Self-limiting viral URTI (common cold) — rhinorrhoea, sore throat, mild cough, low-grade fever lasting 7–10 days.
History taking
- • Nasal discharge, sneezing, sore throat, cough
- • Low-grade fever, malaise, headache
- • Contact with cases
- • Vaccination, comorbidities
Examination
- • Vitals (usually normal or low-grade fever)
- • Throat: erythema without exudate
- • No tonsillar swelling / cervical LN
- • Clear chest
Red flags
- • RR >24, SpO₂ <94%
- • Stridor, drooling, severe sore throat (epiglottitis)
- • Symptoms >10 days or biphasic course (bacterial superinfection)
Differential diagnosis
- • Streptococcal pharyngitis (Centor)
- • Influenza, COVID-19
- • Allergic rhinitis
- • Acute bacterial sinusitis
Recommended investigations
- • Clinical diagnosis
- • RAT for COVID/influenza if at risk or during outbreak
- • FBC/CRP only if uncertain or severe
Diagnosis
- • Clinical based on symptoms <10 d and absent red flags
Initial treatment / management
- • Symptomatic care: rest, hydration, paracetamol
- • Saline nasal douche, steam
- • No routine antibiotics
Drug therapy
- • Paracetamol 1 g PO QDS PRN (max 4 g/d)
- • Xylometazoline 0.1% nasal spray BD × 5 d for congestion
- • Honey for cough in adults / >1 y
Lifestyle advice
- • Hand hygiene
- • Cover cough
- • Stay home until afebrile 24 h
Prescription examples
- • Paracetamol 500 mg — 1–2 tab QDS × 5 d
- • Saline nasal drops PRN
Follow-up advice
- • Return if fever >7 d, breathlessness, or symptoms worsening after improvement
Patient counselling
- • Antibiotics do not help viral illness
- • Expected duration 7–10 d; cough may persist 3 weeks
Referral criteria
- • Refer if persistent fever, complicated sinusitis, or recurrent (>6/year in adults)
Clinical pearls
- • Antibiotics for URTI are over-prescribed — use Centor / FeverPAIN for pharyngitis
References
- • NICE NG79 Cough acute 2019
- • WHO IMCI
Educational outpatient guide — verify against local guidelines before clinical use.
