Upper Respiratory Infections

Fernando Urrego, MD

Introduction

•Upper respiratory tract infections are the most common illness to affect children worldwide.

•Most children experience 1 or more acute respiratory infections per year; the mean is 6–8 per year.

•The frequency of infections varies with the season and the child’s age.

•Infections are more common in autumn and winter in temperate regions and in the rainy season in tropical regions.

•The mode of transmission varies between viruses.

•Infections are usually mild and self-limiting but can occasionally lead to complications.

•The decision to investigate is based on clinical judgment and experience.

•Factors to consider when deciding on treatment are persistence of symptoms, time to cure, and complications arising from progressive disease.

•Most children who present with recurrent upper-airway infections are otherwise healthy.

•Antibiotics should not be commonly prescribed, because there is limited evidence of effectiveness.

•Upper respiratory tract infections cause substantial absenteeism of children from school and parents from work.

Rhinosinusitis (Common Cold)

•The nasal part of the respiratory mucosa is predominantly affected.

•Common viral causes include rhinovirus, coronavirus, respiratory syncytial virus, and metapneumovirus.

•The median number of viral colds is 5 per year, but it is not uncommon for a child to experience as many as 10 episodes in a year.

•The mean duration of symptoms is 8 days, but the normal range extends beyond 2 weeks.

•Symptoms include nasal congestion, rhinorrhea, cough, sore throat, and fever.

•Attendance in child care increases the risks of developing viral colds.

•Rhinosinusitis is usually a self-limiting illness that does not require treatment.

•In 0.5%–5.0% of cases, common colds become complicated by the development of acute sinusitis (see the next section).