Pneumologie 2017; 71(04): 221-226
DOI: 10.1055/s-0042-116112
Point of View
© Georg Thieme Verlag KG Stuttgart · New York

Common Cold – an Umbrella Term for Acute Infections of Nose, Throat, Larynx and Bronchi

Erkältung – ein Sammelbegriff für akute Infektionen von Nase, Rachen, Kehlkopf und Bronchien
P. Kardos
1   Group Practice and Centre for Pneumology, Allergy and Sleep Medicine at Red Cross Maingau Hospital, Frankfurt am Main, Germany
,
F. A. Malek
2   Clinical Research Department, Dr. Willmar Schwabe GmbH & Co. KG, Karlsruhe, Germany
› Author Affiliations
Further Information

Publication History

received 15 August 2016

accepted 29 August 2016

Publication Date:
02 December 2016 (online)

Abstract

Acute respiratory tract infections, i. e. rhinitis, sinusitis, pharyngitis, laryngitis, bronchitis, belong to the most common medical conditions with a high economic burden. Nonetheless, there is little agreement concerning their differential diagnosis.

This paper will discuss to what extent different anatomical sites of acute respiratory tract infections can be uniquely identified or whether the overlap and consecutive development in signs and symptoms renders these distinctions meaningless.

Acute respiratory tract infections are variable but definition of diagnostic categories based on the anatomical sites of the dominant complaints shows that signs and symptoms both overlap to a great extent and/or emerge successively. Thus, in common cold distinguishing between acute symptom-based diagnoses arising from different anatomical sites of the aerodigestive system remains elusive. Therefore, preferred symptomatic treatments should foster a resolution of all possible symptoms as opposed to an isolated treatment of a single symptom (e. g. mucus hypersecretion) according to the presumed anatomical site (i. e. acute bronchitis).

Zusammenfassung

Akute Atemwegsinfektionen wie Rhinitis, Sinusitis, Pharyngitis, Laryngitis und Bronchitis sind weit verbreitet und belasten das Gesundheitswesen mit hohen Kosten. Die Differenzialdiagnose ist dennoch umstritten.

Die vorliegende Arbeit diskutiert, in welchem Ausmaß akute Atemwegsinfektionen jeweils anatomisch genau lokalisiert werden können (z. B. Pharyngitis, Rhinitis etc.) oder ob eine solche Unterscheidung angesichts überlappender und ineinander übergehender Symptome ohne Bedeutung ist.

Akute Atemwegsinfektionen treten mit örtlich und zeitlich wechselnden Symptomen auf. Die diagnostische Einordnung (z. B. Laryngitis oder Bronchitis) basiert auf einer vermuteten anatomischen Lokalisierung der dominierenden Beschwerden. Es zeigt sich allerdings, dass sich die verschiedenen Symptome stark überlappen bzw. in zeitlicher Abfolge auftreten. Eine symptombasierte diagnostische Unterscheidung bei akuten Atemwegsinfektionen in Abhängigkeit von der jeweiligen anatomischen Lokalisation erscheint somit schwierig. Die symptomatische Behandlung sollte daher auf die Verbesserung aller in Frage kommenden Symptome und nicht auf die Behandlung eines einzelnen Symptoms, wie beispielsweise auf die vermehrte Schleimproduktion bei akuter Bronchitis, gerichtet sein.

