Upper respiratory infection (URI)
An upper respiratory infection (URI) is a contagious infection of your upper respiratory tract (including your nasal passages, sinuses, and throat), and is caused by bacteria or a virus.
The most common URI? The common cold
The most common upper respiratory infection is a cold, which often presents with a sore throat. A cold is a different condition than influenza and pneumonia, which are lower respiratory tract illnesses.
URIs might require medical treatment
A URI is caused when a virus or bacteria invades the mucus membranes of your upper respiratory tract, which consists of the sinuses, nasal passages, pharynx and larynx. This causes an infection that may require medical treatment. URIs are extremely common, so your primary care provider will know just what to do to help.
Causes of URIs
A URI can be caused by a virus or bacteria, which enter your airway through your nose or mouth and incubate for varying amounts of time before causing an infection. Most URIs are viral infections, such as the rhinovirus, which causes the common cold. They are most common in the fall and winter, but they can happen at any time.
Possible causes of upper respiratory infections include:
- Epstein-Barr virus.
- Human metapneumovirus.
- Parainfluenza virus.
- Respiratory syncytial virus.
- Chlamydia (Chlamydia pneumoniae).
- Diphtheria (Corynebacterium diphtheriae).
- Gonorrhea(Neisseria gonorrhoeae).
- Group A beta-hemolytic streptococci, which causes strep throat.
- Group C beta-hemolytic streptococci.
- Whooping cough (pertussis).
To avoid catching any of these viruses or bacteria, avoid close contact with people in public or who you know are infected. Be mindful to practice good hygiene – especially washing your hands frequently for at least 20 seconds at a time.
Symptoms of a URI
You may have a URI if you are experiencing any of these symptoms:
- Nasal congestion and trouble breathing through your nose.
- Runny nose.
- Sore or scratchy throat and pain when swallowing.
These symptoms usually last between a few days to 2 weeks.
Less common symptoms
Other less common symptoms include:
- Bad breath.
- Body aches.
- Itchy and watery eyes (conjunctivitis).
- Shortness of breath.
- Sinus pain.
When to see your provider
See your primary care provider for diagnosis and treatment if any of these symptoms become severe or last longer than 14 days.
How are upper respiratory infections diagnosed?
Upper respiratory infections are typically diagnosed based on your symptoms and a physical examination. Your primary care provider may perform an examination of your throat, nose, and ears to assess any signs of infection, as well as listen to your chest to examine your breathing. In some cases, a throat swab or nasal swab may be taken to identify the specific virus or bacteria responsible for the infection.
Imaging tests (such as X-rays) or further laboratory tests aren’t typically required for routine URIs unless there are complications, severe symptoms, or a more serious condition like bronchitis or pneumonia is suspected.
Common types of upper respiratory infections
If you have a URI, your primary care provider may diagnose it according to the specific area of infection, such as:
- Common cold (nasopharyngitis). Inflammation of the nares, pharynx, hypopharynx, uvula and tonsils.
- Epiglottitis. Inflammation of the upper portion of the larynx or the epiglottis.
- Laryngitis. Inflammation of the larynx.
- Pharyngitis. Inflammation of the pharynx, uvula and tonsils.
- Rhinitis. Inflammation of the nasal cavity.
- Sinus infection, sinusitis or rhinosinusitis. Inflammation of the sinuses located around the nose.
- Tracheitis (tracheobronchitis). Inflammation of the trachea that can quickly lead to acute bronchitis.
Treating a URI
Your primary care provider will develop the best treatment plan for your type of URI and symptoms.
Because most URIs are viral infections and are self-limited, you may only need at-home remedies to feel better until the virus passes:
- Adjust the inside temperature and humidity. Keep it warm and use a cool mist humidifier or vaporizer to help ease congestion and coughing.
- Eat a healthy diet. Try chicken soup and other warm fluids to soothe your throat and loosen congestion.
- Hydrate. Water, juice, clear broth or warm lemon water can help, and you should avoid caffeine and alcohol.
- Rest. Stay home from work or school to rest and reduce the chances you’ll infect others.
- Soothe your throat. Try lozenges or a salt water gargle: one-half teaspoon of salt in a 4 to 8ounce glass of warm water.
- Take over-the-counter (OTC) cold and cough medications. Decongestants such as pseudoephedrine (Sudafed), Actifed oral or phenylephrine (Neo-Synephrine nasal) can relieve nasal congestion; antihistamines and pain relievers might offer other symptom relief.
- Use saline nasal drops. They can help relieve nasal congestion.
Your provider may also prescribe steroids such as dexamethasone (Decadron) and prednisone (orally or nasally) to reduce inflammation of your airway passage and decrease swelling and congestion.
Your doctor might prescribe antibiotics in the case of a bacterial infection such as strep throat, bacterial sinusitis or epiglottitis, but this is not always recommended. In rare cases of complicated sinus infection, a surgical procedure may be recommended to help with a compromised airway and difficulty breathing, formation of abscesses behind the throat, or abscess formation of the tonsils (peritonsillar abscess).
Because most URIs are viral in nature, treatment usually focuses on relieving symptoms to help you feel better until the virus runs its course and you return to feeling normal.
FAQs about upper respiratory infections
An upper respiratory infection (URI) refers to any acute infection that affects the upper respiratory tract. This includes the sinuses, nasal passages, pharynx, and larynx. Common URIs include the common cold, sinusitis, pharyngitis, and laryngitis.
An upper respiratory infection (URI) primarily affects the upper respiratory system, including the nasal passages, sinuses, and throat. Common examples are the common cold and sinusitis. In contrast, a lower respiratory infection (LRI) targets the lower respiratory system, including the bronchial tubes and lungs. Examples of LRIs are bronchitis and pneumonia. LRIs tend to be more serious, may require more intensive treatment, and can pose greater health risks (especially for vulnerable individuals).
URIs are most commonly caused by viruses, such as the rhinoviruses (which causes the common cold). However, they can also be caused by bacteria in some cases. Transmission often occurs through airborne droplets from coughs or sneezes, or by touching contaminated surfaces and then touching the face.
Symptoms can vary depending on the specific infection but can include a runny or stuffy nose, sore throat, cough, mild headache, fatigue, fever, and sneezing. In more severe cases, difficulty breathing or severe pain can occur.
Treatment for upper respiratory infections typically focuses on managing the symptoms and supporting the body’s natural healing process, as most upper respiratory infections typically resolve on their own with rest, hydration, and over-the-counter medications to alleviate symptoms. Antibiotics may be prescribed in some cases if a bacterial infection is present.
Good hygiene practices can help prevent the spread of URIs. This includes regular hand washing, avoiding close contact with sick individuals, not touching your face with unwashed hands, and covering your mouth and nose when you cough or sneeze.
You should consult a doctor if your symptoms are severe, persist for more than 14 days, or if you have a high fever, difficulty breathing, or severe headache. These could be signs of a more serious condition.
The duration of upper respiratory infections can vary, but most URIs caused by viruses typically last around 1 to 2 weeks. Bacterial infections, when treated with appropriate antibiotics, generally show improvement within a few days.
Yes, upper respiratory infections are often contagious and can spread through respiratory droplets when an infected person coughs, sneezes, or talks. Close contact with an infected person or touching contaminated surfaces can also contribute to the transmission of these infections.
National Library of Medicine. Upper Respiratory Tract Infection (https://www.ncbi.nlm.nih.gov/books/NBK532961/)
American Academy of Family Physicians. Respiratory Tract Infections (https://www.aafp.org/pubs/afp/topics/by-topic.respiratory-tract-infections.html)