Acute pharyngitis in children

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Doctor Komarovsky about pharyngitis in children

The child has a sore throat. Grandmothers with the air of experts claim that this is a cold due to an extra portion of ice cream eaten the day before. Moms suspect a sore throat. The last word belongs to the doctor, who is urgently taken to see the child or who is called to the house.

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However, the doctor does not share the points of view of the parents and representatives of the older generation and confidently declares that the baby has pharyngitis. Authoritative children's doctor Evgeny Komarovsky will talk about pharyngitis in children.

About the disease

Pharyngitis is an inflammation of the mucous and lymphoid tissue of the pharynx. If the inflammatory process moves and invades the nasopharynx, this is already rhinopharyngitis (its other name is nasopharyngitis). Inflammation of the pharynx occurs for a variety of reasons:

  • viral infection caused by influenza viruses, adenoviruses;
  • bacterial infection with streptococci, staphylococci, pneumococci, fungi of the Candida family;
  • an allergy that develops specifically in the larynx - due to inhalation of poisonous, toxic substances, dust.

Pharyngitis can be acute or chronic. Acute develops immediately after a negative impact or infection, and chronic develops against the background of constant or sometimes recurring unfavorable factors that haunt the child for quite a long time. Sometimes chronic pharyngitis is generally an independent disease, not viral or allergic, and in no way related to ARVI, influenza or manifestations of an allergic reaction. Moreover, such “independent” pharyngitis can have full periods of exacerbation and remission.

Evgeny Komarovsky claims that there is nothing unusual about pharyngitis - the disease occurs in childhood more often than parents are used to thinking. There are children who receive this diagnosis 3-4 times a year, but this can no longer be considered the norm. Quite often, inflammation of the pharynx and nasopharynx can be caused by too dry air inhaled by a child, whose parents are very fond of closing all the windows and maintaining a hot microclimate in the apartment.

Symptoms

Viral pharyngitis is usually acute. It develops against the background of ARVI or influenza, which means that it is characterized by all the symptoms of these diseases - runny nose, running snot, headaches, fever up to 38.0 degrees. With such pharyngitis, the child will complain of pain or a sore throat, and it will be painful for him to swallow. An infant who cannot complain about anything will begin to refuse food, cry and worry.

Another distinctive sign of pharyngitis is a dry cough that torments the child, especially at night. The lymph nodes in the neck often become inflamed. Evgeny Komarovsky claims that this is not surprising, because it is through these nodes that the outflow of lymph from the inflamed larynx occurs. Sometimes large red granular granules can be seen on the tonsils or walls of the larynx. Then pharyngitis will be called granulosa (with damage to lymphoid tissue).

Allergic pharyngitis most often develops acutely, too, a short time after inhaling chemicals or allergens. There are no symptoms of ARVI, but there may well be a runny nose. The temperature rises slightly - up to 37.0-37.5, higher - extremely rarely. A dry, unproductive cough and pain when swallowing are also quite intense.

Bacterial pharyngitis is severe, with a temperature rise above 38.5 degrees, with severe pain in the throat. Upon visual examination, purulent formations may be noticeable in the larynx and tonsils, which are often confused with sore throat.

The main difference between acute tonsillitis (tonsillitis) and acute pharyngitis (for the information of parents) is that with angina, the tonsils are affected, and with pharyngitis, the inflammatory process is more diffuse, it spreads to the walls of the larynx. With tonsillitis, the child complains of pain when swallowing; with pharyngitis, a dry cough will certainly be observed, as well as other symptoms characteristic of the disease.

Chronic pharyngitis is less pronounced, and sometimes it is noticed only during periods of exacerbation. A child with a chronic form of the disease often has a sore throat, a feeling of dryness in the mouth and larynx, and a dry cough often appears, but the temperature does not rise (at least until the next exacerbation). An exacerbation will resemble ordinary acute pharyngitis like two peas in a pod.

Treatment

The choice of treatment tactics depends on what kind of illness the child has developed - viral, bacterial or allergic. It should be noted that even a very experienced doctor will not be able to answer this important question solely on the basis of a visual examination of the child and an assessment of all accompanying symptoms. The doctor, of course, will say that the baby has pharyngitis, but only two simple tests will help determine its origin: a clinical blood test and a throat smear for flora and sensitivity to antibiotics.

Without these studies, says Evgeniy Komarovsky, there can be no talk of any normal, responsible and conscious treatment of pharyngitis. After all, all three types of illness are treated with completely different methods and medications.

You should not rush to follow the recommendations of a doctor who, having looked into the throat and established the presence of a disease, immediately prescribes antibiotics or prescribes several types of antiviral drugs. Such a doctor should be asked to write out a referral for tests, which should show how and what is best to treat.

Viral pharyngitis is more common than other types, since children get sick with viral infections more often than all others. Approximately 85% of acute pharyngitis are viral. Such pharyngitis cannot be treated with antibiotics, says Evgeny Komarovsky. Antimicrobial agents are completely inactive against viruses, but increase the risk of developing a bacterial complication by 7-8 times.

Drugs against viruses that are so effective are usually administered intravenously and used in inpatient settings in infectious diseases hospitals. They have a large number of side effects and are quite difficult to tolerate. Neither homeopathic remedies, nor other tablets and syrups with a claimed antiviral effect, which are freely sold in Russian pharmacies, advertised on television and radio, have an effect on viruses and immunity.

