A variety of viruses and bacteria can cause upper respiratory tract infections including acute bronchitis, the common cold, influenza, and respiratory distress syndromes. • Defining most of these patient diseases is difficult because the presentations connected with upper respiratory tract infections (URIs) commonly overlap and their causes are similar. • Upper respiratory tract infections can be defined as self-limited irritation and swelling of the upper airways with associated cough with no proof of pneumonia, lacking a separate condition to account for the patient symptoms, or with no history of COPD/emphysema/chronic bronchitis. Influenza Viruses • Small hairs (cilia) in the sinuses fail to properly move mucus out. This may be due to some medical conditions. • Colds and allergies may cause too much mucus to be made or block the opening of the sinuses. • A deviated nasal septum, nasal bone spur, or nasal polyps may block the opening of the sinuses. Why should you do the Skin Prick Test? SPT is an essential test procedure to find sensitization in IgE-mediated allergic disease in subjects with Hay fever (allergic rhinitis), asthma, rhinoconjunctivitis, Dermatitis (eczema), anapylaxis, urticaria, atopic eczema and food and drug allergy. Procedure for skin prick test This is not a painful test. A needle(lancet) is used to prick your skin during the test which is not at all painful or you lose any blood. Follow are the steps of the test. • Your skin is cleaned by alcohol • A nurse/technician marked your skin and put a drop of allergen beside every mark • Using a lancet the technician pricks your skin to allow a tiny amount of the solution to enter just below the surface • Now you should wait for a specific amount of time. Usually 30 min. • Now your allergist checks the marks for a observes your skin for signs of allergic reactions. If you are allergic to one of the substances tested, you’ll develop a raised, red, itchy bump (wheal) that may look like a mosquito bite. A nurse will then measure the bump’s size. • After the recording of the result, the nurse/technician clean your testing surface with alcohol

1. UPPER RESPIRATORY TRACT
INFECTIONS
By
Gopal Khodve
M.S.Pharmacology & Toxicology

2. INTRODUCTION
 An upper respiratory tract infection (URTI) is an illness
caused by an acute infection, which involves the upper
respiratory tract, including the nose, sinuses, pharynx,
or larynx.
 This commonly includes nasal obstruction, sore throat,
tonsillitis, pharyngitis, laryngitis, sinusitis, otitis media,
and the common cold.
2

3. What is URTIS?
3

4. Influenza
Common Cold
Sinusitis
Rhinitis
Pharyngitis
Laryngitis
Otitis
INFECTIONS IN URT
4

5. INFLUENZA
 Flu is a contagious respiratory illness
caused by influenza viruses that infect the
nose, throat, and sometimes the lungs. It
can cause mild to severe illness, and at
times can lead to death.
 Influenza is an infectious diseases caused by RNAviruses of
the family Orthomyxoviridae(the influenza)
5

6. Types of Influenza virus
 There are four types of influenza viruses: A, B, C
and D.
 Human influenza A and B viruses cause
seasonal epidemics of disease (known as the flu
season)
 Influenza A viruses are the only influenza
viruses known to cause flu pandemics, i.e.,
global epidemics of flu disease.
6

7. PATHOPHYSIOLOGY
Influenza Virus
Enters the respiratory system from an infected individual
through respiratory droplets.
The virus attaches to and replicates in columnar epithelial
cells
The virus replicates in cells of both upper and lower
respiratory tract
The viral replication combines with the immune
response (both humoral and cell mediated)to
infection
7

8. Leads to destruction and loss of cells lining of the respiratory tract
Release of cytokines
cause local inflammatory response as well as systemic toxic symptoms
such as acute onset of high fever, systemic soreness and pain, and
decreased WBC count.
8

9. Signs & Symptoms
 Fever
 Cough
 Sore throat
 Runny or stuffy nose
 Muscle or body aches
 Headaches
 Fatigue (tiredness)
9

10. COMPLICATIONS IN INFLUENZA
 Sinusitis
 Bronchitis
 Primary viral pneumonia
 Secondary bacterial pneumonia
 Asthma flare-ups
 Otitis media
10

11. • Rapid Influenza Diagnostic Tests
• RT-PCR
• Viral culture
• Rapid antigen testing
• Immunofluorescence assays
Diagnostic tests
11

