Common cold

Last reviewed: 6 Sep 2022
Last updated: 29 Mar 2022

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • acute onset
  • rhinitis
  • sore throat
  • sneezing
  • post-nasal drainage/drip
  • cough
  • fever
  • non-specific red pharynx
  • nasal mucosal oedema/erythema
  • purulent drainage in nares and posterior pharynx
  • pulse <100 bpm; no hypotension
More key diagnostic factors

Other diagnostic factors

  • malaise
  • myalgia
  • halitosis
  • inflamed tonsils
Other diagnostic factors

Risk factors

  • exposure to affected individuals
  • young age
  • winter season
  • day care attendance
  • exposure to cigarette smoke or other respiratory irritants
More risk factors

Diagnostic investigations

1st investigations to order

  • no initial test
More 1st investigations to order

Investigations to consider

  • FBC
  • throat swab
  • sputum culture
  • heterophile antibody test
  • C-reactive protein (CRP)
  • chest x-ray
  • sinus CT scan
  • viral testing
More investigations to consider

Treatment algorithm

ACUTE

all patients

Contributors

Authors

Bruce Arroll, MBChB, PhD, FRNZCGP

Professor

Department of General Practice and Primary Health Care

University of Auckland

Auckland

New Zealand

Disclosures

BA is an author of a number of references cited in this topic.

Timothy Kenealy, MBChB, PhD, FRNZCGP

Associate Professor of Integrated Care

Department of General Practice and Primary Health Care

University of Auckland

Auckland

New Zealand

Disclosures

TK is an author of a number of references cited in this topic.

Peer reviewers

Christopher Cates, MA, FRCGP

Senior Research Fellow

Division of Community Health Sciences

St. George's University of London

London

UK

Disclosures

CC declares that he has no competing interests.

Christopher Del Mar, MA MB, BChir MD, FRACGP, FAFPHM

Professor

Faculty of Health Sciences and Medicine

Bond University

Queensland

Australia

Disclosures

CDM declares that he has no competing interests.

An De Sutter, MD, PhD

Associate Professor

Department of General Practice and Primary Health Care

Ghent University

Belgium

Disclosures

ADS declares that she has no competing interests.

Greg Poland, FRCOG

Mary Lowell Leary Endowed Professor

General Internal Medicine

Paediatrics

Mayo Clinic

Rochester

MN

Disclosures

GP has no competing interests in regards to the common cold. He does consult with a variety of manufacturers and performs research studies related to influenza, founded by vaccine manufacturers, none of which involves virus related to the common cold.

Peter Dicpinigaitis, MD

Professor of Clinical Medicine

Albert Einstein College of Medicine

Director

Intensive Care Unit

Weiler Division/Montefiore Medical Center

Bronx

NY

Disclosures

PD has served as a consultant to Reckitt Benckiser, Procter & Gamble, Wyeth Pharmaceuticals, Novartis, Glaxo SmithKline, and Boehringer Ingelheim.

  • Differentials

    • Coronavirus disease 2019 (COVID-19)
    • Hay fever (allergic rhinitis)
    • Chronic sinusitis
    More Differentials
  • Guidelines

    • Pharmacologic and nonpharmacologic treatment for acute cough associated with the common cold: CHEST expert panel report
    • Appropriate antibiotic use for acute respiratory tract infection in adults: advice for high-value care from the American College of Physicians and the Centers for Disease Control and Prevention
    More Guidelines
  • Patient leaflets

    Common cold

    Treating coughs and colds in children

    More Patient leaflets
  • Calculators

    Sore Throat (Pharyngitis) Evaluation and Treatment Criteria (McIsaac)

    More Calculators
  • padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Use of this content is subject to our disclaimer