Upper Respiratory Tract Infections

Upper respiratory tract infections are common diseases that affect people of virtually all ages. These infections spread very quickly in children's collectives and children's immature immune system is not always able to handle the condition. For this reason we should not underestimate these infections in children, but also in the elderly and in people with weakened immune system. The majority of upper respiratory tract infections is caused by viruses but some are related to bacteria.


Before mentioning the most typical diseases, it is necessary to define the upper respiratory tract. It consists of the nasal cavity, nasal sinuses, nasopharynx, and larynx.


Infectious rhinitis is a common disease of the upper respiratory tract. The causative factor is usually a viral infection. The microorganisms attack nasopharyngeal mucosa, which becomes swollen. The person feels harder to breathe through the nose (may breathe by mouth) and suffers from loss of smell. These problems are accompanied by fatigue, fever and muscle and joint pain. There usually is no cure as the disease is viral, we can administer the anti-inflammatory drugs or use substances causing the swollen mucosa to shrink. The condition may be complicated by a bacterial superinfection because it is easier for bacteria to attack the mucosa damaged by viral attack.


Sinusitis is an unpleasant infection that mainly falls within the competence of otolaryngologists. The nasal sinuses are paired hollow spaces in the skull connected with nasal cavity. We distinguish maxillar, ethmoidal and frontal sinuses. The sinusitis occurs usually when bacteria penetrate into sinuses from the nasal cavity. The sinusitis causes local pus production and swelling of the mucosa, which can clog the openings into the nasal cavity and cause the accumulation of the purulent content. The symptoms include fever and pain in the area of the affected cavity (usually painful cheeks or forehead). The pain is worse when bending forward. The affected person blows out mucus or even blood and pus.


Tonsillitis is also a common infectious disease in children and adults. It is usually caused by streptococci bacteria attacking tonsils. The tonsil is a lymphoid tissue richly occupied by lymphocytes and other immune defense cells serving as primary defense against inhaled microorganisms. The tonsillitis manifests with fever, fatigue, headache, painful muscles, etc. In addition, the patient suffers from sore throat, which often worsens when swallowing. Sometimes the pain can be so severe that swallowing of food or fluids is significantly difficult or impossible. The throat and tonsils are reddish and there are white coats on the surface of enlarged tonsils. Severe tonsillitis may cause swelling of the neck and painful enlargement of local lymph nodes.


Inflammation of the larynx affects both children and adults. The larynx is an important part of the airways. It comes to trachea in its lower part and its upper part borders with the nasopharynx. When swallowing, the nasopharynx and larynx are divided by the laryngeal flap (epiglottis). The larynx also contains two important ligaments – the vocal cords. Exhaled air causes their vibration and this is the basis of human speech.


The most common cause of acute laryngitis is a viral infection. Viruses can weaken the mucosal defense and can be followed by a bacterial superinfection. The disease is often accompanied by symptoms such as fever, fatigue, joint pain and general malaise. However, the most visible symptom is related to swelling of vocal cords – the hoarseness. The affected person also suffers from dry cough and sore throat.


Acute epiglottitis is a life-threatening bacterial infectious disease that affects young children (toddlers and preschoolers). The disease is caused by a bacterium known as Hemophilus. The bacterium attacks the mucosa of laryngeal flap causing its inflammation and swelling. The swollen flap may narrow the airways causing sore throat, cough and shortness of breath and the affected child may easily suffocate. Luckily, thanks to vaccination, epiglottitis is much rare than it used to be in the past.


Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Contact: jiri.stefanek@seznam.cz
 Sources: basic text sources