respiratory tract infection



Overview

A collective term for respiratory infections caused by a variety of pathogens. Respiratory symptoms such as nasal congestion, runny nose, cough, sputum, etc., as well as fever, malaise, muscle aches and pains are common. Upper respiratory infections usually have a better prognosis than lower respiratory infections, and the majority of people with lower respiratory infections also have a better prognosis.

Definition

Respiratory tract infection is a common disease of the respiratory system. It is a collective term for infections in the respiratory tract caused by a variety of pathogens (such as viruses, bacteria, atypical pathogens, and fungi), and can be further divided into upper respiratory tract infections and lower respiratory tract infections; different parts of the respiratory tract are infected with varying degrees of symptoms and different treatment methods.

The respiratory tract consists of the nose, pharynx, larynx, trachea-bronchus at all levels, and lungs, and is divided into two major parts, the upper respiratory tract consisting of the nose, pharynx, and larynx, and the lower respiratory tract mainly referring to the trachea, bronchus at all levels, and lungs, with the lower edge of the cricoid cartilage as the boundary [1].

Classification

Classification according to the site of onset

It can be divided into upper respiratory tract infection and lower respiratory tract infection.

The symptoms of the two are different. Generally speaking, the condition of upper respiratory tract infections is relatively mild, but if it fails to recover for a long period of time, it may be transformed into lower respiratory tract infections.

Upper Respiratory Tract Infection

It is a collective term for acute infections that occur in the upper respiratory tract and can be categorized as common cold, acute pharyngitis and laryngitis, acute herpes pharyngitis, acute pharyngoconjunctivitis, acute pharyngotonsillitis, influenza, etc.

Lower respiratory tract infections

These include acute tracheo-bronchitis, pneumonia, and lung abscess [2].

Chronic bronchitis is a non-specific inflammatory disease that is not necessarily caused by infection, so it is not generally considered to be a lower respiratory tract infection, even though it has the name “bronchitis”.

Morbidity

Respiratory tract infections comprise a wide range of diseases, and the pathogenesis of each disease is not identical.

Upper respiratory tract infections

Can occur throughout the year but are more prevalent in winter and spring, e.g., influenza virus, respiratory syncytial virus, and human coronavirus are more prevalent in winter, and rhinovirus occurs mainly in spring and fall [3].

Most are sporadic and can cause localized or widespread epidemics during sudden changes in climate. Patients are irrespective of age, sex, occupation and region.

Lower respiratory tract infections

According to the World Health Organization (WHO), lower respiratory tract infections are the disease with the highest incidence and total number of deaths from illness in the world in order of disease deaths, and were the fourth leading cause of death in the world in 2019, where it claimed 2.6 million lives in 2019, which is 460,000 fewer than in 2000 [4].

Lower respiratory tract infections are also one of the common infections in hospital-acquired infections, and the results of a large-scale cross-sectional survey of hospital-acquired infections in China showed that the prevalence of hospital-acquired lower respiratory infections among hospitalized patients ranged from 1.76% to 1.94% [5].

Questions you may be concerned about

What is the difference between respiratory infection cough and pneumonia cough?

Respiratory infections are categorized into upper respiratory tract infections and lower respiratory tract infections, which include pneumonia. The difference between an upper respiratory infection cough and a pneumonia cough is the difference in accompanying symptoms.

Patients with upper respiratory tract infection cough will be accompanied by fever, sore throat, sneezing, nasal congestion, runny nose and other symptoms, and occasionally a tickle in the throat caused by a slight cough. Usually the cough symptoms are not obvious, breathing is normal, and the cough lasts for a short period of time.

Cough caused by pneumonia generally affects the lung parenchyma, often manifested as a violent cough, accelerated respiratory rate, cough lasts for a long time, accompanied by dyspnea, dyspnea, nasal flap agitation, severe cyanosis of lips and lips, hypoxia, and even stimulation of the chest and abdomen to cause chest pain, abdominal pain and so on.

Therefore, if the patient has a cough and other related symptoms, it is necessary to consult a doctor in a timely manner to clarify the diagnosis and actively treat it.

What are the serious contraindications of respiratory tract infections

Respiratory tract infections are often caused by viruses and bacteria, fungi, respiratory tract infections serious contraindications are contraindicated smoking, contraindicated alcohol, contraindicated spicy stimulating food.

