Background
- Mild and self limited URTI characterised by nasal stuffiness and discharge, sneezing, sore throat and cough
- Most common in young children (3-8 per child per year), but still incredibly common in adults (~2-4 per person per year); more common in winter months
- Caused by a wide range of pathogens
- Rhinovirus most common (50-80%)- huge variety (over 100 subtypes)
- Coronavirus (10-15%)- can be a cause of SARS
- Respiratory Syncytial Virus (RSV) (5%)- more common in children
- Parainfluenza viruses; adenoviruses; enteroviruses; metapneumovirus
- Unknown (~20%)
- Transmitted via direct contact, small particle aerosols and large particle aerosols.
Presentation
- Sore/irritated throat (often first)
- Nasal irritation, congestion, discharge and sneezing
- Often profuse and clear initially, then becomes thicker and more purulent later on
- Hoarseness
- Cough typically develops after nasal symptoms
- Malaise/feeling unwell
- NB Fever is unusual, headache and myalgia may be present but are usually mild
- Features of complications e.g. sinusitis (frontal head pain) or conjunctivitis may be present
Examination and Investigations are often not required
In Children
- Restlessness/Irritability; Fever (more common in children)
- Severe nasal congestion may interfere with feeding, breathing and sleep
- Occasionally vomiting can follow coughing fits
- There may also be lymphadenopathy but examination of the throat is classically normal (examine also for acute otitis media/ear infection)
Management
- Antipyrexials and analgesia (paracetamol and/or ibuprofen) may or may not be required
- Otherwise, the common cold is self-limiting- symptoms tend to peak after 2-3 days then improve, although can take a while (>2 weeks) to resolve
Complications
- Sinusitis
- CAP
- Acute otitis media in young children
- Bronchiolitis, pneumonia and croup in very young infants/babies
- Asthma exacerbation
Notes on Medicine/Surgery 