Upper Respiratory Infection

Medically Reviewed By William C. Lloyd III, MD, FACS
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What is an upper respiratory infection?

The term, upper respiratory infection, often refers to a head cold or the common cold. However, a broader definition of an upper respiratory infection, or URI, is any infection of the upper parts of the respiratory tract, including the nasal passages, nasal sinuses, and throat. Sometimes the upper bronchi (large air passages leading to the left and right lungs) are included in this definition. In contrast, a lower respiratory infection is an infection of the lungs themselves or the smaller air passages within the lungs.

Types of URIs

The American Academy of Family Physicians defines a URI as an infection of the mucous membranes from the nose down to the respiratory tree or bronchi. Some types of URIs and their causes include:

  • Acute bronchitis is inflammation of the bronchial tubes usually caused by a viral infection or sometimes a bacterial infection. Some sources classify acute bronchitis as a lower respiratory tract infection instead of a URI.

  • Common cold is caused by a viral infection. More than 200 different viruses can cause a cold.

  • Croup, or laryngotracheitis, is inflammation of the larynx (voice box) and windpipe usually caused by a virus.

  • Epiglottitis is a rare, life-threatening inflammation of the epiglottis, the flap of cartilage that covers the windpipe and protects it from inhalation of food. Epiglottitis is usually caused by a viral infection and mainly affects infants and children.

  • Influenza is caused by a viral infection.

  • Laryngitis is inflammation of the larynx (voice box) usually caused by a viral infection.

  • Pharyngitis is inflammation of the throat usually caused by a viral infection and sometimes a bacterial infection.

  • Sinusitis is inflammation of the sinuses usually due to a viral, bacterial or fungal infection.

  • Streptococcal pharyngitis, which is also known as strep throat, is caused by a bacterial infection.

In some cases, ear infections (otitis media, otitis externa, and otitis interna) are included in the definition of URI.

On average, children will have around five URIs in a year, while adults will have two to three of these infections. Viruses are the most common cause of URIs, followed by bacteria. These germs are most often spread by hand-to-hand contact. Washing your hands frequently is an important way to prevent spreading or catching an upper respiratory infection.

Generally, URIs caused by viruses will get better on their own after seven to 10 days. In the meantime, you can find relief by getting plenty of rest, drinking fluids, using over-the-counter cough drops, or taking over-the-counter cold medicines. In some cases, bacterial complications develop and are treated with antibiotic medications. Otherwise, antibiotics are unhelpful for the common cold.

In some cases, a URI can lead to a serious or life-threatening condition, such as epiglottitis or pneumonia. Seek immediate medical care (call 911) if you, or someone you are with, have serious symptoms, such as difficulty breathing, pale or blue lips or skin, drooling, difficulty swallowing, or voice changes. Other serious symptoms include a change in alertness, extreme irritability in an infant, unresponsiveness, sore throat, and high fever with shaking chills.

Seek prompt medical care if you have a chronic disease or have a compromised immune system and develop symptoms of a URI, or if you have a URI that is not getting better.

What are the symptoms of an upper respiratory tract infection?

Symptoms of an upper respiratory infection (URI) are generally mild and appear two to three days after exposure to a virus. Symptoms can vary depending on the specific type of virus causing the infection and the location of the infection in the respiratory tract. However, symptoms of different URIs often overlap. Common URI symptoms include:

  • Abnormal breathing sounds (stridor or severe wheezing)

  • Body aches or headache

  • Cough, which may be dry or productive of phlegm and worse at nighttime

  • Earache

  • Erythema (redness of the throat)

Symptoms that might indicate a serious or life-threatening condition

In some cases, URIs can be serious or lead to serious or life-threatening situations, such as pneumonia or epiglottitis. Seek immediate medical care (call 911) if you, or someone you are with, have a URI with the following symptoms:

  • Agitation or extreme irritability

  • Cough that resembles a barking seal and does not go away with home croup treatments

  • Difficulty breathing or swallowing

  • Drooling

  • Pale or bluish coloration of the lips, skin or fingernails (cyanosis)

  • Retracting of the muscles in the neck or between the ribs when breathing (retractions)

  • Uncontrollable shaking chills

  • Unexplained change in alertness or level of consciousness, such as lethargy or unresponsiveness

What causes an upper respiratory infection?

