History and exam

Key diagnostic factors

common

presence of risk 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.

acute onset

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

rhinitis

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.

sore throat

A characteristic feature.

sneezing

A characteristic feature.

post-nasal drainage/drip

A characteristic feature.

cough

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

fever

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

non-specific red pharynx

Common feature on examination of oropharynx.

nasal mucosal oedema/erythema

Common feature on examination of nares.

purulent drainage in nares and posterior pharynx

Common feature on examination of nares/oropharynx.

pulse and blood pressure within normal limits

Pulse and blood pressure should be within normal limits for the patient's age. Consider other causes or complications in patients with abnormal observations, depending on the clinical picture.

Other diagnostic factors

common

malaise

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

myalgia

A constitutional symptom, suggestive of viraemia.

halitosis

Non-specific sign.

inflamed tonsils

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

Risk factors

strong

exposure to affected individuals

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

young age

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

winter season

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

day care attendance

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]

exposure to cigarette smoke or other respiratory irritants

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

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