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General Medicine

Upper Respiratory Infection (URI)

Lisa M. Schroeder, MD and Emily M. Chau, MD, MS Reviewed 06/2019
 


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; for American Academy of Pediatrics. Clinical practice guideline for the diagnosis and management of acute bacterial sinusitis in children ag...

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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Related Images
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Figure 35.2 Back pressure to blood circulation around the eyes leads to dark areas under the eyes in the child with allergic rhinitis.
Figure 35.2 Back pressure to blood circulation around the eyes leads to dark areas under the eyes in the child with allergic rhinitis.
FIG. 11.55. Pharyngitis in infectious mononucleosis. This girl has inflamed, bilaterally swollen tonsils with a diffuse exudate, as is often seen with infectious mononucleosis.
FIG. 11.55. Pharyngitis in infectious mononucleosis. This girl has inflamed, bilaterally swollen tonsils with a diffuse exudate, as is ofte...
Figure 19-2 Boggy inferior turbinates seen with allergic rhinitis. (Courtesy of Paul S. Matz, MD.)
Figure 19-2 Boggy inferior turbinates seen with allergic rhinitis. (Courtesy of Paul S. Matz, MD.)
Back pressure to the blood circulation around the eye orbit from allergic rhinitis may lead to dark areas under the eyes (allergic shiners). The frequent rubbing of the nose in an upward direction can lead to a peculiar horizontal crease (Dennie's line).
Back pressure to the blood circulation around the eye orbit from allergic rhinitis may lead to dark areas under the eyes (allergic shiners)...
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