URIs are usually caused by viruses, but can also be caused by bacteria in some cases. There are more than 200 different types of viruses and several types of bacteria that can cause a URI. Despite popular belief, being wet or cold does not cause respiratory infections, although these conditions may lower the body’s resistance to infection.

URIs are contagious and are most often spread by hand-to-hand contact. You can become infected by touching a person who has a URI, such as shaking hands or touching a contaminated computer keyboard or doorknob. If you then touch your mouth, eyes or nose before washing your hands, you transmit the virus from your hands into your body. The germs that cause URIs can also spread quickly from person to person when an infected person talks, coughs or sneezes. This shoots droplets contaminated with viruses or bacteria into the air where they can be breathed in by others.

What are the risk factors for an upper respiratory infection?

Upper respiratory infections (URIs) can occur in any age group or population. A number of factors increase your risk of contracting a URI, although not all people with risk factors will become infected. Risk factors for a URI or for developing complications include:

  • Advanced age

  • Chronic disease, such as asthma, COPD, diabetes, heart disease, or high blood pressure

  • Compromised immune system due to such conditions as an immunodeficiency disorder, HIV/AIDS, cancer or cancer treatment, and kidney disease

  • Exposure to a person with a URI

  • Fatigue and not enough rest

  • Frequently touching the eyes, nose or mouth, especially without washing your hands

  • Malnutrition

  • Poor hygiene, or not washing your hands after touching surfaces that are often contaminated with viruses and bacteria, such as doorknobs, computer keyboards, and phones

  • Smoking
  • Young age, particularly elementary school age and younger

Reducing your risk of an upper respiratory infection

You can lower your risk of catching or spreading a URI by :

  • Avoiding contact with a person who has a URI

  • Avoiding touching your eyes, nose and mouth, which can transmit viruses and bacteria from your hands into your body

  • Covering your mouth and nose with your elbow (not your hand) or a tissue when sneezing or coughing

  • Eating a well-balanced diet that includes fruits and vegetables

  • Getting sufficient rest

  • Using appropriate antibacterial cleaners to clean hands and surfaces

  • Washing hands frequently during and after contact with a person who has a URI

  • Washing hands frequently with soap and water for at least 15 seconds

How is an upper respiratory infection treated?

There is currently no cure for upper respiratory infections (URIs) caused by viruses, but by treating your symptoms, you can get the rest you need to keep up your strength and recover without developing complications.

Treatment of viral URIs

Treatment of viral infections includes:

  • Acetaminophen (Tylenol) for fever, sore throat, and body aches

  • Extra fluids

  • Extra rest and sleep

  • Over-the-counter cold remedies

Antibiotic medications are not effective and may even be harmful when given for URIs caused by viruses.

Treatment of bacterial URIs

When bacteria are the cause of a URI, or when bacterial complications develop, treatment with antibiotic medications is generally needed. Examples of bacterial infections include strep throat (streptococcal pharyngitis), bacterial bronchitis, bacterial sinusitis, and some cases of otitis media (middle ear infection).

Your health care provider will decide whether or not antibiotic medications are needed based on the likelihood of your URI being caused by bacteria or actual laboratory culture results showing bacteria to be the cause. In addition, your health care provider will consider your age, your risk of developing complications, and whether antibiotic medications would help speed your recovery.

Currently, the general recommendation is that children under the age of six not use cold or cough medications because of the risk of serious side effects. In addition, people with a URI should not use aspirin or products that contain aspirin because of the risk of developing a rare but life-threatening condition called Reye syndrome. Reye syndrome has been linked to taking aspirin during a viral illness, such as a cold or flu.

What are the potential complications of an upper respiratory infection?

In some people, a minor URI, such as a cold, can break down the body’s defenses and lead to more serious infections. You can best treat an upper respiratory infection and lower your risk of complications by following the treatment plan you and your health care professional design specifically for you.

People most at risk for complications include:

  • Infants and toddlers

  • Older adults

  • People who have a chronic disease, such as asthma, COPD, diabetes, or heart disease

  • People who have a compromised immune system due to such conditions as HIV/AIDS, diabetes, cancer or cancer treatment, or kidney disease

Complications of a viral URI include:

  • Acute bacterial bronchitis

  • Bacterial sinusitis

  • Otitis media

  • Pneumonia

  • Worsening of asthma

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jan 19
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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