Most people experience at least one common cold per year; these are usually self-limited and resolve within a few days.
Diagnosis is generally clinical, based on history and exam. Investigations may be required when symptoms worsen or do not resolve in the usual timeframe.
Treatment includes reassurance that this is a self-limiting condition, rest, adequate fluid intake, and an analgesic/antipyretic for pain/fever. Antibiotics are not recommended.
Decongestants and/or antihistamines may have a role in reducing nasal symptoms in adults; however, the evidence is limited, and these treatments are generally not recommended in young children. Antitussives may be used for cough; however, there is no evidence to support or refute their use, and opioids are not recommended for this indication in children and adolescents under 18 years of age.
Complications include bacterial infections such as otitis media, sinusitis, or pneumonia.
An acute, self-limited inflammation of the upper respiratory mucosa that may involve any or all of the nose, throat, sinuses, and larynx. The condition is not characterized by a discrete set of specific symptoms, with the illness varying according to individual and causative pathogen. Occasionally there is spread to the lower respiratory tract. Symptoms include sore throat, sneezing, blocked and/or runny nose, headache, cough, malaise, and low-grade fever. The condition is associated with more than 200 virus subtypes.
History and exam
Key diagnostic factors
- acute onset
- sore throat
- postnasal drainage/drip
- nonspecific red pharynx
- nasal mucosal edema/erythema
- purulent drainage in nares and posterior pharynx
- pulse <100 bpm; no hypotension
Other diagnostic factors
- inflamed tonsils
- exposure to affected individuals
- young age
- winter season
- daycare attendance
- exposure to cigarette smoke or other respiratory irritants
1st investigations to order
- no initial test
Investigations to consider
- throat swab
- sputum culture
- heterophile antibody test
- C-reactive protein (CRP)
- chest x-ray
- sinus CT scan
- viral testing
- Coronavirus disease 2019 (COVID-19)
- Hay fever (allergic rhinitis)
- Chronic sinusitis
- 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
Treating coughs and colds in childrenMore Patient leaflets
Sore Throat (Pharyngitis) Evaluation and Treatment Criteria (McIsaac)More Calculators
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