Acute nasopharyngitis is an acute inflammation of the entire nasopharyngeal mucosa, submucosa, and lymphoid tissue, primarily affecting the pharyngeal tonsils. In adults and older children, it often manifests as prodromal symptoms of upper respiratory tract infections.

bubble_chart Etiology

The main pathogenic bacteria are beta-hemolytic streptococcus and staphylococcus, and mixed viral and bacterial infections are also common. The disease is more likely to occur during winter and spring when temperature changes, exposure to cold, dampness, fatigue, and other factors lower the body's resistance.

bubble_chart Clinical Manifestations

Infants and young children often present with severe illness, including high fever, convulsions, meningeal irritation symptoms, and systemic toxic symptoms such as abdominal pain, diarrhea, and dehydration. In adults and older children, local symptoms are more prominent, such as nasal congestion, runny nose, headache, and dryness, burning sensation, or foreign body sensation in the nasopharynx. Examination of the nasopharynx reveals acute mucosal congestion and edema, with a large amount of mucopurulent secretions attached, which may flow down the posterior pharyngeal wall. The nasopharynx of infants and young children is difficult to visualize clearly, but due to pharyngeal secretions and severe nasal congestion, they may experience difficulty in breastfeeding, frequent choking, habitual mouth breathing, and disrupted sleep. The disease may also involve enlarged and tender upper cervical lymph nodes.

bubble_chart Diagnosis

In adult and older pediatric patients, local symptoms are prominent, and nasopharyngeal lesions are easily visible under indirect or fiberoptic nasopharyngoscopy, making diagnosis straightforward. However, in infants and young children, the onset is acute, often dominated by systemic toxic symptoms, and frequently misdiagnosed as acute pestilence. Therefore, when infants and young children present with the aforementioned systemic symptoms, along with stuffy nose, nasal discharge, and fever, the possibility of this disease should be considered. Enlarged and tender upper cervical lymph nodes aid in diagnosis. Attention should also be paid to diagnosing complications.

Infant and young child patients may face life-threatening risks due to systemic poisoning or complications. Therefore, treatment measures must be appropriate. Bed rest is essential, along with providing ample fresh juice and warm beverages. Symptomatic treatment should be administered, such as fever reduction and the use of sedatives. For severe cases, intravenous fluids are necessary, combined with intravenous infusion or injection of broad-spectrum antibiotics and appropriate hormones to control disease progression, leading to rapid recovery. Locally, a 1% ephedrine solution mixed with antibiotics can be applied as nasal drops to constrict the nasal mucosa. The drops flowing into the nasopharynx can achieve local therapeutic effects. After the acute inflammatory phase, secretions in the nasal cavity and nasopharynx should be thoroughly suctioned before applying local medication. Concurrently, the displacement method can be used to allow the medication to enter the sinuses, providing treatment or preventing sinusitis. If necessary, adenoidectomy may be performed.

bubble_chart Complications

Common conditions include acute upper and lower respiratory tract infections, otitis media, sinusitis, laryngitis, retropharyngeal abscess, and kidney diseases in infants and young children.