Differentiating acute viral nasopharyngitis from other diseases: Difference between revisions

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| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |  Acute viral nasopharyngitis<ref name="pmid12517470">{{cite journal |vauthors=Heikkinen T, Järvinen A |title=The common cold |journal=Lancet |volume=361 |issue=9351 |pages=51–9 |year=2003 |pmid=12517470 |doi=10.1016/S0140-6736(03)12162-9 |url=}}</ref>
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |  Acute viral nasopharyngitis<ref name="pmid12517470">{{cite journal |vauthors=Heikkinen T, Järvinen A |title=The common cold |journal=Lancet |volume=361 |issue=9351 |pages=51–9 |year=2003 |pmid=12517470 |doi=10.1016/S0140-6736(03)12162-9 |url=}}</ref>
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* Symptoms start with [[sore throat]], [[Nasal congestion]], and [[runny nose]].
* Symptoms start with [[sore throat]], [[nasal congestion]], and [[runny nose]].
* [[Cough]] that may persist after resolution of the other symptoms.
* [[Cough]] that may persist after resolution of the other symptoms.
* [[Fever]] is not common.
* [[Fever]] is not common.
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* Diagnosis is usually clinical; lab tests are rarely needed.
* Diagnosis is usually clinical; lab tests are rarely needed.
* The virus can be [[Culture medium|cultured]] on human lung cells, but it takes time.
* The virus can be [[Culture medium|cultured]] on human lung cells, but it takes time.
* [[PCR]] is rapid and accurate, but done only when the infecting [[virus]] strain in [[immunocompromised]] patients needs to be known.
* [[PCR]] is rapid and accurate, but is done only when the infecting [[virus]] strain in [[immunocompromised]] patients needs to be known.
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| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |  [[Allergic rhinitis]]<ref name="pmid20232579">{{cite journal |vauthors=Pawankar R, Bunnag C, Chen Y, Fukuda T, Kim YY, Le LT, Huong le TT, O'Hehir RE, Ohta K, Vichyanond P, Wang DY, Zhong N, Khaltaev N, Bousquet J |title=Allergic rhinitis and its impact on asthma update (ARIA 2008)--western and Asian-Pacific perspective |journal=Asian Pac. J. Allergy Immunol. |volume=27 |issue=4 |pages=237–43 |year=2009 |pmid=20232579 |doi= |url=}}</ref>
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |  [[Allergic rhinitis]]<ref name="pmid20232579">{{cite journal |vauthors=Pawankar R, Bunnag C, Chen Y, Fukuda T, Kim YY, Le LT, Huong le TT, O'Hehir RE, Ohta K, Vichyanond P, Wang DY, Zhong N, Khaltaev N, Bousquet J |title=Allergic rhinitis and its impact on asthma update (ARIA 2008)--western and Asian-Pacific perspective |journal=Asian Pac. J. Allergy Immunol. |volume=27 |issue=4 |pages=237–43 |year=2009 |pmid=20232579 |doi= |url=}}</ref>
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* Characterized by repeated paroxysms of [[rhinorrhea]], [[sneezing]], and [[cough]].
* Characterized by repeated paroxysms of [[rhinorrhea]], [[sneezing]], and [[cough]].
* Symptoms may be related to a specific season of the year, hence the name “seasonal [[allergies]]”.
* Symptoms may be related to a specific season of the year, hence the name “seasonal [[allergies]].”
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* [[Rhinorrhea]] discharge is usually clear and watery.
* [[Rhinorrhea]] discharge is usually clear and watery.
* Examination of the nose reveals a crease below the [[nasal bridge]], formed from repeated pulling of the nose secondary to irritation.
* Examination of the nose reveals a crease below the [[nasal bridge]], formed from repeated pulling of the nose secondary to [[irritation]].
* [[Edema]] in the area below the eye, if associated [[conjunctivitis]] is present.<ref name="pmid11449200">{{cite journal |vauthors=Skoner DP |title=Allergic rhinitis: definition, epidemiology, pathophysiology, detection, and diagnosis |journal=J. Allergy Clin. Immunol. |volume=108 |issue=1 Suppl |pages=S2–8 |year=2001 |pmid=11449200 |doi= |url=}}</ref>
* [[Edema]] in the area below the eye, if associated [[conjunctivitis]] is present.<ref name="pmid11449200">{{cite journal |vauthors=Skoner DP |title=Allergic rhinitis: definition, epidemiology, pathophysiology, detection, and diagnosis |journal=J. Allergy Clin. Immunol. |volume=108 |issue=1 Suppl |pages=S2–8 |year=2001 |pmid=11449200 |doi= |url=}}</ref>
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* Presents with symptoms similar to [[URTI|URTIs]] ([[sneezing]], [[cough]], and [[runny nose]]).
* Presents with symptoms similar to [[URTI|URTIs]] ([[sneezing]], [[cough]], and [[runny nose]]).
* Symptoms last for a longer time (about 10 days), with the peak between 4th and 6th days.
* Symptoms last for a longer time (about 10 days), with a peak between the 4th and 6th days.
* Usually, [[acute sinusitis]] is not associated with [[fever]].<ref name="pmid7242607">{{cite journal |vauthors= |title=Acute maxillary sinusitis |journal=N. Engl. J. Med. |volume=305 |issue=4 |pages=226–7 |year=1981 |pmid=7242607 |doi=10.1056/NEJM198107233050419 |url=}}</ref>
* Usually, [[acute sinusitis]] is not associated with [[fever]].<ref name="pmid7242607">{{cite journal |vauthors= |title=Acute maxillary sinusitis |journal=N. Engl. J. Med. |volume=305 |issue=4 |pages=226–7 |year=1981 |pmid=7242607 |doi=10.1056/NEJM198107233050419 |url=}}</ref>
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* Inspection may show [[erythema]] and [[edema]] over the involved [[sinus]].
* Inspection may show [[erythema]] and [[edema]] over the involved [[sinus]].
* Palpation of [[sinuses]] shows [[tenderness]].
* Palpation of [[sinuses]] shows [[tenderness]].
* [[Transillumination]] of the sinuses may show opacity.
* [[Transillumination]] of the [[sinuses]] may show opacity.
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* [[X ray|X-ray]] and [[CT]] may show air fluid level or bubbles in the affected sinuses.
* [[X ray|X-ray]] and [[CT]] may show air fluid level or bubbles in the affected [[sinuses]].
* [[Culture medium|Culture]] of the nasal secretions is of limited use in [[acute sinusitis]], as may be contaminated by [[Flora|nasal flora]].
* [[Culture medium|Culture]] of the nasal secretions is of limited use in [[acute sinusitis]], as may be contaminated by [[Flora|nasal flora]].
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* Symptoms are like the symptoms of [[pharyngitis]], which include:
* Symptoms are like the symptoms of [[pharyngitis]], which include:
** [[sore throat]] and [[Dysphagia|difficulty swallowing]]
** [[Sore throat]] and [[Dysphagia|difficulty swallowing]]
** [[Fever]]
** [[Fever]]
** [[Fatigue]]
** [[Fatigue]]
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* Positive monospot test.
* Positive monospot test.
* Elevated [[liver enzymes]]
* Elevated [[liver enzymes]].
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Revision as of 15:10, 9 August 2017

