answer 8

Usually self-limiting.