Rhinitis Common Cold

The classic common cold (coryza) is marked by copious watery nasal discharge and obstruction, sneezing, and perhaps a mild sore throat or cough, but little or no fever. All colds are viral. Rhinoviruses are the major cause, several serotypes being prevalent year-round and accounting for about half of all colds. Coronaviruses are responsible for about another 15%, mainly those occurring m the winter months. Certain enteroviruses, particularly coxsackieviruses A21 and A24 and echoviruses 11 and 20, cause febrile colds and

Respiratory syncytial virus Influenzav'iruses A, B Parainfluenza viruses Coxsackieviruses Adenoviruses

EB virus and cytomegaloviruses

Rhinoviruses Coronaviruses

Respiratory syncytial virus Influenzav'iruses A, B Parainfluenza viruses Coxsackieviruses Adenoviruses

EB virus and cytomegaloviruses

Rhinoviruses Coronaviruses

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Fig. 36-1 Frequency with which particular viruses produce disease al various levefs of the respiratory tract (Courtesy Dr. D A. J. Tyrrell)

sore throats, especially in the summer. In children, respiratory syncytial virus (RSV), parainfluenza viruses, and the low-numbered adenoviruses are between them responsible for up to half of all upper respiratory tract infections (URTJ).

Otitis media or sinusitis sometimes complicate URTI. Bacterial superinfection is generally involved, but viruses have also been recovered from the effusion. Respiratory infections with RSV, influenza, parainfluenza, adenovirus, or measles viruses predispose to otitis media. Indeed, repeated viral infections can precipitate recurrent middle ear infections, leading to progressive hearing loss.

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