Acute Nasopharyngitis/Common Cold
Not yet clinically reviewed
This protocol was migrated from the earlier Pharmapedia and Ward Guide apps for educational use. Follow your hospital's own policies and consult seniors when in doubt.
Clinical Features
More severe in young children. Fever, irritability, restlessness, sneezing, nasal discharge, vomiting, congestion of eardrums. Usual duration of illness is 3-4 days. Complications Due to secondary bacterial invasion—sinusitis, mastoiditis, orbital cellulites, otitis media.
Treatment
Paracetamol for fever
- Normal saline nasal drops
- Suction of nasal cavity by sucker in young children
- Oral phenylephrine or pseudoephedrine in older children as decongestant
- Humidified air
- Treatment of the complications with appropriate antibiotics.
Acute Pharyngitis
Includes all infection of pharynx including tonsil.
Clinical Features
Viral: Gradual onset, fever highest on 2nd or 3rd day of infection. Malaise, anorexia, moderate throat pain.
On examination
Mild pharyngeal inflammation, small ulcers on soft palate and posterior pharyngeal wall. Cervical lymph nodes may be enlarged but are not tender. Usually no complications. May be associated with conjunctivitis and rhinitis. b. Bacterial: Age > 2 yr. Headache, abdominal pain and vomiting. High fever >40o C lasting 12 to 96 hours. Severe sore throat is a feature. Enlargement of tonsil with exudates is often seen, sometimes associated with dysphagia. Tender cervical lymphadenopathy, usually not associated with rhinitis and conjunctivitis. Complications are acute glomerulonephritis, acute rheumatic fever (in 3% cases), ASOM, sinusitis.
Diagnosis
Differentiate from diphtheria, infectious mononucleosis and agranulocytosis. Investigation
- Culture of pharyngeal swab
- Rapid detection by streptococcal antigen (false negative: 15-18%)
- Routine blood count.
Treatment
Penicillin V: 30-50 mg/kg/d × 10 days OR
- Erythromycin: 40-50 mg/kg/day × 10 days
- Paracetamol: 50-60 mg/kg/day
- Cool bland diet.