History and exam

Key diagnostic factors

Key risk factors include exposure to affected individuals, young age, winter season, day care attendance, and exposure to cigarette smoke or other respiratory irritants.

Onset is rapid over the course of 1 to 2 days.

Clear or purulent rhinitis may be present. Coloured secretions are often a sign of oxidation and do not necessarily indicate any complications to a viral illness bacterial superinfection.

A characteristic feature.

A characteristic feature.

A characteristic feature.

Clear sputum initially, may become purulent, may be non-productive.

More likely in children; greater than 38°C (>100.4°F) suggestive of alternative cause in adults.

Common feature on examination of oropharynx.

Common feature on examination of nares.

Common feature on examination of nares/oropharynx.

Pulse should be <100 bpm and blood pressure normal for the patient's age. Pulse and BP should be checked in any patient who appears moderately ill, to rule out septic shock from a bacterial cause (e.g., meningococcal septicaemia).

Other diagnostic factors

Unwell but not extremely tired; persistent fatigability may suggest alternative cause.

A constitutional symptom, suggestive of viraemia.

Non-specific sign.

May be suggestive of streptococcal infection if tonsillar exudates are present.

Risk factors

Bedroom sharing is associated with higher rates of antibody conversion to common rhinoviruses than sleeping in a room alone.[9]

Children have more episodes than adults.[1][2][3][4]

Respiratory infections are more common in the winter than in other seasons.[9]

According to one study analysing data from the US, children in day care centres were 4.5 times more likely to be hospitalised than those in other settings and developed more upper respiratory tract infections.[13]

Smokers are at greater risk of developing the condition than non-smokers.[14]

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