The only correct treatment for viral pharyngitis is drinking plenty of warm water, sufficiently humidified air in the apartment where the sick child is, and irrigating the mucous membrane of the nose and nasopharynx with saline solution (1 teaspoon of salt per liter of water). If the child’s age allows, you can gargle the sore throat with the same saline solution. An antiseptic (for example, Miramistin), as well as lozenges with an anti-inflammatory and analgesic effect, are used locally for an inflamed throat. Komarovsky warns that there is no need to use “Lugol” (and even more so to cauterize the tonsils and larynx with iodine), since this is much more harmful to the child than pharyngitis, which is not smeared with anything, not treated or cauterized.

Allergic pharyngitis will require a more detailed approach. Antibiotics are strictly contraindicated in the treatment of such a disease. The doctor may prescribe antihistamines, depending on the allergen (if its type can be quickly determined). Salt rinses of the nose and larynx, as well as local antiseptics (except iodine), are relevant.

In addition, you will need to remove from the room all objects that can accumulate dust - carpets, soft toys, books. The air is humidified to a level of 50-70%, ventilated, and the child’s room is often wet cleaned.

For bacterial pharyngitis, according to Evgeny Komarovsky, the issue of the need to use antibiotics is decided on an individual basis. Not in all cases are antimicrobial agents needed at all. If there is a need for them, drugs of the penicillin group are most often used.

A child is contagious until he is given antibiotics. Usually, a day after this, the child can easily attend school or kindergarten if he does not have a fever. Bed rest is optional.

If a child's laboratory tests confirm streptococcal pharyngitis, then all family members should take similar throat swabs. If necessary, all household members should undergo antibiotic treatment to avoid re-infection of the baby.

Advice from Dr. Komarovsky

The best antiseptic for the throat, which even the most expensive pharmaceuticals cannot compare with, is saliva. If there is enough of it, it may well protect the child from pharyngitis. To prevent saliva from drying out, it is advisable to have a humidifier in the house and use it for its intended purpose. In addition, the child should drink enough fluids (to maintain the consistency of saliva). There are no vaccinations against pharyngitis. The main prevention is taking care of the quality of saliva and strengthening the immune system.

In the next video, Dr. Komarovsky will talk about sore throats in children.

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Source: http://www.o-krohe.ru/komarovskij/faringit/

Pharyngitis in children

By pharyngitis, doctors mean severe inflammation of the lymphoid tissue and mucous membranes in the throat. This unpleasant disease is accompanied by a lot of unpleasant symptoms and can be infectious. In children, this disease manifests itself much more strongly than in adults and requires qualified comprehensive treatment.

Causes

Pharyngitis can be caused by a number of reasons. The most famous of them:

  1. Bacteria. Most often, the mucous membranes and lymphoid tissue are affected by pneumococci and streptococci.
  2. Viruses. The activators of the problem in this case are adenoviruses or influenza.
  3. Mushrooms. Pharyngitis can be caused by a fungal infection called candida.
  4. Complications of other diseases. A number of diseases of the nasopharynx and adjacent organs, in particular rhinitis, sinusitis and even caries, in advanced stages activate the development of pharyngitis.
  5. Physiological reasons. The disease may not be of an infectious nature, in particular, it can be induced by the influence of chemical irritants on the body, inhalation of very cold, hot or dirty air.
  6. Allergy. Natural and drug allergies also provoke the development of pharyngitis.

Symptoms

The main symptoms of pharyngitis in children usually include:

  1. Severe pain and sore throat, especially when eating and swallowing.
  2. High temperature, usually between 38 and 40 degrees Celsius.
  3. Lack of appetite and severe lethargy.

The younger your baby is, the more severe the symptoms of pharyngitis will be. This disease is especially dangerous in children under one year of age, since it causes swelling of the mucous membrane, which ultimately, given the underdevelopment of the respiratory system, can cause throat spasm and suffocation.

Types of pharyngitis

Next, we will consider the most common types of diseases that are often diagnosed in children.

Acute pharyngitis

This type of disease develops rapidly and immediately after the mucous membrane of the throat is damaged by an infection or an irritating factor. In this case, a high temperature immediately rises, and a full “bouquet” of the above-described symptoms is observed.

Chronic pharyngitis

The chronic form of pharyngitis almost never forms on its own and is either a transitional process between the acute phase of the above-mentioned disease, or a consequence of constant irritation of the mucous membranes by an unfavorable factor. Chronic pharyngitis has remission phases with temporary disappearance of symptoms and exacerbations, similar in clinical manifestations to the acute form of the disease.

Granular pharyngitis

With granulosa pharyngitis, not only the mucous membrane, but also the lymphoid tissue is severely affected, resulting in the formation of peculiar “red nodules” on the back wall of the pharynx, formed from the altered structure of the epithelium. These “granules” greatly irritate the trigeminal nerve, the mucous membranes become very dry, fibrosis of other tissues in the pharynx and atrophy of the glands are also observed.

Atrophic pharyngitis

The last stage of development of untreated pharyngitis is characterized by a strong pathogenic change in the glandular, lymphoid and mucous apparatus of the pharynx. Hypotrophy of such structures leads to serious complications not only with accompanying organs, but also negatively affects the intestines and stomach.

