Respiratory Problems, Age 12 and Older

Topic Overview

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, ears, sinuses, and throat) or the lower bronchial tubes and lungs. See a picture of the respiratory system.

Upper respiratory system

The upper respiratory system includes the nose, ears, 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 include:

• Facial pain or pressure.
• A runny or stuffy nose, which may lead to blockage of the nasal passages and cause you to breathe through your mouth.
• A sore throat.
• Irritability, restlessness, poor appetite, and decreased activity level.
• Coughing, especially when lying down.
• Fever that occurs suddenly and may reach 39°C (103°F) or higher.

Lower respiratory system

The lower respiratory system includes the bronchial tubes and lungs. Respiratory problems are less common in the lower respiratory system than upper respiratory system.

The symptoms of a lower respiratory (bronchial tubes and lungs) problem usually are more severe than symptoms of an upper respiratory (ears, nose, sinuses, and throat) problem.

Symptoms of lower respiratory system infections include:

• Cough, which continues throughout the day and night, often producing green, yellow, brown, or grey mucus (sputum) from the lungs.
• Fever, which may be high with some lower respiratory system infections, such as pneumonia.
• Difficulty breathing. You may notice:
  • Shortness of breath.
  • Grunting, which is heard during the breathing out (exhaling) phase of breathing.
  • Wheezing.
  • Flaring the nostrils and using the neck, chest, and abdominal muscles to breathe, causing a "sucking in" between or under the ribs (retractions).
• Chest pain with exertion or when you take a deep breath.

Respiratory problems may have many causes.

Viral infections

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).

• Colds are minor upper respiratory illnesses that usually go away without treatment. Symptoms may include cough, mild sore throat, nasal congestion, runny nose or sneezing, and occasionally a fever of 38°C (101°F) or lower.
• Influenza (flu) symptoms are usually more severe than a cold. The key symptoms in adults are fever, often 40°C (104°F) or higher, and body aches. Headache, eye pain, muscle aches, and cough are also common. For more information, see the topic Influenza.

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 antibiotic-resistant bacteria.

Severe acute respiratory syndrome (SARS) is caused by a type of coronavirus, a family of viruses that often cause mild to moderate upper respiratory illness, such as the common cold. For more information, see the topic Severe Acute Respiratory Syndrome (SARS).

Bacterial infections

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 ears, sinuses, and throat. In the lower respiratory system, the most common sites are the bronchial tubes (bronchitis) and the lungs (pneumonia).

Bacterial infections are more common in smokers, people exposed to second-hand 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.

Allergies

Allergies, especially 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 Allergic Rhinitis.

Asthma

Asthma is a 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 the topic Asthma in Children or Asthma in Teens and Adults.

Review the Emergencies and Check Your Symptoms sections to determine if and when you need to see a doctor.

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Author:	Jan Nissl, RN, BS	Last Updated: March 26, 2008
Medical Review:	William M. Green, MD - Emergency Medicine H. Michael O'Connor, MD - Emergency Medicine
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