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Liliana Rios, M.D. – PGY-1 July 24 - 2008
 
CASE: Mr. Sniffle, 35 y.o. male ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
QUIZ What is the most likely diagnosis? a. influenza b. acute bacterial sinusitis c. the common cold d. pneumonia e. asthma
QUIZ What is the most likely diagnosis? a. influenza b. acute bacterial sinusitis c.  the common cold d. pneumonia e. asthma
Definition: the common cold benign self-limited syndrome caused by members of several families of viruses Mild upper respiratory viral illness
Symptoms: the common cold ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Symptoms: the common cold* Day 1 *  Epidemiol Infect 1993 Aug;111(1):143-56
Symptoms: the common cold* Day 2 to 3 *  Epidemiol Infect 1993 Aug;111(1):143-56
Symptoms: the common cold* Day 4 to 5 * Epidemiol Infect 1993 Aug;111(1):143-56 ,[object Object]
QUIZ: the common cold What is the most common culprit? a. rotavirus b. coronavirus c. rhinovirus d. echovirus e. influenza virus
QUIZ: the common cold What is the most common culprit? a. rotavirus b. coronavirus c.  rhinovirus d. echovirus e. influenza virus
Virology  *4,5 * 4  Lancet 2003 Jan 4;361(9351):51-9.  * 5  Lancet Infect Dis. 2005 Nov;5(11):718-25.   
Seasonal Patterns Fall, late spring :  Rhinovirus Parainfluenza  Winter, spring:  RSV, coronavirus Summer:  Enterovirus  (year) Adenovirus:  Outbreaks in Military facilities daycare centers, hospital
Facts: the common cold ,[object Object],[object Object],[object Object],[object Object],[object Object],*Ann Allergy Asthma Immunol 1997 Jun;78(6):531-9;
Diferential diagnosis: the common cold ,[object Object],[object Object],[object Object],[object Object]
But how do I know it’s just a cold? Mod-Severe Mild Chest discomfort/ cough Common Common Sore throat Sometimes Common  Sneezing Common Common Nasal congestion Usual Unusual Extreme fatigue May last 3 wks Mild Malaise Severe Mild Myalgia Usual Rare Headache 39-40 o Rare Fever INFLUENZA COLD
Facts: Influenza ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Facts: Influenza Vaccine All of the mentionated before  Plus Health care workers Pregnant women in second or third trimestrer
But how do I know it’s just a cold? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
But how do I know it’s just a cold? ,[object Object],[object Object],[object Object],[object Object]
[object Object],Airway reactivity *1 Vs Acute asthma attacks exacerbations Up to 40% of viral upper resp infection *2 *1 Am J Respir Crit Care Med 1995 May;151(5):1666-73; discussion 1673-4.    *2 Chest 1997 Sep;112(3):591-6.
Complications Sinusitis:  Acute bacterial sinusitis develops in 0.5 to 2.5 percent of adult patients after viral  *1   Lower respiratory tract disease : RSV, elderly (CHF)  and  immunocompromised Acute otitis media:  Eustachian tube dysfunction; *1 J Allergy Clin Immunol 1998 Sep;102(3):403-8.
QUIZ: the common cold ,[object Object],[object Object],[object Object]
QUIZ: the common cold ,[object Object],[object Object],[object Object],* Prim Care 1996 Dec;23(4):657-75
FACTS: transmission* ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],*Epidemiol Rev 1988;10:243-58.
FACTS: the common cold ,[object Object],[object Object],*1 Am J Epidemiol 1989 Feb;129(2):319-40.  *2 Prim Care 1996 Dec;23(4):657-75.
FACTS: the common cold ,[object Object],[object Object],* Arch Intern Med. 2003 Feb 24;163(4):487-94. ,[object Object],[object Object],[object Object],[object Object]
QUIZ: the common cold ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
QUIZ: the common cold ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Treatment: the common cold ,[object Object],[object Object],*1  Cochrane Database Syst Rev. 2005 Jul 20;(3):CD000247.
Treatment: what might work ,[object Object],[object Object],[object Object],[object Object],[object Object]
Treatment: what might work ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],*1 Cochrane Database Syst Rev 2004;(3):CD001953 *2 Cochrane Database Syst Rev 2004;(3):CD001953 *3 Arch Fam Med. 1998 Jan-Feb;7(1):39-43.   
Treatment: what  WON’T  work ,[object Object],[object Object],[object Object],*1 Chest. 2006 Jan;129(1 Suppl):72S-74S *2  Chest. 2006 Jan;129(1 Suppl):72S-74S
Treatment: what  WON’T  work ,[object Object],[object Object],[object Object],[object Object],[object Object],*1 J Gen Intern Med 1996 Apr;11(4):240-4.  
Treatment: the common cold ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],*1  Cochrane Database Syst Rev. 2007 Jul 18;(3):CD000980.    *2  Am J Med. 2006 Nov;119(11):937-42.   
Treatment: the common cold ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],*1 Cochrane Database Syst Rev. 2006 Jan 25;(1):CD000530.  *2  Laryngoscope. 2006 Feb;116(2):217-20.
Case Conclusion: Mr. Sniffle ,[object Object],[object Object],[object Object],[object Object]
 

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Common Cold

  • 1. Liliana Rios, M.D. – PGY-1 July 24 - 2008
  • 2.  
  • 3.
  • 4. QUIZ What is the most likely diagnosis? a. influenza b. acute bacterial sinusitis c. the common cold d. pneumonia e. asthma
  • 5. QUIZ What is the most likely diagnosis? a. influenza b. acute bacterial sinusitis c. the common cold d. pneumonia e. asthma
  • 6. Definition: the common cold benign self-limited syndrome caused by members of several families of viruses Mild upper respiratory viral illness
  • 7.
  • 8. Symptoms: the common cold* Day 1 * Epidemiol Infect 1993 Aug;111(1):143-56
  • 9. Symptoms: the common cold* Day 2 to 3 * Epidemiol Infect 1993 Aug;111(1):143-56
  • 10.
  • 11. QUIZ: the common cold What is the most common culprit? a. rotavirus b. coronavirus c. rhinovirus d. echovirus e. influenza virus
  • 12. QUIZ: the common cold What is the most common culprit? a. rotavirus b. coronavirus c. rhinovirus d. echovirus e. influenza virus
  • 13. Virology *4,5 * 4 Lancet 2003 Jan 4;361(9351):51-9. * 5 Lancet Infect Dis. 2005 Nov;5(11):718-25.  
  • 14. Seasonal Patterns Fall, late spring : Rhinovirus Parainfluenza Winter, spring: RSV, coronavirus Summer: Enterovirus (year) Adenovirus: Outbreaks in Military facilities daycare centers, hospital
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  • 17. But how do I know it’s just a cold? Mod-Severe Mild Chest discomfort/ cough Common Common Sore throat Sometimes Common Sneezing Common Common Nasal congestion Usual Unusual Extreme fatigue May last 3 wks Mild Malaise Severe Mild Myalgia Usual Rare Headache 39-40 o Rare Fever INFLUENZA COLD
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  • 19. Facts: Influenza Vaccine All of the mentionated before Plus Health care workers Pregnant women in second or third trimestrer
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  • 23. Complications Sinusitis: Acute bacterial sinusitis develops in 0.5 to 2.5 percent of adult patients after viral *1   Lower respiratory tract disease : RSV, elderly (CHF) and immunocompromised Acute otitis media: Eustachian tube dysfunction; *1 J Allergy Clin Immunol 1998 Sep;102(3):403-8.
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