The symptoms of pharyngitis and tonsillitis should be distinguished - they are similar in symptoms, but the infection in these two cases is localized in different places. A severe chest cough and coughing at night usually indicates the manifestation of symptoms of bronchitis - the infection descends below and affects the associated parts of the respiratory apparatus.

Treatment of pharyngitis in children

It will not be possible to cure pharyngitis in a child with just a miracle spray or magic sucking tablets, especially if the disease is advanced and is at the final stage of development. Act systematically and correctly!

In children 1-12 months

In very young children, pharyngitis is very painful, and it is also quite problematic to use rinsing in this case, since the child simply does not know how to do it. It is highly undesirable to carry out any activities on your own, since you can harm the baby’s fragile body. In case of acute pharyngitis, it is necessary to urgently seek qualified medical help.

If your baby’s pharyngitis is mild, there is no high fever and there are no contraindications for use, then you can put a honey-mustard compress on your child’s throat.

It is also worth giving your baby plenty of warm liquids to drink. Ventilate and humidify the rooms where the baby is constantly located. The affected throat can be moistened with antiseptic agents that do not contain alcohol, menthol and other irritants. If they are not available, grind one Faringosept tablet into dust, dip the pacifier in the ground mixture and let the child suck. The maximum dose should not exceed ¼ tablet, no more than three times a day.

In children 1-2 years old

In children of this age, pharyngitis is also severe, but not as intense as in infants. They also need to be given plenty of fluids, apply compresses if there are no contraindications, and also carry out inhalations, preferably with a nebulizer, using saline or Borjomi water as the active substance.

At this age, you can already start using antiseptic sprays - these are Givalex and Yox: they disinfect the affected throat and promote a speedy recovery. In addition, the room where the child is constantly located must be regularly ventilated and ensure normal humidity.

For children over 3 years old

With the onset of the disease, the child needs bed rest and plenty of drinking with alkali. Try to organize a diet that is gentle on the body, remove as much as possible all sweet, sour and fried foods, saturating your diet with fruits.

For pharyngitis, honey compresses on the feet, as well as hot foot baths, help. It is rational to carry out inhalations both using a nebulizer and using classic decoctions of medicinal mixtures.

From the age of three, children already know how to gargle - both with special antiseptic medicinal liquids and mixtures prepared independently: dissolve two drops of iodine and furatsilin in 300 milliliters of warm boiled water, then bring the temperature to room temperature and let the child gargle by typing in mouth the liquid, throwing his head back, sticking out his tongue, opening his mouth wide and saying “ahh”.

In addition, as an alternative, use antiseptic sprays in the throat - these are iodine-based Yox and Givalex. If your child already knows how to dissolve tablets, then it is recommended to give him lozenges and tablets against pharyngitis: Faringosept, Septolete, Angisept, etc.

Antibiotics for pharyngitis in children

A separate dispute between doctors and parents is the need to use antibiotics for pharyngitis. A fairly large number of cases of this disease can indeed be cured without resorting to extensive antibacterial therapy, but in particularly difficult cases it cannot be avoided, especially when it comes to a threat to the life of a child or an advanced stage of the disease, up to atrophy of the mucous membrane.

In this case, the best possible option would be to use not broad-spectrum antibiotics, but local remedies that do not have such a negative effect on your child’s liver, kidneys and heart. In addition, for the antibiotic to be truly effective in such a situation, it is worth taking it together with corticosteroids, also for local use.

The most popular drugs of this type used in the treatment of pharyngitis are Bioparox, Biseptol, Hexoral.

Prevention

Basic measures to prevent pharyngitis:

  1. Maintain normal humidity in the premises, especially in the autumn-winter period.
  2. Drive your child through dusty and gas-polluted areas as little as possible.
  3. Don't smoke around your child.
  4. During the onset of seasonal epidemics, take multivitamin complexes, give your baby interferon and homeopathic medicines that increase immunity. For preventive purposes, take daily evening inhalations with infusions of rose hips, chamomile and sea buckthorn, as well as Borjomi water.
  5. If possible, begin to harden your child.

Useful video

Dr. Komarovsky talks about the dangers of pharyngitis in children, as well as methods of treating it.

Source: http://www.doctorfm.ru/sickness/faringit-u-detey

Acute pharyngitis in children: developmental features and various treatment methods

Children, especially younger ones, have an imperfect, not yet fully formed immune system, so they get sick much more often than adults. They are especially susceptible to various colds.

This name refers to various inflammatory processes of the upper and lower respiratory tract, as well as the ears. They can have different origins, but they all require a quick response and immediate proper treatment, as they are dangerous due to possible complications; the consequences of colds can be much more serious than the diseases themselves.

Description of the disease

Pharyngitis in children - developmental features

Acute pharyngitis in children, treatment of which should be started as early as possible, is an inflammation of the pharyngeal mucosa, accompanied by a number of characteristic symptoms. The disease affects children of all ages, from infants to teenagers.

Adults also suffer from pharyngitis, but much less often than children, and they also tolerate the disease more easily than children.

Pharyngitis can have two variants of manifestation - asymptomatic, in which the child does not feel severely unwell until the disease has already developed strongly, and acute, which begins suddenly with a rise in temperature and severe sore throat.

Most often, parents pay attention to the fact that the child has become capricious, does not want to play and refuses food.

