Common Cold

Introduction

• Mild self-limiting upper respiratory tract infection
• Mostly viral especially Rhinovirus
• Diagnosis mainly by clinical history

Signs and symptoms

• General malaise
• Sore and irritated throat
• Nasal discharge (rhinorrhoea) which may lead to sneezing
• Clear and profuse (becomes thicker)
• Cough
• Hoarse voice (due to laryngitis)

Differential diagnosis

• Meningitis
  • pre-verbal: high fever; drowsiness; blank, staring expression; vomiting and loss of appetite; high-pitched screaming; floppiness; a tense or bulging fontanelle; or a non-blanching rash
  • Verbal and adults: fever, vomiting, stiff neck, photophobia, severe headache, muscular pains, fits, abdominal cramps, and/or confusion
• Influenza (suspect if fever and/or myalgia predominates)
• Streptococcal pharyngitis (sore throat predominates)
• Allergic rhinitis (rhinorrhoea 2 weeks or more)
• Glandular fever (prolonged fever, a severe sore throat, fatigue, and cervical lymphadenopathy)
• Whooping cough (persistent cough)

Natural history

• Rapid onset
• Symptoms peaking after 2–3 days
• Typically resolving after 7 days in adults and 14 days in younger children
• A mild cough may persist for 3 weeks

Treatment

• Self-limiting
• Antibiotic does not have
• Symptomatic relief
  • Analgesia
  • Non-medical (Over the counter)
    • Vapour rub
    • Steam inhalation
    • Menthol
    • Gargling with salt water
  • Medical
    • Intra-nasal decongestion
    • Oral decongestion