Inflammatory diseases of the upper respiratory tract are quite common in pediatric practice. Throughout life, every person at least once gets sick with pharyngitis. What you need to know about this disease in order to successfully cope with it, this article will tell.
What it is?
A pathological condition localized in the oropharynx is called pharyngitis. This disease affects both boys and girls equally often. A baby can get pharyngitis at any age. Doctors note cases of the disease even in newborn babies and infants.
This disease is widespread throughout the world.
The inflammatory process in pharyngitis is mainly localized. Edema extends mainly to the region of the posterior pharyngeal wall, individual areas of the upper palate, the root of the tongue, and in some cases to the tonsils and lymphoid tissue. This process is characterized by the occurrence of pronounced edema and an acute local reaction of immunity.
The predominant method of infection is airborne. In this case, the smallest viruses or bacteria easily enter the mucous membranes. The transmission of infection occurs from a sick person to a healthy one. In some cases, the "transmitter" of an infectious disease may not even suspect that pathogens are present in his body. Such a person also lacks the corresponding symptoms of pharyngitis. In medicine, this condition is called "infection carrier".
According to statistics, the greatest number of cases of inflammation of the pharynx occur in the cold season. Late autumn, winter and early spring are the most likely months for pharyngitis infections.
Kids who attend various educational institutions and leisure centers get sick much more often. This feature is due to the easy prevalence of viruses and bacteria in the environment. Many microorganisms are very resistant to the effects of adverse environmental factors and can maintain their vital activity for a long time. In babies aged 2-3 years, the disease is much more severe than in older children. This is due to the immaturity of the immune system: it usually develops during the first 5-6 years of a baby's life. The failure of the local and systemic immune response leads to the fact that any infection quickly spreads through the child's body and can cause serious complications in the child.
During life, each person can get sick with pharyngitis more than once. This is due to the fact that with each infection, it becomes infected with completely different subtypes of viruses or bacteria.
The immune system "remembers" the causative agents of the disease, but does not form a stable memory mechanism. The only exceptions are a few viral and bacterial infections of children, which are also called "quarantine".
Causes
A variety of reasons can cause inflammation in the oropharynx in a child. Their exposure can be short in time or rather long. Such a variety of various causal factors leads to the fact that a lot of clinical variants of the disease are registered.
Most often, the following reasons lead to the development of inflammation in the oropharynx:
Viral infections
Getting on the delicate mucous membranes of the upper respiratory tract, viruses easily cause inflammation. Different antigenic variants of these microorganisms can cause symptoms of varying severity in a child. Quite often, viral infections cause illness in babies under one year old.
The most common sources of the disease in children's practice are: adenoviruses, parainfluenza and influenza viruses, rhinoviruses, coronaviruses, Coxsackie viruses, Apt-Barr viruses and many others.
Bacterial infections
Bacterial infections are a fairly common cause of various types of pharyngitis in young patients. A fairly common variant of the disease is streptococcal. Bacterial pharyngitis can be quite difficult, with severe intoxication syndrome. To eliminate adverse symptoms, an optimal antibiotic regimen is required.
Chronic diseases of internal organs
Some pathologies of the gastrointestinal tract, diseases of the endocrine system and immunodeficiency states are common causes of adverse symptoms of pharyngitis in a baby.
To eliminate the clinical signs of the disease in this case, initial therapy of the underlying disease is required.
Bad teeth
The presence of carious or periostitis teeth in the mouth is often the cause of the disease. An infected dental cavity is an excellent breeding ground for the development of pathogens. Long-term infection leads to the fact that microbes begin to spread through the bloodstream throughout the body. The organs that are located in the neighborhood, including the oropharynx, are more affected.
Herpes infection
Herpetic or vesicular pharyngitis occurs mainly in babies weakened or often suffering from colds. The causative agents of the disease in this case are various types of herpes. While settling in the body, they act on the lymphoid tissue, causing a strong inflammatory process. Treatment for herpes pharyngitis is usually longer than for viral or bacterial infections.
Allergic pathologies
Allergic reactions occur in babies who have individual sensitivity to various types of allergens. Various food products, inhalation of polluted air, and some chemicals can act as allergenic substances. The course of allergic pharyngitis is usually wavy: periods of exacerbations are replaced by remissions. The ingestion of an allergen in a child's body in the shortest possible time can cause an allergic reaction, which also involves the oropharynx.