After checking the baby's throat, parents discover redness and swelling in the throat area. This gives reason to suspect pharyngitis and quickly seek medical help.

Causes

Possible causes of the development of the disease in children

This disease can occur as a primary disease, but most often it is a consequence of the presence of some other infectious or inflammatory process in the body. Pharyngitis can be caused by viruses, bacteria or fungi, so it is very important to accurately determine this in order to properly prescribe treatment.

With a bacterial infection, the main causes of damage to lymphoid tissue and mucous membranes are streptococci and pneumococci.

For viral infections, influenza viruses and adenoviruses are the most suspected. They are the most common cause of pharyngitis. Of the fungal infections, fungi from the genus Candida most often provoke the disease.

Pharyngitis often results from other diseases, especially various rhinitis, sinusitis, sinusitis, even otitis media and dental caries.

The presence of a focus of infection in a child’s body can provoke any inflammatory processes, including pharyngitis.

This disease may also have a different nature. Pharyngitis is often caused by various types of allergic reactions, as well as mechanical and chemical irritations of the nasal and pharyngeal mucosa. The most common cause is inhalation of cigarette smoke (passive smoking) and very dusty rooms, high dry air. Also, pharyngitis can be a manifestation of extreme air temperatures if a child finds himself outside in severe frost or heat.

Symptoms

Signs of acute pharyngitis in a child

In rare cases, pharyngitis begins asymptomatically, but most often the child reacts to the disease immediately.

The following symptoms appear:

  • Severe sore throat that gets worse when swallowing, trying to speak, or eating.
  • High temperature, feeling of heat, which quickly gives way to chills.
  • Redness of the pharynx with severe inflammation and irritation, possible plaque on the tonsils and back of the throat, bad breath.
  • Runny nose and cough.
  • Severe tickling, a feeling of dryness, the child describes it as “a feather in the throat.”
  • Weakness, lethargy, reluctance to play, apathy.
  • Refusal to eat, increased moodiness.
  • A baby may constantly worry and cry.
  • An older child may complain of nausea, abdominal pain, and digestive disorders.
If pharyngitis is accompanied by other diseases, its symptoms may be masked by signs of other diseases. In the case of an acute course of the disease, it is necessary to consult a doctor, since pharyngitis can be complicated by dangerous diseases such as pneumonia or bronchitis.

Drug treatment

Treatment of acute pharyngitis - sprays, tablets and antibiotics

For acute pharyngitis in children, treatment can be aimed at relieving the symptoms of the disease and treating the immediate source of the disease. Before starting therapy, you need to find out the nature of the infection.

If the disease is bacterial in nature and is severe, the doctor will often prescribe antibiotics. You should not do this yourself, since not all antibiotics are equally effective. The selection of the right drug is entirely within the competence of the doctor. The same applies to the choice of treatment for pharyngitis of viral or fungal origin.

On their own, parents can only give their child topical medications - lozenges, throat sprays, rinses such as Chlorophyllipt, and the like.

In this case, possible allergic reactions must be taken into account. It is best to choose medications for children based on natural remedies - honey, propolis, sage, chamomile and other medicinal herbs.

To improve the child’s well-being, you need to maintain bed rest and give him plenty to drink. If the baby has difficulty swallowing, food should be served in the form of purees and soups, excluding dry and hard types, as well as spicy, sour and too sweet, which can increase irritation of the mucous membrane of the throat.

Treatment with traditional methods

Traditional medicine recipes and advice

If acute pharyngitis is detected in children, its treatment should depend on what caused the disease. However, there are simple folk methods that are very helpful for the different origins of this disease. These are rinsing, inhalation and warming.

For rinsing, decoctions of various medicinal herbs are used. To do this, they make up mixtures or use ready-made mixtures purchased at special pharmacies. Such herbs act as a softener, disinfectant, anti-inflammatory, relieve swelling and reduce soreness and irritation. This can be chamomile, calendula, eucalyptus, mint, oak bark and many other remedies. However, you can also use very simple compositions that are accessible to everyone. To do this you will need soda, salt and a few drops of iodine. You should gargle with the warm solution as often as possible, avoiding eating and drinking liquids for at least 15 minutes after each procedure.

By rinsing, germs and decay products are well washed out of inflamed tissues, inflammation and swelling are relieved, the throat quickly softens, and discomfort passes much faster.

In young children, pharyngitis is often accompanied by severe swelling, up to the closure of the walls of the pharynx. In such a situation, inhalations with soda solution, saline solution or mineral water such as Borjomi help well. For infants, it is best to use a nebulizer. Warm steam softens inflamed tissues of the pharynx, quickly relieves swelling and reduces irritation. In addition, this procedure is harmless and well tolerated by the child.

More information about pharyngitis can be found in the video.

Applying compresses to the throat with pharyngitis, as with a sore throat, can be dangerous - the infection can be spread throughout the body by blood flow. However, if pharyngitis is accompanied by a runny nose or cough, heating, especially with an infrared emitter, can reduce the inflammatory process, relieve a runny nose and suffocating cough, and improve the child’s overall well-being.

Consequences of improper treatment

Possible complications of the disease

If you do not start treating pharyngitis in a timely manner or use medications not as prescribed by a doctor, the disease can lead to various complications.

