Clinical Reference Systems: Pediatric Advisor 10.0

Description of a Cold (Upper Respiratory Infection, or URI)

• runny or stuffy nose
• usually a fever and sore throat
• sometimes a cough, hoarseness, red eyes, and swollen lymph nodes in the neck.

Similar Conditions

• Vasomotor rhinitis: Many people have a profusely runny nose in the wintertime when they are breathing cold air. The nose usually stops running within 15 minutes after you come indoors. It requires no treatment beyond a handkerchief and has nothing to do with infection.
• Chemical rhinitis: Chemical rhinitis is a dry stuffy nose that results from using vasoconstrictor nosedrops too often and too long (longer than 1 week). It will be better a day or two after you stop using the nosedrops.

CAUSE

A cold or upper respiratory infection is a viral infection of the nose and throat. The cold viruses are spread from one person to another by hand contact, coughing, and sneezing. Colds are not caused by cold air or drafts. There are many different viruses that cause colds. Most healthy teenagers get at least three colds a year.

Expected Course

Usually the fever lasts less than 3 days, and all nose and throat symptoms are gone in a week. A cough may last 2 to 3 weeks.

Watch for signs of secondary bacterial infections such as earaches, yellow drainage from the eyes, sinus pressure or pain (often indicating a sinus infection), or difficulty breathing (often a sign of pneumonia).

Home Care

Not much can be done to affect how long a cold lasts. However, we can relieve many of the symptoms. Keep in mind that the treatment for a runny nose is quite different from the treatment for a stuffy nose.

1. Treatment for a runny nose with a lot of discharge

   Sniffing and swallowing the secretions is probably better than blowing because blowing the nose can force the infection into the ears or sinuses. Nasal discharge is the nose's way of getting rid of viruses. Medicine is not helpful unless you have a nasal allergy.

2. Treatment for a dry or stuffy nose with only a little discharge or dried, yellow-green mucus

   Most stuffy noses are blocked by dry mucus. Blowing the nose alone cannot remove most dry secretions.

   Nosedrops of warm tap water or saline are better than any medicine you can buy for loosening up mucus. Use a clean dropper to put drops into the nose. Water can be splashed in or dripped in using a wet cotton ball.

   The main mistakes people make when they use warm-water nosedrops are not putting enough water in their nose, not waiting long enough for secretions to loosen up before blowing their nose, and not repeating the procedure until their breathing is easy. The front of the nose can look open while the back of the nose is all gummed up with dried mucus.

   Use the nasal washes at least 4 times a day or whenever you can't breathe through your nose.

3. Treatment for associated symptoms of colds
   • Fever: Use acetaminophen or ibuprofen for aches or mild fever (over 102 degrees F, or 38.9 degrees C).
   • Sore throat: Use hard candies and warm chicken broth.
   • Cough: Use cough drops and a humidifier in your bedroom.
   • Red eyes: Rinse frequently with wet cotton balls.

4. Prevention of colds

   A cold is caused by direct contact with someone who already has a cold. Over the years we are all exposed to many colds and develop some immunity to them.

   A humidifier prevents dry mucous membranes, which may be more susceptible to infections.

   Vitamin C, unfortunately, has not been shown to prevent or shorten colds. Large doses of vitamin C (for example, 2 grams) cause diarrhea.

5. Common mistakes in treating colds

   Most nonprescription cold remedies or tablets are worthless. Nothing can make a cold last a shorter time. If your nose is really running, consider using a pure antihistamine (for example, chlorpheniramine products). Especially avoid drugs that have several ingredients because there is a greater chance of side effects from these drugs. Use acetaminophen for a cold only if you also have a fever, sore throat, or muscle aches.

   Do not take leftover antibiotics for uncomplicated colds because they have no effect on viruses and may be harmful.

Call Your Physician Immediately If:

• Breathing becomes difficult AND no better after you clear your nose.

Call Your Physician During Office Hours If:

• The fever lasts more than 3 days.
• The nasal discharge lasts more than 10 days.
• Your eyes develop a yellow discharge.
• You have an earache or sinus pain.
• Your throat becomes quite sore (get a throat culture).
• You have other questions or concerns.