In viral nasopharyngitis patients have profuse nasal discharge [1], fever, halitosis, mouth breathing leading to dry mouth, hyposmia, sneezing and odynophagia, symptoms that occur 2-3 days after inoculation and last for 7-14 days, depending on the age of the patient [2]. Nasal secretions are initially clear and after 2-3 days turn green or yellow, which may signify a superimposed bacterial infection [3]. Examination of the uvula and posterior pharynx reveals inflammation. Cough may result from postnasal drip. Conjunctivitis and photophobia may accompany ocular pain.

More severe viral upper respiratory infections also cause vomiting, nausea, diarrhea and abdominal pain, as well as myalgia, fatigue or malaise- more frequent in influenza virus infection.

Viral rhinosinusitis [4] is also characterized by nasal discharge with mucopurulent secretion that does not improve with decongestants or antihistamines administration. Facial or dental pain related to the affected sinus raise rhinosinusitis suspicion. Other symptoms include sore throat, dry mouth, cough, posttussive emesis, hyposmia, and fatigability.

Laryngeal involvement is recognized by hoarseness or voice loss and dry cough [5].

Epiglottitis may represent a potential lethal emergency [6]. It is characterized by an acute onset of symptoms like fever, dyspnea, fatigability, odynophagia- as severe as to prevent saliva swallowing, leading to drooling, dysphonia or total voice loss [7]. Severe episodes are accompanied by respiratory distress, manifested as tachypnea, tachycardia, perioral cyanosis and use of accessory respiratory muscles.

Acute viral otitis media also has a rapid onset [8], consisting of fever, otalgia, difficulty sleeping, irritability, headache, loss of appetite, fluid drainage from the ear and diminished hearing [9].

All viral upper respiratory tract infections can cause cervical lymphadenopathy. Specific etiologies lead to specific signs: mononucleosis is accompanied by splenomegaly and hepatomegaly, herpes virus infection causes palatal vesicles, vesicles located on the uvula, palate and anterior tonsillar pillars suggest herpangina. Tonsil hypertrophy is a common finding. Cough may be severe enough to produce conjunctival hemorrhages.

• Fever

  It is characterized by an acute onset of symptoms like fever, dyspnea, fatigability, odynophagia- as severe as to prevent saliva swallowing, leading to drooling, dysphonia or total voice loss. [symptoma.com]

  We report the cases of eight military patients with fever (≥38°C) induced by viral upper respiratory tract infection (URTI) who requested treatment with acupuncture in the military medical service room. [ncbi.nlm.nih.gov]

  Differentiating between the two requires medical intervention since both may cause fever and irritability. And the treatments vary significantly. [dukehealth.org]

  These were ‘fever’ (P = 0.01) and ‘low energy, tired’ (P = 0.04). [academic.oup.com]

• Inflammation

  In addition to the common cold, there are other types of URIs: Sinusitis Sinusitis is inflammation of the sinuses. Epiglottitis Epiglottitis is inflammation of the epiglottis, the upper part of your trachea. [healthline.com]

  Post mortem histology of the larynx showed an acute pseudomembranous inflammation with the classical morphology of HSV infection. [pure.au.dk]

  […] cord) encephalitis (inflammation of the brain). [sahealth.sa.gov.au]

  uvula, and tonsils, pharyngitis (inflammation of the pharynx, uvula, and tonsils), epiglottitis (inflammation of the upper portion of the larynx or the epiglottis laryngitis (inflammation of the larynx), laryngotracheitis (inflammation of the larynx [cmc.ph]

  Sinusitis Sinuses are air-filled spaces in your skull, and sinusitis occurs when there is an infection or inflammation of the sinuses. [gleneagles.com.sg]

• Fatigue

  More severe viral upper respiratory infections also cause vomiting, nausea, diarrhea and abdominal pain, as well as myalgia, fatigue or malaise- more frequent in influenza virus infection. [symptoma.com]

  Case 3 18-year-old male presents complaining of 2 weeks of severe nasal stuffiness, bilateral facial pain and fatigue. He has tried using OTC Sudafed without benefit. He admits to being fatigued, but denies fevers. [medicine.uiowa.edu]

  Symptoms of the common cold Blocked nose Sneezing Sore throat Dripping mucus from your nose Stuffy feeling Fatigue Treatment options Lots of rest Extra fluids Decongestants or nasal sprays (medications to relieve symptoms) Healthy diet Hot soups or drinks [gleneagles.com.sg]

  […] viral infection like a cold A sore throat caused due to bacterial infection is called strep throat that is less common Dryness in air Allergies Muscle strain usually caused as a result of yelling or talking aloud for a long time Symptoms Throat pain Fatigue [beingtheparent.com]

