4.APR.2019 4 MIN READ | 4 MIN READ

Did you know that upper respiratory tract infections (URTI) come in many forms, and some are more serious than others?

Last updated on 7 October 2021

What is an upper respiratory tract infection?

An URTI is an infection of your upper respiratory tract. This includes your throat, nose, pharynx, larynx, sinuses, and trachea (windpipe). This upper portion of your airway is susceptible to many bacterial and viral infections that can cause a range of symptoms, with varying degree of severity. Infections and airborne illnesses are easily spread by contact with other people, and are often transferred by sneezing or coughing.

Infections in the upper respiratory tract include:

  • Common cold
  • Pharyngitis
  • Sinusitis
  • Laryngitis
  • Rhinitis

What are the causes of upper respiratory infection?

An URTI can be caused by either viruses or bacteria which are expelled by an infected person in droplets of saliva or mucous. These droplets may be airborne and inhaled by others or land on surfaces that others may come in contact with.

What are the symptoms of upper respiratory infection?

Symptoms of an URTI include:

  • Cough
  • Sore or scratchy throat
  • Mild fever
  • Runny nose or nasal discharge
  • Nasal congestion
  • Loss of smell
  • Pain or pressure in the face
  • Pain or discomfort in the nasal passages

The common cold

The common cold is an infection that affects your entire upper respiratory system. A virus attaches to the lining of your nose or throat and triggers an immune response. This immune response results in congestion in the local area and leaves your body feeling generally run down as you try to fight it.

Causes of the common cold

Most colds are caused by the rhinovirus, but other culprits include:

Symptoms of the common cold

  • Blocked nose
  • Sneezing
  • Sore throat
  • Dripping mucus from your nose
  • Stuffy feeling
  • Fatigue

Treatment options for the common cold

  • Lots of rest
  • Extra fluids
  • Decongestants or nasal sprays (medications to relieve symptoms)
  • Healthy diet
  • Hot soups or drinks

Many colds can last as long as 7 – 10 days. However, if your cold is severe or lasts a long time, you should see your doctor. If you also have a fever or difficulty breathing, it may be something more serious like the influenza and will require medical attention.

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).

Pharyngitis

Causes of pharyngitis

Possible causes include streptococcus bacteria, which causes strep throat, or an infection of your tonsils, known as tonsillitis. In most cases, pharyngitis is due to a viral infection that attacks the tissue of your throat.

Symptoms of pharyngitis

  • Raw, irritated feeling in your throat
  • Redness or inflammation of the throat
  • Fatigue and general feeling of being unwell
  • Pain when swallowing

Treatment options for pharyngitis

  • Drinking more fluids for hydration
  • Painkillers such as ibuprofen or paracetamol
  • Gargling salt water
  • Lozenges or throat sprays

If your sore throat is severe or lasts more than a few days, you should see your doctor.

Sinusitis

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

Sinusitis

Causes of sinusitis

Sinusitis is the inflammation of the sinus, which are the air cavities found in the nasal passage. It can be caused by an infection, allergies, or some other form of irritation. This can lead to excessive production of mucous, allowing bacteria or germs to build up.

Symptoms of sinusitis

  • Nasal congestion
  • Pain and pressure in your face
  • Headaches
  • A runny nose
  • Loss of smell and taste
  • Thick mucus discharge
  • Postnasal drainage and cough

Treatment options for sinusitis

  • Inhaling steam
  • Saline nasal rinse
  • Painkillers such as ibuprofen or paracetamol
  • Nasal decongestion

If your symptoms last for more than 3 months, you may have chronic sinusitis, and should visit your doctor for treatment.

Laryngitis

Laryngitis is often confused with pharyngitis (a sore throat) but refers specifically to an inflammation in your larynx, also known as your voice box. It is usually a result of a viral infection, but can sometimes occur because of voice overuse.

Laryngitis

Causes of laryngitis 

Laryngitis is the inflammation of your vocal cords. This may be caused by overuse, such as talking or shouting. It can also be caused by a bacterial or viral infection. These causes usually result in an acute (temporary) condition.

People who have long-term exposure to irritants such as chemicals, cigarette smoke or digestive acids due gastric reflux may suffer from chronic laryngitis, which is usually more severe.

