Upper respiratory tract infection

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In ENT, everyone can hear you scream.


The upper respiratory tract is a common place for infections, and a big cause of GP consultations. Whilst there are lots of names such as laryngitis and sore throat, clinically they tend to be treated pretty similarly; hence the lumping together as upper respiratory tract infections.



Really common - most people get one a year. More common in small children. As a GP you will see at least one of these in an average clinic, so it will be in the exam!


The majority are viral, and thus are basically not treated. Commonly adenovirus and rhinovirus, although there are loads.

Risk Factors

  • Being a child.

That's about it

Clinical Features

  • The key one is a sore throat.
  • Fever for several days.
  • Big ole lymph nodes.
  • Purulent tonsils (got pus on the tonsils)
  • Sometimes ear ache, which points to them having otitis media


Generally none. If doesn't respond to antibiotics any getting worse, will probably be referred to hospital for all kinds of test. Don't worry about it.


Mostly: do nothing.

Centor criteria

There is a set of criteria determining whether or not to give antibiotics:

  • tonsillar exudate (pus on tonsils)
  • tender anterior cervical lymph nodes
  • absence of cough
  • history of fever

3 or more and there's a fair chance is a Streptococcal infection, so you give amoxicillin (or cephalosporins in allergic patients.


You will be fine. Unless you have epiglottitis so always have this in the back of your mind...