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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 should be differentiated from other diseases that cause runny nose, cough, and constitutional symptoms such as influenza, allergic rhinitis, and acute sinusitis.

Differentiating acute viral nasopharyngitis from other diseases

Acute viral nasopharyngitis should be differentiated from other diseases that cause runny nose, cough, and constitutional symptoms.

Disease History Physical examination Laboratory or radiological findings
Acute viral nasopharyngitis[1]
  • Diagnosis is usually clinical; lab tests are rarely needed.
  • The virus can be cultured on human lung cells, but it takes time.
  • PCR is rapid and accurate, but is done only when the infecting virus strain in immunocompromised patients needs to be known.
Allergic rhinitis[2]
  • Characterized by repeated paroxysms of rhinorrhea, sneezing, and cough.
  • Symptoms may be related to a specific season of the year, hence the name “seasonal allergies.”
Acute sinusitis[4]
Infectious mononucleosis[6]

Differentiating Flu and Common Cold
Symptoms Flu Common cold
Fever High fever (100-102° F) Rare
Headache Common Rare
Cough Common,

moderate to severe

Rare,

mild to moderate

Body aches Common, may be severe Slight
Fatigue Usual, can last up to 2-3 weeks Sometimes
Nasal congestion Sometimes Common
Sneezing Sometimes Common
Sore throat Sometimes Common
Adapted from the National Institute of Allergy and Infectious Diseases (NIAID) [7]

References

  1. ↑ Heikkinen T, Järvinen A (2003). "The common cold". Lancet. 361 (9351): 51–9. doi:10.1016/S0140-6736(03)12162-9. PMID 12517470.
  2. ↑ Pawankar R, Bunnag C, Chen Y, Fukuda T, Kim YY, Le LT, Huong le TT, O'Hehir RE, Ohta K, Vichyanond P, Wang DY, Zhong N, Khaltaev N, Bousquet J (2009). "Allergic rhinitis and its impact on asthma update (ARIA 2008)--western and Asian-Pacific perspective". Asian Pac. J. Allergy Immunol. 27 (4): 237–43. PMID 20232579.
  3. ↑ Skoner DP (2001). "Allergic rhinitis: definition, epidemiology, pathophysiology, detection, and diagnosis". J. Allergy Clin. Immunol. 108 (1 Suppl): S2–8. PMID 11449200.
  4. ↑ Low DE, Desrosiers M, McSherry J, Garber G, Williams JW, Remy H, Fenton RS, Forte V, Balter M, Rotstein C, Craft C, Dubois J, Harding G, Schloss M, Miller M, McIvor RA, Davidson RJ (1997). "A practical guide for the diagnosis and treatment of acute sinusitis". CMAJ. 156 Suppl 6: S1–14. PMID 9347786.
  5. ↑ "Acute maxillary sinusitis". N. Engl. J. Med. 305 (4): 226–7. 1981. doi:10.1056/NEJM198107233050419. PMID 7242607.
  6. ↑ Niederman JC, McCollum RW, Henle G, Henle W (1968). "Infectious mononucleosis. Clinical manifestations in relation to EB virus antibodies". JAMA. 203 (3): 205–9. PMID 4864269.
  7. ↑ "National Institute of Allergy and Infectious Diseases (NIAID)- Flu (Influenza)".
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