1. Avoid smoking: patients with respiratory tract infections, the entire respiratory mucosa is in a highly reactive state, especially when smoking, the nicotine in tobacco is easy to stimulate the respiratory tract, aggravating the condition.

2. Avoid alcohol: wine itself contains alcohol and other irritating ingredients, not only easy to stimulate the respiratory mucosa, but also easy to produce drug interactions with some of the drugs used by patients to treat infections (such as ceftriaxone, etc.), resulting in a disulfiram-like reaction, which can be life-threatening in severe cases.

3. Avoid spicy and stimulating food: spicy and stimulating food can also stimulate the respiratory mucosa, aggravate the condition.

It is recommended that patients with respiratory tract infections eat a light diet, avoid smoking and alcohol, and pay attention to rest. And aggravated need to consult a doctor in time, and follow the doctor’s instructions for treatment.

Causes

Causes

The main cause is the invasion of pathogenic microorganisms into the respiratory tract and reproduction. Common pathogenic microorganisms include bacteria, viruses, fungi and atypical pathogens.

In general, about 70% to 80% of upper respiratory tract infections are caused by viruses [6], whereas most of the lower respiratory tract infections are caused by bacteria and atypical pathogens, and the causative organisms usually invade the respiratory tract through air inhalation, blood transmission, and spreading from nearby infected sites.

Bacteria

Such as Haemolytic Streptococcus A, Streptococcus pneumoniae, Haemophilus influenzae, Klebsiella pneumoniae, Staphylococcus aureus, Pseudomonas aeruginosa, etc.

Viruses

Such as coronavirus, rhinovirus, respiratory syncytial virus, adenovirus, influenza virus, cytomegalovirus, herpes simplex virus, etc.

Fungi

e.g. Cryptococcus, Candida albicans, Pneumocystis, Aspergillus, Trichoderma, etc.

Atypical pathogens

Such as Mycoplasma, Chlamydia, Legionella, etc.

Triggering factors

Rain, cold, sudden change of climate, overwork, etc. can reduce the local defense function of the respiratory tract, resulting in the rapid reproduction of colonized viruses or bacteria, or direct contact with pathogen-carrying patients, sneezes, air, and contaminated hands and utensils induced the disease.

Risk factors

The risk factors for respiratory infections are not identical for the different disease types, but in general, the following groups are more likely to develop the disease.

Old and young people who are frail, or who are in close contact with sick people.

Exhaustion, exposure to cold, or prolonged exposure to crowded, poorly ventilated environments.

Suffering from underlying diseases (e.g. diabetes, chronic obstructive pulmonary disease, malignant tumors, immune and blood diseases, chronic diseases of the liver and kidneys, etc.).

Immunocompromised (e.g. using glucocorticoids or other immunosuppressive agents, or having diseases such as immunodeficiency syndrome).

Pathogenesis

Whether the disease develops after exposure to pathogens depends on the virulence and number of pathogenic pathogens on the one hand, and on the resistance of the body on the other.

Under normal circumstances, the endobronchial mucosa, cilia and intact intra-alveolar cellular defense, etc., constitute the respiratory immune defense mechanism, even if the exposure to a small number of pathogens, or there is a slight stimulus from the outside world, it is not easy to develop infectious inflammation.

If the local defense function of the respiratory tract decreases as a result of rain, cold, sudden change of climate, overwork, etc., or the immune function of the respiratory tract or even the whole body is impaired, respiratory tract infections may occur if they are exposed to a large number of pathogenic microorganisms with high virulence or if they are subjected to overly strong stimuli.

Pathogens can enter the respiratory tract through the air, bloodstream dissemination, spread of adjacent sites, and misinhalation of colonized bacteria, a process that can damage the trachea, bronchus, and alveoli or cause an immune response, etc., which in turn leads to respiratory tract inflammation.

Questions you may be concerned about

Can a respiratory infection cause 2+ occult blood in the urine?

Respiratory tract infections usually do not cause urinary occult blood 2+. Positive urinary occult blood is usually associated with urinary tract disease, glomerular disease, and strenuous exercise.

