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 and blood pressure within normal limits
Other diagnostic factors
- malaise
- myalgia
- halitosis
- inflamed tonsils
Risk factors
- exposure to affected individuals
- young age
- winter season
- day care attendance
- exposure to cigarette smoke or other respiratory irritants
Diagnostic investigations
1st investigations to order
- no initial test
Investigations to consider
- FBC
- throat swab
- sputum culture
- heterophile antibody test
- C-reactive protein (CRP)
- chest x-ray
- sinus CT scan
- viral testing
Treatment algorithm
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
Fatima Syed, MD, MSc
Associate Professor of Medicine
Duke University School of Medicine
Durham
NC
Disclosures
FS declares that she has no competing interests.
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.
Differentials
- Hay fever (allergic rhinitis)
- Chronic sinusitis
- Tonsillitis
More DifferentialsGuidelines
- Cough (acute): antimicrobial prescribing
- Sore throat (acute): antimicrobial prescribing
More GuidelinesPatient information
Common cold
Treating coughs and colds in children
More Patient informationCalculators
Sore Throat (Pharyngitis) Evaluation and Treatment Criteria (McIsaac)
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