The most dangerous consequences of improper treatment are acute and chronic bronchitis and pneumonia - pneumonia. The younger the child, the more dangerous such problems are for him. That is why, if the slightest signs of the disease occur, you should immediately consult a doctor and not start self-medication.

The arbitrary use of various medications is dangerous because parents cannot independently determine the true cause of the disease. If the disease is caused by a virus and is treated with antibiotics, at best it will have no effect on the source of the disease.

In the worst case scenario, uncontrolled use of antibiotics can provoke an outbreak of fungal infection and have a detrimental effect on beneficial microflora, including dysbacteriosis.

Such consequences can be much more dangerous than the original disease itself. In order not to harm your own child, consult a doctor, undergo the necessary examinations and tests, and then follow the specialist’s instructions and give your baby the prescribed medications in certain doses.

Prevention of pharyngitis in children

In order for acute pharyngitis in children, the treatment of which takes quite a long time, to interfere with your plans as little as possible, the child needs to be provided with certain conditions. In order not to provoke the disease, you need to monitor the cleanliness of the air in the room.

Smoking near a baby most often causes throat irritation, so it should be prohibited. You also need to avoid places where it is smoky, where there is a fine suspension of dust, cement, lime, chlorine and other caustic chemicals in the air, which often cause irritation and inflammation.

Staying in a room with very dry air-conditioned air and central heating can also cause pharyngitis, so it is advisable to use special humidifiers that reduce the risk of inflammation.

In order for a child’s body to resist infection and various diseases, it needs to be hardened.

To do this, the baby needs to be provided with maximum mobility, not bundled up, allowed to sleep in the fresh air, and fed properly. The child's nutrition should be balanced, and the food should be enriched with vitamins and minerals. If possible, the baby should be taken to the sea more often or sent out of town - to the dacha or to grandma’s in the village. If your child is prone to allergies, you need to provide him with maximum protection from pollen and other allergens. In this case, the incidence of diseases will be minimal.

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Comments (1)

09/11/2017 at 23:35 | #

Gargling with furacelin helps me with pharyngitis, take 1 tablet per glass and dissolve it in warm water, you can also use Ingalipt spray, or Hepilor. Decatylene lozenges help me very well for my throat at the initial stage of the disease, but it can be very difficult to get them.

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Pharyngitis in children

Pharyngitis in children is an infectious-inflammatory process in the mucous membrane and lymphoid tissue of the oropharynx. Pharyngitis in children occurs with symptoms of dryness, burning, rawness, sore throat, coughing, and hoarseness. Diagnosis of pharyngitis in children is based on the pharyngoscopy picture and the results of a microbiological examination of a smear from the back wall of the pharynx. For pharyngitis in children, local therapy is usually carried out: gargling, lubricating the mucous membrane of the back of the throat with antiseptics, inhalation, irrigating the throat with aerosols.

Pharyngitis in children

Pharyngitis in children is a manifestation of an acute respiratory infection that occurs with inflammation of the mucous membrane and lymphoid structures of the posterior pharyngeal wall. In frequently ill children, pharyngitis accounts for about 40% of all cases of morbidity. In otolaryngology, chronic pharyngitis in children accounts for 9% of the total number of upper respiratory tract diseases. Given the tendency of children to diffuse damage to the respiratory tract, pharyngitis in a child is often combined with rhinitis, laryngitis, tracheitis, and bronchitis.

Causes of pharyngitis in children

As an independent nosology, pharyngitis in children develops with the direct impact of infectious pathogens on the pharyngeal mucosa. In addition, acute pharyngitis can serve as one of the manifestations of inflammatory diseases of the upper respiratory tract, general infections, intestinal infections, etc.

The greatest role in the etiology of pharyngitis in children belongs to viral infections (influenza and herpes viruses, adenoviruses, enteroviruses) and bacterial microorganisms (Haemophilus influenzae, Moraxella, streptococci of groups A, C, G, diplococci, corynebacteria diphtheria), fungi, intracellular agents (mycoplasma, chlamydia). Acute pharyngitis of viral etiology in children accounts for 70% of cases, bacterial and others - 30%.

Acute pharyngitis in children can accompany the clinical course of acute respiratory viral infections, infectious mononucleosis, measles, and scarlet fever. In some cases, the cause of pharyngitis in children may be burns and foreign bodies in the pharynx. Chronic pharyngitis in children is usually associated with other inflammatory diseases of the ENT organs (rhinitis, adenoiditis, sinusitis, stomatitis, sore throat, chronic tonsillitis), caries, dysbacteriosis, gastroesophageal reflux, allergic reactions. Tonsillectomy performed at the age of 3-7 years, during the period of active immunogenesis, can stimulate compensatory hypertrophy of the lymphoid tissue of the posterior pharyngeal wall and the development of chronic pharyngitis in children.

The occurrence of pharyngitis in a child is predisposed by general and local hypothermia, exposure to the pharyngeal mucosa of various irritants (tobacco smoke, spicy food, cold or dusty air, etc.), constitutional abnormalities, hypovitaminosis (vitamin A deficiency), endocrine disorders (hypothyroidism, diabetes mellitus). ).

Classification of pharyngitis in children

Based on the nature of inflammation of the pharyngeal tissues, acute (lasting up to 1 month), protracted (lasting more than 1 month) and chronic pharyngitis in children (lasting more than 6 months with frequent exacerbations) are distinguished. Chronic pharyngitis in children can occur in catarrhal, hyperplastic (granulosa) and atrophic forms.

