Respiratory tract infections: when to see a doctor

In the winter months, pneumonia and ‘flu are some of the most common reasons to be admitted into hospital. It’s important for all patients to recognise the signs and know when to get medical advice – so this article by consultant respiratory specialist Dr Ben Marshall provides a brief guide.

What are the commonest respiratory tract infections?

Respiratory tract infections generally affect either or both of:

• the upper respiratory tract - nasal passages and throat
• lower respiratory tract - trachea, bronchial walls and alveolar air sacs.

The commonest causative organisms are:

• bacteria – such as pneumococci, haemophilus and staphylococci
• viruses – such as influenza, rhinovirus (common cold virus), respiratory syncytial virus (often a cause of wheezy bronchiolitis in infants) and human metapneumovirus.

As diagnostic aids become more sophisticated, we recognise that some individuals can have more than one concurrent infection. All of these infections occur more commonly during the winter months, particularly as we spend more time indoors and in closer contact with each other, making it easier for the bugs to transmit themselves from person to person.

What are the symptoms?

The symptoms are generally the same regardless of the cause of the infection, with common manifestations being fever, cough, snuffles, breathlessness and chest pain, often with generalised aches and tiredness.

How are they caused?

Most of these infections are transmitted from one infected person to another, through coughing and sneezing – but also by hand contact with surfaces (e.g. computer keyboards and stair rails) contaminated by the germs which then can be transferred to the mouth and face.

What can I do at home for a respiratory tract infection?

Most respiratory tract infections are self-limiting and don’t need antibiotic treatment. Important supportive measures include the use of analgesics which also serve to control fever (paracetamol), fluids to keep well hydrated, and bed rest. Decongestants and cough linctus will often alleviate symptoms too.

A small proportion of vulnerable persons might need antibiotics or even hospital admission. These include those with pre-existing medical conditions such as asthma and the frail elderly.

When would I need to see a doctor?

I would recommend that persons who have a pre-existing medical condition and develop a respiratory tract infection consult their GP early for advice. Additionally, those persons whose symptoms either worsen or don’t respond to conventional supportive measures should seek advice – and arrange a consultation and examination.