Acute viral nasopharyngitis overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmed Younes M.B.B.CH [2]
Overview
Acute viral nasopharyngitis, is a highly contagious, viral infectious disease of the upper respiratory system, primarily caused by rhinovirus; less commonly by picornaviruses or coronaviruses.
Common symptoms are sore throat, runny nose, nasal congestion, sneezing and cough; sometimes accompanied by muscle aches, fatigue, malaise, headache, muscle weakness, or loss of appetite. Fever and extreme exhaustion but these symptoms are more usual in influenza. The symptoms of a cold usually resolve after about one week but can last up to 14 days. Symptoms may be more severe in infants and young children. Although the disease is generally mild and self-limiting, patients with common cold often seek professional medical help, use over-the-counter drugs, and may miss school or work days. The annual cumulative societal cost of the common cold in the United States is billions of dollars.
No vaccines are available: the primary method to prevent infection is hand washing to minimize person-to-person transmission of the virus. There are no antiviral drugs approved to treat or cure the infection. Most available medications are palliative and treat symptoms only. Megadoses of vitamin C, preparations from echinacea, and zinc gluconate have been studied as treatments for the common cold although none has been approved by the Food and Drug Administration or European Medicines Agency.
Historical Perspective
Common cold was first considered as a distinct diagnosis by Benjamin Franklin in the 18th century.
Classification
There is no established classification system for acute viral nasopharyngitis.
Pathophysiology
Rhinovirus (the most common cause of common cold) is usually transmitted via aerosol generated by coughing or sneezing. Following transmission, the virus invades the epithelial cells and causes the release of inflammatory cytokines that leads to the various symptoms of cold.
Causes
Acute viral nasopharyngitis is most commonly caused by an infection with rhinovirus. Other common causes include coronavirus, human parainfluenza viruses, and human respiratory syncytial virus.
Differentiating Hemorrhoids from other Diseases
Acute viral nasopharyngitis should be differentiated from other diseases that cause runny nose, cough and constitutional symptoms such as influenza, allergic rhinitis and acute sinusitis.
Epidemiology and Demographics
Acute viral nasopharyngitis is the most common human infection worldwide and responsible for about half of the family physicians visits.
Risk Factors
Common risk factors in the development of acute viral nasopharyngitis are contact with an infected patient and going to daycare centers.
Natural History, Complications, and Prognosis
If left untreated, common cold resolves completely within 7-10 days. Common complications of acute viral nasopharyngitis include sinusitis, otitis media, and exacerbation of reactive airway disease. Prognosis is generally excellent and 50% of patients recover completely within 7 days and 90% of patients recover within 15 days.
History and Symptoms
Symptoms of acute viral nasopharyngitis include runny nose, cough, and sore throat.
Physical Examination
Patients with acute viral nasopharyngitis usually appear ill. Physical examination of patients with acute viral nasopharyngitis is usually remarkable for a runny nose, hyperemic nasal mucosa and mild cervical lymphadenopathy.
Laboratory Findings
Laboratory findings consistent with the diagnosis of acute viral nasopharyngitis include positive viral culture, positive PCR, and CBC showing leucocytosis.
Imaging Findings
There are no x ray, CT, MRI or ultrasound findings associated with acute viral nasopharyngitis.
Medical Therapy
The mainstay of therapy for acute viral nasopharyngitis is symptomatic treatment. The common cold is self-limiting, and the host's immune system effectively deals with the infection. Within a few days, the body's humoral immune response begins producing specific antibodies that can prevent the virus from infecting cells. Additionally, as part of the cell-mediated immune response, leukocytes destroy the virus through phagocytosis and destroy infected cells to prevent further viral replication. In healthy immunocompetent individuals, the common cold resolves in seven days on average.
Surgery
Surgical intervention is not recommended for the management of acute viral nasopharyngitis.
Prevention
Effective measures for the primary prevention of acute viral nasopharyngitis include avoiding close contacts with patients and washing hands regularly.