Etiology and risk factors
The etiology of viruses is prominent, among which rhinovirus is the most common (30-50%), followed by coronavirus (10-15%), as well as respiratory syncytial virus, parainfluenza virus, adenovirus and enterovirus. Malnutrition, anemia, vitamin AD deficiency, overexertion, cold or lack of exercise, crowded living environment, atmospheric pollution, etc. are all triggers of common cold. Atopic children are prone to common colds, and their rhinitis symptoms are often confused with common colds. Children with immunodeficiency disease or immunocompromised common cold have more severe symptoms.
Clinical manifestations
The common cold often occurs at the change of seasons, especially in winter and spring, and has an acute onset, with rhinitis as the main symptom, including sneezing, congestion, clear watery nose and congestion in the pharynx, etc. It starts 10-12 hours after infection, peaks in 2-3 days, and then gradually decreases for 7-10 days, with some children having symptoms for 3 weeks or longer. Older children may complain of sore throat, itchy throat and burning sensation in the throat. Children may have hearing loss due to Eustachian tube obstruction, lacrimation, dulled sense of taste, dyspnea, cough and small amount of sputum, etc. Systemic symptoms are mild and fever is not obvious or only low.
It should be noted that infants and young children often have less pronounced nasopharyngeal cicatricial symptoms and more severe systemic symptoms, which can start suddenly with high fever, cough, loss of appetite, abdominal pain, vomiting, diarrhea, irritability, and even febrile convulsions.
Complications
Most often seen in infants and young children, the disease may spread to adjacent organs or downward, or may cause secondary bacterial infections such as otitis media, sinusitis, tonsillopharyngitis, posterior pharyngeal wall abscess, cervical lymphadenitis, laryngitis, tracheitis, bronchopneumonia, etc. In addition, streptococcal tonsillopharyngitis may be complicated by acute nephritis and rheumatic fever after 2 to 4 weeks.
Diagnosis and differential diagnosis
Diagnosis principle of common cold is mainly based on clinical symptoms, but other diseases must be ruled out, and it must be noted that the preliminary symptoms of many infectious diseases in children are similar to those of common cold, such as measles, influenza, scarlet fever, hand, foot and mouth disease, etc.. At that time, the epidemiological history, contact history, symptoms and signs of infectious diseases and laboratory data should be combined with a comprehensive analysis, and the evolution of the disease should be closely observed to differentiate.
Laboratory tests
The peripheral blood picture in viral infections has a low or low total white blood cell count, a decrease in neutrophils, and a relative increase in the proportion of lymphocytes; some patients may have a decrease in total white blood cell count and lymphocyte count. In bacterial infections, total leukocyte count is elevated and neutrophils are elevated.
C-reactive protein is not high in viral infections. It is significantly higher in cases of co-infection with bacteria.
Treatment and prevention
The treatment principle of common cold is self-limiting, the symptoms are mild and generally do not require medication, but if the symptoms are more obvious and affect the daily life, medication should be taken mainly for symptomatic treatment, and attention should be paid to rest, proper hydration and avoid bacterial infection.
At present, there are problems of repeated medication, inappropriate combination of medication and blind medication for common cold, such as the combination of compound cold preparations containing antipyretic ingredients and antipyretic drugs; the use of compound cold preparations containing antipyretic ingredients for children without fever; taking more than two kinds of cold medicines at the same time, resulting in overdose and increasing adverse reactions.
General drug therapy is preferred to the oral route, avoiding blind intravenous rehydration. Intravenous rehydration is used in the following cases: the child needs intravenous medication because of the aggravation of the original underlying disease or complications caused by the cold; the child is dehydrated and electrolyte disorders caused by severe diarrhea or high fever; the child has little food due to gastrointestinal discomfort and vomiting.
Drug treatment
Ribavirin may be beneficial when applied early in the course of the disease. Systemic antiviral drugs are generally not required.
Symptomatic treatment of nasal congestion oral pseudoephedrine, or 0.5% pay marijuana nasal drops, no more than 1 week. For runny nose and sneezing, take paracetamol orally. Acetaminophen and ibuprofen for body temperature ≥ 38.5°C and/or systemic discomfort. Aspirin or nimesulide are not recommended for pediatric patients. Taurine may be given for hypothermia, especially in infants and children. Cough herbal cough syrup or cough syrup containing methamphetamine. Oral aminoglutethimide for those with phlegm, etc.
Several problems in treatment
The use of antibacterial drugs too much use or even abuse of antibacterial drugs is a misconception in the treatment of the common cold. An analysis of the data found that 62% of children with the common cold receive antibacterial treatment, which is considered unnecessary.
The use of antiviral drugs currently there is no specific antiviral drugs specifically for the common cold. Some compound cold preparations with amantadine, the drug only has inhibitory effect on influenza A virus, and no inhibitory effect on the common cold rhinovirus, coronavirus.
The reports of general use and misuse of Chinese medicine and its adverse reactions have increased in recent years. When applying herbal medicines, we should pay attention to the following: we should have full knowledge and understanding of its components; we should choose suitable herbal formulas to avoid wrong medication; we should pay attention to the combination and contraindication of drugs.
Prevention
Develop good and healthy living habits; pay attention to relative isolation from people with common cold; wash hands regularly; wear masks during the common cold-prone season and go to less crowded public places; influenza virus vaccine is not effective against common cold.