ENT- URI, common cold Flashcards
What is the most frequent acute illness in the US?
URI
500 million non-influenza viral respiratory infections annually
Do children or adults experience URIs more?
Children!
Preschool children experience 5-7 episodes/year
Adults experience 2-3 episodes/year
What is the most common etiology of the common cold?
30-50% of cases are caused by Rhinovirus
How is the common cold transmitted?
Through direct contact and respiratory droplets
What are the risk factors of the common cold?
- Daycare
- At home parents
- Psychological stress
- Poor sleep
What are risk factors for more severe infections of the common cold?
- Chronic disease
- Immunodeficiency
- Malnutrition
- Cigarette smoking
What are the symptoms of the common cold?
- cough
- rhinorrhea
- fatigue
- sore throat
- body aches
- +/- fever
- +/- conjunctivitis
- +/- Headache (mild)
- +/- watery eyes
What is the incubation time for the common cold?
2-3 days
What is the typical clinical presentation of the common cold?
Day 1: sore throat
Day 2-3: Nasal congestion, rhinorrhea
Day 4-5: cough
(usually resolves in the same order with the cough being last)
What is the typical duration of the common cold?
~7-10 days
What are the physical exam findings?
- Nasal mucosal edema
- Nasal congestion
- Pharyngeal erythema
- +/- adenopathy
- Lungs clear
- +/- Conjunctival infection
How do you diagnose the common cold?
Based on H&P!
sinus imaging should not be needed unless sxs have persisted for months
Viral cultures should only be ordered if sxs are during flu season
What are complications of the common cold?
- Viral sinusitis
- Bacterial sinusitis
- Lower respiratory disease (pneumonia is typically seen in people with comorbidities)
- Acute asthma exacerbation
- AOM
- ETD/transient middle ear effusion
How do you treat the common cold?
- Supportive care- fluids and rest
- Patient eduction
What medications can be used to treat the common cold?
- Zinc, >75mg/day
- Hypertonic nasal saline irrigation
- Nasal decongestant sprays
- Oral decongestants (Psudoephedrine, Phenylephrin)
- Antihistimines (diphenhydramine, chlorpheniramine)
- Intranasal ipratropim bromide (Atrovent)
- Intranasal cromolyn sodium
- Antitussives: dextromethorphan, codeine
- Expectorants: Guafenesin
- Analgesics: NSAIDS, acetaminophen