Ver el código de «Upper respiratory infection»

==Background==
*Infection and inflammation of the upper respiratory tract, typically self-limiting
**May involve any portion of the upper airway, thus causing rhinitis, sinusitis, pharyngitis, or laryngitis, etc
*A variety of viruses and bacteria can cause an URI
**Rhinovirus is most common cause<ref>Tallman TA. Acute Bronchitis and Upper Respiratory Tract Infections. In: Tintinalli JE, Stapczynski J, Ma O, Cline DM, Cydulka RK, Meckler GD, T. eds. Tintinalli's Emergency Medicine: A Comprehensive Study Guide. New York, NY: McGraw-Hill; 2011</ref>
**Other causes include: [[coronavirus]], [[adenovirus]], [[influenza]], [[Respiratory syncytial virus]], [[adenovirus]], [[enterovirus]], [[parainfluenza]]
*Pathophys: Aerosolized (droplet and airborne) transmission, deposition in the nasopharyngeal mucosa, hours-days incubation period, host inflammatory response leading to symptoms
**Although aerosol transmission predominates, contact (ex. hand to eye) transmission is also common

==Clinical Features==
*Common cold<ref>Tallman TA. Acute Bronchitis and Upper Respiratory Tract Infections. In: Tintinalli JE, Stapczynski J, Ma O, Cline DM, Cydulka RK, Meckler GD, T. eds. Tintinalli's Emergency Medicine: A Comprehensive Study Guide. New York, NY: McGraw-Hill; 2011</ref>
**[[Sore throat]]
**Malaise
**Low-grade [[fever]]
***Fevers are more common in pediatrics than adults
**[[Cough]] (usually 24-48 hrs later)
***Postinfectious cough can last for weeks after other symptoms have resolved
**[[Rhinorrhea]]
**Nasal congestion
**[[Sneezing]]
**[[Myalgia]]
**Hoarse voice
*Depending on the organism, typically symptoms peak by day 3 or 4, resolve by day 7

==Differential Diagnosis==
{{ILI DDX}}

{{Cough DDX}}

==Evaluation==
*Clinical diagnosis
*Depending on provider preference, can send viral panels, but this often doesn't change management
**Exceptions: Tamiflu for flu, paxlovid for COVID, etc
*Rule out other serious causes of this presentation, such as [[pneumonia]], bacterial sinusitis, epiglottitis, etc

==Management==
*Supportive care and symptomatic relief are the mainstays of management
*Analgesics, including [[ibuprofen]] and [[acetaminophen]]<ref>Kim SY, Chang YJ, Cho HM, Hwang YW, Moon YS. Non-steroidal anti-inflammatory drugs for the common cold. Cochrane Database Syst Rev. 2015 Sep 21;2015(9):CD006362. doi: 10.1002/14651858.CD006362.pub4. PMID: 26387658; PMCID: PMC10040208.</ref>
*Nasal decongestants<ref>Deckx L, De Sutter AI, Guo L, Mir NA, van Driel ML. Nasal decongestants in monotherapy for the common cold. Cochrane Database Syst Rev. 2016 Oct 17;10(10):CD009612. doi: 10.1002/14651858.CD009612.pub2. PMID: 27748955; PMCID: PMC6461189.</ref>
**Oral decongestants such as [[pseudoephedrine]] may be used, but contraindicated in systemic [[hypertension]]
**Topical decongestants: Nasal saline spray and [[oxymetazoline]] spray can reduce nasal passageway resistance
***Avoid oxymetazoline use in children due to risk of unintended a2-agonism; limit number of days to <3 to prevent rhinitis medicamentosa
*Antitussives have equivocal evidence but may be trialed for symptomatic relief<ref>Smith SM, Schroeder K, Fahey T. Over-the-counter (OTC) medications for acute cough in children and adults in community settings. Cochrane Database Syst Rev. 2014 Nov 24;2014(11):CD001831. doi: 10.1002/14651858.CD001831.pub5. PMID: 25420096; PMCID: PMC7061814.</ref>
**Cough suppressants: [[Dextromethorphan]] or Benzonatate; avoid in young children
**Cough expectorant: Guaifenesin
*Topical anesthetics for sore throat: [[Benzocaine]], menthol lozenges
*Avoid prescribing antibiotics<ref>Choosing Wisely. Infectious Diseases Society of America. http://www.choosingwisely.org/clinician-lists/infectious-diseases-society-antbiotics-for-upper-respiratory-infections/</ref>
*Mucolytics: little evidence to support usage
*[[Bronchodilators]] if [[wheezing]] present

==Disposition==
*Outpatient

==See Also==


==External Links==


==References==
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