Management of the common cold

What it is

The common cold, also called coryza, is one member of a group gathered under upper respiratory tract infection. The others in that group are sore throat, meaning pharyngitis and tonsillitis with it, acute otitis media, and sinusitis, which is relatively uncommon. Acute bronchitis stands beside them, and its defining symptom is cough.

How it presents

Swelling of the lymph nodes in the neck is a familiar companion. Cervical lymphadenopathy has local and systemic causes, and among the local ones is infection or inflammation of nearby structures: the common cold, bronchitis, dental decay, conjunctivitis, ear infection and salivary gland infection. The systemic causes are cancer, an autoimmune disorder and chronic infection. In acute bronchitis the defining symptom is cough, and symptoms are likely to last 2 to 3 weeks.

How it is diagnosed

A neck node is worked through by asking about its duration, the characteristics of the nodes themselves, and whether nodes in other body areas are involved. For the sore throat member of the group, the Modified Centor criteria, also called McIsaac, give a score of two kinds of row: first four clinical findings, each worth one point, and second the age band, which adds a point, adds nothing, or takes one away:

• Fever: 1
• Tonsillar exudate: 1
• Absent cough: 1
• Anterior cervical lymphadenopathy: 1
• Age 3 to 14 years: 1
• Age 15 to 44 years: 0
• Age above 44 years: minus 1

A chest radiograph is not routine in acute bronchitis. It is indicated in an adult with bloody sputum, rusty-colored sputum or dyspnea; a pulse rate above 100 beats/min; a respiratory rate above 24/min; or a temperature above 37.8 C (100.0 F). It is also indicated when the chest examination is abnormal, with fremitus, egophony or focal consolidation.