The common cold is caused by a viral infection; however, there are thousands of viruses that cause problems when they infect our bodies. Although the typical course of a cold can be mild, there can also be viral infection complications that you hope to never develop.
I think by now, most people have heard physicians loudly state that antibiotics do not cure or impact a viral infection. If your physician feels that a medication is needed. there are anti-viral medications that can be prescribed. Just as there are different antibiotics, there are also different antiviral medications.
The most common antiviral medication that people know about is Tamiflu which is used to treat flu symptoms that have occurred for less than 2 days. It can also be used to prevent the flu in people exposed to the influenza virus.
There are growing numbers of physicians who do not like Tamiflu for a variety of reasons; consequently, the best way to treat the flu is to prevent it! Do not use a lame excuse to avoid getting a flu shot.
Viral infections typically last up to 2 weeks. The concept of having a cold that lasts for a month or more is false. Illnesses that last for several weeks may actually be viral infection complications.
Physicians do understand that healthcare is expensive and that patients wish to avoid multiple trips to the be examined. However, if your symptoms have changed, we need a new exam to determine what the next course of action should be.
At the onset of a viral infection, physicians often recommend a variety of supportive treatment measures but caution you to not feel the illness is “just a virus”. Viral infection complications can range from mild and self-limiting to severe and life-threatening.
Viral infections can lead to swelling and allow bacteria to set up a secondary infection. If this happens, antibiotics may be prescribed at that time. Viruses may also directly spread to different parts of the body which may then require more aggressive management.
Many practices employ non-physician healthcare providers, such as nurse practitioners and physician assistants. Because these providers have not had the extensive medical training and in-depth residency training, you should always be sure to ask for the credentials of your healthcare providers.
Please do not delay seeking another examination or ask to see your physician if you feel your symptoms are progressing.
Viral Infection Complications You Hope to Avoid
Ear
Most colds start with a stuffy or a runny nose. If the swelling is persistent, it can block the eustachian tube and lead fluid build up behind the eardrum. This fluid may cause pain or pressure or dizziness. No specific treatment is needed unless bacteria grow in the fluid causing an ear infection.
If an ear infection becomes severe or the fluid fails to drain, additional severe complications may occur.
Nose
Typical cold symptoms include nasal congestion which may lead to headaches and nosebleeds. Aggressive salt water washes can be helpful to reduce excess nasal mucus and reduce nasal tissue swelling.
When nasal swelling persists, sinus infections may occur. A severe sinus infection may lead to complications where infection moves into the area around the eye and the brain. Emergency surgery would then be needed to provide drainage.
Throat
Viral infections in the throat tend to cause superficial irritation with general pain, sore throat, tender gums, ulcers, and sometimes swelling of “that thing that hangs in the back of the throat!”
Tonsils are lymph nodes located in the back of the throat, and they tend to enlarge to help the body fight infection. If the tonsils remain enlarged, they are often described as ‘kissing tonsils’ because the tonsil on each side of the throat touches in the middle.
Severely enlarged tonsils can make it hard for kids to breathe and they develop sleep apnea. Some children need to be hospitalized and placed on steroids to shrink the tissue to improve breathing. I have seen this happen most often with a Mono infection.
Tonsillitis occurs most commonly due to viral infections; however, bacterial infections (Strep Throat) also occur. If the infection in tonsil spreads, it can create an abscess around the tonsil which requires urgent surgical drainage.
Neck
Viral infections are associated with muscle aches, so the neck may become tender and stiff for this reason. However, lymph nodes may swell in the neck to help fight infection.
When lymph nodes enlarge on both sides of the neck, difficulty breathing may occur. In its most severe form, these swollen lymph nodes are called ‘bull neck’. This is a description commonly associated with Diphtheria (which is not seen much due to the amazing impact of vaccinations!)
However, I have seen children hospitalized with this problem when they have severe cases of Mono. If the infection breaks out of the lymph nodes, it can lead to a neck abscess that requires urgent surgical drainage.
Respiratory
Basic viral illnesses lead to hoarseness and coughing. As inflammation progresses deeper into the lower respiratory tract, more serious complications may occur.
Croup occurs when the swelling is located just below the vocal cords, while bronchitis occurs when the inflammation extends lower in the main breathing tubes.
Swelling in the smaller breathing tubes may lead to wheezing and ultimately to pneumonia. Lower respiratory inflammation and mucus collection make it hard for oxygen to move from the lungs into the rest of the body. Hospitalization, steroids, extra oxygen and possibly antibiotics may be needed.
Cardiovascular
Although we mostly think about colds impacting the upper and lower respiratory tract, viruses may have devastating consequences in other parts of the body.
Some viruses in the blood hurt our cells that help us make blood clots. This can be a temporary or long-lasting problem and can be associated with easy skin bruising and longer than normal bleeding from simple cuts.
How many of you have heard of the movie “Beaches’? Remember when the mom was dying because she her “heart caught a cold”? And recently on my TV drama “Major Crimes”, the star just died when she “got a cold in her heart”. (oops…spoiler alert?).
Anyway, both of these actresses had myocarditis, a devastating viral infection in the heart muscle that may require a heart transplant.
Neurologic
So now we understand significant viral infection complications can occur due to swelling and inflammation in the respiratory tract. We also understand how viruses can enter the bloodstream and impact our blood cells and heart.
This final category includes the permanent problems that occur after a virus damages nerve cells. As an ENT, I took care of many patients with Bell’s Palsy who had a virus that injured the nerve that moves the face. Most of the time, the symptoms completely resolve however permanent damage may lead to facial changes that resemble a stroke.
During my residency, one of my peers studying to be a heart surgeon came to my ENT to ask me to clean the wax out of his ear. He woke up and could not hear out of one ear. I looked, but there was no wax. A hearing test showed complete deafness in one ear. He had a cold but otherwise felt fine. This event allowed me to witness how a permanent hearing loss could occur when a virus injures the hearing nerve.
Guillain-Barre (gee-YAH-buh-RAY) is a rare but complication that occurs after a viral illness triggers the body to attack its nerves.
And finally, meningitis (infection of fluid around the brain) and encephalitis (infection of the brain tissue) are examples of severe viral illness complications.
The moral of this story is that all viruses will not act like the simple common cold.
Even if you or your child has been seen by a physician and no additional medications are prescribed, please be sure to monitor for symptoms that indicate a significant viral infection complication.
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