• Swelling

  It is an abscess of the forehead area with frontal swelling. Potts puffy tumor is usually seen in late childhood or adolescence. Symptoms include red, tender swelling in the mid-forehead, headache and fever. Orbital cellulitis. [rileychildrens.org]

  Continue reading to know more about three most commonly found URTIs during pregnancy: Rhinitis: Rhinitis refers to the irritation and swelling of the mucous membrane in the nose. [beingtheparent.com]

  Breathing problems are getting better Yes Symptoms of serious illness No Symptoms of serious illness Do you have pain or swelling in one calf? Pain and swelling in the lower leg can be symptoms of a blood clot. [northshore.org]

• Asymptomatic

  Whilst little research exists on asymptomatic viral infections, these cases suggest that viruses can be transmitted by asymptomatic subjects unknowingly. [bmcinfectdis.biomedcentral.com]

  Among asymptomatic participants, 187 (87%) had bacterial colonization or bacterial/viral co-infection at baseline or end of the study. Viruses were also isolated from 5 (2.4%) asymptomatic cases. [infectioncontroltoday.com]

  From 2008 to 2010, naso/oropharyngeal swabs were collected from outpatients with influenza-like illness, inpatients with severe respiratory illness, and asymptomatic controls in rural Kenya. [ncbi.nlm.nih.gov]

  Otopathogen abundance was increased during symptomatic viral infection, but not during asymptomatic infection. The risk for AOM complicating URI was reduced by increased abundance of Staphylococcus and Sphingobium. [utmb.influuent.utsystem.edu]

• Cough

  Two previous studies incorporating capsaicin cough challenge methodology have demonstrated that cough reflex sensitivity is transiently enhanced during URI. These studies used single measurements of cough reflex sensitivity during the URI period. [ncbi.nlm.nih.gov]

  Measurement of cough reflex sensitivity Measurement of cough reflex sensitivity has allowed insight into the effects of viral URI on human cough reflex sensitivity. [jtd.amegroups.com]

  European Respiratory Journal 2011 38: p3510; DOI: Abstract One previous study has demonstrated that cough reflex sensitivity to inhaled capsaicin is transiently enhanced during acute viral respiratory tract infection (URI) by comparing single cough reflex [erj.ersjournals.com]

  Cough may result from postnasal drip. Conjunctivitis and photophobia may accompany ocular pain. [symptoma.com]

  Variance explained Stage 1 (n = 240) Age −0.07 (0.02) <0.001 8.3% Cough 0.40 (0.17) 0.02 Stage 2 (n = 175) Fever 0.13 (0.06) 0.02 7.7% Low energy 0.11 (0.05) 0.04 Variable B Coeff. (SD) Sig. [academic.oup.com]

• Sore Throat

  Pharyngitis Pharyngitis is more commonly known as a sore throat. Sometimes a sore throat is a symptom of a wider respiratory illness such as the common cold, but it can also be due to an infection only in your pharynx (throat). [gleneagles.com.sg]

  […] of the throat that often worsens during swallowing Causes The virus or bacteria can cause a sore throat You can catch a sore throat after a viral infection like a cold A sore throat caused due to bacterial infection is called strep throat that is less [beingtheparent.com]

  throat, conjunctivitis–with adenovirus infections; sore throat with pain on swallowing, fever, absence of cough, and exposure to a person with streptococcal pharyngitis in the prior 2 wks support Dx of GABHS-related pharyngitis; Pts with acute sinusitis [medical-dictionary.thefreedictionary.com]

  The benefits of tonsillectomy in preventing recurrent sore throat are modest.... Access to the complete content on Oxford Medicine Online requires a subscription or purchase. [oxfordmedicine.com]

  The symptoms of flu can include fever or feeling feverish/chills, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches and fatigue (tiredness). Cold symptoms are usually milder than the symptoms of flu. [baptisthealth.net]

• Common Cold

  (common cold), Acute nasopharyngitis [common cold], acute rhinitis, acute rhinitis (diagnosis), rhinitis acute, common cold, common cold (diagnosis), Common cold syndrome, Rhinitis (infective), Infective nasopharyngitis, NOS, Acute nasopharyngitis, NOS [fpnotebook.com]

  KEYWORDS: Antitussive; Capsaicin; Common cold; Cough; Upper respiratory tract infection [ncbi.nlm.nih.gov]

  Manifestations Common Cold Initially, the common cold begins with nasal stuffiness, sneezing, and headache. Rhinorrhea then occurs with increasing severity. [atsu.edu]

  cold in children The common cold is one of the most common illnesses. [hopkinsmedicine.org]

