2. • 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-limited
Correct termed Rhino-sinusitis
4. 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.
5. • 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.
6. • 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
8. Etiology Key Points on History or
Physical ExaminationI
Infections
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 signs
Allergy
Allergic rhinitis History of atopy, itchy and watery eyes, allergic
facies, nasal eosinophilia
Structural
Foreign body Unilateral, foul-smelling
Anatomic (polyp, adenoids) Duration (>2 mo), often unilatera
Systemic Disease
Cystic fibrosis or immune Failure to thrive, duration (>2 mo), diarrhea,
pneumonia, and other infections
10. Laboratory Findings
ROUTINE 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.
11. Treatment
The management
of the common
cold consists
primarily of Symptomatic Treatment:
symptomatic Antiviral Treatment
treatment
Ineffective Treatments
12. 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.
13. 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.
14. 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.
15. • Vitamin C, guaifenesin, and inhalation of warm,
humidified air .
• Zinc,
• Echinacea
16. • 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.
18. Important consequence of the
common 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
19. • Chemoprophylaxis or • Handwashing is
immunoprophylaxis is commonly
generally not available recommended for
for the common cold prevention of colds