upper respiratory tract infection

upper respiratory tract infection

URI Infectious disease A nonspecific term used to describe acute infections involving the nose, paranasal sinuses, pharynx, and larynx, the prototypic URI is the common cold; flu/influenza is a systemic illness involving the URT and is differentiated from other URIs Clinical 1–3 days after exposure to pathogen, nasal congestion, sneezing, sore throat, conjunctivitis–with adenovirus infections; sore throat with pain on swallowing, fever, absence of cough, and exposure to a person with streptococcal pharyngitis in the prior 2 wks support Dx of GABHS-related pharyngitis; Pts with acute sinusitis often have fever for > 1 wk, facial pain–especially unilateral, maxillary toothache, headache, and excessive purulent nasal discharge; hoarseness suggests laryngitis; difficulty in swallowing oral secretions and stridor should raise suspicion for epiglottitis or pharyngeal abscess; influenza presents as a sudden illness characterized by high fever, severe headache, myalgia, dry cough, with lingering fatigue and malaise; elderly patients may also present with confusion and somnolence Physical exam Common cold–nasal voice, macerated skin over the nostrils, inflamed nasal mucosa; GABHS-related pharyngitis–pharyngeal erythema/exudate, palatal petechiae–popularly, “doughnut lesions,” tender anterior cervical lymphadenopathy, and occasionally a scarlatiniform rash; pharyngeal or palatal vesicles and ulcers (herpangina) suggest enteroviral or herpetic pharyngitis; pharyngeal exudates are most common in GABHS-related pharyngitis, but can be seen with infectious mononucleosis due to EBV, acute retroviral syndrome, candidal infections, diphtheria; swelling, redness, and tenderness overlying affected sinuses and abnormal transillumination are specific for, but not commonly seen in acute sinusitis; generalized lymphadenopathy with sore throat, fever, and rash should raise the possibility of a systemic viral infection–eg, EBV, CMV, HIV; Pts with influenza appear toxic and may have pulmonary rhonchi and diffuse myalgias Types Pharyngitis, sinusitis, laryngitis/epiglottitis, otitis Diagnosis Because viruses cause most URIs, the diagnostic role of lab and radiologic studies is limited; rapid antigen detection of influenza virus on a nasopharyngeal swab is indicated in cases where specific antiviral therapy is recommended; a rapid antigen detection test is also available for adenovirus, RSV, and parainfluenza virus; serologic tests for viruses that can cause a mononucleosis-type illness should be done in the correct clinical setting; influenza serologies have only epidemiologic value and should not be used for clinical care; pharyngeal swab for rapid antigen detection of GABHS is 80% to 95% sensitive and should be considered in all patients in whom GABHS-related pharyngitis is suspected; pharyngeal culture remains the gold standard for diagnosis and should be done if GABHS-related pharyngitis is highly likely on clinical grounds but in which the rapid antigen detection test is negative; cultures obtained by paranasal sinus puncture should be reserved for only severely ill patients with acute sinusitis and intracranial or orbital complications; blood cultures should be done in severely ill Pts or in those with epiglottitis or a pharyngeal abscess Management Symptomatic to relieve the most prominent Sx; rest, ↑ fluid intake are measures recommended for all URIs. Cf Acute laryngotracheobronchitis (croup. ), Common cold, Epiglottitis, Otitis media. Viral URI

McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.

cold

(kōld)

1. A low temperature; the sensation produced by a temperature notably below an accustomed norm or a comfortable level.

2. Popular term for a virus infection involving the upper respiratory tract and characterized by congestion of the mucosa, watery nasal discharge, and general malaise, with a duration of 3-5 days.
See also: rhinitis
Synonym(s): common cold, frigid (1) , upper respiratory infection, upper respiratory tract infection.

Medical Dictionary for the Health Professions and Nursing © Farlex 2012

upper respiratory tract infection

Any infection of the nose, throat, sinuses or LARYNX such as the common cold, sore throat (pharyngitis), tonsillitis, sinusitis, laryngitis and croup. The cumbersome phrase is often abbreviated to URTI.

Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005