Contents:
Acute nasopharyngitis – characteristics
Most of the forms of nasopharyngitis diagnosed in children have a benign evolution (common cold), self-limiting (passes on its own without treatment), but there are also situations in which the pathology can be due to a bacterial infection, in which case it becomes necessary to institute specific antibiotic treatment.
Nasopharyngitis manifests itself in the form of an inflammation of the respiratory mucosa at the level of the nose and pharynx, constituting the most frequent cause of presentation to the pediatrician of children from nurseries and kindergartens. Viral and bacterial pathogens that favor the appearance of nasopharyngitis in children are easily spread by air within the collectives of educational institutions, especially during the cold season.
Acute nasopharyngitis is characterized by persistent inflammation of the respiratory mucosa and occurs after an acute episode of the disease that is incorrectly treated or in people who associate other comorbidities at the pulmonary level: COPD, asthma, cystic fibrosis. Active or passive smoking irritates the respiratory mucosa and increases the risk of viral and bacterial infections manifested in the form of chronic nasopharyngitis.
Symptoms of acute nasopharyngitis in children
The symptoms that make up the evolving clinical picture of children with acute nasopharyngitis are frequently represented by:
Discomfort at the level of the pharyngeal mucosa manifested in the form of itching, feeling of dryness or pain when swallowing; The appearance of abundant nasopharyngeal secretions that drain on the posterior pharyngeal wall (postnasal drip) and cause breathing difficulties for the child, especially in the supine position (evening at bedtime); Nasal congestion; Discreet ulcerative lesions in the oral cavity; Otalgia (ear pain); Sneeze; Frequent dry irritating cough, especially at night; Hoarseness; Cervical adenopathy (inflammation of the lymph nodes in the neck area); Headache; Fever; myalgia; Scarlatiniform rash (skin eruption specific to infections with group A beta hemolytic streptococcus involved in the occurrence of acute bacterial rhinopharyngitis); Altered general condition.
Nasopharyngitis in children frequently associates the child’s irritability, refusal to eat, and in the case of a high fever syndrome, diarrhea or vomiting, it can develop with important hydroelectrolytic imbalances as a result of water loss from the body.
Symptoms affecting adults
Adult nasopharyngitis is manifested in the vast majority of cases by nasal congestion, abundant respiratory secretions, feeling of discomfort in the pharynx, sneezing and coughing that can be accompanied by fever, myalgias, fatigue, headache, loss of appetite and altered general condition. The symptoms may vary from case to case depending on the etiological agent involved in the occurrence of nasopharyngitis and the evolution of the disease.
The symptomatology reaches a maximum on day 2-4 of the evolution of the pathology and is remitted in the vast majority of cases within a few days from the onset. The cough can persist up to 3-5 weeks after the onset of nasopharyngitis, the duration of the manifestations associated with nasopharyngitis being mostly influenced by the functioning capacity of the patient’s immune system and associated comorbidities.
How is acute nasopharyngitis transmitted?
The transmission of pathogens involved in the occurrence of nasopharyngitis is airborne and is carried out through contaminated respiratory secretions released during sneezing, coughing or talking that come into contact with the respiratory and ocular mucosa of healthy individuals.
Diagnosis of nasopharyngitis in children
The diagnosis of nasopharyngitis in children is established by the family doctor or the pediatrician with the help of the information obtained from the anamnesis and the clinical examination of the patient. The epidemiological characteristics of this condition can guide the attending physician’s decision to perform a series of investigations frequently represented by rapid antigenic tests and pharyngeal exudate. Rapid immunochromatographic tests are used for the detection of infections with respiratory viruses, while the culture of pharyngeal exudate identifies bacterial pathogens such as group A beta hemolytic streptococcus involved in the occurrence of nasopharyngitis in children.
When it is necessary to contact the doctor
In the case of infants and small children who refuse feeding due to swallowing difficulties (severe pain when swallowing), those who present with diarrheal stools and persistent fever in the context of acute nasopharyngitis, it is recommended to see a doctor as soon as possible because there is an increased risk of imbalances hydroelectrolytic with unfavorable evolution.
Children enrolled in daycare, kindergarten or school, who have more than 6 episodes of acute nasopharyngitis per year, require a specialized medical evaluation to identify the causes and possible complications that may occur in the context of recurrent infections of the upper respiratory tract. Persistence or aggravation of the specific manifestations of nasopharyngitis and those that associate otalgia, require presentation to the otorhinolaryngologist for a detailed evaluation and, if necessary, the establishment of a treatment plan adapted according to the clinical characteristics of each individual case.
Mild to moderate forms of nasopharyngitis show a favorable evolution with improvement of symptoms within 7 to 10 days of onset and can be treated at home by the parents, according to the telephone instructions of the attending physician.
Home care in case of nasopharyngitis
Home care by parents of children with mild/moderate nasopharyngitis involves maintaining hydration and an appropriate caloric intake of the little one, by administering soups, teas and food that is easy to chew and swallow that does not accentuate pharyngeal discomfort. Room humidifiers, nasal sprays with sea water and frequent clearing of the nasal airways with sterile saline reduce nasal congestion, improving the breathing of the child with nasopharyngitis.
Treatment of nasopharyngitis in children
The pharmacological therapy of nasopharyngitis in children is symptomatic and etiological. In children older than 2 years, corticoid medication in the form of nasal sprays relieves the congestion of the respiratory mucosa, but this therapy is administered for a limited period, according to the indications of the attending physician. The febrile syndrome and pharyngeal discomfort can be alleviated with the help of anti-inflammatory and analgesic medication in doses corresponding to the age and weight of the child prescribed by the pediatrician or family doctor.
The etiological therapy of nasopharyngitis involves the administration of antibiotics in the situation where the infection of the respiratory mucosa is due to group A beta hemolytic streptococcus. The selection of the antimicrobial medication is carried out in accordance with its spectrum of action and the susceptibility of the pathogen determined by means of the antibiogram that is obtained after the isolation of the bacterium in the microbiology laboratory.
In the vast majority of cases, the doctor recommends the administration of penicillin (or erythromycin in the case of penicillin allergy) or a cephalosporin to treat the child’s nasopharyngitis. Depending on the severity of the manifestations, the antibiotic medication can be administered orally or parenterally in the doses and at the time interval recommended by the doctor.
The antiviral treatment administered to children with nasopharyngitis is reserved for certain cases selected by the doctor and is administered only on his recommendation due to the adverse effects that this type of medication can cause.
In the case of adults, the symptomatic treatment of pharyngitis is similar to that applied to children and includes rest, proper hydration and an adequate diet to ensure the patient’s daily caloric needs. Non-steroidal anti-inflammatories, nasal decongestants and antiseptic oral solutions relieve the discomfort generated by fever and inflammation of the nasal and pharyngeal respiratory mucosa. The etiological treatment of nasopharyngitis in adults is represented by antivirals and antibiotics prescribed by the attending physician.
The nasopharyngitis of children and adults is due in the vast majority of cases to viral infections with respiratory tropism and frequently presents a self-limited evolution (disappears without treatment) that is remitted within a few days from the onset. The management of this pathology mainly aims at improving the symptoms, people with a competent immune system eliminating the virus without the need to institute specific drug treatment.
2023-10-13 09:02:43
#Acute #nasopharyngitis #children #symptoms #treatment
