The Common Cold
Evaluation
General—the common cold is a lay term for mild upper respiratory illness.
Clinical—self-limited disease restricted to the upper respiratory tract; mean duration is 7 to 10 days.
Frequent symptoms—nasal discharge and congestion, sneezing, sore throat, and cough
Less frequent symptoms—hoarseness, headache, malaise, myalgia, lethargy, and fever
Etiology—heterogeneous viral illness; common viral causes include:
Rhinovirus (30%-50%)
Coronavirus (10%-15%)
Influenza virus (5%-15%)
Respiratory syncytial virus (RSV) (5%)
Parainfluenza virus (5%)
Adenovirus (<A onclick="get_content(event,'AB1-M12'); return false;" onmouseover="window.status=this.title; return true;" onmouseout="window.status=''; return true;" title="<5%)
Enterovirus (<A onclick="get_content(event,'AB1-M12'); return false;" onmouseover="window.status=this.title; return true;" onmouseout="window.status=''; return true;" title="<5%)
Unknown (20%-30%)
Epidemiology
Incidence is inversely proportional to age.
Rate of infection increases rapidly in the fall and remains high in the winter (temperate zone).
Risk factors—day care, psychologic stress, and so on
Transmission
Hand contact with secretions (often transmits infection)
Large-particle aerosols (transmits infection less often)
Small-particle aerosols
Diagnosis—clinical; can use rapid antigen detection kits.
Specimens of choice—nasopharyngeal aspirates and nasal wash specimens
Complications—although usually self-limiting, bacterial complications such as the following may arise:
Otitis media (the most common bacterial complication in children)
Sinusitis
Pneumonia
Asthma or chronic obstructive pulmonary disease (COPD) exacerbation
Treatment—targets symptoms; no antibiotics given viral etiology (unless complications suspected)
Antitussives (control or prevent cough; indicated if cough is creating significant discomfort)
Nonopioid
Opioid
Expectorants (promote expulsion of phlegm)