Local hypothermia
The mucous membranes of the oropharynx are very delicate. Exposure to unfavorable temperature contributes to their damage and the onset of the inflammatory process. The inflammation quickly passes to the lymphoid tissue, which is well represented on the back of the pharynx.
Drinking your favorite ice cream during the cold season or walking in windy weather without a scarf very often leads to the fact that the baby wakes up in the morning with clinical symptoms of pharyngitis.
Long-term use of certain medications
All pharmaceuticals have side effects. One of which is the appearance of nonspecific (non-infectious) pharyngitis. Quite often, long-term use of clozapine, sulfasalazine or carbimazole leads to the development of adverse symptoms of inflammation in the oropharynx in a child.
Smoking
This causative factor is relevant for adolescents. The components of the smoke inhaled during smoking contain a lot of various toxic substances that irritate the mucous membranes of the oropharynx.
Smoking in cold weather significantly increases the risk of inflammatory diseases of the upper respiratory tract.
Candidiasis
Also, this disease is often called "thrush". It is most often found in weakened babies, as well as children suffering from obesity or endocrine diseases. Diabetes mellitus can also cause signs of pharyngitis in a child. It should be noted that this clinical form is rare in children.
Classification
The development of this disease is caused by the influence of a wide variety of reasons. This causes a large number of nosological variants of the disease. For the convenience of setting the correct diagnosis, all of them are collected in special classifications that doctors use in their daily practice. To establish the correct form of the disease, in many cases, pediatricians have to carry out a fairly voluminous complex of differential diagnostics. This is necessary to establish the correct cause of the disease, as well as to draw up further tactics for treating the baby.
By the duration of the onset of symptoms
According to the duration of the onset of symptoms, doctors identify several clinical variants of inflammation of the oropharynx.
- Acute. All adverse symptoms usually develop within 5-7 days. After the acute period of the disease, complete recovery occurs. Unfortunately, the immunity after the illness is unstable. According to statistics, acute pharyngitis mainly affects children aged 6 to 14 years.
- Chronic. The chronic form has an undulating course. Acute periods of illness are followed by periods of relative or absolute clinical well-being. During periods of remission, babies usually do not experience any uncomfortable oropharyngeal symptoms. The duration of the exacerbation period in chronic pharyngitis can be different: from several days, weeks, or up to a couple of months. In their work, pediatricians and pediatric otolaryngologists take into account not only one classification by the duration of the onset of clinical symptoms. They also use a different division of disease, taking into account morphological (structural) changes. This classification includes the following anatomical variants of pharyngitis.
By structural changes
- Catarrhal. The mildest form of the disease. It is characterized by minor inflammatory changes in the oropharynx and pharynx. The severity of adverse symptoms is moderate. Complications with this form of the disease, as a rule, do not occur.
- Hypertrophic. It is the next stage of the process chronization. It is characterized by a pathological increase in oropharyngeal tissue. The hypertrophic form is divided into lateral and granular. The granular variant is characterized by the formation of numerous red granules on the posterior wall of the pharynx, which are accumulations of lymphoid tissue. The course of the hypertrophic variant of the disease is much more severe than the catarrhal one.
- Atrophic. It is considered the most unfavorable clinical form of the disease according to the prognosis. It causes a lot of adverse symptoms in a sick child, which significantly disrupt his well-being and are tolerated quite hard. With atrophic pharyngitis, a fairly large number of dense crusts are formed in the oropharynx. Often, the process goes on to the nasal cavities, which significantly worsens the baby's well-being.
Symptoms
The length of the incubation period may vary. It depends on which infectious agent caused the disease in a particular child. So, the first clinical signs of viral pharyngitis appear, as a rule, after 1-3 days from the moment of infection, in some cases this time is significantly reduced. For example, having visited a kindergarten during the day, the baby may already feel bad in the evening, and by the morning he will have all the unfavorable symptoms of the inflammatory process in the oropharynx.
The first clinical signs of the disease in bacterial pharyngitis appear 5-7 days after infection. This time is necessary for the development and reproduction of bacteria in the child's body. The duration of the incubation period for different clinical variants of pharyngitis can be different: from a couple of hours to several days. At this time, the child's illness, as a rule, does not bother. Only in some cases, attentive parents can notice that the baby has become somewhat lethargic and less active.
