What is the difference between rhinorrhea and a cold?

Difference Between Rhinorrhea and Colds

Rhinorrhea is a symptom characterized by nasal discharge (runny nose), while the common cold is a viral illness that includes rhinorrhea along with other symptoms like nasal congestion, cough, and sometimes fever.

Rhinorrhea

Rhinorrhea refers specifically to nasal discharge or runny nose, which can be:

• Clear and watery discharge, often seen in allergic rhinitis or early viral infections 1
• Mucopurulent (cloudy or discolored) discharge, which may suggest rhinosinusitis 1
• Can occur as an isolated symptom in various conditions including:
  • Allergic reactions 1
  • Vasomotor rhinitis (triggered by temperature changes, odors, alcohol) 1
  • Cold-induced rhinorrhea (triggered by exposure to cold temperatures) 2
  • Food-related rhinorrhea (after ingestion of spicy foods or alcohol) 1

Common Cold

The common cold is a comprehensive viral illness with multiple symptoms:

• Caused by various viruses including rhinoviruses, respiratory syncytial virus, parainfluenza, influenza, and adenoviruses 1
• Self-limited viral upper respiratory infection lasting 7-10 days 1
• Characterized by a constellation of symptoms:
  • Rhinorrhea (runny nose) - initially clear and watery, may become cloudy 1
  • Nasal congestion/obstruction 1
  • Sneezing 1
  • Sore throat 1
  • Cough (present in up to 83% of cases within first 2 days) 1
  • Low-grade fever, headache, and malaise may occur 1
  • Symptoms typically last less than 10 days 1

Key Diagnostic Differences

• Duration: Rhinorrhea can be acute or chronic, while common cold is self-limited (typically resolving within 7-10 days) 1
• Associated symptoms: Rhinorrhea is a single symptom, while common cold presents with a cluster of symptoms 1
• Etiology: Rhinorrhea has multiple possible causes (allergic, vasomotor, infectious), while common cold is specifically viral in origin 1

Treatment Approaches

For Rhinorrhea:

• Treatment depends on the underlying cause:
  • For allergic rhinorrhea: antihistamines, intranasal corticosteroids 1
  • For vasomotor rhinorrhea: anticholinergics like ipratropium bromide nasal spray 3, 4
  • For cold-induced rhinorrhea: anticholinergic nasal sprays like atropine sulfate 2

For Common Cold:

• Symptomatic treatment is recommended as antibiotics are ineffective 1
• Options include:
  • Nasal decongestants (for up to 3 days to avoid rebound congestion) 5
  • Combination antihistamine/decongestant preparations for adults 5
  • Ipratropium bromide nasal spray for rhinorrhea 6, 3
  • Dextromethorphan for cough in adults 5
  • Adequate hydration and humidified air 5

Clinical Pitfalls to Avoid

• Avoid confusing common cold with acute bacterial sinusitis - bacterial sinusitis typically develops after cold symptoms persist beyond 10 days or worsen after initial improvement 1
• Antibiotics should not be prescribed for common cold or viral rhinorrhea as they provide no benefit and contribute to antibiotic resistance 1
• Be aware that approximately 25% of patients may have persistent symptoms (cough, postnasal drip) even 14 days after onset of a cold 1
• Avoid prolonged use of topical decongestants (>3 days) as this can lead to rhinitis medicamentosa (rebound congestion) 1