Lower respiratory tract infections: What to know

Lower respiratory tract infections are any infections in the lungs or below the voice box. These include pneumonia, bronchitis, and tuberculosis.

A lower respiratory tract infection can affect the airways, such as with bronchitis, or the air sacs at the end of the airways, as in the case of pneumonia.

In this article, we look at the causes and symptoms of lower respiratory tract infections and discuss their treatments and prevention.

Symptoms

Symptoms of a less severe lower respiratory tract infection can include a dry cough, a low fever, and a runny nose.

Symptoms of lower respiratory tract infections vary and depend on the severity of the infection.

Less severe infections can have symptoms similar to the common cold, including:

a stuffed up or a runny nose

a dry cough

a low fever

a mild sore throat

a dull headache

In more severe infections, symptoms can include:

a severe cough that may produce phlegm

fever

difficulty breathing

a blue tint to the skin

rapid breathing

chest pain

wheezing

What are the signs of an upper respiratory infection?
In this article, we discuss upper respiratory tract infections.
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Upper vs. lower respiratory tract infections

Lower respiratory tract infections differ from upper respiratory tract infections by the area of the respiratory tract they affect.

While lower respiratory tract infections involve the airways below the larynx, upper respiratory tract infections occur in the structures in the larynx or above.

People who have lower respiratory tract infections will experience coughing as the primary symptom.

People with upper respiratory tract infections will feel the symptoms mainly above the neck, such as sneezing, headaches, and sore throats. They may also experience body aches, especially if they have a fever.

Lower respiratory tract infections include:

bronchitis

pneumonia

bronchiolitis

tuberculosis

Upper respiratory tract infections include the following:

common colds

sinus infections

tonsillitis

laryngitis

Flu infections can affect both the upper and lower respiratory tracts.

Causes and risk factors

Tobacco smoke can lead to a lower respiratory tract infection.

Infections in the lower respiratory tract are primarily the result of:

viruses, as with the flu or respiratory syncytial virus (RSV)

bacteria, such as Streptococcus or Staphylococcus aureus

fungal infections

mycoplasma, which are neither viruses or bacteria but are small organisms with characteristics of both

In some cases, substances from the environment can irritate or cause inflammation in the airways or lungs, which can lead to an infection. These include:

tobacco smoke

dust

chemicals

vapors and fumes

allergens

air pollution

Risk factors that make a person more likely to develop a lower respiratory tract infection include:

a recent cold or flu

a weakened immune system

being more than 65 years old

being under 5 years old

recent surgery

Diagnosis

A doctor will usually diagnose a lower respiratory infection during an exam and after discussing the symptoms a person has and how long they have been present.

During the exam, the doctor will listen to the person’s chest and breathing through a stethoscope.

The doctor may order tests to help diagnose the problem, such as:

pulse oximetry to find how much oxygen is in the blood

chest X-rays to check for pneumonia

blood tests to check for bacteria and viruses

mucus samples to look for bacteria and viruses

Treatment

Some lower respiratory tract infections go away without needing treatment. People can treat these less-severe viral infections at home with:

over-the-counter medications for a cough or fever

plenty of rest

drinking plenty of fluids

In other cases, a doctor may prescribe additional treatment. This may include antibiotics for bacterial infections, or breathing treatments, such as an inhaler.

In some cases, a person may need to visit the hospital to receive IV fluids, antibiotics, or breathing support.

Very young children and infants may need more treatment than older children or healthy adults.

Doctors often monitor infants especially closely if they have a higher risk of severe infections, such as premature infants or infants with a congenital heart defect. In these cases, a doctor may be more like to recommend hospitalization.

Doctors can also recommend similar treatment for people of 65 years of age and above or those individuals with weakened immune systems.

Recovery time

Recovery time for a lower respiratory tract infection varies from person to person.

According to the American Lung Association, a healthy young adult can recover from a lower respiratory tract infection, such as pneumonia, in around 1 week. For older adults, it may take several weeks to make a full recovery.

Prevention

Washing the hands frequently can help prevent lower respiratory tract infections.

A person can take many steps to prevent getting a lower respiratory tract infection, including:

washing their hands frequently

avoiding touching the face with unwashed hands

staying away from people with respiratory symptoms

cleaning and disinfecting surfaces regularly

getting vaccines, such as the pneumococcal vaccine and MMR vaccine

getting a flu shot every year

avoiding known irritants, such as chemicals, fumes, and tobacco

Complications

Most lower respiratory tract infections are uncomplicated. However, when complications occur, they can be very serious.

Complications of lower respiratory tract infections can include:

congestive heart failure

respiratory failure

respiratory arrest

sepsis, which is a blood infection that can lead to organ shutdown

lung abscesses

Outlook

Most healthy people make a full recovery from uncomplicated lower respiratory tract infections. However, complications can have long-term effects.

People who are most at risk for complications include people with other health conditions, adults over 65 years of age and children under 5 years old. These groups can take steps to prevent lower respiratory infections and can consult a doctor if they develop symptoms.

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