Upper Respiratory Infection (URI)
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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 and can last 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/year
- Kindergarten: 12 URI/year
- Schoolchildren: 7 URI/year
- Adolescents/adults: 2 to 3 URI/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