  Retrieved 19/3/19 from https://www.webmd.com/cold-and-flu/cold-guide/understanding-common-cold-basics#3 Felson, S. (2017, March 16) Understanding the Common Cold Treatments. [gleneagles.com.sg]

• Sneezing

  Wash hands as soon as possible after sneezing or coughing and after contact with nose and throat discharges or articles soiled by these. Use soap and water or an alcohol-based hand rub. Cover a cough or sneeze with tissue or arm. [sahealth.sa.gov.au]

  Decongestants – may provide symptom relief for stuffy nose and sneezing. Antihistamines – may reduce stuffy nose, sneezing, and nasal secretions. Saline nasal drops – may provide relief from congestion and thick secretions. [inogen.com]

  Droplets of infected saliva and mucus spray out into the air when a person sneezes or coughs. Other people may breathe them in, or they can land on surfaces that others touch. [medicalnewstoday.com]

  Other preventions include: Washing hands after toilet and cooking Washing surfaces that have been touched by infected individuals Covering mouth when sneezing and coughing Using a tissue for sneezing and coughing Stay away from others to prevent infecting [urgentclinicsmedicalcare.com]

• Pharyngitis

  […] lesions,” tender anterior cervical lymphadenopathy, and occasionally a scarlatiniform rash; pharyngeal or palatal vesicles and ulcers (herpangina) suggest enteroviral or herpetic pharyngitis; pharyngeal exudates are most common in GABHS-related pharyngitis [medical-dictionary.thefreedictionary.com]

  Acute Pharyngitis MicrobiologyAcute Pharyngitis Microbiology Commonest bacterial etiology: GAS: 5 – 15 % of sore throat visits in adults (20 – 30 % in children). 27. [slideshare.net]

  Patients with adenoviral pharyngitis often have pharyngeal exudate, so the disease can mimic streptococcal pharyngitis. [microbiologybook.org]

  Pharyngitis Viral pharyngitis typically resolves in 1-2 weeks, but immunocompromised persons may have a more severe course. [emedicine.medscape.com]

• Vomiting

  More severe viral upper respiratory infections also cause vomiting, nausea, diarrhea and abdominal pain, as well as myalgia, fatigue or malaise- more frequent in influenza virus infection. [symptoma.com]

  When to seek medical advice Seek medical advice if you are concerned about your symptoms or have any of the following: worsening symptoms shortness of breath difficulty breathing confusion inability to keep liquids down because of vomiting symptoms of [sahealth.sa.gov.au]

  Other side effects such as stomach upset, nausea vomiting, diarrhea or decreased appetite may occur. [healthcentral.com]

  Bacterial and viral infections can cause similar symptoms such as coughing and sneezing, fever, inflammation, vomiting, diarrhea, fatigue, and cramping -- all of which are ways the immune system tries to rid the body of infectious organisms. [webmd.com]

  Call your doctor if: You experience abdominal cramps that don’t go away You have diarrhea and vomiting You experience vaginal bleeding You have very high fever You have chest pain and experience shortness of breath You don’t feel better even a week Preventing [beingtheparent.com]

• Myalgia

  Accompanying symptoms such as headache, myalgia and nasal obstruction also showed a tendency to decrease. Within 3 days of treatment, six of the eight patients had recovered from the URTI. No adverse effects of acupuncture treatment were reported. [ncbi.nlm.nih.gov]

  More severe viral upper respiratory infections also cause vomiting, nausea, diarrhea and abdominal pain, as well as myalgia, fatigue or malaise- more frequent in influenza virus infection. [symptoma.com]

  […] nasal discharge; hoarseness suggests laryngitis; difficulty in swallowing oral secretions and stridor should raise suspicion for epiglottitis or pharyngeal abscess; influenza presents as a sudden illness characterized by high fever, severe headache, myalgia [medical-dictionary.thefreedictionary.com]

  Some Infectious Agents that Cause the Common Cold Agents* Human Serotypes Other unique symptoms in addition to coryza Myxoviruses Influenza A, B, C Myalgia and fatigue Parainfluenza 1, 2, 3, 4 Myalgia and fatigue Respiratory syncytial virus 1 (possibly [atsu.edu]

  She denies myalgias, shortness of breath, and ear pain, but does admit to mild headache. On physical exam, the nasal mucosa is swollen and erythematous. There is a small amount of whitish discharge inside the left naris. [medicine.uiowa.edu]

• Neck Pain

  […] ul><ul><li>the neck is flexed. [slideshare.net]