Since viral and bacterial agents have a tropism for the epithelium of the upper and lower respiratory tract, pharyngitis in children usually occurs not in an isolated form, but in the form of nasopharyngitis, pharyngolaryngitis, pharyngotracheitis, and pharyngobronchitis.

Taking into account the influencing etiological factors, pharyngitis in children can be of a viral, bacterial, fungal, allergic, or traumatic nature.

Symptoms of pharyngitis in children

Signs of acute pharyngitis in children are a sudden burning sensation, dryness, soreness, rawness and pain in the throat when swallowing. Characterized by a shallow cough and hoarseness. Body temperature may be normal or low-grade; if pharyngitis in a child develops against the background of a viral infection, the temperature is usually high due to the underlying disease, headache, intoxication syndrome, and regional lymphadenitis are pronounced. In infants, pharyngitis is much more severe; in this case, general symptoms predominate: severe fever, sleep disturbance, loss of appetite, salivation, dysphagia, dyspepsia, runny nose, conjunctivitis, rash on the body.

The pharyngoscopic picture is characterized by bright hyperemia and pronounced vascular injection of the posterior wall of the pharynx, velopharyngeal arches, and soft palate; the presence of protruding inflamed follicles in the form of red grains. With lateral pharyngitis in children, hyperemia and edema involve the lateral ridges of the pharynx and uvula.

Severe acute bacterial pharyngitis in children may be complicated by the development of a retropharyngeal abscess, purulent otitis media or purulent mediastinitis.

With chronic catarrhal pharyngitis, children are bothered by discomfort and the sensation of a foreign body in the throat, and an obsessive cough. Upon examination, the mucosa is loosened, diffusely infiltrated and hyperemic.

Chronic hyperplastic pharyngitis is characterized by hyperplasia of the epithelium, submucosal layer and lymphoid elements. Children complain of sore and dry throat, accumulation of viscous mucous secretion with the urge to vomit, pain when swallowing, radiating to the ear. Hyperemia of the mucous membrane is moderate, but against this background there is noticeable thickening of the mucous membrane and lateral ridges, the presence of lymphoid granules or strands of lymphoid tissue, sometimes blocking the mouths of the auditory tubes and leading to the development of conductive hearing loss in children.

Atrophic pharyngitis in childhood is rare and almost never occurs in isolation. It is usually accompanied by atrophic rhinitis, laryngitis, tracheitis, and the clinical course is accompanied by an obsessive dry cough and voice disturbance such as dysphonia. Endoscopy of the pharynx in children reveals a pale, dry (with a “varnish shine”), thinned mucous membrane with translucent vessels, dried and difficult to remove crusts.

Subjective symptoms of fungal pharyngitis in children (pharyngomycosis) do not differ from catarrhal and hyperplastic forms. Objectively, cracks and erosions in the corners of the mouth (candida seizures), enlargement of the posterior cervical lymph nodes, and a cheesy coating in the posterior wall of the pharynx, under which a bright red, often eroded, mucous membrane is visible, are often detected.

Diagnosis of pharyngitis in children

Recognizing pharyngitis in children is not difficult, but it should be distinguished from catarrhal tonsillitis, diphtheria and other infectious diseases. Therefore, a child with pharyngitis should be consulted by a pediatrician, pediatric otolaryngologist, pediatric infectious disease specialist, and pediatric allergist-immunologist.

When diagnosing pharyngitis in children, data from the anamnesis and pharyngoscopy picture are taken into account. To identify inflammatory processes accompanying pharyngitis in children, auscultation, rhinoscopy, and otoscopy are performed. Examination of a smear from the pharynx for microflora makes it possible to clarify the causative agent of the infection for the selection of etiopathogenetic therapy.

Treatment of pharyngitis in children

As a rule, for pharyngitis in children, they are limited to the prescription of local therapy. During acute inflammation, irritating foods (spicy, sour, cold, hot), exposure to nicotine should be excluded from the diet, comfortable temperature and humidity levels in the room should be ensured, and vocal strain should be limited.

Local treatment of pharyngitis in children includes disinfectant gargles (herbal decoctions, antiseptics), treatment of the back wall of the pharynx with drugs (Lugol's solutions, iodinol, etc.), medicinal and alkaline inhalations, spraying of anti-inflammatory aerosols, resorption of lozenges with an antibacterial, softening, analgesic effect . Young children who cannot rinse their mouths or dissolve tablets are prescribed plenty of fluids and endopharyngeal instillation of antiseptics. If there is a threat of bacterial complications (descending infection, rheumatism), systemic antimicrobial therapy is indicated.

In case of severe hyperplasia of lymphoid tissue, laser treatment is performed on granules of the pharynx, cauterization with silver nitrate, shading of the posterior wall of the pharynx using the radio wave method, cryodestruction of granules and side ridges.

To prevent exacerbations of chronic pharyngitis in children, measures are taken to restore nasal breathing, sanitize foci of chronic infection (treatment of hypertrophic rhinitis and sinusitis, adenotomy, submucosal resection of the nasal septum), treatment of caries, concomitant gastrointestinal diseases (intestinal dysbiosis, GERD), etc.