Inflammation in the pharynx is characterized by the following symptoms:
- Soreness when swallowing. It appears immediately after the end of the incubation period. The severity of this symptom can be different: from mild to significant pain syndrome. In severe cases, it may be difficult for a child to swallow even chopped or pureed food. Foods that are too hot or too cold will significantly increase the pain syndrome.
- Redness of the back of the pharynx. This symptom is most specific for pharyngitis. The back wall of the pharynx, tonsils, palate, and root of the tongue become hyperemic (bright red). When examining the oropharynx with a spoon or spatula, pronounced swelling and "graininess" are visible.
- Increased body temperature. It can reach different values. With a mild course of the disease, the body temperature rises to 37-35.5 degrees. More severe forms of the disease cause a pronounced febrile condition in sick babies. The high temperature lasts, as a rule, 3-5 days, and then gradually decreases. During an exacerbation of persistent chronic tonsillitis, subfebrile condition may persist a little longer.
- Intoxication syndrome. In the acute period of the disease, the baby develops a headache, severe weakness. The behavior of a sick child also changes. He becomes more lethargic, apathetic, he loses interest in his favorite games and activities. Sick babies spend more time in bed, can be capricious and whine.
- Accumulation of excess mucus. The inflammatory process leads to an increased formation of various secrets, one of which is mucus. It accumulates on the back of the pharynx, exacerbating the onset of adverse symptoms.
- Paroxysmal cough. This symptom occurs mainly in the smallest patients. The accumulation of mucus on the back of the throat irritates the receptors, which causes the baby to cough. It can be different: both dry and wet. The cough usually lasts 1-1.5 weeks, then this unfavorable symptom gradually disappears.
How does the disease manifest in babies under three years old?
The most severe course in newborn babies and infants has streptococcal pharyngitis. It causes the appearance of numerous adverse symptoms in the child and significantly worsens his general well-being. During streptococcal infection, the mucous membrane of the oropharynx becomes bright red, and in some cases even "flaming". When examining the pharynx, pronounced hyperemia of the inflamed areas and severe swelling are visible.
Body temperature in this clinical form of the disease is growing rapidly. Its values often reach 38-39 degrees. Such a pronounced febrile condition can persist for 4-7 days.
Reduction and normalization of elevated body temperature is a very favorable symptom, which indicates the beginning of recovery. During a streptococcal infection, a child develops a strong discharge from the nasal passages. They are usually yellow or green in color, quite thick. The discharge is bad. Parents should remove them from the nasal cavity of infants, since babies still do not know how to blow their nose on their own. Quite often, this infection causes various complications in sick babies: inflammation of the paranasal sinuses (sinusitis, sinusitis, frontal sinusitis), severe otitis media, and in some cases - bacterial conjunctivitis.
The disease in a child is quite difficult. The severity of the intoxication syndrome increases with every hour.A one-year-old child becomes lethargic, his appetite decreases, and his sleep is disturbed. Babies may refuse breastfeeding or poorly attach to the breast. The sick child has increased daytime sleepiness. In many cases, systemic disorders are also added to the symptoms of pharyngitis in bacterial infections. These include: muscle and joint pain, soreness in the abdomen, stool disturbance, headache, increased sensitivity to various sounds, and photophobia.
The severity of these symptoms can be different. Treatment of bacterial forms of pharyngitis in babies under three years old, especially in severe cases of the disease, is given in a hospital setting.
Diagnostics
The appearance of adverse symptoms of the disease should be a good reason for seeking advice from a pediatrician. To establish the correct diagnosis, he must conduct a clinical examination. During the examination of the child, the doctor will necessarily examine the oropharynx and pharynx, as well as palpate the abdomen to exclude complications of a viral or bacterial infection. After a clinical examination, pediatricians prescribe a whole range of laboratory tests, which is necessary to establish the severity of functional disorders, as well as to determine the cause of the disease. You can seek advice not only from a pediatrician. Also, pediatric otolaryngologists are engaged in the treatment of pharyngitis, especially chronic ones. Bacterial variants that occur with the appearance of pus from the nasal passages or in the pharyngeal cavity are treated only in the ENT.