Urine occult blood 2 + refers to the presence of red blood cells in the urine, that is, hematuria, normal people in strenuous exercise, heavy physical labor, there may be a transient hematuria; glomerulonephritis, nephrotic syndrome and other glomerular diseases, urinary tract inflammation, stones or trauma can also cause urine occult blood 2 +.

Respiratory tract infections can be caused by bacteria, viruses, fungi and other pathogens, usually does not cause abnormal urine routine; but if the patient has tuberculosis, may also be secondary to urinary tract tuberculosis occult blood in urine.

Therefore, when respiratory tract infection or urine occult blood is positive, it is necessary to clarify the cause under the guidance of the doctor in order to actively treat.

Symptoms

Main Symptoms

Symptoms vary depending on the site of infection and the causative agent. Nasopharyngeal symptoms and pharyngolaryngitis symptoms predominate in upper respiratory tract infections [7], and pulmonary symptoms predominate in lower respiratory tract infections.

Nasopharyngeal Catarrhal Symptoms

Commonly found in common cold.

Mainly manifested as nasal congestion, sneezing, watery nasal discharge, but also may be manifested as cough, dry throat, throat itching or burning sensation or even postnasal drip sensation. watery nasal discharge becomes thicker after 2 to 3 days.

It may be accompanied by sore throat, headache, tearing, dulled sense of taste, dyspnea and hoarseness.

Pharyngitis Symptoms

Seen in acute pharyngitis, tonsillitis, pharyngitis, laryngitis and so on.

The main manifestations are sore throat, burning sensation in the throat accompanied by cough, sputum, and pain in swallowing. Often accompanied by fever, predominantly low fever, a few appear more than 39 ℃ high fever.

Acute pharyngitis, tonsillitis can appear tonsils enlarged and congested surface with purulent secretion.

Herpes pharyngitis can appear pharynx and tonsil surface gray-white herpes and ulcers.

Acute laryngitis may present with hoarseness and difficulty in speaking. Severe loss of voice with wheezing sounds in the larynx may occur.

Lung symptoms

Common in tracheo-bronchitis and pneumonia.

The main ones are cough, sputum, dyspnea, cyanosis, and chest pain.

Cough

May be a paroxysmal, irritating dry cough; in severe cases, the cough is persistent and severe and may interfere with sleep.

Cough and sputum

May occur after the onset of cough, with specific changes depending on the pathogen.

For example, rusty sputum may be a Streptococcus pneumoniae infection, and reddish brown jelly-like sputum may be a Klebsiella pneumoniae infection.

It may also present as bloody sputum or hemoptysis.

Cyanosis

Associated with hypoxia, the skin of the lips and fingers is cyanotic.

Dyspnea

There is an increased respiratory rate of >20 breaths/minute.

Changes in respiratory depth, either deep or shallow.

Changes in respiratory rhythm, e.g., inhibited breathing, sigh-like breathing, tidal breathing.

Chest pain

Can be caused by inflammation of the lungs, severe coughing, or complications such as pleurisy.

Systemic symptoms

Influenza is often characterized by systemic symptoms, and pneumonia is also common.

They may include fever, chills, chills, malaise, loss of appetite, and limb pain.

Complications

Due to the differences in anatomical location and pathogens, upper and lower respiratory tract infections often cause different complications.

Upper respiratory tract infection

Sinusitis, otitis media

If the disease spreads to the neighboring organs and tissues, it can cause otitis media, which is common in infants and young children, and may cause hearing loss, earache, tinnitus and other symptoms.

Repeated upper respiratory tract infections can easily lead to paranasal sinusitis, which may cause nasal congestion, runny nose, headache, decreased sense of smell and other symptoms.

Throat abscess

When purulent bacteria infect the throat, a few patients may form a pharyngeal abscess, which may present symptoms such as fever, sore throat and pharyngeal obstruction.

Rheumatic fever, glomerulonephritis

Rheumatic fever and glomerulonephritis can be caused by some infections caused by hemolytic streptococcus.

Rheumatic fever is mainly characterized by heart disease and arthritis.

Glomerulonephritis mainly manifests as abnormal urine, edema, and high blood pressure.

Viral myocarditis

Inadequate treatment or poor rest in a small number of patients can lead to damage to the heart muscle and cause viral myocarditis. Symptoms such as chest tightness, chest pain, palpitations, and fatigue may occur.

