The common cold in children: Clinical features and diagnosis
- Diane E Pappas, MD, JD
Diane E Pappas, MD, JD
- Professor of Pediatrics
- University of Virginia School of Medicine
The common cold is an acute, self-limiting viral infection of the upper respiratory tract, involving, to variable degrees, sneezing, nasal congestion and discharge (rhinorrhea), sore throat, cough, low grade fever, headache, and malaise. It can be caused by members of several families of viruses; the most common are the more than 100 serotypes of rhinoviruses.
The common cold is the most frequent human illness. An estimated 25 million individuals seek medical care for uncomplicated upper respiratory tract infections (URI) annually in the United States [1,2]. Approximately 30 percent of these visits result in a prescription for antibiotics. Inaccurate perceptions that colds are caused by bacteria and that antibiotics improve outcome fuel the number of visits and requests for antibiotics . Infants and children are affected more often and experience more prolonged symptoms than adults. The common cold accounts for approximately 22 million missed days of school and 20 million absences from work, including parents’ time away from work while caring for ill children [2,4].
The epidemiology, clinical features, complications, and diagnosis of the common cold in children will be discussed here. The treatment and prevention of the common cold in children and the common cold in adults are discussed separately. (See "The common cold in children: Management and prevention" and "The common cold in adults: Diagnosis and clinical features" and "The common cold in adults: Treatment and prevention".)
The symptoms of the common cold can be caused by a variety of viruses. Rhinoviruses, which include more than 100 serotypes, cause up to 50 percent of colds in children and adults . Other common causes of colds in preschool children include respiratory syncytial virus (RSV), influenza viruses, parainfluenza viruses, and adenoviruses (table 1). (See "Epidemiology and clinical manifestations of adenovirus infection" and "Epidemiology, clinical manifestations, and pathogenesis of rhinovirus infections" and "Seasonal influenza in children: Clinical features and diagnosis", section on 'Clinical features' and "Parainfluenza viruses in children", section on 'Clinical presentation' and "Respiratory syncytial virus infection: Clinical features and diagnosis", section on 'Clinical manifestations'.)
Cold symptoms also can be caused by nonpolio enteroviruses (echoviruses and coxsackieviruses), coronaviruses, and human metapneumovirus [5-7]. (See "Enterovirus and parechovirus infections: Clinical features, laboratory diagnosis, treatment, and prevention" and "Coronaviruses" and "Human metapneumovirus infections".)
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- Immune response
- Seasonal patterns
- Period of infectivity
- Incubation period
- CLINICAL FEATURES
- Frequency and duration
- Symptoms and signs
- - Overview
- - Fever
- - Nasal manifestations
- - Cough
- - Other symptoms and signs
- Middle ear abnormalities
- Radiographic features
- Acute otitis media
- Asthma exacerbation
- Lower respiratory tract disease
- Other complications
- DIFFERENTIAL DIAGNOSIS
- INFORMATION FOR PATIENTS