To assess the condition of the upper respiratory tract, a pediatric otolaryngologist conducts a special examination - pharyngoscopy. The essence of this study is a visual examination of the oropharynx and the identification of all pathological conditions present there. To exclude concomitant complications, the doctor also performs rhinoscopy and otoscopy. Using a special instrument (retractor), he assesses the visual condition of the visible mucous membranes of the ear cavity and nasal passages. If the doctor also needs to examine the larynx, then he uses another device called a laryngoscope.
Carrying out such a comprehensive study allows for a fairly complete differential diagnosis, the result of which will be the correct diagnosis. To establish the cause and severity of the disease, the sick child must undergo general clinical blood and urine tests. An increase in the total number of leukocytes and the resulting deviations in the leukocyte formula indicate a viral or bacterial cause of the disease.
The acute form or exacerbation of chronic pharyngitis is accompanied by a significant acceleration of ESR. In some cases, it can grow up to 30-50 mm / hour.
Conducting a bacteriological study to identify the causative agent of the disease is also an important component of a successful diagnosis. The biological material for this study is, as a rule, discharge from the nasal cavity or mucus collected on the back wall of the oropharynx. This laboratory test allows you to establish the exact cause of the disease, as well as to determine the sensitivity of the detected microorganisms to various antibiotics and bacteriophages. Bacteriological examination has a sufficiently high sensitivity and helps to establish the correct diagnosis.
Complications
The most frequent complication of acute pharyngitis is the transition of this pathological condition into a chronic form. This occurs mainly in children who are often ill, as well as children with serious long-term diseases of internal organs. The chronic course of the disease is more unfavorable according to the prognosis than the acute one. It is this that contributes to the progression of the disease and the appearance of adverse long-term complications in the baby.
The spread of the inflammatory process to neighboring organs leads to the development of pathologies in these organs. One of these pathological conditions is tracheitis. It is often a complication of viral and especially bacterial pharyngitis. Acute tracheitis is characterized by a strong inflammatory process in the trachea, which is manifested by the appearance of a severe cough in the baby. The spread of inflammation leads to the fact that the cervical lymph nodes are involved in the process.
One of the most dangerous complications are considered a pharyngeal abscess... It can develop in a child and independently. However, quite often this pathology develops precisely as a complication of bacterial pharyngitis. The retropharyngeal abscess occurs in the periopharyngeal space due to the spread of the inflammatory process to this anatomical zone. It is characterized by a pronounced increase in temperature and an increase in intoxication syndrome.
The well-being of the child with this pathology is significantly impaired. The kid categorically refuses to eat, is more in bed. Daytime sleepiness can be quite severe. At night, on the contrary, it is more difficult for the baby to fall asleep and may wake up several times. A characteristic symptom of a pharyngeal abscess is unbearable pain when swallowing, which does not decrease after taking local antiseptic and analgesic drugs and sprays. A retropharyngeal abscess is an extremely serious pathology. Treatment of this pathological condition is surgical. For therapy, a sick child is urgently hospitalized in a hospital. After the surgery, the child is assigned special recommendations that will help the child to recover and gain strength sooner.
Treatment in children
Pharyngitis therapy includes the appointment of a whole range of different therapeutic techniques. The treatment period for the acute form usually takes 5-7 days. Exacerbation of chronic pharyngitis is quite difficult and requires the appointment of a more intensive therapy regimen. The selection of the necessary treatment is carried out either by a pediatrician or a pediatric otolaryngologist.
To eliminate the adverse symptoms of the disease, the following recommendations should be followed.
- Use a variety of medications. By their mechanism of action, drugs can be anti-inflammatory and pain relieving. As a rule, modern pharmacological preparations have a complex effect and also have an excellent antiseptic effect. These funds can be prescribed in various forms of release: lozenges for resorption, sprays, aerosols, solutions for inhalation and use through a nebulizer, and others. When using these medicines, it is very important to remember that prolonged use can provoke addiction and lead to a decrease in the desired effect.
- Observe the daily routine. For a quick recovery and prevention of undesirable complications of the disease, the child should spend the entire acute period of the disease at home. Attending kindergarten or school is not permissible. Forced quarantine is also an excellent measure to prevent massive outbreaks of infectious diseases. During a high body temperature, the child should be kept in bed.