Oil inhalations, climatotherapy, and instillation of oil drops into the nose are added to the treatment of atrophic pharyngitis in children. For pharyngomycosis, antimycotic drugs (amphotericin, ketoconazole, fluconazole, itraconazole), lubrication and irrigation of the pharynx with antifungal solutions, and OKUF therapy are prescribed.

Treatment of chronic tonsillitis in children can be carried out under the supervision of a pediatric homeopath.

Forecast and prevention of pharyngitis in children

With acute pharyngitis, children usually recover within 7-14 days. As part of the treatment of chronic pharyngitis in children, it is necessary to resort to regular symptomatic therapy or surgical tactics.

As measures to prevent pharyngitis in children, hardening procedures, strengthening the immune system, carrying out specific vaccine prevention of infections, maintaining a favorable microclimate in the room, and a nutritious diet are recommended. A child should not be allowed to develop chronic ENT pathology; It is necessary to treat diseases of the teeth, gums, and gastrointestinal tract in a timely manner.

Pharyngitis in children - treatment in Moscow

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Causes of acute pharyngitis in children and methods of treatment

Acute pharyngitis is understood as an acute inflammation of the pharyngeal mucosa. Typically, the inflammatory process accompanies infectious diseases of the respiratory tract. More often, acute pharyngitis in children is caused by a viral infection, less often the causative agents are streptococci and other bacteria. The pathological process may be complicated by other diseases of the respiratory system or become chronic. Competent and timely treatment helps to avoid the unpleasant and sometimes dangerous consequences of acute pharyngitis.

Causes of the disease

In acute infectious inflammation of the respiratory tract, pharyngitis occurs in half of the cases. In 70%, the cause of inflammation is viruses - adenoviruses, influenza and parainfluenza viruses, rhinoviruses (especially often), coronaviruses. In other cases, bacterial pathogens are determined - streptococci, pneumococci, staphylococci and others. The disease is most rarely caused by fungi or protozoa.

Sometimes the mucous membranes become inflamed when vasoconstrictor drops are instilled into the nose, which enter the throat from the nasal passages.

Signs of pharyngitis also occur against the background of postnasal drip, when mucus enters the throat from the nasal passages or sinuses. In this case, along with inflammation of the throat, a constant weak cough and wheezing appear. In such situations, it is better to carry out differential diagnosis to exclude bronchial asthma.

Acute pharyngitis can develop simultaneously with other ENT diseases - laryngitis, rhinitis, tracheitis, bronchitis.

Symptoms and signs

The main manifestations of acute pharyngitis are:

  • pain and discomfort in the throat (itching, scratching, tickling);
  • coughing;
  • itching and pain in the ears (if inflammation affects the tubopharyngeal ridges).

The pain is mild or moderate and intensifies with swallowing. Infants cannot yet explain that they have a sore throat. You can suspect pharyngitis in a baby by:

  • loss of appetite or categorical refusal to eat;
  • restless behavior and sleep disorders;
  • lethargy and general malaise.

Often the symptoms of inflammation are combined with other signs of infectious lesions of the respiratory system. This:

The cough at the initial stage of the disease is dry and painful, but on the fourth day it usually either subsides or becomes productive. Body temperature can reach 38–40 °C (if the causative agent of pharyngitis is the influenza virus). For pharyngitis caused by other viruses, the temperature remains between 37.5–38.5 °C. If the causative agent is a rhinovirus, the temperature does not rise.

In young children (especially those under one year old), inflammation is severe. There is a marked increase in temperature and intoxication, sleep disturbance. With viral infections, the temperature drops after 3-4 days, with influenza - 4-6 days after the onset of the disease. If the inflammation is bacterial in nature, a high temperature is observed on days 3–4, normalizing after starting antibiotics.

Types of disease

By origin, acute pharyngitis is divided into:

  1. viral;
  2. bacterial;
  3. fungal;
  4. allergic;
  5. traumatic (occurs due to the entry of a foreign body or after surgery);
  6. arising as a result of the irritating action of environmental factors (hot steam or liquid, chemical compounds, radiation, etc.).

Possible complications

With timely detection and proper treatment, inflammation goes away within 1–2 weeks. In children of high school age and adolescence, severe complications from viral inflammation rarely occur. In children 3–5 years old, against the background of viral pharyngitis, the following may develop:

In children with enlarged adenoids, adenoiditis often worsens during acute pharyngitis. A characteristic sign of such an exacerbation is nausea (or even vomiting), caused by mucus flowing down the back of the throat.

More serious consequences can occur with a bacterial form of inflammation caused by streptococcal infection. Possible development:

  • laryngotracheitis and laryngeal stenosis;
  • purulent otitis;
  • purulent inflammation of the mediastinum (mediastinitis);
  • abscesses (peritonsillar, peritonsillar);
  • phlegmon;
  • glomerulonephritis;
  • acute form of articular rheumatism;
  • endocarditis, myocarditis;
  • brain inflammation.

Sometimes complications develop as a result of taking antibiotics - allergic reactions, intestinal dysbiosis.

Severe viral pharyngitis in children under 2 years of age can also cause inflammation and spasm of the larynx.

Which doctor will help?

In children, pediatricians and otorhinolaryngologists treat acute pharyngitis. If pharyngitis is allergic, examination by an allergist is required. Frequently ill children should additionally visit an immunologist.

