Pediatric Acute Upper Respiratory Infections: Symptoms, Treatment, and When to Seek Medical Help

Upper respiratory tract infections (URTIs) are among the most common illnesses in children, particularly during seasonal transitions. These infections primarily affect the nose, throat, and sinuses and are especially prevalent in infants and young children due to their developing immune systems. Understanding the symptoms and appropriate management strategies is crucial for parents and caregivers.

Common Symptoms in Infants and Young Children

In younger infants and toddlers, upper respiratory infections often present with more severe systemic symptoms rather than localized ones. High fever is a hallmark sign, sometimes spiking to 39–40°C (102.2–104°F). This elevated body temperature can lead to reduced appetite, irritability, and gastrointestinal disturbances such as nausea and vomiting.

One of the most concerning complications in this age group is febrile seizures—brief convulsions triggered by a rapid rise in body temperature. While these episodes are typically short-lived and not harmful in the long term, they can be extremely distressing for parents and require immediate medical evaluation to rule out more serious conditions.

Symptoms in Older Children

As children grow older, the presentation of URTIs tends to shift toward more localized symptoms. School-aged children commonly experience nasal congestion, runny nose, sore throat, and cough. Fever may still occur but is generally milder compared to infants, and the risk of febrile seizures significantly decreases.

These children may also complain of headaches, fatigue, and difficulty sleeping due to blocked nasal passages. Despite feeling unwell, many older kids maintain their appetite and hydration, which supports faster recovery.

Viral vs. Bacterial Causes

The vast majority of upper respiratory infections in children are caused by viruses, including rhinovirus, influenza, and respiratory syncytial virus (RSV). Because antibiotics are ineffective against viral pathogens, treatment focuses on symptom relief rather than eradication of the infection.

Antiviral medications may be considered in specific cases, especially during flu season or in high-risk patients. Over-the-counter remedies such as acetaminophen or ibuprofen can effectively reduce fever and alleviate discomfort.

When to Seek Medical Attention

While most URTIs resolve on their own within 7–10 days, certain red flags warrant prompt medical consultation. Persistent high fever lasting more than three days, signs of dehydration, labored breathing, or lethargy should not be ignored.

In such cases, a healthcare provider may recommend a complete blood count (CBC) to assess for signs of bacterial infection. If evidence of bacterial involvement—such as elevated white blood cell count—is found, antibiotic therapy may be initiated to prevent complications like sinusitis or otitis media.

Supportive Care and Prevention Tips

Ensuring adequate fluid intake, maintaining a comfortable room temperature, and using saline nasal sprays can help ease symptoms. Humidifiers may also provide relief from nasal congestion, especially in dry indoor environments.

Preventive measures such as regular handwashing, avoiding close contact with sick individuals, and staying up to date with vaccinations—including the annual flu shot—are essential in reducing the frequency and severity of upper respiratory infections in children.

By recognizing the differences in symptom presentation across age groups and knowing when to seek professional care, parents can better support their child's recovery and minimize unnecessary anxiety during illness.