• The common cold is a viral illness in which the Prominent nasal symptoms => rhinorrhea and nasal obstruction; Mild or absent systemic symptoms = > headache, myalgia, and fever. Self-limitedCorrect termed Rhino-sinusitis
Reflecting the seasonal prevalence• Early fall until the late spring, (RHINOVIRUS ) .• Late fall and late spring (IV , PIV , RSV ).• The incidence :• Young children have an average of 6-8 colds per year, but 10-15% of children have at least 12 infections per year.• The incidence of illness decreases with age, with 2 to 3 illnesses per year by adulthood.• Mannose-binding lectin deficiency with impaired innate immunity may be associated with an increased incidence of colds in children.
• Spread by small-particle aerosols, large-particle aerosols, and direct contact.• Infections with rhinoviruses and adenoviruses (NOT BY IV,PIV, RSV )result in the development of serotype-specific protective immunity. But Repeated infections due to a large number of distinct serotypes of each virus.• Viral infection of the nasal epithelium can be associated with destruction of the epithelial lining, as with influenza viruses and adenoviruses, BUT no apparent histologic damage, as with rhinoviruses and RSV.• acute inflammatory response appears to be responsible for S/S .• Inflammation can obstruct the sinus ostium or eustachian tube and predispose to bacterial sinusitis or otitis media.
• IP=> 1-3 days after viral • The physical findings of infection. the common cold are• The 1st symptom noted is often limited to the upper sore or scratchy throat, respiratory tract. followed closely by nasal obstruction and rhinorrhea. • Increased nasal secretion• The sore throat usually is usually obvious; a resolves quickly and, by the change in the color or 2nd and 3rd day of illness, consistency of the nasal symptoms predominate. secretions is common• Cough is associated with during the course of the ∼30% of colds and usually begins after the onset of nasal illness and does not symptoms. indicate sinusitis or• The usual cold persists for bacterial superinfection. about 1 wk, although 10% last • Examination of the nasal for 2 wk. cavity might reveal swollen, erythematous nasal turbinates, although
Etiology Key Points on History or Physical ExaminationIInfections Sinusitis Age (>2 yr), duration (>10 days), high fever, unilateral headache, or facial tenderness, nasal discharge Pharyngitis (streptococcal) ) Exudate, petechiae, tender cervical lymph nodes, minimal congestion Pneumonia (viral or bacterial) Respiratory signsAllergy Allergic rhinitis History of atopy, itchy and watery eyes, allergic facies, nasal eosinophiliaStructural Foreign body Unilateral, foul-smelling Anatomic (polyp, adenoids) Duration (>2 mo), often unilateraSystemic Disease Cystic fibrosis or immune Failure to thrive, duration (>2 mo), diarrhea, pneumonia, and other infections
Laboratory FindingsROUTINE LAB STUDY &SUSPECTED Routine laboratory polymerase chain studies are not helpful for reaction (PCR), culture, the diagnosis and antigen detection, or management of the serologic methods. common cold. Bacterial cultures or A nasal smear for antigen detection are eosinophils may be useful useful only when group A if allergic rhinitis is streptococcus , Bordetella suspected . pertussis or nasal diphtheria is suspected.
TreatmentThe managementof the commoncold consistsprimarily of Symptomatic Treatment:symptomatic Antiviral Treatmenttreatment Ineffective Treatments
NASAL OBSTRUCTION • Either topical or oral adrenergic FEVER agents can be used as nasal• Not indicated EXCEPT decongestants.• COMPLICATION & H/O • Effective topical adrenergic FS agents such as xylometazoline, oxymetazoline, or phenylephrine are available as either intranasal drops or nasal sprays. • > 2 YEARS . • Saline nose drops (wash, irrigation) can improve nasal symptoms.
RHINORRHOEA SORE THROAT• The first-generation • Treatment with mild antihistamines reduce analgesics is occasionally rhinorrhea by 25-30% indicated, particularly if there BUT not second is associated myalgia or generation . headache.• The major adverse effect is sedation, but less • The use of acetaminophen bothersome in children during rhinovirus infection than in adults . has been associated with• Ipratropium bromide, a suppression of neutralizing topical anticholinergic , antibody responses, antihistamines NON sedative agent.
COUGH• Cough suppression is • cough that persists for generally not necessary in days to weeks after the patients with colds. acute illness and might• Treatment with a first- benefit from generation antihistamine bronchodilator therapy . may be helpful. • The combination of• Sugar-containing cough camphor, menthol, and drops or honey as a eucalyptus oils may demulcent may be relieve nocturnal cough. temporarily effective.
• Vitamin C, guaifenesin, and inhalation of warm, humidified air .• Zinc,• Echinacea
• Specific antiviral therapy has no role in the treatment of the common cold.• Antibacterial therapy is of no benefit in the treatment of the common cold.
• OTITIS MEDIA ,• SINUSITIS ,• Exacerbation of asthma
Important consequence of thecommon cold• is the inappropriate use of antibiotics for these illnesses and the associated contribution to the problem of increasing antibiotic resistance of pathogenic respiratory bacteria
• Chemoprophylaxis or • Handwashing is immunoprophylaxis is commonly generally not available recommended for for the common cold prevention of colds