 
  • References

  • 1 Nichol KL, D’Heilly S, Ehlinger E. Colds and influenza-like illnesses in university students: impact on health, academic and work performance, and health care use. Clin Infect Dis 2005; 40: 1263-1270
  • 2 Bizzintino J, Lee WM, Laing IA. et al. Association between human rhinovirus C and severity of acute asthma in children. Eur Respir J 2011; 37: 1037-1042
  • 3 Sethi S. Infection as a comorbidity of COPD. Eur Respir J 2010; 35: 1209-1215
  • 4 Wootton SC, Kim DS, Kondoh Y. et al. Viral infection in acute exacerbation of idiopathic pulmonary fibrosis. Am J Respir Crit Care Med 2011; 183: 1698-1702
  • 5 Heikkinnen T, Järvinen A. The common cold. Lancet 2003; 361: 51-59
  • 6 Scott J, Orzano AJ. Evaluation and treatment of the patient with acute undifferentiated respiratory tract infection. J Fam Pract 2001; 50: 1070-1077
  • 7 Hueston WJ, Mainous 3rd AG, Dacus EN. et al. Does acute bronchitis really exist? A reconceptualization of acute viral respiratory infections. J Fam Pract 2000; 49: 401-406
  • 8 Albert RH. Diagnosis and treatment of acute bronchitis. Am Fam Physician 2010; 82: 1345-1350
  • 9 Mostov PD. Treating the immunocompetent patient who presents with an upper respiratory infection: pharyngitis, sinusitis, and bronchitis. Prim Care 2007; 34: 39-58
  • 10 Eccles R. Mechanisms of symptoms of common cold and flu. In: Eccles R. Weber O. eds. Common Cold. Basel: Birkhäuser; 2009: 23-45
  • 11 Arroll B. Common cold. BMJ Clin Evid 2011; 3: 1510
  • 12 Rohilla A, Sharma V, Kumar S. Upper respiratory tract infections: an overview. Int J Curr Pharm Res 2013; 5: 1-3
  • 13 Eccles R. Understanding the symptoms of the common cold and influenza. Lancet Infect Dis 2005; 5: 718-725
  • 14 Palmenberg AC, Spiro D, Kuzmickas R. et al. Sequencing and analyses of all known human rhinovirus genomes reveal structure and evolution. Science 2009; 324: 55-59
  • 15 Simasek M, Blandino DA. Treatment of the common cold. Am Fam Physician 2007; 75: 515-520
  • 16 Thompson M, Vodicka TA, Blair PS. et al. Duration of symptoms of respiratory tract infections in children: systematic review. BMJ 2013; 347: f7027
  • 17 Bizzintino J, Lee WM, Laing IA. et al. Association between human rhinovirus C and severity of acute asthma in children. Eur Respir J 2011; 37: 1037-1042
  • 18 Teach SJ, Gill MA. Togias A. et al. Preseasonal treatment with either omalizumab or an inhaled corticosteroid boost to prevent fall asthma exacerbations. J Allergy Clin Immunol 2015; 136: 1476-1485
  • 19 Papi A, Contoli M, Adcock IM. et al. Rhinovirus infection causes steroid resistance in airway epithelium through nuclear factor κB and c-Jun N-terminal kinase activation. J Allergy Clin Immunol 2013; 132: 1075-1085.e6
  • 20 Fendrick AM. Monto AS. Nightingale B. et al. The economic burden of non-influenza-related viral respiratory tract infection in the United States. Arch Intern Med 2003; 163: 487-494
  • 21 Dicpinigaitis PV. Cough: an unmet clinical need. Brit J Pharmacol 2011; 163: 116-124
  • 22 Bundesverband der Arzneimittel-Hersteller e. V. ed. Der Arzneimittelmarkt in Deutschland, Zahlen und Fakten 2014. Accessed at URL https://www.bah-bonn.de/presse-und-publikationen/zahlen-fakten/ Accessed July 27th 2016
  • 23 Tatar M, Plevkova J, Brozmanova M. et al. Mechanisms of the cough associated with rhinosinusitis. Pulm Pharmacol Ther 2009; 22: 121-126
  • 24 Morice AH, Widdicombe J, Dicpinigaitis P. et al. Understanding cough. Eur Respir J 2002; 19: 6-7
  • 25 Irwin RS, Baumann MH, Bolser DC. et al. Diagnosis and management of cough executive summary: ACCP evidence-based clinical practice guidelines. Chest 2006; 129 (Suppl. 01) 1S-23S
  • 26 Pratter MR. Cough and the common cold: ACCP evidence-based clinical practice guidelines. Chest 2006; 129 (Suppl. 01) 72S-74S