Lower respiratory tract infection

Pleurisy.

Inflammation of the lungs can seep out and cause pleurisy, often with chest pain on top of existing fever and cough.

Pyothorax

A bacterial infection that produces purulent exudate into the chest cavity, leading to symptoms such as high fever and dyspnea.

Lung Blisters

Some pneumonias can destroy the normal structure of the alveoli, with multiple alveoli rupturing and fusing, forming lung blisters and losing normal function.

Sepsis

Severe lung infections are prone to infectious shock, especially in the elderly, which manifests itself in the form of lowered blood pressure, cold extremities, even to the elbows and above the knees, excessive sweating, tachycardia, and cardiac arrhythmia.

Consultation

Department of Medicine

Respiratory Medicine

For symptoms such as obvious cough, sputum, dyspnea, chest pain, etc., it is recommended to consult a doctor promptly.

Ear, Nose and Throat

For symptoms such as nasal congestion, runny nose, sore throat, etc., it is recommended to consult a doctor promptly.

Family Medicine

If you experience the above symptoms, you may also consult the Department of Family Medicine first, and if necessary, you may need to go to other departments to confirm the diagnosis.

Emergency Medicine

When symptoms such as high fever, unconsciousness, irritability, cold and wet limbs, and oliguria occur, it is recommended that you go to the Emergency Department immediately, or call 120 for emergency medical help.

Preparation for medical treatment

Preparing for medical treatment: registration, preparation of documents, common problems

Tips for seeking medical treatment

Avoid taking fever-reducing drugs or antibiotics by yourself before seeking medical treatment, as this may affect the doctor’s judgment of the condition.

Patients with high fever can first take physical cooling, such as applying cold compresses to the forehead and wiping the hands, feet and armpits with lukewarm water.

Chest X-rays or chest CTs are often needed, so avoid wearing clothes made of metal, and inform your doctor if you are pregnant or preparing for pregnancy.

Preparation Checklist

Symptom list

Pay particular attention to the time of onset of symptoms, special manifestations, etc.

Is there fever? What is the highest degree?

Is there nasal congestion and runny nose? What is the color and nature of the nasal discharge?

Is there a cough? How long has the cough lasted?

Is there any phlegm? What kind of phlegm?

Is there any other discomfort?

How long have the symptoms lasted? Are there any factors that can aggravate or relieve it?

Medical History Checklist

Any recent exposure to cold or exertion?

Was there any exposure to cold or fever before the onset of the illness?

Are there any chronic diseases such as diabetes mellitus or chronic obstructive pulmonary disease?

Any long-term oral glucocorticoid, immunosuppressant or other drugs?

Checklist

Test results in the past six months, which can be brought to the doctor’s office

Laboratory tests: blood test, C-reactive protein, calcitonin, sputum bacterial culture + drug sensitivity test, influenza + parainfluenza virus nucleic acid, novel coronavirus nucleic acid

Imaging tests: Chest X-ray, Chest CT scan

Medication List

Medication used in the last 3 months, if there is a box or package, you can bring it with you to the doctor’s office

Antibiotics: e.g. penicillin, cefaclor, ceftazidime, azithromycin, moxifloxacin, vancomycin, etc.

Antipyretics: e.g., ibuprofen, acetaminophen, etc.

Nasal decongestants: e.g. pseudoephedrine nasal drops, etc.

Phlegmolytic drugs: e.g. Ambroxol, etc.

Diagnosis

Diagnostic basis

The diagnostic basis of different diseases is not exactly the same. Generally speaking, the clinical diagnosis can be made based on the patient’s history, epidemiological situation, respiratory and systemic symptoms and signs, combined with laboratory examination, chest X-ray or chest CT examination, and the pathogenetic examination can help to clarify the cause of the disease.

Upper respiratory tract infection

Medical history

There is a history of close contact with patients with upper respiratory tract infections, most often in winter and spring, and there may be triggers such as cold and fatigue before the onset of illness.

Clinical manifestations

Typical symptoms such as nasal congestion, sneezing, watery nasal discharge, cough, dry throat, itchy throat, sore throat, fatigue, fever and limb pain.

