Acute Rhinitis
- causes and risk factors
- signs, symptoms, and diagnosis
- pathophysiology
- treatments
- consequences and course
- the patient
- health care team
- community involvement
- resources and references
Acute rhinitis, or the common cold, is just that - the most common diagnosis made in a family doctor's office. With a peak in the winter months, adutls tend to get 2-4 colds per year, while children get 6-10.
Causes and Risk Factors
Acute rhinitis is predominantly caused by rhinoviruses, which are responsible for 30-35% of all colds. Other pathogens include coronavirus, adenovirus, RSV, influenza, parainfluenza, echovirus, and coxsackie virus.
Risk factors for developing illness include psychological stress, excessive fatigue, allergic nasopharyngeal disorders, smoking, and contact with sick people.
Signs, Symptoms, and Diagnosis
- history
- physical exam
- lab investigations
- diagnostic imaging
- differential diagnosis
History
Incubation is generally between 1-5 days.
Transmission can be via secretions on skin/objects, or by aerosol droplets.
Nasal congestion, with clear to mucopurulent secretions, sneezing, sore throat, conjunctivitis, and cough are all common.
Malaise, headache, myalgias, and mild fever can also occur.
Physical Exam
The nasal/oropharyngeal mucosa can become boggy and erythematous.
Lymph nodes can enlarge.
Chest exam is clear.
Lab Investigations
Diagnostic Imaging
Differential Diagnosis
Differential diagnosis includes allergic rhinitis, streptococcal pharyngitis, influenza, laryngitis, croup, sinusitis, and bacterial infections.
The cold versus influenza
Pathophysiology
Treatments
Patient Education is very important, especially in regards to the lack of efficacy of antibiotics. Symptoms of viral infection typically subside within one week, though cough can persist for weeks. Secondary bacterial infection can occur within 3-10 days after cold onset.
Prevention includes frequent hand washing, avoidance of touching face, and use of surface disinfecant.
Symptomatic relief can come from rest, hydration, gargling salt water, and steam.
Analgesics and antipyretics can include acetaminophen and ASA (avoiding the latter in children due to Reye's syndrome)
Dextromethorphan or codiene can be used for cough suppression.
Decongestants, antihistamines may be useful.
Zinc losenges are controversial.
Patients with reactive airway disease or asthma will require increased usie of bronchidilators and inhaled steroids.
Consequences and Course
The Patient
Health Care Team
Community Involvement
Resources and References