- Refuse water treatments. You cannot bathe a child during a high temperature. Hygiene procedures in the early days of the disease should be abandoned. Prolonged hot baths can lead to severe thermoregulation disorders. During the acute period of the illness, it is better to limit yourself to a quick hygienic shower or washing. You can bathe your baby when the body temperature is normalized and the child's well-being improves.
- Cancel walks. You can not walk with a temperature crumbs, especially in the cold season. The first days of the disease are quite difficult for the baby. In order not to cause the progression of the disease and not to aggravate the course of the disease, you should limit active walks on the street for several days. Subsequently, after the child's well-being has normalized, walks can be carried out only by carefully choosing comfortable and warm clothes for the season.
- Monitor nutrition. You need to carefully plan your baby's diet. The daily calorie intake of a sick baby should exceed the age norm by 10%. The main components of food are protein foods and complex carbohydrates. All meals should be prepared in a gentle way and chopped up. Cooked food should be at a comfortable temperature, free of hot spices, and well chopped.
- Observe the drinking regime. The consequence of the inflammatory process is the formation of a huge amount of toxins and decay products. Accumulating in the child's body, they lead to the persistence of intoxication syndrome. Only water can remove waste harmful substances from the body. Various compotes and fruit drinks made from berries and dried fruits are perfect as drinks during illness.
Drugs
A wide variety of medications are prescribed to eliminate the adverse symptoms of pharyngitis.
Pain Relief Lozenges
Pain relieving lozenges help relieve pain and redness in the throat. These medicines are produced in the form of various animal figures or alphabet letters. Such treatment will be interesting even for the smallest patient. Lozenges are used in babies over three years old. It is dangerous to use these medicines at an earlier age, as the child may swallow them or choke on them.
Sprays
Sprays for relieving sore throat, in addition to analgesic and anti-inflammatory effects, also have a pronounced antiseptic effect on the affected inflamed tissues of the oropharynx. As a local antibacterial treatment, various nasal sprays can be used, for example, "Isofra". They help to effectively eliminate the adverse symptoms of bacterial nasopharyngitis.
Antibiotics
These are the most effective treatments for bacterial pharyngitis. Currently, doctors give preference to drugs with a wide spectrum of action. For the treatment of pharyngitis in children are used: "Amoxiclav", "Sumamed", "Ceftriaxone" and others. The dosage, frequency and duration of use are selected by the attending physician. Usually antibiotic therapy is prescribed for 3-7 days with mandatory monitoring of effectiveness.
Antitussives
Prescribed when complications and the spread of the inflammatory process to the trachea and bronchial tree. These remedies help to eliminate severe cough, and also improve sputum flow. "Lazolvan", "Erespal", licorice root syrup are excellent means for normalizing bronchial breathing.
Antipyretic drugs
Should be used only when the temperature rises above 38 degrees. As antipyretic drugs in children, drugs based on paracetamol and ibuprofen are actively used. Long-term use of these drugs for prophylactic purposes is not advisable, since it can contribute to the appearance of adverse side effects.
Local immunostimulating therapy
Immunostimulating drugs help to strengthen the immune response, which leads to a faster recovery of the baby. Derinat is an excellent topical treatment. It is available in various forms. Systemic action is possessed by "Immudon", which is prescribed for use by a strictly attending physician.
How to treat at home?
It is possible to treat mild pharyngitis at home. However, even in this case, the course of the disease must be carefully monitored. First aid for pharyngitis is to remove the pain component that is present when swallowing. Medicinal pastilles or herbal decoctions, which also have a good anti-inflammatory and local anesthetic effect, can help in this.
As a home treatment, chamomile, calendula, sage are perfect. To prepare the infusion, you will need 2 tablespoons of chopped plant materials. This amount should be poured with 1-1.5 cups of boiling water and covered with an infusion towel, after 30-35 minutes the infusion will be ready. Rinse the inflamed oropharynx 3-4 times a day one hour after eating. This simple method has positive reviews, time-tested, and allows you to quickly cure the adverse symptoms of pharyngitis.
Prevention
Strengthening the immune system is an important preventive task. A strong immune system is able to cope with the entry of various pathogens into the child's body. Active walks and games in the fresh air, healthy nutritious food and a good night's rest help to strengthen the immune system and give the child the necessary strength to fight various infections.
What to do when a child has a sore throat, Dr. Komarovsky will tell in the next video.