On physical examination, nasal mucosa congestion, pharyngeal congestion, edema; in acute tonsillitis, tonsils are seen to be enlarged, congested, with purulent secretion; some patients can palpate the submandibular and cervical enlarged lymph nodes, accompanied by pressure pain.

Laboratory tests

Blood counts may be normal, or the white blood cell count may be normal or low.

An elevated lymphocyte ratio is often suggestive of viral infection.

An increased white blood cell count and neutrophil ratio with a leftward shift of the nucleus suggests a high likelihood of bacterial infection.

C-reactive protein can reflect the degree of inflammatory infection and severity, the higher the value, suggesting that the more serious bacterial infection, viral infection C-reactive protein is generally not elevated.

Viral isolation, bacterial culture, viral serology, and drug susceptibility testing can be used to determine the type of virus or bacteria, but in most cases these tests are not necessary.

Imaging

Not routinely performed, but only when the presence of a lung infection is suspected, chest X-ray and CT are performed to confirm or rule out the diagnosis.

Lower respiratory tract infections

medical history

The following conditions may be present:

Previous close contact with a person with confirmed or suspected pneumonia.

Long-term use of immunosuppressive drugs and immunodeficiency diseases.

Cold, rain, or excessive fatigue prior to onset of illness.

Poor physical fitness or even prolonged bed rest.

Clinical manifestations

There are common symptoms such as cough, sputum, fever, etc., which may be accompanied by chills, chest pain, fatigue and poor appetite.

The respiratory rate may increase, and there may be bruising of the lips and mouth; bronchial breath sounds and wet rales may be heard in the chest.

Laboratory tests

Usually, blood routine, C-reactive protein, calcitoninogen, blood biochemistry, chest radiograph, chest CT, etc., and bronchoscopy, etc. may be required if necessary, which can be referred to lower respiratory tract infection.

Diagnostic criteria, grading and staging

The diagnostic criteria for different diseases are not identical, and can be found in the disease-specific terms.

Differential diagnosis

Upper and lower respiratory tract infections require different diseases to be differentiated. Sometimes, upper and lower respiratory tract infections need to be differentiated from each other.

Differential diagnosis of upper respiratory tract infections

Allergic rhinitis

Similarities: Continuous sneezing, itchy nose, nasal congestion, and profuse runny nose.

Differences: Allergic rhinitis has no fever and less cough. And it is mostly caused by allergic factors, such as mites, dust and other stimuli. After detaching from the allergens, the symptoms will disappear within a few minutes to 1~2 hours.

Cough variant asthma

Similarity: both can have cough.

Differences: Cough variant asthma often lasts for more than 2 months, cough is obvious at night or in the early hours of the morning, occasional chest tightness, no fever, dry throat, sore throat and other symptoms, the application of inhaled glucocorticosteroids can quickly relieve the symptoms.

Other acute infectious disease prodromal symptoms

Similarities: nasal congestion, headache, general malaise.

Differences: Measles, poliomyelitis, encephalitis, hepatitis and myocarditis can have nasal congestion, headache and other similar symptoms at the initial stage, usually within 1 week of the respiratory symptoms to reduce the emergence of new symptoms, with specific pathogenetic and serologic indicators, can be identified.

Differentiation of lower respiratory tract infections

Tuberculosis

Similarities: both may present with fever, malaise, cough and other symptoms.

Differences: Tuberculosis is slower, with low-grade fever in the afternoon, accompanied by night sweats, weight loss, loss of appetite, etc. It can be differentiated by the detection of mycobacteria through antacid bacillus smear, mycobacteria culture, and nucleic acid test.

Pulmonary thromboembolism

Similarity: both may have symptoms such as dyspnea and hemoptysis.

Differences: Pulmonary thromboembolism often has a history of braking, trauma, surgery, tumor, lower extremity venous thrombosis, etc. Elevated D-dimer can reveal a tendency to thrombosis, and CT pulmonary arteriography, radionuclide lung ventilation/perfusion scanning, and MRI can help to differentiate.

Lung cancer

Similarities: Both may present with prolonged cough, fever and chest pain.

Differences: Lung cancer often occurs in people who have smoked for a long time and are of advanced age; it may also present with chest pain and hemoptysis. Imaging examination can find nodules, enlarged hilar lymph nodes and other changes; sputum exfoliative cells and histopathological examination can find malignant tumor cells, which can lead to a clear diagnosis.