12. COMMON COLD
• The common cold, also known simply as a cold, is a viralinfectious
disease of the upper respiratory tract. Although many types of
viruses can cause a common cold, rhinoviruses are the
most common culprit.
• That primarily affects the respiratory mucosa
of the nose, throat, sinuses, and larynx.
• Signs and symptoms may appear less than two
days after exposure to the virus.
Rhinovirus 12

13. Transmission of Rhinoviruses
13

14. Pathophysiology
14

15. Conti.
Small number of virus infected cells
elaborate a variety of cytokines
Initiating a host inflammatory
response, which bring about
Chemotaxis and expression of
endothelial adhesion receptor
molecules resulting in the typical
common cold symptoms. 15

16. Signs & Symptoms
16

17. SINUSITIS
• Sinusitis is present when
the tissue lining the
sinuses become swollen or
inflamed.
• It occurs as the result of
an inflammatory reaction
or an infection from a
virus, bacteria, or fungus.
17

18. Types of Sinusitis
3
2
1
when the swelling is present between one and three
months. This condition commonly occurs with
bacterial infections or seasonal allergies.
Subacute Sinusitis
when the swelling of the sinuses is present
for longer than 3 months. It may be caused
by bacteria or a fungus.
Chronic Sinusitis
when symptoms are present for 4 weeks
or less. It is caused by bacteria growing in
the sinuses.
Acute Sinusitis
18

19. Common causes of Sinusitis
19

20. Pathophysiology
Due to risk factor and etiological factors
Inflammation and edema
Nasal congestion
Obstruction of nasal sinus
Provide medium for bacterial growth
Symptoms and signs will appear
20

21. Stages of sinusitis
21

22. Signs & Symptoms
22

23. Diagnostic tests
• Physical examination
• Nasal endoscopy
• Imaging studies:- CT-Scan
• Nasal and sinus samples
• Allergy testing
23

24. RHINITIS
• Inflammation of the
nasal mucosa.
• Rhinitis is a group of
disorders characterized
by inflammation and
irritation of the mucous
membranes of the nose.
24

25. Types of Rhinitis
25

26. Pathophysiology
• Pathological changes observed are nasal airway epithelial metaplasia in which goblet
cells replace ciliated columnar epithelial cells in the nasal mucous membrane. This results
in mucin hypersecretion by goblet cells and decreased mucociliaryactivity. 26

27. 27

28. Sign & Symptoms
28

29. Diagnostic tests
• Skin prick test
• Blood test
• Nasal inspiratory flow test
• Nasal endoscopy
29

30. Pharyngitis
• Pharyngitis is the inflammation of
the mucous membranes of the
oropharyn.
• It typically results in a sore
throat and fever. In most cases,
the cause is an infection, either
bacterial or viral.
30

31. Etiology
Viruses are responsible Bacteria's are responsible
31

32. Difference in bacterial & Viral infection
32

33. Sign & Symptoms
Pharyngitis
33

34. Diagnosis
• Physical Examination
• Rapid antigen detection test
• Blood Test
• Throat Culture
34

35. Laryngitis
• Laryngitis is an inflammation
of your voice box (larynx)
from overuse, irritation or
infection.
35

36. Etiology
• Viral infection
• Bacterial Infection
• Common cold
• Strep throat(Tonsils)
36

37. Signs and Symptoms
37

38. Otitis Media
• An infection of the air-filled
space behind the eardrum
(the middle ear).
• Otitis media is a common
complication of upper
respiratory tract infection
whose pathogenesis involves
both viruses and bacteria.
38

39. Etiology
• An ear infection is caused
by a bacterium or virus in
the middle ear.
• This infection often results
from another illness — cold,
flu or allergy — that causes
congestion and swelling of
the nasal passages, throat
and eustachian tubes. 39

40. Pathophysiology
Viral/Bacterial Infections of URTIS
Eustachian tubes get infected & Swells
Due to this decrease in ventilation in
middle ear
This leads to increase negative pressure in
middle ear
Due to this inflamed mucosa and build-up
of mucosal secretions
This leads to middle ear viral infections
Due to this fluid accumulate 40

41. Sign & Symptoms
41

42. Diagnosis
• Tympanometry
• Acoustic reflectometry
• Hearing test
• Pneumatic otoscope
42

43. Thank
you
Thank
you
43