Upper Respiratory Tract Infection

Upper respiratory tract infection (URTI) is one of the most common reasons for people to see their GP. It is a massive public health problem and leads to more loss of time from work than any other condition. On average an adult may suffer from two to three such infections a year. It is the most common illness affecting children. Most URTIs are mild and resolve completely without specific treatment. Inappropriate antibiotic prescribing adds to the problem of antibiotic resistance. There are clinical decision-making tools to help GPs decide whether or not to request additional tests or provide antibiotics when the illness may appear to be more complex.

Definition

A URTI is an inflammatory and usually infectious condition of the upper respiratory tract: the throat, nose, nasal sinuses, tonsils, pharynx or larynx.

Pathology

URTIs are caused by infection of the upper respiratory tract by any one of a number of viruses such as rhinovirus, coronavirus, parainfluenza, adenovirus, enterovirus or respiratory syncytial virus. The largest reservoir of viruses is in young children; transmission occurs through either inhalation of airborne respiratory droplets or by direct contact with infectious secretions by hand contact with people infected with the virus.

History

A patient may present with any of the following symptoms:

• Headache and sinus pains (over the face)
  
• Burning of eyes
  
• Nasal obstruction or discharge
  
• Loss of smell and taste
  
• Sore throat
  
• Hoarseness of voice
  
• Cough.

Cough tends to occur in 30% of cases, usually on the fourth or fifth day, when nasal symptoms have subsided. There may be a mild increase in temperature.

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