Upper respiratory infection - Revision history

Patricklin at 06:37, 11 December 2023

2023-12-11T06:37:29Z

← Older revision		Revision as of 06:37, 11 December 2023
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	==Background==		==Background==
	*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>		*Infection and inflammation of the upper respiratory tract, typically self-limiting
	**Other causes include: [[coronavirus]], [[adenovirus]].		**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==		==Clinical Features==
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	**Malaise		**Malaise
	**Low-grade [[fever]]		**Low-grade [[fever]]
			***Fevers are more common in pediatrics than adults
	**[[Cough]] (usually 24-48 hrs later)		**[[Cough]] (usually 24-48 hrs later)
			***Postinfectious cough can last for weeks after other symptoms have resolved
	**[[Rhinorrhea]]		**[[Rhinorrhea]]
	**Nasal congestion		**Nasal congestion
	**~~Symptoms~~ peak by day 3 or 4, resolve by day 7		**[[Sneezing]]
			**[[Myalgia]]
			**Hoarse voice
			*Depending on the organism, typically symptoms peak by day 3 or 4, resolve by day 7

	==Differential Diagnosis==		==Differential Diagnosis==
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	==Evaluation==		==Evaluation==
	*Clinical diagnosis.		*Clinical diagnosis
	*Rule out other serious causes		*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==		==Management==
	*Supportive care		*Supportive care and symptomatic relief are the mainstays of management
	**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>		*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>
	**Mucolytics: little evidence to support usage		*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>
	**[[Bronchodilators]] if [[wheezing]] present		**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==		==Disposition==

ClaireLewis at 20:28, 22 October 2019

2019-10-22T20:28:01Z

← Older revision		Revision as of 20:28, 22 October 2019
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	**Low-grade [[fever]]		**Low-grade [[fever]]
	**[[Cough]] (usually 24-48 hrs later)		**[[Cough]] (usually 24-48 hrs later)
	**Rhinorrhea		**[[Rhinorrhea]]
	**Nasal congestion		**Nasal congestion
	**Symptoms peak by day 3 or 4, resolve by day 7		**Symptoms peak by day 3 or 4, resolve by day 7
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	**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>		**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		**Mucolytics: little evidence to support usage
	**[[Bronchodilators]] if wheezing present		**[[Bronchodilators]] if [[wheezing]] present

	==Disposition==		==Disposition==
	Outpatient		*Outpatient

	==See Also==		==See Also==

Mholtz at 06:37, 13 July 2017

2017-07-13T06:37:50Z

← Older revision		Revision as of 06:37, 13 July 2017
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	==See Also==		==See Also==


	==External Links==		==External Links==


	==References==		==References==

	<references/>		<references/>

	[[Category:ID]]		[[Category:ID]]

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-26T13:48:10Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Older revision		Revision as of 13:48, 26 July 2016
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	{{Cough DDX}}		{{Cough DDX}}

	==~~Diagnosis~~==		==Evaluation==
	*Clinical diagnosis.		*Clinical diagnosis.
	*Rule out other serious causes		*Rule out other serious causes

Rossdonaldson1: /* Management */

2016-05-11T13:01:57Z

Management

← Older revision		Revision as of 13:01, 11 May 2016
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	**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>		**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		**Mucolytics: little evidence to support usage
	**Bronchodilators if wheezing present		**[[Bronchodilators]] if wheezing present

	==Disposition==		==Disposition==

Rossdonaldson1 at 13:01, 11 May 2016

2016-05-11T13:01:41Z

← Older revision		Revision as of 13:01, 11 May 2016
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	==Background==		==Background==
	*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>		*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.		**Other causes include: [[coronavirus]], [[adenovirus]].

	==Clinical Features==		==Clinical Features==
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	<references/>		<references/>

			[[Category:ID]]

Rossdonaldson1: /* Differential Diagnosis */

2016-04-28T13:43:53Z

Differential Diagnosis

← Older revision		Revision as of 13:43, 28 April 2016
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	==Differential Diagnosis==		==Differential Diagnosis==
	{{ILI DDX}}		{{ILI DDX}}

			{{Cough DDX}}

	==Diagnosis==		==Diagnosis==

Rossdonaldson1: /* Differential Diagnosis */

2016-04-28T13:42:48Z

Differential Diagnosis

← Older revision		Revision as of 13:42, 28 April 2016
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	==Differential Diagnosis==		==Differential Diagnosis==
	*[[Bronchitis]]		{{ILI DDX}}
	*[[Cough]]
	*[[Influenza]]

	==Diagnosis==		==Diagnosis==

Rossdonaldson1: /* Differential Diagnosis */

2016-04-28T13:19:44Z

Differential Diagnosis

← Older revision		Revision as of 13:19, 28 April 2016
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	*[[Cough]]		*[[Cough]]
	*[[Influenza]]		*[[Influenza]]
	*[[Severe Acute Respiratory Syndrome]]

	==Diagnosis==		==Diagnosis==

Rossdonaldson1 at 13:19, 28 April 2016

2016-04-28T13:19:29Z

← Older revision		Revision as of 13:19, 28 April 2016
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	==Background==		==Background==
	*Rhinovirus is most common cause		*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.		**Other causes include: coronavirus, adenovirus.

	==Clinical Features==		==Clinical Features==
	*Common cold		*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		**[[Sore throat]]
	**Malaise		**Malaise
	**Low-grade fever		**Low-grade [[fever]]
	**Cough (usually 24-48 hrs later)		**[[Cough]] (usually 24-48 hrs later)
	**Rhinorrhea		**Rhinorrhea
	**Nasal congestion		**Nasal congestion
	**Sx peak by day 3 or 4, resolve by day 7		**Symptoms peak by day 3 or 4, resolve by day 7

	==Differential Diagnosis==		==Differential Diagnosis==
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	==References==		==References==
	*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
	<references/>		<references/>