INFECTIONS OF THE UPPER RESPIRATORY TRACT
Upper respiratory tract infections are those primarily affecting the
structures of the respiratory tract above the larynx, but most respiratory
illness affect both the upper and lower portions of the tract simultaneously
Pathophysiologic features include
1. Inflammatory infiltrates
2 . Edema of the mucosa
3. Vascular congestion
4. Increased mucus secretion
5. Alterations of ciliary structure and function.
Many different micro organism, [chiefly viruses]are capable of
causing primary upper respiratory tract disease. The same organism may
cause inapparent infection or clinical symptoms of differentiating severity
and extent in accordance with host factor such as age, sex, previous
contact with the agent, allergy and nutritional status.
Children enrolled in childcare are exposed to a wide range of
pathogenes at an earlier age.
1. Most acute respiratory tract infections are caused by viruses and
mycoplasma. An exception is acute epiglottis
2. Streptococci and the diptheria organisms are the major bacterial
agents capable of causing primary pharyngeal disease.
3. Although considerable overlapping exists, some micro organisms
are more likely to produce a given respiratory syndrome than
others, and certain agents have a greater tendency than other to
produce severe disease.
4. Some viruses (measeles) may be associated. Varying amounts of
upper and lower respiratory tract symptomatology as part of a
general clinical picture involving the other organ systems.
a. Acute Nasopharyngitis
b. Acute Pharyngitis
d. Acute Uvulitis
e. Chronic rhinitis and Nasopharyngitis.
f. Retero pharyngeal abcess
g. Peritonsillar Abcess
i. Lateral pharyngeal abcess.
The Respiratory syncitial virus (RSV)
Is the principle single cause of bronchiolitis, accounting for about one
third of all cases. It is a common cause of pneumonia, croup and
bronchilitis as well as of undifferentiated febrile disease of the upper
The parainfluenza viruses account for most cases of the croup
syndrome but may also produce bronchitis bronchiolitis and febrile upper
respiratory tract disease.
The influenza viruses do not play a large part in the various
respiratory syndromes except during epidemics. In infants and children
influenza viruses account for more disease of the upper than the lower
The adenoviruses account for fewer than 10% of respiratory illness,
many of which are mild or asymptomatic. Pharyngitis and pharygno
conjuctival fever are the most common clinical manifestation in children
The rhinoviruse and cornaviruses
Usually produce symptoms limited to the upper tract, most commonly
the nose and account for a significant proportion of the ‘common cold’
Coxsakies viruses A and B
Produce primarily disease of naso pharynx
Can produce both upper and lower respiratory tract illness, including
- otitis media