  • 27 Braman SS. Chronic cough due to acute bronchitis: ACCP evidence-based clinical practice guidelines. Chest 2006; 129 (Suppl. 01) 95S-103S
  • 28 Kardos P, Berck H, Fuchs KH. et al. Guidelines of the German Respiratory Society for diagnosis and treatment of adults suffering from acute or chronic cough. Pneumologie 2010; 64: 701-711
  • 29 Morice AH, Fontana GA, Belvisi MG. et al. ERS guidelines on the assessment of cough. Eur Respir J 2007; 29: 1256-1276
  • 30 Kohno S, Ishida T, Uchida Y. et al. Committee for the Japanese Respiratory Society Guidelines for Management of Cough. The Japanese Respiratory Society guidelines for management of cough. Respirology 2006; 11 (Suppl. 04) 135-186
  • 31 Morice AH, McGarvey L, Pavord I. British Thoracic Society Cough Guideline Group. Recommendations for the management of cough in adults. Thorax 2006; 61 (Suppl. 01) i1-24
  • 32 Shields MD, Bush A, Everard ML. et al. British Thoracic Society Cough Guideline Group. BTS guidelines: Recommendations for the assessment and management of cough in children. Thorax 2008; 63 (Suppl. 03) iii1-iii15
  • 33 Wenzel RP, Fowler 3rd AA. Clinical Practice. Acute bronchitis. N Engl J Med 2006; 355: 2125-2130
  • 34 Evertsen J, Baumgardner DJ, Regnery A. et al. Diagnosis and management of pneumonia and bronchitis in outpatient primary care practices. Prim Care Respir J 2010; 19: 237-241
  • 35 Reimer LG, Carroll KC. Role of the microbiology laboratory in the diagnosis of lower respiratory tract infections. Clin Infect Dis 1998; 26: 742-748
  • 36 Fischer J, Dethlefsen U. Efficacy of cineole in patients suffering from acute bronchitis: a placebo-controlled double-blind trial. Cough 2013; 9: 25
  • 37 Lehrl S, Matthys H, Kamin W. et al. The BSS – A valid clinical instrument to measure the severity of acute bronchitis. J Lung Pulm Respir Res 2014; 1: 00016
  • 38 Kardos P, Lehrl S, Kamin W. et al. Assessment of the effect of pharmacotherapy in common cold/acute bronchitis – the Bronchitis Severity Scale (BSS). Pneumologie 2014; 68: 542-546
  • 39 Worrall G. Acute bronchitis. Can Fam Physician 2008; 54: 238-239
  • 40 Morice AH, Fontana GA, Sovijarvi AR. et al. The diagnosis and management of chronic cough. Eur Respir J 2004; 24: 481-492
  • 41 Chung KF, Pavord ID. Prevalence, pathogenesis, and causes of chronic cough. Lancet 2008; 371: 1364-1374
  • 42 Lai K, Lin L, Liu B. et al. Eosinophilic airway inflammation is common in subacute cough following acute upper respiratory tract infection. Respirology 2016; 21: 683-688
  • 43 Fokkens W, Lund V, Bachert C. et al. EAACI position paper on rhinosinusitis and nasal polyps executive summary. Allergy 2005; 60: 583-601
  • 44 Plevkova J, Brozmanova M, Pecova R. et al. Effects of intranasal capsaicin challenge on cough reflex in healthy human volunteers. J Physiol Pharmacol 2004; 55: 101-106
  • 45 Plevkova J, Varechova S, Brozmanova M. et al. Testing of cough reflex sensitivity in children suffering from allergic rhinitis and common cold. J Physiol Pharmacol 2006; 57 (Suppl. 04) 289-296
  • 46 Buday T, Brozmanova M, Biringerova Z. et al. Modulation of cough response by sensory inputs from the nose – role of trigeminal TRPA1 versus TRPM8 channels. Cough 2012; 8: 11
  • 47 Fokkens WJ, Lund VJ, Mullol J. et al. European position paper on rhinosinusitis and nasal polyps. Rhinology 2012; 50 (Suppl. 23) 1-298
  • 48 Worrall GJ. Acute sore throat. Can Fam Physician 2007; 53: 1961-1962
  • 49 Fashner J, Ericson K, Werner S. Treatment of the common cold in children and adults. Am Fam Physician 2012; 86: 153-159
  • 50 Wilson WR, Drew WL, Henry NK. et al. Current Diagnosis & Treatment in Infectious Diseases. 1st. ed. New York, United States: McGraw-Hill/Appleton & Lange; 2001