Treatment

Treatment purpose: cure the disease, control or relieve the symptoms and prevent complications.

Treatment principle: upper respiratory tract infection is mainly symptomatic treatment, lower respiratory tract infection needs to be based on different pathogens, combined with the specific conditions, choose the appropriate anti-infective drugs, and give symptomatic treatment at the same time.

Upper respiratory tract infection

General treatment

Patients with fever, severe condition or old and frail patients should rest in bed, avoid exertion and reduce strenuous exercise.

Consume light and easy-to-digest food and drink plenty of water.

Keep indoor air circulating and prevent catching cold.

Medication

The treatment of upper respiratory tract infection is mainly to improve the symptoms and prevent secondary bacterial infection.

Antipyretic and analgesic drugs

For headache, fever, muscle aches and pains.

Commonly used drugs such as acetaminophen, aspirin, ibuprofen and so on. However, aspirin is contraindicated in children to prevent Reye’s syndrome. Ibuprofen should not be used by pregnant women.

Common adverse reactions include gastrointestinal irritation.

Anti-allergy drugs

Suitable for patients with frequent sneezing and more nasal discharge.

Commonly used drugs such as chlorpheniramine maleate or diphenhydramine.

Common adverse reactions include dizziness, drowsiness, etc. It is generally recommended to take them before going to bed.

Cough expectorant treatment

For those with thick and sticky phlegm that is not easy to cough up, expectorants such as Ambroxol Hydrochloride and N-Acetyl Cysteine can be used to promote the expulsion of phlegm.

When coughing is obvious, it is necessary to use cough suppressants such as dextromethorphan and compound licorice combination at the discretion of the doctor according to the condition, and should not be used on its own, especially for those with a lot of phlegm, and blindly suppressing coughing may cause airway obstruction.

N-acetylcysteine is contraindicated in patients with asthma.

Decongestants

Nasal mucosal congestion, edema, severe nasal congestion affecting breathing and sleep, can choose pseudoephedrine hydrochloride and other drugs nasal drops.

Avoid prolonged application, easy to cause nasal mucosa atrophy.

Antiviral drugs

Antiviral therapy need not be applied to patients without fever and with normal immune function, and should be used early in immunodeficient patients.

Antiviral drugs such as ribavirin can be used as appropriate.

Definite influenza virus infection can be applied early with oseltamivir, zanamivir and paramivir.

Antibacterial drugs

For those with bacterial infection such as elevated white blood cells, pus in the throat, coughing up yellow sputum.

Oral penicillins, first/second generation cephalosporins, macrolides or quinolones such as amoxicillin, cefradine, cefuroxime, azithromycin and moxifloxacin may be used empirically.

Quinolone antibiotics are contraindicated under the age of 18.

Chinese medicine treatment

According to the diagnosis and treatment, take Chinese medicine treatment, the specific treatment should be carried out under the guidance of Chinese medicine doctors.

Lower respiratory tract infection

General treatment

Influenza viral pneumonia and novel coronavirus pneumonia are contagious and should be isolated as required by the doctor. Other statutory infectious diseases are isolated according to the law.

Keep the respiratory tract open and give oxygen to those who show signs of hypoxia.

For those with respiratory distress, choose conventional oxygen therapy, transnasal high-flow oxygen therapy, non-invasive ventilation or invasive mechanical ventilation according to the severity of hypoxia, and use extracorporeal membrane oxygenation (ECMO) if necessary.

Pay attention to rest, drink more water, increase nutrition, choose food with sufficient calories and easy to digest. Ensure adequate intake of high quality protein. Eat more fresh vegetables and fruits.

Medication

The treatment of lower respiratory tract infections is mainly to relieve symptoms, control disease progression, prevent and reduce complications. Among them, anti-infective treatment is the key treatment for lower respiratory tract infections.

Symptomatic treatment

Antipyretics such as ibuprofen, acetaminophen, and loxoprofen may be used for fever.

Those with nasal congestion can use drugs to reduce nasal mucosal congestion and antihistamines, such as pseudoephedrine hydrochloride and chlorpheniramine.

For cough and phlegm, coughing and expectorant drugs can be used, such as compound licorice combination, aminoglutethimide and so on.

