Upper respiratory infections (URIs)
Upper respiratory infections (URIs) are usually caused by viruses such as cold viruses, influenza or COVID‑19, but
sometimes bacteria like group A strep or sinus bacteria are to blame infections. At your visit, your doctor
will ask about a runny or stuffy nose, sore throat, cough, fever, chills, body aches, headache, sneezing, hoarseness,
facial pressure or fatiguehttps://my.clevelandclinic.org/health/diseases/4022-upper-respiratory-infection#:~:text=Symptoms%20of%20upper%20respiratory%20infections,can%20includehttps://healthcare.utah.edu/primary-care/upper-respiratory-infections#:~:text=Upper%20Respiratory%20Infection%20Symptoms. They will examine your ears and throat
and feel your lymph nodes, check your temperature, and listen to your heart and lungshttps://healthcare.utah.edu/primary-care/upper-respiratory-infections#:~:text=Your%20health%20care%20provider%20performs,to%20check%20for%20bacterial%20infections. Most
URIs are diagnosed clinically and don’t require testing, but if you have a bad sore throat, fever or swollen glands,
your doctor may do a rapid strep test or throat culture. Nasal or throat swabs for flu, COVID‑19 or RSV may be done
during the first few days of symptomshttps://my.clevelandclinic.org/health/diseases/4022-upper-respiratory-infection#:~:text=Diagnosis%20and%20Tests. Labs like a complete blood count are not usually
necessary, but your provider may order one if you are very ill or have risk factors. If symptoms persist or your doctor
suspects a more serious problem, they may order a chest X‑ray to rule out pneumonia or, for chronic sinus problems, a
sinus CT scan.
Most URIs are viral and improve with supportive care. Your doctor will recommend rest, hydration, and over‑the‑counter
medicines: acetaminophen or ibuprofen for fever and aches, decongestants and antihistamines for stuffy or runny nose,
and cough suppressants if a cough is keeping you uphttps://healthcare.utah.edu/primary-care/upper-respiratory-infections#:~:text=Over. Saline nasal rinses, humidifiers and
warm fluids can ease congestion and soothe sore throatshttps://healthcare.utah.edu/primary-care/upper-respiratory-infections#:~:text=Upper%20Respiratory%20Infection%20Supportive%20Therapy. For bacterial infections like strep
throat or bacterial sinusitis, a course of antibiotics may be prescribed after a positive
testhttps://my.clevelandclinic.org/health/diseases/4022-upper-respiratory-infection#:~:text=How%20do%20you%20treat%20upper,respiratory%20tract%20infections. Antiviral medications for influenza (for example, oseltamivir) are reserved for
high‑risk patients and must be started within the first two days of symptoms. Your provider will advise against
unnecessary antibiotics for viral infections.
Testing is usually minimal. When symptoms and exam raise concern, your doctor may perform a rapid antigen test or throat
culture for group A streptococcal pharyngitis, or a nasal swab for influenza, COVID‑19 or RSVhttps://my.clevelandclinic.org/health/diseases/4022-upper-respiratory-infection#:~:text=Diagnosis%20and%20Tests.
A complete blood count might be ordered if there is a high fever or suspected bacterial infection. Additional tests
(such as a monospot for mononucleosis or sinus culture) are rarely needed. No routine blood work is required for typical
viral colds.
Imaging is not part of routine URI care. A chest X‑ray may be done if you have trouble breathing, chest pain or your
doctor hears abnormal lung sounds, to check for pneumonia. A sinus CT scan may be recommended for recurrent or chronic
sinusitis that doesn’t improve with medical treatmenthttps://my.clevelandclinic.org/health/diseases/4022-upper-respiratory-infection#:~:text=When%20should%20I%20see%20my,healthcare%20provider.
Call your doctor if your symptoms are severe, last more than two weeks or come back
frequentlyhttps://my.clevelandclinic.org/health/diseases/4022-upper-respiratory-infection#:~:text=When%20should%20I%20see%20my,healthcare%20provider. High fever over 103 °F (40 °C), difficulty breathing, chest pain, noisy breathing
(wheezing or stridor), dizziness, confusion or pulling in of the skin between ribs (retractions) require urgent medical
attentionhttps://my.clevelandclinic.org/health/diseases/4022-upper-respiratory-infection#:~:text=,to%20the%20ER. Persistent ear pain or swelling of the face, or a deep, productive cough, may
indicate complications like ear infection or pneumonia and should be evaluated.
Most viral URIs resolve on their own within one to two weeks. Follow up with your primary care provider if symptoms last
longer than 10–14 days, get worse after starting to improve, or if you have underlying conditions that put you at higher
risk for complications. There is usually no routine follow‑up unless antibiotics were prescribed, in which case your
doctor may check in within a few days to ensure the infection is responding.
You can reduce your risk of catching or spreading a URI by getting recommended vaccinations such as the influenza and
COVID‑19 vaccines, washing your hands often, disinfecting frequently touched surfaces, avoiding sharing cups or
utensils, and staying home when you’re sickhttps://my.clevelandclinic.org/health/diseases/4022-upper-respiratory-infection#:~:text=Can%20upper%20respiratory%20tract%20infections,be%20prevented. Wearing a mask in crowded places or if you have
symptoms helps prevent transmission. Maintaining a healthy immune system by eating a balanced diet, staying active,
sleeping well and not smoking also lowers your risk. During cold and flu season, avoid close contact with people who are
ill.
Most URIs can be managed by your primary care provider. They will advise on symptom relief and, if necessary, prescribe
antibiotics or antivirals. You may be referred to an ear, nose and throat (ENT) specialist if you have recurrent sinus
infections, chronic ear problems or suspected structural issues. Urgent care or emergency services are appropriate for
severe symptoms or complications. Your provider may also coordinate testing for influenza, COVID‑19 or other respiratory
infections and provide guidance on isolation to protect others.