URTIs

Upper respiratory tract infections (URTIs) are a broad group of illnesses that affect the nose, sinuses, throat, voice box, and sometimes the middle ear. They are among the most common infections worldwide and are typically viral in origin, though bacteria can be involved in certain conditions.

Most URTIs are caused by viruses such as rhinoviruses, coronaviruses, influenza viruses, parainfluenza viruses, and respiratory syncytial virus. Bacterial pathogens can contribute in some cases, including Streptococcus pyogenes (group A streptococcus), Streptococcus pneumoniae, and Haemophilus influenzae, but antibiotics are not routinely required for uncomplicated URTIs.

Common presentations include nasal congestion or runny nose, sneezing, sore throat, cough, and fever. Symptoms are usually self-limited and peak within a few days, with recovery over one to two weeks in many cases. Lower respiratory involvement or high-risk individuals may experience more severe illness.

Diagnosis is typically clinical, based on history and examination. Tests are not routinely necessary, but may be used to confirm bacterial etiologies or rule out competing diagnoses when indicated. Red flags warranting further evaluation include shortness of breath, chest pain, dehydration, severe throat swelling, or signs of a more serious infection.

Management focuses on supportive care, such as fluids, rest, analgesics, and relief of nasal symptoms. Antibiotics are reserved for specific bacterial URTIs or complications, as guided by clinical criteria and local guidelines. Preventive measures include vaccination (influenza, pneumococcal, and others where appropriate), good hand hygiene, and avoiding tobacco smoke exposure.

Most URTIs have a favorable prognosis, but complications like bacterial sinusitis, otitis media, or, less commonly, pneumonia can occur, particularly in children, older adults, or individuals with chronic diseases.