Upper Respiratory Infection (URI)
Upper respiratory infections (URIs) are one of the most common medical diagnoses, contributing to ~30 million office visits annually and resulting in significant lost productivity through missed days from work/school.
- Inflammation of nasal passages resulting from infection with respiratory viruses
- Most cases are mild to moderate in severity, self-limited, and amenable to self-treat.
- System(s) affected: ENT; pulmonary
- Each virus has different seasonal peaks (e.g., rhinovirus: late spring, fall); most infections occur during the winter months.
- Symptoms usually peak in 1 to 3 days, lasting up to 2 weeks.
- Contact with contaminated skin/surface followed by contact with mucous membranes (hand-to-face contact)
- Aerosolized particles from sneezing and coughing
- Viruses may last up to 2 hours on skin and even longer on environmental surfaces.
- Predominant age: children > adults
- Preschool children: 5 to 7 URI per year
- Kindergarten: 12 URI per year
- Schoolchildren: 7 URI per year
- Adolescents/adults: 2 to 3 URI per year
- Predominant sex: male = female
Etiology and Pathophysiology
Rhinoviruses infect the ciliated epithelial mucosa of the upper airway, resulting in edema, hyperemia, and mucous production.
- Histology: edema of subepithelial connective tissue and a scanty cellular infiltrate containing neutrophils, plasma cells, lymphocytes, and eosinophils with exudation of serous and mucinous fluid
- Rhinovirus causes a “nondestructive” inflammation of the mucous membranes.
- Influenza and parainfluenza viruses denude respiratory epithelium to the basement membrane.
- Several hundred viral strains from different families; spread within geographic region and groups with close contact
- Rhinovirus (>100 serotypes): 30–50%; incubation period 1 to 5 days
- Influenza virus types A, B, C: 10–15%; incubation period 1 to 4 days
- Coronaviruses: 10–15%
- Parainfluenza, respiratory syncytial virus (RSV): 5%; more common in children; incubation period 1 week
- Enteroviruses, adenoviruses: <10%
- In many cases, no specific pathogen is identified.
- Exposure to infected people
- Touching one’s face with contaminated fingers
- Allergic disorders
- Frequent hand washing, especially in children
- Limiting exposure to infected persons/children
Commonly Associated Conditions
- Otitis media
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Domino, Frank J., et al., editors. "Upper Respiratory Infection (URI)." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2020. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816892/all/Upper_Respiratory_Infection__URI_.
Upper Respiratory Infection (URI). In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2020. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816892/all/Upper_Respiratory_Infection__URI_. Accessed May 29, 2023.
Upper Respiratory Infection (URI). (2020). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (27th ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816892/all/Upper_Respiratory_Infection__URI_
Upper Respiratory Infection (URI) [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2020. [cited 2023 May 29]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816892/all/Upper_Respiratory_Infection__URI_.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Upper Respiratory Infection (URI) ID - 816892 ED - Domino,Frank J, ED - Baldor,Robert A, ED - Golding,Jeremy, ED - Stephens,Mark B, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816892/all/Upper_Respiratory_Infection__URI_ PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -