Common Cold

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
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