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Most adults and older
children have several respiratory infections each year. Respiratory problems
can be as minor as the common cold or as serious as
pneumonia. They may affect the upper respiratory
system (nose, mouth, sinuses, and throat) or the lower bronchial tubes and
lungs. See a picture of the
The upper respiratory system
includes the nose, mouth, sinuses, and throat. When you have an upper
respiratory infection, you may feel uncomfortable, have a stuffy nose, and
sound very congested. Other symptoms of an upper respiratory infection
The lower respiratory system
includes the bronchial tubes and lungs. Respiratory problems are less common in
the lower respiratory system than upper respiratory system.
symptoms of a lower respiratory (bronchial tubes and lungs) problem usually are
more severe than symptoms of an upper respiratory (mouth, nose, sinuses, and
Symptoms of lower respiratory system infections
Respiratory problems may have many causes.
Viral infections are the most common
cause of upper respiratory symptoms. Symptoms of a viral illness often come on
quickly (over hours to a day or two) without prior illness. Common viral
illnesses include colds and influenza (flu).
Antibiotics are not used to treat viral illnesses and do
not alter the course of viral infections. Unnecessary use of an antibiotic
exposes you to the risks of an
allergic reaction and antibiotic side effects, such as
nausea, vomiting, diarrhea, rashes, and yeast infections. Antibiotics also may
kill beneficial bacteria and encourage the development of dangerous
Bacterial infections may develop
after a viral illness, such as a cold or influenza, and are less common than
viral illnesses. Bacterial infections may affect the upper or lower respiratory
system. Symptoms tend to localize to one area. In the upper respiratory system,
the most common sites of bacterial infections are the sinuses and throat. In
the lower respiratory system, the most common site is the lungs (pneumonia).
Bacterial infections are more
common in smokers, people exposed to secondhand smoke, and people with chronic
lung disease (such as
asthma or chronic obstructive pulmonary disease [COPD]) and other chronic medical problems. Antibiotics
can effectively treat most bacterial infections.
hay fever, are another common respiratory problem. Symptoms include
sneezing, clear runny drainage from the nose and eyes, itchy eyes or nose, and
stuffy, congested ears and sinuses. The symptoms of allergies often last longer
than a typical viral respiratory infection. For more information, see the topic
chronic disease of the respiratory system. It causes
inflammation and narrowing in the tubes that carry air
to the lungs (bronchial tubes). The inflammation leads to difficulty breathing,
wheezing, tightness in the chest, and cough.
Asthma often begins during childhood and may last throughout a person's
life. The cause of asthma is not clearly known. It is more common in people who
also have allergies. For more information, see the topic
Asthma in Children or
Asthma in Teens and Adults.
Check your symptoms to decide if and when
you should see a doctor.
Based on your answers, the problem may not improve without medical
Symptoms of a severe allergic reaction
(anaphylaxis) may include:
A severe reaction can be life-threatening. If you have had a
bad allergic reaction to a substance before and are exposed to it again, treat
any symptoms as an emergency. Even if the symptoms are mild at first, they may
quickly become very severe.
Many things can affect how your body responds to a symptom and what kind
of care you may need. These include:
Based on your answers, you need
or other emergency services now.
Symptoms of serious illness may
Temperature varies a little depending on how you measure it.
For adults and children age 12 and older, these are the ranges for high,
moderate, and mild, according to how you took the temperature.
Oral (by mouth) temperature
Ear or rectal temperature
Armpit (axillary) temperature
Symptoms of a heart attack may
The more of these symptoms you have, the more likely it is that
you're having a heart attack. Chest pain or pressure is the most common
symptom, but some people, especially women, may not notice it as much as other
symptoms. You may not have chest pain at all but instead have shortness of breath, nausea, numbness,
tingling, or a strange feeling in your chest or other areas.
It is easy for your diabetes to become out of control when
you are sick. Because of an illness:
Certain health conditions and medicines weaken the immune system's ability to fight off infection and
illness. Some examples in adults are:
You have answered all the questions. Based on your answers, you may be
able to take care of this problem at home.
Severe trouble breathing means:
Moderate trouble breathing means:
Mild trouble breathing means:
Pain in adults and older children
An illness plan for people with diabetes usually covers things like:
The plan is designed to help keep your diabetes in control even
though you are sick. When you have diabetes, even a minor illness can cause
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
Symptoms of difficulty breathing can range from mild to severe. For example:
If you're not sure if a fever is high, moderate, or mild,
think about these issues:
With a high fever:
With a moderate fever:
With a mild fever:
Based on your answers, you need
After you call
911 , the operator may tell you to chew 1 adult-strength (325 mg) or 2
to 4 low-dose (81 mg) aspirin. Wait for an ambulance. Do not try to drive yourself.
Based on your answers, you may need care soon. The
problem probably will not get better without medical care.
Home treatment can help you feel
more comfortable when you have mild to moderate respiratory symptoms.
Keep in mind the following guidelines for taking
nonprescription medicine for your symptoms:
Many people use
alternative medicines or supplements to prevent colds or to shorten their cold
symptoms. Before using any treatment for your cold symptoms, it is important to
consider the risks and benefits of the treatment. For more information, see the
Complementary Medicine. Some of the common alternative
medicines or supplements used are:
If you decide to use an alternative medicine or supplement,
follow these precautions:
Call your doctor if any of the following occur during home
There is no sure way to prevent
respiratory illnesses. To help reduce your risk:
To prepare for your appointment, see the topic Making the Most of Your Appointment.
You can help your
doctor diagnose and treat your condition by being prepared to answer the
Singh M, Das RR (2011). Zinc for the common cold. Cochrane Database of Systematic Reviews (3).
Davidson TM, Smith WM (2010). The Bradford Hill criteria and zinc-induced anosmia: A causality analysis. Archives of Otolaryngology—Head and Neck Surgery, 136(7): 673–676.
February 7, 2013
William H. Blahd, Jr., MD, FACEP - Emergency Medicine
& David Messenger, MD
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