Table of Contents
Overview – Common Cold (Acute Rhinitis)
The common cold (acute rhinitis), is a self-limiting viral infection of the upper respiratory tract (URT). It is most frequently caused by rhinoviruses, but other viruses like adenovirus, influenza, and RSV also play roles. Symptoms include nasal congestion, sore throat, cough, and mild fever. Diagnosis is clinical, and management focuses on symptomatic relief and avoiding unnecessary antibiotics. Know the red flags for complications, particularly in vulnerable groups such as children, the elderly, and those with asthma or COPD.
Aetiology
- Most commonly caused by rhinoviruses
- Other pathogens:
- Adenoviruses
- Paramyxoviruses
- Influenza viruses
- Myxoviruses
Pathogenesis
- Transmission: Droplet spread or direct contact with respiratory secretions
- Mechanism:
- Viral replication in the nasal mucosa
- → Local inflammation
- → Mucous hypersecretion
- No serotype cross-protection → recurrent infections possible
Clinical Features
- Incubation: 2–3 days.
- Course: ~1 week of symptoms.
Local symptoms:
- Nasal congestion.
- Sneezing.
- Sore throat.
- Hoarseness.
- Cough.
- Conjunctivitis.
General symptoms:
- Malaise.
- Headache.
- Myalgia.
- Mild fever.
Examination findings:
- Rhinorrhoea.
- Inflamed nasal and oropharyngeal mucosa.
- Lymphadenopathy.
- Chest examination usually normal.
Complications
- Secondary bacterial infections:
- Otitis media
- Sinusitis
- Tonsillitis
- Bronchitis
- Pneumonia
- Asthma/COPD exacerbations
- Benign nasal polyps (inflammatory)
Diagnosis
- Clinical: based on history and exam (symptoms, inflamed mucosa, watery discharge).
- Differentials: allergic rhinitis, influenza, pharyngitis, laryngitis, croup, sinusitis, bacterial infection.
- Laboratory tests: only if alternative diagnosis is suspected.
Management
Patient Education
- Antibiotics are not indicated (viral aetiology).
- Consider secondary bacterial infection if symptoms persist beyond 3–10 days.
Symptomatic Relief
- Paracetamol for fever and myalgia.
- Decongestants: phenylephrine, pseudoephedrine.
- Antihistamines (for rhinorrhoea/sneezing).
- Supportive care: rest, hydration, salt-water gargles, steam inhalation.
- Asthmatics/COPD patients: may require increased bronchodilator or inhaled steroid use during viral illness.
Summary – Common Cold (Acute Rhinitis)
The common cold is an acute viral infection of the upper respiratory tract that presents with nasal congestion, sore throat, cough, and malaise. Although usually self-limiting, it can lead to complications such as secondary bacterial infections and exacerbations of asthma or COPD. Management focuses on patient reassurance and symptomatic relief, while avoiding unnecessary antibiotics. For a broader context, see our Respiratory Overview page.