Common Cold (nasopharyngitis)

Clinical Description

Common cold is a self-limiting upper respiratory tract infection affecting nasopharyngeal mucosa and sinuses. It is self-limiting and usually resolves within a week. It is mainly caused by viruses (rhinoviruses, corona viruses and Respiratory Syncytial Virus-RSV). Influenzae virus can cause a protracted common cold.

It is highly contagious and spread by airborne droplets, as well as from hands and contact with contaminated surfaces. Secondary bacterial infection may be associated with purulent phlegm or offensive nasal discharge and fever. Occasionally, the common cold is complicated by otitis media and pharyngotonsillitis, particularly in children, in which case one should refer to the appropriate sections for treatment

Signs and Symptoms

• Running nose (rhinorrhea)/nasal congestion
• Sneezing
• Cough
• Irritation of the throat
• Fever (often causes fever in young children that may last up to 72 hours)
• Muscle ache.
• Malaise
• Mild headache
• In infant, nasal congestion may interfere with breast feeding and cause difficulty in breathing
• Low grade fever
• Nasal discharge
• Reddening of nasal mucosa
• Watering of eyes

Investigations

• No investigation required

Treatment

NO-PHARMACOLOGICAL TREATMENT

• Rest
• Encourage adequate fluid intake
• Gargle lukewarm salt water if sore throat
• Steam inhalation may also relieve nasal congestion

Pharmacological

• Uncomplicated common cold
• 1st Line Treatment: Paracetamol, oral, Adults 500-1g 6–8-hourly Children 10-15 mg/kg/dose 6-8 hourly
• 6-12 years; 250-500 mg 6-8 hourly
• 1-5 years; 120-250 mg 6-8 hourly
• 3 months-1 year; 60-120 mg 6-8 hourly
• Saline (sodium Chloride 0.9%) nasal drops
• Adult and Children 2 drops, into each nostril, 4 hourly to relieve congestion as necessary Or
• Chlorpheniramine maleate, oral
• Adult 4 mg 12 hourly

Children

o 6-12 years; 2 mg 6-12 hourly daily (max. 12 mg daily) o 2-6 years; 1 mg 6-8 hourly (max. 6 mg daily) 1-2 year.

• Cough syrups may also relieve symptoms
• Antibiotics are not recommended in common cold.

Complications

• Secondary bacterial infection (associated with purulent phlegm or offensive nasal discharge and fever).
• Occasionally otitis media and pharyngotonsillitis particularly in children (refer appropriate sections for treatment and refer to ENT clinic where appropriate)