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Medical expert of the article

Doctor Amir ONN
Internist, pulmonologist

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Runny nose and cough

, medical expert
Last reviewed: 30.06.2024
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When runny nose and cough appear, the diagnosis is determined almost immediately: a cold, that is, an acute respiratory viral infection (ARVI) or nasopharyngitis - with inflammation of the mucous membranes of the nose, throat and larynx.

These symptoms and their treatment were described as early as the 15th century BC in the Egyptian papyrus of Ebers, the oldest surviving medical text.

Causes of the runny nose and cough

The true causes of the common cold were identified in the mid-20th century, and nearly 200 viral strains have been implicated, the most common of which are:

Nasopharyngitis or ARVI causes copious nasal discharge and other symptoms: sneezing, coughing, sore throat.

Cough, runny nose and fever occur in seasonal upper respiratory tract infections with different serotypes of influenza virus (Influenza virus) of the family Orthomyxoviridae, [5] as well as parainfluenza viruses (Human parainfluenza virus) of the genus Orthorubulavirus [6] - with nasal congestion and runny nose, persistent dry cough and sore throat.

Pathogenesis

The mechanism of development of clinical manifestations of acute respiratory viral infection, such as fever, runny nose, cough, weakness, headache, is still under investigation.

And to date, it is believed that the pathogenesis of these symptoms is due to the immune response to viral infection. Once rhinovirus capsids attach to epithelial cells of the nasopharyngeal mucosa via intercellular adhesion receptors (ICAM-1, LDLR and CDHR3), replication begins. In response, there is a release of inflammatory mediators and activation of immune system cells producing cytokines, in particular, interleukins IL-1 and IL-6, which act as endogenous pyrogens and cause hyperthermia - an increase in body temperature or fever. As a nonspecific defense reaction of the body, fever promotes the production of interferons (IFN) - signaling proteins that activate natural killer cells and macrophages, which destroy the viral infection. [7]

However, rhinovirus infection, by compromising the integrity of the epithelial barrier, can cause increased pathogen migration and complications of respiratory disease (in the form of bronchiolitis in infants or bronchitis and pneumonia in immunocompromised children), as well as exacerbate existing lung diseases such as asthma or chronic obstructive pulmonary disease. [8]

Increased mucous discharge from the nose in rhinitis, that is, runny nose, also represents a protective response aimed at neutralizing and removing infectious agents.

The main function of coughing, an important protective reflex, is to create a strong airflow to clear the airways, and such airflow is provided by intense contractions of the muscles involved in exhalation (internal intercostal, subcostal, and anterior abdominal wall) when the vocal cleft of the larynx is closed. The cough reflex, arising due to stimulation of a complex reflex arc, initiates chemical irritation of cough receptors of peripheral nerves in the mesenteric epithelium of the pharynx, larynx and trachea. And impulses from stimulated cough receptors through afferent branches of the vagus nerve pass to the cough center located in the medulla oblongata.

Forms

A runny nose can be catarrhal or purulent. As a rule, the appearance of purulent rhinitis is associated with the attachment of bacterial infection and inflammation of the paranasal sinuses (paranasal sinuses).

The main types of cough include nonproductive or dry cough (without sputum separation) and productive - cough with sputum (with separation of tracheobronchial secretion), that is, wet cough, which can appear both in colds and in bronchitis and pneumonia.

In most cases, fever, cough, and runny nose in a child are symptoms of rhinovirus infection in children. Influenza and acute respiratory viral infections (ARI) cause fever, cough, and runny nose in adults.

In addition, children with similar symptoms, including nasal congestion, runny nose and barking cough, subfebrile fever or mild sore throat, begin with subclavian acute laryngitis (false croup), [9] as well as having a viral origin stenosing laryngotracheitis or croup - inflammation and swelling of the larynx and trachea with frequent noisy breathing (stridor) and hoarse voice. [10] In this case, the cough gets worse at night, and there are fairly long bouts of dry, harsh coughing for three to four days.

When you have a sore throat, cough and runny nose, it most often indicates:

If cough and runny nose appear without fever in a child or adult, these are symptoms of a cold without fever. But when sneezing, runny nose and dry cough are observed against a background of normal temperature, these may be signs of seasonal allergies (or allergic rhinitis). [11], [12]

Who to contact?

Therapist
Pulmonologist
Infectionist

Diagnostics of the runny nose and cough

In most cases, acute respiratory infections and influenza are diagnosed clinically - based on symptoms and listening to the lungs.

If the sputum changes in character, it may need to be bacterioscopically analyzed.

Laboratory tests for antigen detection, virus isolation, or detection of influenza-specific RNA by polymerase chain reaction are performed only when the results will affect treatment.

Instrumental diagnosis is limited to rhinoscopy, laryngoscopy and chest x-ray.

A differential diagnosis is made with allergic and vasomotor rhinitis; respiratory mycoplasmosis; pneumonic form of legionellosis (caused by Legionella pneumophila bacteria); echovirus infection (ECHO).

Treatment of the runny nose and cough

There are currently no approved antiviral therapies for acute respiratory infections/colds and treatment remains symptomatic.

How to treat runny nose and cough? What medicines are recommended to use?

The main drugs (names), methods of their use and other necessary information in publications:

Cough and runny nose medicines are available in different dosage forms:

In acute respiratory viral infections apply inhalation therapy, that is, do inhalation for cough and runny nose with various drugs, including using a fine inhaler nebulizer. Read more in the materials:

Read about whether antibiotics are used for cough and runny nose:

Do not forget and proven by generations of home remedies for the treatment of acute respiratory viral infections: well help teas for colds, with runny nose and stuffy nose - star, that is balm "Golden Star" (which includes essential oils containing biologically active substances), with cough - ginger root with honey, etc. For more details see:

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