Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2004 Jun;21(3):317-23.
doi: 10.1093/fampra/cmh319.

Acute respiratory symptoms in adults in general practice

Affiliations

Acute respiratory symptoms in adults in general practice

Ching-Ye Hong et al. Fam Pract. 2004 Jun.

Abstract

Background: Community studies have shown that approximately 30% of patients with acute respiratory tract symptoms have no identifiable infective aetiology. This may not be applicable in general practice.

Objective: The purpose of this study was to determine the infective aetiology in patients who presented to primary care doctors with acute respiratory symptoms.

Methods: A prospective study was carried out in all nine primary care clinics belonging to the National Healthcare Group Polyclinics (NHGPs) in Singapore. The subjects comprised 594 consecutive patients (318 males, 276 females) aged > or = 21 years who presented with complaints of any one of cough, nasal or throat symptoms of <7 days duration. Data collection was through interview using structured questionnaire, physical examination, throat swabs for bacterial culture and nasal swabs for virus identification by immunofluorescence (IF) and polymerase chain reaction (PCR). Additional PCR was performed on a subsample of 100 patients. Patients were followed-up until resolution of symptoms.

Results: The aetiological diagnosis by infective agent is as follows: 150 patients (25.2%) had virus infections, of which 90.7% (136/150) were by rhinovirus. Fourteen patients (2.4%) had bacterial infections, of which 10 were due to group G streptococcus. Group A streptococcus was not detected. Nineteen patients with new pathogens were identified by further PCR. These included parainfluenza 4, human coronavirus OC43, adenovirus, enterovirus and Chlamydia pneumoniae. No pathogen could be identified in 49% of patients. There were no differences in clinical presentation and socio-demographic variables between patients who had viral infections and those in whom no pathogen could be identified.

Conclusion: In about half of patients who presented at NHGPs, no pathogens could be identified even after PCR. A non-infective aetiology could be considered in these patients.

PubMed Disclaimer

References

    1. Heikkinen T, Järvinen A. The common cold. Lancet 2003; 361:51–59. - PMC - PubMed
    1. Badger GF, Dingle JH, Feller AE et al A study of illness in a group of Cleveland families. II. Incidence of the common respiratory deseases. Am J Hyg 1953; 58:31–40. - PubMed
    1. Monto AS, Cavallaro JJ. The Tecumseh study of respiratory illness. II. Patterns of occurrence of infection with respiratory pathogens, 1965–1969. Am J Epidemiol 1971; 94:280–289. - PubMed
    1. Mäkelä MJ, Puhakka T, Ruuskanen O et al Viruses and bacteria in the etiology of the common cold. J Clin Microbiol 1998; 36:539–542. - PMC - PubMed
    1. Gray GC, Schulz RG, Gackstetter GD et al Prospective study of respiratory infections at the U.S. Naval Academy. Mil Med 2001; 166:759–763. - PubMed

Publication types