Prepared by Moses Kazevu

CORYZA (COMMON COLD)

CORYZA (COMMON COLD/ NASOPHARYNGITIS)

• This is the commonest infection of childhood.
• The commonest pathogens are viruses- rhinovirus (over 100 different serotypes),
coronavirus, RSV, influenza, parainfluenza and adenovirus.
• Transmission is by droplet infection.
• Predisposing factors:
➢ Chilling, sudden exposure to cold air
➢ Overcrowding,
➢ Rhinitis could also be due to allergy.

CLINICAL FEATURES
• Classical features:
➢ Fever (low grade), irritability
➢ Clear or mucopurulent nasal discharge (rhinorrhea)
o Mucopurulent discharge does not always indicate secondary infection it
can sometimes result from shedding of epithelial and inflammatory cells
resulting from the viral infection.
➢ Nasopharyngeal and nasal blockage (which can cause respiratory distress in
young infants because they are obligate nose breathers)
➢ Eustachian tube openings may be blocked leading to serous otitis media and
congestion of tympanic membrane.
➢ Narrowing of the airway and pharyngeal irritation causes dry hacking cough.
➢ Sore throat.
➢ Cervical lymph node enlargement.
• Excessive lacrimation is due to blocked lacrimal ducts in the nose.
• Health education to advise parents that colds are self-limiting (usually lasting 3-
4 days) and have no specific curative treatment may reduce anxiety and save
unnecessary visits to doctors.
• Persistent symptoms for more than 10 days or fever should prompt the clinician
to evaluate for bacterial superinfection (e.g. sinusitis, acute otitis media)
DIAGNOSIS
• Clinical.
Prepared by Moses Kazevu

• Viral agent is rarely identified.

MANAGEMENT
• Principles of management:
➢ Relieve nasal congestion
➢ Control fever
➢ Manage pain
➢ Antibiotics
• Relieve nasal congestion:
➢ Nasal saline drops PRN (when necessary)
➢ Nasal decongestants (ephedrine, xylometozoline) may cause rebound
congestion and should not be used routinely and only used in refractory cases
for limited duration.
➢ Antihistamines are also not recommended in children below 6 months.
➢ Non-sedating angents e.g. cetirizine and loratadine may be used in allergic
rhinitits. Terfenadine should not be used in children because of its potential
cardiotoxicity
• Fever and pain:
➢ Best treated with paracetamol (calpol).
➢ Avoid giving cough syrups: if cough is suppressed in infants and young
children mucoid secretions may be retained in the bronchi and this may
predispose to spasmodic cough, wheezing, atelectasis and suppuration.
• Antibiotics are of no benefit as the common cold is viral in origin. They are used
if the secretions become purulent, the fever continues to rise and if the child
develops bronchopneumonia.
• Secondary bacterial infection is very uncommon but should be treated with
antibiotics when suspected.
• There is no evidence supporting that large doses of vitamin C are helpful.
DIFFERENTIAL DIAGNOSIS
• Differential diagnosis:
➢ Foreign body in nose (presents with unilateral serosanguineous or purulent
discharge from a nostril)
➢ Snuffles of congenital syphilis: this is severe rhinitis with bilateral
serosanguineous discharge commonly excoriating the upper lip and leaving
fine scars. Nasal strictures may ulcerate leaving a flat nasal bridge.
Prepared by Moses Kazevu

COMPLICATIONS
• Complications:
➢ Otitis media
➢ Sinusitis
➢ Laryngitis
➢ Bronchiolitis
➢ Exacerbation of asthma
➢ Bronchopneumonia