• Nasopharyngitis (common cold) is a frequent cause of URIs, and most patients with this diagnosis with present with nasal congestion (80%). Nasopharyngitis rarely presents with a fever. Causes are predictably viral, and determining the exact viral pathogen is usually unnecessary. Treatment of the common cold is symptomatic, and hand washing is the best prevention.

  • Sinusitis is a common diagnosis seen in primary care. The diagnosis and differentiation between bacterial and viral sinusitis is made clinically, based on the history and examination. Augmentin is the antibiotic preferred by the Infectious Diseases Society of America for empiric treatment of bacterial sinusitis. Nasal steroids are highly effective for both viral and bacterial acute sinusitis.

  • Identifying the cause of pharyngitis, especially group A β-hemolytic streptococcus (GABHS), is important in preventing potential life-threatening complications. Group A streptococcal infection (GAS) pharyngitis accounts for 15% to 30% of infections in children and 5% to 15% in adults. The Centor criteria are useful prediction rules for the evaluation and management of possible GAS pharyngitis. Penicillins are the drugs class of choice for streptococcal pharyngitis.

  • Acute laryngotracheobronchitis (LTB) is an infectious-induced inflammatory condition affecting the larynx, trachea, and bronchi. It occurs most often in children ages 6 months to 6 years, with the peak age at 2 years. Recommended imaging for suspected croup includes anterior-posterior views of the neck, which show edematous subglottic walls converging to create a characteristic “steeple sign.” The cornerstone of medical management of LTB is nebulized epinephrine and dexamethasone.


Upper respiratory infections (URIs) are infections of the mouth, nose, throat, larynx (voice box), and trachea (windpipe). URIs include nasopharyngitis (common cold), sinusitis, pharyngitis, laryngitis, and laryngotracheitis.







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