Acute Respiratory Infections

Overview

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Acute Respiratory Infections (ARIs) encompass a range of infections affecting the respiratory tract, including the upper respiratory tract (such as the nose and throat) and the lower respiratory tract (such as the bronchi and lungs). ARIs are common and can be caused by various pathogens, including viruses and bacteria. They can range from mild, self-limiting conditions like the common cold to more severe infections such as pneumonia or bronchitis.

ARIs are common and can be caused by various pathogens, including viruses and bacteria. They can range from mild, self-limiting conditions like the common cold to more severe infections such as pneumonia or bronchitis.

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Symptoms

Upper Respiratory Tract Infections (URTIs):

  • Cough: Usually dry or productive with mucus.
  • Sore Throat: Pain or discomfort in the throat.
  • Runny or Stuffy Nose: Nasal congestion or discharge.
  • Sneezing: Frequent sneezing.
  • Fever: Mild to moderate, often accompanied by chills.
  • Headache and Body Aches: General discomfort and muscle pain.
  • Fatigue: Feeling unusually tired or weak.

Lower Respiratory Tract Infections (LRTIs):

  • Cough: Persistent and often severe, may produce phlegm.
  • Shortness of Breath: Difficulty breathing or rapid breathing.
  • Chest Pain: Discomfort or pain in the chest, often exacerbated by coughing or deep breaths.
  • Wheezing: High-pitched whistling sound during breathing.
  • High Fever: Elevated body temperature, sometimes with shaking chills.
  • Fatigue: Severe tiredness or weakness.
Complications
  • Pneumonia: Inflammation of the lungs that can be severe and require hospitalization.
  • Bronchitis: Inflammation of the bronchial tubes, which can become chronic.
  • Chronic Respiratory Issues: Repeated infections can lead to chronic conditions like asthma or chronic obstructive pulmonary disease (COPD).
  • Sinusitis: Infection or inflammation of the sinuses that can develop as a complication of URTIs.
  • Ear Infections: Particularly in children, infections can spread to the middle ear.
  • Sepsis: In severe cases, particularly with bacterial infections, the infection can spread to the bloodstream causing a systemic response.
Causes

Viruses: The most common cause of ARIs, including:

  • Rhinoviruses: Commonly cause the common cold.
  • Influenza Viruses: Cause seasonal flu.
  • Respiratory Syncytial Virus (RSV): Common in infants and young children.
  • Coronaviruses: Include those causing the common cold and COVID-19.

Bacteria: Can cause more severe infections, including:

  • Streptococcus pneumoniae: Common cause of pneumonia.
  • Haemophilus influenzae: Can cause bronchitis and pneumonia.
  • Mycoplasma pneumoniae: Often causes atypical pneumonia.
  • Fungi: Rare but possible, particularly in immunocompromised individuals.
  • Environmental Factors: Exposure to irritants like smoke or pollutants can exacerbate or contribute to respiratory infections.
Prevention
  • Good Hygiene: Regular handwashing with soap and water, especially before eating or touching the face.
  • Vaccination: Immunizations for preventable diseases, such as the flu vaccine and pneumococcal vaccine.
  • Avoid Close Contact: Stay away from people who are sick, and avoid sharing utensils or personal items.
  • Healthy Lifestyle: Maintain a balanced diet, exercise regularly, and get adequate rest to support a strong immune system.
  • Avoid Smoking: Smoking and exposure to secondhand smoke can increase susceptibility to respiratory infections.
  • Cover Coughs and Sneezes: Use tissues or elbows to cover coughs and sneezes to prevent spreading germs.
Risk Factors
  • Age: Infants, young children, and the elderly are at higher risk.
  • Chronic Health Conditions: Conditions like asthma, diabetes, or heart disease can increase susceptibility.
  • Weakened Immune System: Due to conditions like HIV/AIDS, cancer treatment, or immunosuppressive medications.
  • Smoking and Exposure to Pollutants: Increases the risk of respiratory infections and exacerbates symptoms.
  • Living Conditions: Crowded or unsanitary living conditions can facilitate the spread of infections.
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How is it Treated?

  • Antibiotics: Prescribed for bacterial infections, such as pneumonia or bacterial bronchitis. Not effective against viral infections.
  • Antiviral Medications: For certain viral infections, such as influenza, antiviral drugs may be prescribed if caught early.

Over-the-Counter Medications:

  • Decongestants: To relieve nasal congestion.
  • Cough Suppressants and Expectorants: To manage cough and mucus production.
  • Pain Relievers: Such as acetaminophen or ibuprofen for fever and body aches.
  • Rest and Hydration: Adequate rest and fluid intake to help the body recover and stay hydrated.

Home Remedies:

  • Humidifiers: Adding moisture to the air can help ease symptoms of congestion and coughing.
  • Saltwater Gargle: Can soothe a sore throat.
  • Honey and Lemon: May provide symptomatic relief for cough and sore throat.
  • Hospitalization: In severe cases, particularly if complications like pneumonia or sepsis develop, hospitalization may be necessary for more intensive treatment and monitoring.
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How is it Diagnosed?

Acute Respiratory Infections (ARIs) affect the upper or lower respiratory tract and are among the most common causes of morbidity. Diagnosis starts with clinical history including sudden onset of cough, sore throat, nasal congestion, fever, and breathing difficulty. Duration (typically <14 days), symptom severity, and exposure history (travel, sick contacts) are noted.

Physical examination includes auscultation for wheezes, rales, or decreased breath sounds. Vital signs may reveal fever, tachypnea, or hypoxia.

For upper respiratory tract infections (e.g., viral pharyngitis, common cold), diagnosis is clinical. For suspected lower respiratory infections like pneumonia or bronchitis, further evaluation is needed. A chest X-ray is crucial for detecting lung infiltrates, consolidation, or pleural effusion.

Pulse oximetry assesses oxygen saturation; arterial blood gas (ABG) may be used in severe cases. CBC can show leukocytosis in bacterial infections or lymphocytosis in viral infections. In select cases, sputum culture, nasopharyngeal swabs for viral PCR (e.g., influenza, RSV, SARS-CoV-2), and blood cultures are indicated.

Special tests like CRP or procalcitonin levels may assist in distinguishing bacterial from viral causes. Prompt diagnosis enables appropriate antimicrobial therapy, supportive care, and isolation measures when needed.

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FAQs

  • Acute respiratory infections are infections that affect the respiratory tract, including the upper (e.g., colds, sinus infections) and lower (e.g., pneumonia, bronchitis) respiratory tracts.

Symptoms may include:

  • Cough
  • Sore throat
  • Fever
  • Shortness of breath
  • Nasal congestion

  • Acute respiratory infections can be caused by viruses (most common) or bacteria. Influenza, common cold viruses, and Streptococcus pneumoniae are examples.

  • Diagnosis typically involves a physical examination and medical history review. Additional tests, like chest X-rays or sputum cultures, may be conducted if necessary.

Treatment varies based on the cause but may include:

  • Rest and hydration
  • Over-the-counter medications (pain relievers, decongestants)
  • Antibiotics (if bacterial infection is confirmed)
  • Antiviral medications (for specific viral infections)
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