• Lethargy

  Other typical symptoms in children include decreased appetite, lethargy, and a general feeling of illness (malaise). Headaches and body aches develop, particularly with influenza. [merckmanuals.com]

  Upper respiratory infections, colds and flu cases, represent the most frequent reason for a doctor visit in the U.S., with varying symptoms ranging from runny nose, sore throat and cough, to breathing difficulty, lethargy, fever and general malaise. [baptisthealth.net]

  However the most common upper respiratory tract infections causes symptoms such as: High temperature Coughing Sneezing Sore throat Runny nose Stuffed up nose (nasal congestion) Nasal discharge Mucus or phlegm Tightness of chest Lethargy These symptoms [urgentclinicsmedicalcare.com]

  Same as above, +/- May have tonsilar exudates Headache Abdominal pain Fever Cervical lymphadenopathy Lethargy Often antibiotics prescribed, despite only 1/3 of infections being bacterial. 10 days treatment required to eradicate risk of rheumatic fever [almostadoctor.co.uk]

The diagnosis of viral upper respiratory tract infection is mostly clinical, but several tests may also be helpful. For instance, the physician may order influenza rapid test, Epstein-Barr heterophile antibody test, cell culture for herpes simplex virus identification [10] or polymerase chain reaction in order to detect the same type of infection. Epiglottitis can be diagnosed by direct visualization during laryngoscopy, provided that the patient's clinical status allows it. The microbiological specimen is obtained from throat or nasal swabs or washes; they are cultured on special media in order to identify respiratory syncytial virus, influenza and parainfluenza virus and adenovirus. Antibody titers should be observed in a dynamic manner.

The complete blood cell count shows lymphocytosis in acute viral infections, but lymphopenia may also be noticed in some cases. A high white blood cell number is not unusual. In case dyspnea is noticed, foreign body inhalation should be excluded using imaging methods. In croup, the steeple sign representing subglottic stenosis may be noticed [11]. In acute viral otitis media, tympanometry may be useful.

• Streptococcus Pneumoniae

  Lower carriage rates of Haemophilus influenzae (0%) and Streptococcus pneumoniae (10.8%) were observed in a study in China [18]. [bmcinfectdis.biomedcentral.com]

  Bacterial diversity was lower in culture-positive samples for Streptococcus pneumoniae, and Haemophilus influenzae, compared to cultured-negative samples. URI frequencies were positively associated with increasing trend in otopathogen colonization. [utmb.influuent.utsystem.edu]

  Acute otitis media Streptococcus pneumoniae, H.influenzae, M. catarrhalis Amoxicillin clavulanate 1gm oral BD for 7 days Azithromycin 500 mg OD for 5 days. [speciality.medicaldialogues.in]

• Chlamydia

  […] pneumoniae (chlamydia) Group C beta-hemolytic streptococci Several actions, events or conditions can increase the risk of a URI, including: When someone sick sneezes or coughs without covering their nose and mouth. [reverehealth.com]

  […] pneumoniae (chlamydia) The types of URIs refer to the parts of the upper respiratory tract most involved in the infection. [healthline.com]

  Prevalence of asymptomatic nasopharyngeal carriage of chlamydia pneumoniae in subjectively healthy adults: assessment by polymerase chain reaction-enzyme immunoassay and culture. Clin Infect Dis. 1995;20(5):1174–8. 36. [bmcinfectdis.biomedcentral.com]

  MICROBIOLOGY Other pathogenVirusesBacteria Mycoplasma pneumoniae respiratory syncytial virus Streptococcus pneumoniae 31.7 % Chlamydia trachomatis picornaviruses (eg, rhinovirus, enterovirus) Haemophilus influenzae 28.4 % C. pneumoniaecoronavirusesMoraxella [slideshare.net]

  Few cases of acute bronchitis are caused by Bordetella pertussis or atypical bacteria, such as Chlamydia pneumoniae and Mycoplasma pneumoniae. [aafp.org]

Within 3 days of treatment, six of the eight patients had recovered from the URTI. No adverse effects of acupuncture treatment were reported. [ncbi.nlm.nih.gov]

(N.D) Retrieved 19/3/19 from https://www.aaaai.org/conditions-and-treatments/conditions-dictionary/allergic-rhinitis [gleneagles.com.sg]

Diagnostic Findings and Appropriate Treatments for Upper Respiratory Tract Infections Condition Key diagnostic findings Treatment Acute bronchitis and tracheitis Cough, possible phlegm production Symptomatic treatment; antibiotics are not recommended [aafp.org]