Antibacterial drugs

Including empirical treatment and anti-pathogen treatment. Sensitive antimicrobial drugs should be used as prescribed by the doctor, and the following categories are commonly used [8].

β-lactams: including penicillins, cephalosporins, and amoxicillin-clavulanate potassium, etc.

Macrolides: such as erythromycin, roxithromycin, azithromycin, and clarithromycin.

Quinolones: such as moxifloxacin, levofloxacin, norfloxacin, etc.

Tetracyclines: such as tetracycline, doxycycline, minocycline, etc.

Antiviral drugs

Viral pneumonia can be treated with antiviral drugs such as oseltamivir, acyclovir and ganciclovir.

Antifungal drugs

Anti-fungal drugs can be used as prescribed by the doctor in case of fungal infections in the lungs.

Antifungal drugs include fluconazole, itraconazole, voriconazole and posaconazole.

Chinese medicine treatment

Pneumonia has more common symptoms in Chinese medicine. When choosing Chinese medicine treatment, professional Chinese medicine practitioners are required to identify and treat the symptoms.

Possible proprietary Chinese medicines used are such as Shuo Feng Dui Toxin Relief Capsule, Tong Xuan Li Lung Pill, and Qing Lung and Anti-inflammatory Pill [9].

Questions you may be concerned about

What kind of medicine can be taken to treat respiratory tract infection with bronchitis?

Respiratory tract infection with bronchitis may need to be treated with cough suppressants, phlegm removers, and antibiotics, etc., which need to be combined with specific conditions.

1. Cough and phlegm medication, respiratory tract infections with bronchitis will often have coughing and phlegm symptoms, you can use drugs such as Ambroxol for symptomatic treatment to promote the expulsion of phlegm.

2. Anti-infection treatment, respiratory tract infection with bronchitis for bacterial infection, may need to use cefixime sodium and other antibiotics; for mycoplasma infection, may need to use azithromycin, moxifloxacin and other antibiotic treatment.

Therefore, when the respiratory tract infection with bronchitis, you need to consult a doctor in time to assess the specific condition and then targeted treatment. The above drugs need to be standardized and rationally applied under the guidance of professional physicians and pharmacists.

What kind of medicine does a six-year-old child take for respiratory tract infection?

The cause of respiratory tract infection in a six-year-old child may be caused by bacterial infection or viral infection, according to the cause of the disease were given antibiotic drugs such as cefixime, antiviral drugs such as oseltamivir, and so on.

1. Bacterial infections: if caused by bacterial infections, antibiotics such as cefixime can be used, and if combined with mycoplasma infections, azithromycin and other drugs can be used.

2. Viral infections: If the respiratory tract infections caused by viruses, generally symptomatic treatment is the main, can also use oseltamivir phosphate and other antiviral drugs.

It is recommended that children with respiratory infections should seek medical attention promptly to avoid delays. Please note that the above drugs must be used under the guidance of a doctor or pharmacist, and should not be used at random.

How to treat a 2-year-old child with recurrent respiratory infections and fever?

The 2-year-old child respiratory tract infection recurrent fever, can be seen in the acute upper respiratory tract infection, lower respiratory tract infection, the treatment needs to be carried out according to the cause, such as bronchopneumonia caused by Mycoplasma pneumoniae infection, the need to use azithromycin anti-infective treatment.

1. Acute upper respiratory tract infection: such as acute suppurative tonsillitis, clinical recurrence of fever, may be accompanied by sore throat, examination can be seen in the tonsils are enlarged, can be seen in the purulent secretion, improve the infection indicators can be seen to be elevated, the treatment needs to be used in amoxicillin and other anti-infective, and at the same time during the course of the disease needs to be used in the use of ibuprofen reasonable fever, the use of the open-throat sword sprays to alleviate the discomfort in the pharynx, the symptom.

2. Lower respiratory tract infections: bronchopneumonia caused by Mycoplasma pneumoniae infection, the above symptoms can be seen in the clinic, often accompanied by coughing, perfect chest X-ray and Mycoplasma pneumoniae antibody examination, sputum culture, respiratory viral nucleic acid PCR can assist in the diagnosis of bacterial infections can be given piperacillin to anti-infection, if considered mycoplasma infection can be given azithromycin to anti-infection.

