Summary
Definition
History and exam
Key diagnostic factors
- acute onset
- rhinitis
- sore throat
- sneezing
- postnasal drainage/drip
- cough
- fever
- nonspecific red pharynx
- nasal mucosal edema/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
- daycare attendance
- exposure to cigarette smoke or other respiratory irritants
Diagnostic tests
1st tests to order
- no initial test
Tests to avoid
- serum Monospot for Epstein-Barr virus infection
Tests to consider
- CBC
- throat swab
- sputum culture
- 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.
References
Key articles
Harris AM, Hicks LA, Qaseem A, et al. 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. Ann Intern Med. 2016 Mar 15;164(6):425-34.Full text Abstract
Jefferson T, Del Mar CB, Dooley L, et al. Physical interventions to interrupt or reduce the spread of respiratory viruses. Cochrane Database Syst Rev. 2020 Nov 20;11:CD006207.Full text Abstract
van Driel ML, Scheire S, Deckx L, et al. What treatments are effective for common cold in adults and children? BMJ. 2018 Oct 10;363:k3786.
De Sutter AI, Eriksson L, van Driel ML. Oral antihistamine-decongestant-analgesic combinations for the common cold. Cochrane Database Syst Rev. 2022 Jan 21;1:CD004976.Full text Abstract
Isbister GK, Prior F, Kilham HA. Restricting cough and cold medicines in children. J Paediatr Child Health. 2012 Feb;48(2):91-8. Abstract
Smith SM, Schroeder K, Fahey T. Over-the-counter (OTC) medications for acute cough in children and adults in community settings. Cochrane Database Syst Rev. 2014 Nov 24;(11):CD001831.Full text Abstract
Kenealy T, Arroll B. Antibiotics for the common cold and acute purulent rhinitis. Cochrane Database Syst Rev. 2013 Jun 4;(6):CD000247.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Hay fever (allergic rhinitis)
- Chronic sinusitis
- Tonsillitis
More DifferentialsGuidelines
- 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
More GuidelinesPatient information
Common cold
Treating coughs and colds in children
More Patient informationCalculators
Sore Throat (Pharyngitis) Evaluation and Treatment Criteria (McIsaac)
More Calculators
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