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Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Related Articles. Signs and Symptoms of the Common Cold. Can Allergies Cause a Fever? An Overview of Epidemic Keratoconjunctivitis. Bronchitis vs.
Cold: What's the Difference? Causes and Risk Factors of Mumps. Causes and Risk Factors of Strep Throat. Strep Throat: Signs, Symptoms, and Complications. Why You Cough. Allergy Cough vs. Stages of the Flu Day by Day. Elkhatieb et al 33 described a total of 91 subjects who had symptoms of nasal obstruction and a documented rhinovirus cold.
The changes were especially evident after 2 to 3 days of infection. These abnormalities usually resolved by 2 weeks; however, in 1 patient with a history of middle ear infections during childhood, a major abnormality in middle ear pressure persisted in 1 ear at 4 weeks. Interestingly, middle ear pressure abnormalities were not clearly associated with complaints of earache or pressure or with the severity of the rhinoviral infection.
Similarly, experimentally induced rhinovirus infection produced eustachian tube dysfunction and middle ear pressure abnormalities in adults that were detected within 2 days of infection and resolved within 2 weeks.
Finally, and perhaps most importantly, the presence of virus in middle ear fluid of patients with AOM predisposes them to antibiotic failure. Their study defined the pathogenesis, frequency, and severity of illness and the use of medical care services.
Acute respiratory illness occurred more frequently in the subjects with moderate to severe COPD 3. The subjects with COPD had more nonvirus-identified illnesses than virus-identified illnesses. No control subjects required emergency care or hospitalization. Despite a similar rate of yearly occurrence of respiratory infections, there was a 2-fold increase in acute respiratory tract illness among the subjects with COPD compared with the control group.
The cohort with moderate to severe COPD used significantly more medical resources, as reflected in the number of clinician visits, emergency center visits, and hospitalizations. Declines in pulmonary function were comparable in children with rhinovirus or other picornavirus infections as well as in those with nonpicornavirus infections. These findings suggest that many respiratory viruses can adversely affect pulmonary function in cystic fibrosis.
The impact of rhinovirus infections in the elderly was evaluated in a prospective community-based surveillance study conducted in England. The consequences of rhinovirus infection were significant. The median duration of illness was 16 days overall, but it was 19 days among those with lower respiratory tract illness. One patient died of COPD that was exacerbated by the rhinovirus infection.
Among high-risk patients with cancer, rhinovirus infections are often fatal. In 6 of the 7 fatal cases, rhinovirus had been isolated in bronchoalveolar lavage fluid or an endotracheal aspirate before death. Nevertheless, these studies show that rhinovirus infections cause considerable pulmonary morbidity and mortality in high-risk patients with cancer. The specific diagnosis of rhinovirus infections has traditionally been made by virus isolation from appropriate patient specimens, using culture methods.
Serologic testing is impractical, given the numerous rhinovirus serotypes. These assays use probes directed to conserved regions of the rhinoviral or enteroviral genome, and accordingly they are capable of identifying most serotypes. Therefore, the diagnosis is usually made clinically, based on signs and symptoms.
Rhinorrhea, nasal congestion, and sore or scratchy throat are very common symptoms. Arruda et al 5 found that sore throat, nasal congestion, and rhinorrhea were the first symptoms noticed. The most bothersome symptoms were runny nose, stuffy nose, sore throat, and malaise. Coughing, sneezing, hoarseness, facial pressure, ear fullness, and headache are also typical symptoms.
Less often, malaise, chills, and low-grade fever may occur. The use of over-the-counter symptomatic treatments can reduce symptoms in some patients. Antihistamines and nonsteroidal anti-inflammatory drugs may relieve some symptoms, but they do not shorten the duration of illness.
These other medications include zinc lozenges, echinacea, and high-dose vitamin C. Antiviral Agents. No antiviral drugs are currently approved for clinical use in picornaviral infections.
Intranasal interferon alfa therapy was shown to be protective in early prophylactic trials, but it was not pursued for clinical use because of its local adverse effects.
In early studies, intravenously administered recombinant soluble ICAM-1 tremacamra appeared to reduce the severity of symptoms in patients with experimental rhinovirus colds. However, the compound has not been tested further.
Human rhinovirus 3C protease inhibitors, such as AG, represent an alternative approach for rhinovirus infections because of their potent antiviral activity against rhinoviruses and enteroviruses. The most common drug-related adverse events nausea and taste disturbance were mild. Capsid-function inhibitors bind to a hydrophobic pocket in VP4 at the site of viral attachment and uncoating, thereby inhibiting viral replication.
Pleconaril was studied in an experimental challenge model using coxsackievirus A21 in normal adults. Pleconaril mg or placebo was administered twice a day for 7 days to 33 subjects infected with a safety-tested strain of coxsackievirus A In 2 randomized, double-blind, placebo-controlled studies of patients with self-diagnosed colds for 24 hours or less, pleconaril mg twice a day was compared with placebo.
A significant reduction from baseline symptom scores was observed by day 2. Adverse events profiles were similar. Pooled analysis of 2 pivotal trials showed that compared with placebo-treated patients, picornavirus-positive patients treated with mg of pleconaril twice a day had a 1.
New formulations are being considered for clinical studies. Viral respiratory infections caused by picornaviruses can have significant consequences in both children and adults, producing exacerbations of asthma and other pulmonary disorders as well as various respiratory tract abnormalities. New antiviral agents that have activity against rhinoviruses have been developed based on current understanding of virus replication and assembly.
Antiviral therapy that is specifically targeted to rhinovirus infection and shortens the clinical course of picornaviral infections should reduce the likelihood of serious sequelae. Because of the need to reduce the significant morbidity and mortality associated with VRI, treatment studies should be performed in groups of high-risk patients, such as those who have asthma or are immunosuppressed.
Corresponding author and reprints: Stephen B. Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy Continue.
Download PDF Top of Article Abstract Picornavirus rhinovirus structure Epidemiology and impact of rhinovirus infection Rhinovirus infections in patients with asthma Rhinovirus infection in acute rhinosinusitis Acute otitis media and rhinovirus infection Rhinovirus infection in chronic obstructive pulmonary disease Rhinovirus infection in patients with cystic fibrosis Rhinovirus infection in the elderly Rhinovirus infection in the immunocompromised Diagnosis and treatment Conclusions References.
View Large Download. Arch Fam Med. Rotbart HA Enteroviruses. Clinical Virology. Ann Med. Rotbart HAKirkegaard K Picornavirus pathogenesis: viral access, attachment and entry into susceptible cells. Semin Virol. J Clin Microbiol. Viruses and bacteria in the etiology of the common cold. Clin Infect Dis. Gonzales RSteiner JFSande MA Antibiotic prescribing for adults with colds, upper respiratory tract infections, and bronchitis by ambulatory care physicians.
Text Size. Rhinovirus Infections. Page Content. What happens when a child gets a cold? What can I do to help my child feel better? When should I call my child's doctor? Call the doctor if your older child has symptoms such as: Lips or nails that turn blue Noisy or difficult breathing A cough that doesn't get better See Why Does My Child Have a Chronic Cough Very tired Ear pain, which may mean that your child has an ear infection How can I tell when my child has a cold?
How can I treat my child's rhinovirus infection? What can I do to keep my child from getting a rhinovirus infection? Keep infants younger than 3 months away from children or adults who have colds. Additional Information from HealthyChildren.
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