Viral infections are mainly treated with symptomatic supportive therapy, such as oxygen inhalation, ambroxol nebulization, sputum aspiration, etc. For influenza A virus infection, oseltamivir can be used to counteract infection as prescribed by the doctor, and ibuprofen or acetaminophen can be used to reasonably reduce the fever if there is fever.

3. Others: If congenital bronchial stenosis, repeated respiratory tract infections with fever may occur in the clinic, bronchoscopic lavage examination can be perfected and lavage treatment can be given at the same time.

The above drugs should be used under the guidance of a physician, 2-year-old children with recurrent respiratory tract infections and fever, it is recommended to actively seek medical attention, evaluation and treatment by a specialist physician.

Prognosis

Cure

Most upper respiratory tract infections can be cured without sequelae, but some frail patients, or those who do not receive timely and standardized treatment, may develop lower respiratory tract infections or become chronic.

Bronchitis and pneumonia can mostly be cured after treatment, and most of the lungs will not be left with damage, and the structure and function can be restored to normal.

However, pneumonia caused by Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Aspergillus may lead to necrotic lesions in the lung tissues, forming cavities or fibrosis. In a few cases, the disease may develop into a serious and even life-threatening condition.

Prognostic factors

Alcoholism, smoking, advanced age, and immunosuppressed status may lead to a worse prognosis.

Hazards

Viral infections can be spread by droplet transmission, which can easily cause group morbidity.

With underlying diseases, such as chronic obstructive pulmonary disease (COPD), asthma, bronchiectasis, nephritis, etc., acute exacerbations can be induced by respiratory infections.

In cardiac insufficiency, exacerbation of heart failure may occur.

Nasal congestion, cough, fever and other symptoms can affect work and life when they are severe.

Daily

Daily management

Life management

Most respiratory infections are contagious and close contact with immunocompromised people such as children, the elderly and pregnant women should be avoided as much as possible.

Wear a mask when going out and cover the mouth and nose when coughing to prevent causing transmission.

Rest in bed during the fever period and reduce physical exertion. After the fever subsides, you can resume activities gradually.

Maintain a good work routine, ensure sufficient sleep time, and avoid exertion and staying up late.

Ventilate the room, and keep the temperature and humidity at a suitable level to minimize cold air and other stimuli and prevent cold.

If you already have high blood pressure, diabetes and other diseases, you need to follow the doctor’s requirements, the full amount of regular medication, and follow up on time, do not stop taking medication on your own because of symptomatic relief, to avoid relapse.

Diet management

Pay attention to the nutritional balance of the diet, the diet should be light, more protein, vegetables and fruits.

Eat less high salt and fried food. Abstain from alcohol, strong tea and coffee, and avoid raw garlic, ginger, chili peppers and curry.

Drink an adequate amount of water, 7 to 8 glasses (1500 to 1700 ml) per day for adults, advocate drinking plain water and tea, do not drink or drink less sugary drinks.

Smoking cessation

Strictly quit smoking and avoid exposure to “second-hand smoke”.

Disease monitoring

Watch for a decrease in temperature, cough and other symptoms. If symptoms worsen or new symptoms appear, consult a doctor.

Follow-up

Regular follow-ups will help you understand your condition and how you are recovering. For lower respiratory tract infections, blood tests, C-reactive protein, chest X-ray or chest CT are usually repeated 1 to 2 weeks after discharge from the hospital, or at regular intervals as recommended by the doctor.

Prevention

Most respiratory infections cannot be completely prevented, but proper protection can reduce the chance of developing them.

Avoid contact with people with respiratory infections when going out and avoid crowds. Wash your hands regularly. Do not share cups, cutlery, etc. [10].

Moderate exercise can be performed according to one’s own situation, and it is recommended to perform more aerobic exercise such as jogging, swimming, brisk walking, yoga, square dancing, etc. to improve physical fitness.

Those who meet the indications for vaccination can be prevented by injecting influenza vaccine and pneumococcal vaccine.

For patients with frequent and recurrent upper respiratory tract infections, immune preparations such as BCG, bacterial hemolysates, etc. can be applied as appropriate, and those with indications can be injected with respiratory polyvalent bacterial vaccine.