Pharyngitis treatment in children
The content of the article:
- Development reasons
- Symptoms
- Diagnostics
- How and how to treat pharyngitis in children
- Video
Treatment of pharyngitis in children requires an integrated approach. It is important to determine the causative agent and the form of the disease. Therapy must be started quickly, from the moment the first symptoms appear, in order to prevent the occurrence of complications: tracheobronchitis, bronchopneumonia, otitis media, stomatitis, etc.
To prescribe an adequate treatment for pharyngitis, you must consult a pediatrician or an ENT doctor
Pharyngitis is an inflammatory lesion of the mucous membrane of the back of the throat. There are acute and chronic forms of the disease. The latter is subdivided into catarrhal, hyperplastic and atrophic pharyngitis.
The disease can develop in children of any age.
Development reasons
In the occurrence of pharyngitis, anatomical and functional characteristics of the child's body, as well as predisposing factors, play a special role:
- immaturity of the immune system;
- the severity of allergic reactions;
- increased permeability of epithelial, connective tissue, blood-brain barriers;
- immaturity of organs and central nervous system;
- weakness of enzymatic systems;
- increased vulnerability of the mucous membrane of the upper respiratory tract;
- congenital malformations of the pharynx;
- throat injury;
- the presence of cysts, adenoids, foreign bodies, hypertrophy of the mucous membrane of the upper respiratory tract;
- congenital and acquired immunodeficiency states;
- operations on the lymphoid pharyngeal ring;
- chronic diseases of the gastrointestinal tract and cardiovascular system;
- diabetes;
- avitaminosis;
- metabolic disease;
- environmental factors (dry hot climate, air pollution).
Bacterial infection, such as staphylococci, leads to the development of the disease
Most often, acute pharyngitis develops against the background of an acute respiratory viral infection. Together with the inhaled air, bacteria (staphylococci, streptococci, Haemophilus influenzae, chlamydia, mycoplasma) and fungi can enter the mucous membranes, which can also cause inflammation of the posterior pharyngeal wall. Pharyngitis can also be allergic due to inhaled polluted air, chemicals, dust.
Chronic pharyngitis is caused by prolonged irritation of the mucous membrane of the posterior pharyngeal wall. This often occurs as a result of difficulty or impossibility of nasal breathing as the baby is forced to breathe through the mouth.
In addition, infection of the mucous tissues of the pharynx often occurs in the presence of chronic foci of inflammation in the oral cavity: stomatitis, lacunar angina, chronic tonsillitis, adenoiditis. Irritation of the nasopharynx is possible with acute or chronic purulent rhinitis or sinusitis, when discharge flows down the back of the pharynx, causing inflammation.
An important role is played by the reactivity of the body, the state of general and local immunity, which is directly related to the age of the child. At the age of 3, antibody formation begins, and by the age of 5, the lymphoid apparatus of the pharynx is formed, which acts as an organ of local immunity.
Tonsillectomy at the age of 3 to 7 years leads to compensatory proliferation of lymphoid tissue in the posterior pharyngeal wall, which can contribute to the development of chronic pharyngitis. Therefore, the tonsils during this period of active immunogenesis can be removed only on strict indications.
Symptoms
The clinical course of pharyngitis is characterized by a wide variety depending on the causes of development, the form and course of the disease, concomitant pathologies and the age of the child.
The disease is manifested by obsessive cough, runny nose, dry throat
The main symptoms of pharyngitis are:
- dry and sore throat;
- pain when swallowing;
- obsessive cough;
- runny nose (possibly).
The younger the child, the more severe the inflammation can be. At high temperatures, irritability and apathy appear. At an older age, complaints of headache and chills are possible.
In children, especially under 3 years old, mouth breathing leads to excessive swallowing of air, and the child develops flatulence, which also worsens the general condition.
In the case of an increase in body temperature, dyspeptic disorders (vomiting, loose stools) may join. With a severe course of the disease, sleep is disturbed, the child becomes restless.
In infants, any inflammation tends to generalize, therefore, acute pharyngitis is often accompanied by inflammation of the nasal mucosa with the development of nasopharyngitis. The anatomical narrowness and small vertical size of the nasal cavity in young children contribute to the fact that even a slight swelling of the mucous membrane causes difficulty in nasal breathing.