Treatments Treatments Treatment for lung infections depends on how severe the illness is and whether the infection is bacterial, viral or fungal. Most bacterial infections are treated with a full course of prescribed antibiotics. [rileychildrens.org]

Most RTIs get better without treatment, but sometimes you may need to see your GP. [nhs.uk]

Rhinosinusitis The prognosis is generally favorable for acute rhinosinusitis, and many cases appear to resolve even without antibiotic therapy. [emedicine.medscape.com]

Hillary Clinton's Pneumonia: How Serious, the Prognosis Posted 12 Sep 2016 by Drugs.com MONDAY, Sept. 12, 2016 – Democratic presidential candidate Hillary Clinton's pneumonia may have heightened questions about her overall health, but doctors say pneumonia [drugs.com]

[…] high-risk persons with influenza exposures. [13] Differential Diagnosis Common Cold Allergic rhinitis Sinusitis Tracheobronchitis Pneumonia Influenza Atypical Pneumonia Pertussis Epiglottitis Streptococcal Pharyngitis/Tonsillitis Infectious Mononucleosis Prognosis [ncbi.nlm.nih.gov]

Bacterial infections, people with weak immune systems, and those with complications of upper respiratory infections (listed above) may have less favorable prognosis. Medically Reviewed on 7/19/2019 References Meneghetti, A. [medicinenet.com]

A viral etiology was identified in 62 of 108 (57.4%) samples. Symptom measures that best differentiated children with a viral etiology from those without were significant runny nose and significant cough on days 1-4 of the illness. [ncbi.nlm.nih.gov]

Specific etiologies lead to specific signs: mononucleosis is accompanied by splenomegaly and hepatomegaly, herpes virus infection causes palatal vesicles, vesicles located on the uvula, palate and anterior tonsillar pillars suggest herpangina. [symptoma.com]

Bacterial etiology is same as in otitis media. [speciality.medicaldialogues.in]

Bacterial etiologies of some of the common upper respiratory tract infections may be primary or superinfections of the original viral processes and are amenable to treatment (Table 75–1). [accessmedicine.mhmedical.com]

Epidemiology of acute respiratory infections in children in Guangzhou: a three-year study. PLoS One. 2014;9(5):e96674. 18. Liu J, Ai H, Xiong Y, Li F, Wen Z, Liu W, Li T, Qin K, Wu J, Liu Y. [bmcinfectdis.biomedcentral.com]

The prevalence, clinical profile, and epidemiology of respiratory virus in adults are different from those in young people. [hindawi.com]

[…] recommended; a rapid antigen detection test is also available for adenovirus, RSV, and parainfluenza virus; serologic tests for viruses that can cause a mononucleosis-type illness should be done in the correct clinical setting; influenza serologies have only epidemiologic [medical-dictionary.thefreedictionary.com]

Analyses of routinely collected administrative healthcare data can provide valuable information on the number of URTIs, antibiotic use and bacterial complications to patients, prescribers and policy-makers. epidemiology epidemiology infection control [bmjopen.bmj.com]

[…] shortens the duration of influenza symptoms, decreases the length of hospital stays, and reduces the risk of complications.[ Recommendations for the treatment of influenza are updated frequently by the Centers for Disease Control and Prevention based on epidemiologic [ncbi.nlm.nih.gov]

PATHOPHYSIOLOGY innate immune response to infection viral replication occurs in only a small number of nasal epithelial cells The infected cells release cytokines, including interleukin (IL)-8 6. [slideshare.net]

Upper respiratory tract infections are accountable for greater than 20 million missed days of school and greater than 20 million days of work lost, thus generating a large economic burden. [6] Pathophysiology A URTI usually involves direct invasion of [ncbi.nlm.nih.gov]

Mouth[edit] Small round red lesions may occur on the soft palate.[7] Decongestants may also cause decreased saliva.[7] Cause[edit] In terms of pathophysiology, rhinovirus infection resembles the immune response. [en.wikipedia.org]

Take Anti-Flu Medications Two medicines are approved for prevention of influenza viral infection. [med.uth.edu]

More research is needed to see if taking a vitamin D supplement can help to prevent respiratory infections. [vitamindcouncil.org]

Summary and Clinical Applicability Healthy young children may not need more than the standard 400 IU/day of vitamin D to prevent upper respiratory tract infections. [pulmonologyadvisor.com]

Smoking is known to be a cause of many infections and so giving up smoking goes a long way to help prevent it. [urgentclinicsmedicalcare.com]

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11. Ragosta KG, Orr R, Detweiler MJ. Revisiting epiglottitis: a protocol--the value of lateral neck radiographs. J Am Osteopath Assoc. 1997;97(4):227-229.