Symptoms of laryngitis

  • Sore throat
  • Hoarse voice
  • Loss of voice
  • Swelling in your glands
  • Need to clear your throat

Treatment options for laryngitis

  • Vocal rest
  • Using dehumidifiers in your house
  • Gargling salt water
  • Drinking more fluids
  • Avoiding smoking and alcohol

If your laryngitis lasts for more than 1 – 2 weeks, or you cough up blood, you should call your doctor.

Rhinitis

Rhinitis refers to an inflammation in your nasal passages. Rhinitis is usually defined as either allergic or non-allergic. Allergic rhinitis is also known as hay fever, and is caused by your body’s immune response to certain allergens. Non-allergic rhinitis has the same symptoms but is not caused by an allergen.

Rhinitis

Causes of rhinitis 

Rhinitis, or allergic rhinitis, is caused by an allergic reaction to allergens such as dust, animal dander or pollen.

While allergic rhinitis is specifically linked to allergens, nonallergic rhinitis is usually caused by changes in the weather, certain types of food or medications, as well as chronic health conditions.

Symptoms of rhinitis

  • Runny nose
  • Sneezing
  • Itchy and watery eyes
  • Nasal congestion
  • Postnasal drip

Treatment options for rhinitis

  • Antihistamines
  • Allergen avoidance
  • Nasal douche
  • Nasal spray

If your rhinitis is severe, recurrent or persistent, you should see your doctor.

When should you seek treatment?

When to seek treatment?
As with any illness, the severity of your URTI defines whether or not it is an emergency. URTIs are extremely common and often self-limiting. Infants and the elderly are at a higher risk of complications, so they should seek treatment early if there is no improvement after a few days.

When to seek medical attention immediately

The following symptoms may be an indication of a more severe disease and you should seek treatment immediately:

  • Difficulty breathing
  • A high fever that doesn’t go away
  • Pale or blue tinged skin or lips
  • Respiratory illness accompanied by light-headedness, nausea or dizziness
  • Prolonged respiratory illness

When to visit a 24-hour A&E clinic

As severe URTI can potentially cause serious complications, you should visit the nearest 24-hour A&E clinic if you experience symptoms like these:

  • Dehydration
  • Poor oxygenation (hypoxia)
  • Confusion
  • Lethargy
  • Significant shortness of breath

If you do not think it is an emergency, but you have been unwell for several days, you should consult your doctor for advice.

 

Article reviewed by Dr Chao Siew Shuen, ENT specialist at Gleneagles Hospital

References

(2018, June 7) Nonallergic Rhinitis. Retrieved 19 March 2019 from https://www.webmd.com/allergies/nonallergic-rhinitis#3

(2018, February 28) Sore Throat? Retrieved 19 March 2019 from https://www.webmd.com/cold-and-flu/sore-throat-cold-strep-throat-tonsillitis#3

(2018, November 27) What Is Laryngitis? Retrieved 19 March 2019 from https://www.webmd.com/cold-and-flu/what-is-laryngitis#2

(2017, March 22) Understanding the Common Cold Basics. Retrieved 19 March 2019 from https://www.webmd.com/cold-and-flu/cold-guide/understanding-common-cold-basics#3

(2017, March 16) Understanding the Common Cold Treatments. Retrieved 19 March 2019 from https://www.webmd.com/cold-and-flu/understanding-common-cold-treatment#3

(2018, March 23) Upper Respiratory Infection. Retrieved 19 March 2019 from https://www.healthline.com/health/acute-upper-respiratory-infection#types

(2018, July 9) Sinus Infection (Sinusitis). Retrieved 19 March 2019 from https://www.webmd.com/allergies/sinusitis-and-sinus-infection#2

(n.d.) Rhinitis Defined. Retrieved 19 March 2019 from https://www.aaaai.org/conditions-and-treatments/conditions-dictionary/allergic-rhinitis

4.APR.2019
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Chao Siew Shuen
ENT Specialist
Gleneagles Hospital

Dr Chao Siew Shuen is an ear, nose and throat (ENT) surgeon practising at Gleneagles Hospital, Singapore. She specialises in treating ear, nose and throat conditions in adults and children. In particular, she is well-known for managing nasal (nose) and sinus disorders such as nasal allergy, obstruction, bleeding, infection, polyps (non-cancerous growths) and tumours.