The inflammatory process in the pharyngeal mucosa is of a descending nature and is rarely isolated.
Diagnostics
The diagnosis of acute or chronic pharyngitis is made by the doctor on the basis of the history data, complaints of the child or his parents, the results of laboratory and instrumental research methods.
One of the most informative diagnostic methods is pharyngoscopy.
The child's examination includes:
- clinical blood test;
- bacteriological smear from the oropharynx with determination of sensitivity to antibiotics;
- pharyngoscopy;
- consultation of related specialists.
On examination, a child has enlarged occipital and cervical lymph nodes.
For acute pharyngitis with pharyngoscopy, redness and swelling of the mucous tissues of the posterior pharyngeal wall is characteristic, hyperemic, protruding forward, clogged mucous glands are determined on the soft palate.
With catarrhal chronic pharyngitis, there is also hyperemia of the mucous membrane, its looseness. On the back of the throat, streaks of viscous phlegm may be seen coming down from the nose.
Hyperplastic pharyngitis is characterized by the appearance of lymphoid granules on the posterior wall of the pharynx, thickening of the lateral ridges. The mucous membrane is covered with a viscous secretion, moderately hyperemic.
With atrophic pharyngitis, a dry, pale, thinned mucous membrane is determined during pharyngoscopy, with translucent vessels and dried crusts that are difficult to separate.
Modern equipment allows you to take a photo or video during the study, which makes it possible to dynamically observe, and in severe cases, allows you to consult with other specialists without disturbing the baby again.
How and how to treat pharyngitis in children
Pharyngitis treatment should be aimed primarily at eliminating the cause of the disease or irritating factor. For this, the doctor conducts the sanitation of chronic foci of infection in the upper respiratory tract and oral cavity. If necessary, surgery is performed to restore nasal breathing.
Treatment of concomitant diseases is carried out, which not only irritate the mucous membrane of the posterior pharyngeal wall (gastroesophageal reflux in pathology of the gastrointestinal tract), but also negatively affect the general condition of the body (heart disease, especially with decompensation).
Food should be rich in vitamins and minerals. Spicy, sour, hot or cold food is excluded. Drinking plenty of warm drinks is very important.
The room in which the child stays should not be dusty, stuffy.
At home, gargling with antiseptic solutions is recommended.
Treatment of pharyngitis in children at home is possible with a mild course of the disease. Gargling with antiseptic solutions (Chlorhexidine, Miramistin) and preparations with sea salt is recommended.
To reduce irritation, the mucous membrane of the posterior pharyngeal wall can be lubricated with an antiseptic solution of Collargol or Lugol.
To eliminate pathogenic microbial flora, rinsing with a Furacilin solution helps well. Alkaline inhalations are prescribed. A nebulizer can be conveniently used for their implementation.
With bacterial pharyngitis or a complicated course of the disease, antibiotic therapy is selected. Antibacterial drugs for the treatment of pharyngitis in children:
- protected penicillins;
- cephalosporins;
- macrolides.
Anti-inflammatory drugs (Paracetamol, Nurofen) are used at high body temperature. To relieve edema, vasoconstrictor sprays and nasal drops (Vibrocil, Nazivin) are prescribed.
Herbal decoctions can be used for gargling.
Treatment of pharyngitis in children from 2 years of age and older is possible using folk remedies, in addition to basic medical prescriptions. The throat can be washed with pharmacy chamomile, a solution with the addition of calendula and sage tincture, a warm solution with baking soda or sea salt.
Complications of acute pharyngitis or nasopharyngitis in children can be:
- tracheobronchitis;
- bronchopneumonia;
- otitis;
- stomatitis;
- ethmoiditis;
- dacryocystitis;
- retropharyngeal abscess;
- purulent mediastinitis.
It is important to pay attention to the prevention of the development of pharyngitis, in particular, hardening
According to Dr. Komarovsky, the prevention of pharyngitis in children should include:
- general strengthening procedures (hardening);
- timely detection and therapy of pathologies of the upper respiratory tract;
- remediation of chronic foci of infection in the body;
- treatment of concomitant diseases.
Video
We offer for viewing a video on the topic of the article.
Alina Ervasova Obstetrician-gynecologist, consultant About the author
Education: First Moscow State Medical University. THEM. Sechenov.
Work experience: 4 years of work in private practice.
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