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Upper Respiratory Infection (URI)

Lisa M. Schroeder, MD and Melissa A. Banzon, MD, MHA Reviewed 06/2018
 


BASICS

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 misse...

DIAGNOSIS

HISTORY

  • Nasal congestion: 80–100%

  • Sneezing: 50–70%

  • Throat irritation: 50%

  • Cough: 40%

  • Hoarseness: 30%

  • Malaise: 20–25%

  • Headache: 25%

  • Fever >100°F (37.7°C): 0–1%

PHYSICAL EXAM

  • Low-grade temperature; m...

TREATMENT

GENERAL MEASURES

  • Smoking cessation

  • Vaporizer/humidifier: no consistent benefit proven

  • Cold preparations do not change course.

  • Antibiotics not indicated

  • Avoid cough and cold preparations in childr...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Contact a physician's office for prolonged fever, difficulty breathing, or concern for secondary complications. 

DIET

Encourage fluids and adequate hydration. 

PATIENT EDUCATION

REFERENCES

1
Schuetz P, Müller B, Christ-Crain M, et al. Procalcitonin to initiate or discontinue antibiotics in acute respiratory tract infections. Cochrane Database Syst Rev.  2012;(9):CD007498....

ADDITIONAL READING

Wald ER, Applegate KE, Bordley C, et al. Clinical practice guideline for the diagnosis and management of acute bacterial sinusitis in children aged 1 to 18 years. Pediatrics.  ...

SEE ALSO

Bronchitis, Acute; Pharyngitis; Rhinitis, Allergic 

CODES

ICD10

  • J06.9 Acute upper respiratory infection, unspecified

  • J11.1 Influenza due to unidentified influenza virus with other respiratory manifestations

  • B97.4 Respiratory syncytial virus causing diseas...

CLINICAL PEARLS

  • Supportive therapy is mainstay for most upper respiratory tract infections.

  • Point of care testing can rule out group A Streptococcus infection in the appropriate clinical setting.

  • Limit ...

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