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common cold; acute nasopharyngitis; viral rhinosinusitis
also see upper respiratory tract infection, rhinovirus
Etiology:
- rhinovirus
Pathology:
- cleavage of viral protein VP0 into VP4 & VP2 in the intact viral capsid [2]
- VP0 is N-myristoylated by host cell N-myristoyltransferase [2]
Clinical manifestations:
- initially: sore throat, headache, low-grade fever
- later: rhinorrhea, nasal congestion, dry cough
- improvement in 10-14 days
Differential diagnosis:
- see common cold vs influenza vs Covid-19
Management:
- antibiotics not indicated [1]; effective [3]
- cough suppressants dextromethorphan, codeine ineffective [3]
- zinc gluconate lozenge 45-276 mg/day for 4.5-21 days & other forms of zinc shorten duration of common cold by 2 days [4]
- zinc does not prevent the common coldd [4]
- investigational agent IMP-1088, a small molecule inhibitor of N-myristoyltransferase (NMT1 & NMT2) inhibits maturation of rhinovirus [2]
Related
common cold vs influenza vs Covid-19
Rhinovirus
Specific
long cold syndrome
General
upper respiratory tract infection (URI, common cold)
nasopharyngitis; rhinopharyngitis
rhinitis
viral infection
References
- Harris AM, Hicks LA, Qaseem A et al
Appropriate Antibiotic Use for Acute Respiratory Tract
Infection in Adults: Advice for High-Value Care From the
American College of Physicians and the Centers for Disease
Control and Prevention.
Ann Intern Med. Published online 19 January 2016
PMID: 26785402
http://annals.org/article.aspx?articleid=2481815
- Lewis R
New Enzyme Inhibitor May Stop Common Cold.
Medscape - May 18, 2018.
https://www.medscape.com/viewarticle/896928
- Mousnier A, Bell, AS, Swieboda DP et al
Fragment-derived inhibitors of human N-myristoyltransferase
block capsid assembly and replication of the common cold virus.
Nature Chemistry. vol 10:599-606. June 2018.
PMID: 29760414
https://www.nature.com/articles/s41557-018-0039-2.epdf
- Medical Knowledge Self Assessment Program (MKSAP) 19
American College of Physicians, Philadelphia 2022
- Nault D, Machingo TA, Shipper AG et al
Zinc for prevention and treatment of the common cold.
Cochrane Database Syst Rev. 2024 May 9;5(5):CD014914
PMID: 38719213 PMCID: PMC11078591 (available on 2025-05-09)
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD014914.pub2/full