Diagnostic methods

To identify the disease, pharyngoscopy (visual examination of the pharynx) is performed. In this case, the child may experience:

  1. redness and swelling of the pharyngeal mucosa (usually the posterior wall, less often the lateral ridges), velopharyngeal arches, and sometimes the soft palate;
  2. looseness and graininess of fabrics;
  3. the presence of inflamed lesions that look like red grains;
  4. the presence of pinpoint hemorrhages on the back wall of the pharynx.

In acute pharyngitis, unlike tonsillitis, the palatine tonsils do not become inflamed.

Redness of the throat is mild, moderate or severe. Sometimes the presence of a film or purulent exudate is noticeable on the mucous membrane. Typically, with pharyngitis, the cervical lymph nodes are enlarged, inflamed and painful, which is detected by palpation.

This is how both viral and bacterial inflammation manifests itself (in the latter case, the symptoms are more pronounced). If a bacterial nature of pharyngitis is suspected, a bacteriological examination of material taken from the back wall of the pharynx is carried out.

Treatment methods

Treatment of acute pharyngitis with medications includes:

  1. gargling with antiseptic solutions (Rotocan, Chlorophyllipt, Chlorhexidine, infusions of eucalyptus and chamomile);
  2. irrigating the throat with antiseptic or antibacterial sprays (Ingalipt, Yox, Tantum-Verde, Givalex, Stopangin, Hexoral, Bioparox);
  3. resorption of lozenges, tablets, pastilles with antiseptic, anesthetic, antibacterial and emollient components (Faringosept, Trachisan, Decatylene, Falimint, Septolete);
  4. taking antipyretics at elevated temperatures (Panadol, Paracetamol, Nurofen);
  5. the use of systemic drugs - antiviral, antifungal, antibacterial, antiallergic (depending on the type of inflammation).

Infants do not yet know how to gargle or dissolve tablets. They are only recommended to irrigate their throat with an aerosol.

In children under 2 years of age, any sprays should be used with caution, as they can provoke a spasm of the glottis!

For viral pharyngitis, Tsitovir, Groprinosin, Viferon and other antiviral drugs are prescribed. Uncomplicated forms of bacterial inflammation are treated with local antibiotics (Bioparox spray, Grammidin lozenges). If the bacterial inflammation is severe or accompanied by complications, systemic antibiotics are prescribed: penicillins (Amoxicillin) or macrolides (Sumamed).

In addition to drug treatment, it is recommended:

  • compliance with the drinking regime: in case of infectious respiratory inflammation, plenty of warm drinking is indicated;
  • following a gentle diet (spicy, salty, sour dishes and foods that irritate the throat should be excluded from the child’s diet until recovery, and all food should be consumed warm);
  • carrying out warming procedures (compresses on the front of the neck, warm foot baths);
  • carrying out inhalations (solutions of soda or salt, herbal decoctions, infusions).

Disease prevention

It is quite difficult to prevent inflammation due to the high prevalence of viral infections, especially during epidemics. However, prevention must be carried out. You can reduce the likelihood of inflammation by following simple rules. Recommended:

  1. compliance with hygiene measures;
  2. rinsing the nose after staying in a child care facility;
  3. the use of preventive antiviral drugs of systemic (Amiksin, Ribomunil, Imudon) and local (Oxolinic ointment, Nazoferon) action;
  4. elimination of chronic foci of infection (for diseases of the digestive system, caries);
  5. taking vitamin complexes and products that strengthen the immune system;
  6. carrying out hardening and restorative procedures (swimming, rubbing);
  7. providing a varied diet balanced in the content of nutrients, vitamins and microelements;
  8. regular walks;
  9. ensuring a normal microclimate: the air in the room should be humid (50–70%), cool (up to 20 °C), clean.

You can try to cure an uncomplicated form of pharyngitis yourself using systematic rinsing, local agents (aerosols, lozenges), and folk methods. But if the child’s condition does not improve, the temperature rises, and disturbing symptoms intensify, you need to consult a doctor. The doctor knows exactly how to treat pharyngitis correctly and alleviate the baby’s condition in the shortest possible time.

Severe and complicated pharyngitis may require hospitalization. Inpatient treatment is usually carried out for:

  1. development of purulent complications (abscess, phlegmon);
  2. severe current inflammation in a small child (especially if tonsillopharyngitis or laryngotracheitis develops);
  3. the presence of serious concomitant diseases (heart defects, kidney diseases, diabetes mellitus);
  4. the presence of other infections requiring hospital treatment (diphtheria, scarlet fever).

Often parents, trying to alleviate the child’s condition, only worsen the inflammation. Therefore, it is important to know not only how to treat the disease, but also what not to do.

  1. Any warming procedures (compresses, baths, inhalations) are strictly contraindicated at elevated temperatures and when inflammation is of a bacterial nature (heat accelerates the growth and reproduction of pathogenic flora).
  2. If a pathological process in the throat occurs with an increase in temperature in an infant or preschool child, diaphoretic teas and infusions should be given in limited quantities, otherwise dehydration will occur.
  3. In the treatment of young children, it is prohibited to use alcohol and vinegar rubdowns, and even more so, compresses. The consequence of such procedures can be vasospasm and breathing problems (in infants).
  4. Reducing the temperature with cool rubdowns is also unacceptable, since it can cause febrile convulsions, hypothermia, and vasospasm.

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