History and exam

Key diagnostic factors

commonVIEW ALL

acute onset

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

rhinitis

Clear or purulent rhinitis may be present. Colored 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.

postnasal drainage/drip

A characteristic feature.

cough

Clear sputum initially, may become purulent, may be nonproductive.

fever

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

nonspecific red pharynx

Common feature on examination of oropharynx.

nasal mucosal edema/erythema

Common feature on examination of nares.

purulent drainage in nares and posterior pharynx

Common feature on examination of nares/oropharynx.

pulse <100 bpm; no hypotension

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 sick, to rule out septic shock from a bacterial cause (e.g., meningococcal septicemia).

Other diagnostic factors

commonVIEW ALL

malaise

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

myalgia

A constitutional symptom, suggestive of viremia.

halitosis

Nonspecific sign.

inflamed tonsils

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

Risk factors

strongVIEW ALL

exposure to affected individuals

Bedroom sharing is associated with higher rates of antibody conversion to common rhinoviruses than sleeping in a room alone.[8]

young age

Children have more episodes than adults.[3][4][5][6]

winter season

Respiratory infections are more common in winter than in other seasons.[8]

daycare attendance

According to one study analyzing data from the US, children in daycare centers were 4.5 times more likely to be hospitalized than those in other settings and developed more upper respiratory tract infections.[12]

exposure to cigarette smoke or other respiratory irritants

Smokers are at greater risk of developing the condition than nonsmokers.[13]

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