Upper Respiratory Tract Infection

Upper Respiratory Tract Infection (URTI) is common in children and adults and is a major cause of mild morbidity. It has a high cost to society, is responsible for school and work absenteeism and unnecessary medical care and is occasionally associated with a serious sequel.

URTIs are usually caused by several virus families; rhinoviruses, coronaviruses. URTI are diseases caused by an acute infection involving the upper respiratory tract including the nose, sinuses, pharynx or larynx.

This commonly includes nasal obstruction, sore throat, tonsillitis, pharyngitis, laryngitis, sinusitis, otitis media and common cold-Typically a mild, self- limited, nasopharyngeal catarrhal syndrome— to life-threatening diseases such as epiglottitis.

The majority of infections are viral in nature and are bacterial in other cases. Upper Respiratory Tract Infection (URTI) may affect sinuses, throat, airways, and lungs.

Most RTIs improve without treatment, but you may have to see your doctor sometimes. While upper and lower respiratory infections lead to a cough, an examination of the chest of the patient does not reveal any signs of infection in the upper respiratory infection.

Whereas the normal function of the lungs is disturbed in a lower respiratory infection and characteristic sounds can be clearly heard.

Causes

Rhinovirus infection resembles the immune response in terms of pathophysiology. The viruses do not cause damage to the upper respiratory tract cells, but rather cause changes in the tight joints of epithelial cells.

This enables the virus to access tissues within the epithelial cells and initiate innate and adaptive immune responses.

URTIs can be caused by a variety of relatively common things that most of us don’t even know we’re exposed to. We breathe daily into various agents, such as bacteria, viruses, and fungi, which are all microscopic organisms that can cause infections in our bodies.

Our immune system naturally kills most of these agents, but sometimes we fail to combat the infection that results in illness when our body is under stress.

Think of all the people who coughed or sneezed last week in your presence. When a person coughs or sneezes near us, the germs reach the air in their lungs, leaving us susceptible to inhalation.

Viruses are often released and are the most common cause of URTI. If our immune system cannot combat these germs or if our nasal hairs and mucous membranes fail to catch them, the bacteria or virus attach to our upper airways and reproduce in a URI.

Now consider the last time you touched a button, keys, money or a countertop. It was probably in the last hour if not inferior. We also contract URI by direct contact with contaminated objects.

For example, if a person has a cold and wipes his or her nose, then touch a pin, every person who touches the pin will be exposed to the infectious agent later. If each person then touches his or her nose or mouth, they have the chance to develop the same infection.

Type of URTI

Common colds- Common colds are the most common entity of all respiratory infections and are the leading cause of physician visits and absenteeism at work and school.

Most colds occur through viruses. The most common pathogens are rhinoviruses with more than 100 serotypes, which cause at least 25 percent of adult colds.

Coronaviruses can account for more than 10% of the cases. Parainfluenza viruses, syncytial respiratory viruses, adenoviruses, and influenza viruses were all linked to the common cold syndrome.

All these organisms have a seasonal incidence variation. The cause of cold syndromes between 30% and 40% was not determined.

Sinusitis– Sinusitis is an acute inflammation of one or more of the sinuses. In this affliction, infection plays an important role.

Sinusitis is often caused by infections in other respiratory tract sites, as the paranasal sinuses are contiguous to the upper respiratory tract and communicate with it.

Pharyngitis – Pharyngitis is an inflammation of the pharynx involving post-pharynx lymphoid tissues and lateral pharynx bands.

Bacterial, viral and fungal infections, as well as non-infectious etiologies, such as smoking, can be considered. Most cases are caused by viral infections and are associated with common cold or flu.

Epiglottitis and Laryngotracheitis– Based on the location, clinical manifestations, and pathogens of the infection, inflammation of the upper airway is classified as epiglottitis or laryngotracheitis (croup).

The most common cause of epiglottitis is Haemophilus influenza type b, especially in children between the ages of 2 and 5.

Epiglottitis is less prevalent in adults. Some cases of epiglottitis may have a viral origin in adults. The majority of laryngotracheitis cases are caused by viruses.

H influenza type b, group A beta-hemolytic streptococcus and C diphtheria have been associated with more severe bacterial infections. Parainfluenza viruses are most common but syncytial respiratory viruses, adenoviruses, influenza viruses, enteroviruses, and Mycoplasma pneumonia are involved.

Symptoms

Symptoms and signs of URI include a runny nose, low fever, cough (wet or dry), sore throat, and fatigue. Most people have cold-like symptoms, which can be self-limiting but not entirely weakening like grip.

If the infection is bacterial, it is most likely that the person has nasty green or gray mucous color. When the infection is viral, the mucous membrane is usually yellow clear.

Treatment

Symptomatic treatment– The main focus is on fever relief, nasal congestion, and coughing. For these purposes, a variety of adrenergic agonists, anticholinergic drugs, antihistamines, antitussives, and expectorants are marketed.

Common components of such drugs are antihistamines, antipyretics (paracetamol) or anti-inflammatory agents (ibuprofen) of the first generation.

Although symptom relief is provided, there is no conclusive evidence that they shorten the duration of symptoms. The Food and Drug Administration recently issued a warning advisory statement against the use of counter drugs for URTIs in children under two years of age.

Since placebo of these medications in children of any age is not proven to be beneficial and the risks of side effects in children are high, practitioners should be careful to recommend or prescribe such therapies.

Antibiotic– The use of antibiotics in childhood URTIs remains controversial because more than 90% of the infections are viral aetiological.

The reasons for prescribing antibiotics include diagnostic uncertainty, socio-cultural and economic pressures, concern about litigation in cases of malpractice and antibiotic parental expectations.

Antibiotics are over-prescribed to URTIs and promote resistance to antibiotics. However, certain indications, such as severe acute rhinosinusitis lasting more than 10 days and severe acute otitis media, play an important role.

Complementary and alternative medicine (CAM) for URTI– The use of supplementary and alternative medicines for URTIs is becoming increasingly important. Herbal remedies have been investigated and conflicting results have been identified.

Echinacea and Andrographis paniculata are two of the most commonly used and studied herbs, both of which are believed to be immunostimulants.

Propolis (bee resin) was also investigated and stimulates the production of antibodies. The lack of standardization is an important problem in the investigation and use of herbal products.

Prevention

Nasal saline spray may be beneficial. For instance, daily spraying with physiological saline reduced the incidence of common cold and nasal symptoms significantly in a study of Swedish military recruits.

In a recent study of children with URTIs, daily nasal washing with a seawater-based preparation reduced symptoms significantly compared to standard drugs. Unfortunately, the study agent was not compared with saline physiology.

Honey is superior to dextromethorphan and no night coughing treatment associated with URTIs.

Although it is assumed that the effect could be due to its antioxidant or antimicrobial effects, another assumption is that a sweet taste could lead to endogenous opioids.

Honey should not be given to infants under the age of 12 months due to the real danger of infant botulism.

The promotion of household handwashing significantly reduces the incidence of respiratory and gastrointestinal infections in children in both poor and resourced communities.

Parental smoking exacerbates respiratory infections in children and is predisposed to asthma. Tobacco is a highly addictive substance that requires concerted efforts to help addicts with themselves.

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