Acute Naso Pharyngitis
Acute naso pharyngitis is the most common infectious condition of
children this syndrome is more extensive than in adults.
The illness is caused by more than 200 serologically different viral
1. The principal agents are rhinoviruses which account for more than a
third of all colds. Coronaviruses are responsible for about 10%
2. Group A streptococci are the principal bacterial cause of acute
3. Mycoplasma pneumonia infections may localize to the naso pharynx
and in these cases are difficult to distinguish from viral naso
During the initial acute stages, The nasal mucosa is thickened,
edematous and red, the nasal cavities are narrowed and the turbinates are
1. Colds are more severe in young children than in olderchildren and
2. Children 3 month to 3 yr have fever early in the course of infection.
3. Initial manifestations in infants older than 3 mo of age are the
sudden onset of fever, irritability, restlessness, sneezing Nasal
4. A few infants may vomit and some have diarrhoea
5. In older children. Low grade fever, thin nasal discharge, Headache,
Malaise, anorexia, muscularuches, cough.
1. Initial manifestation of measles and pertusis
2. Poliomyelitis, mumps
3. Peristant nasal discharge if it is bloody suggests, A. foreign body, B.
Diptheria and in infants A. choanal atresia, B. congenital syphilis.
4. Allergic rhinitis
5. Infectious rhinitis.
2. Peritonsillar cellulits,
4. Otitis media [ most common complication]
5. Tracheo bronchitis
7. Viral naso pharyngitis is also a frequent trigger for asthma symptoms
The term refers to all acute infection of the phaynx including tonsillitis
and pharyngotonsilits. Pharyngeal involvement is part of most upper
respiratory tract infection.
Incidence – 4 – 7 yr of age.
1. Generally caused by viruses.
2. Group A, B – hemolytic streptococcus is the only common
bacterial causative agent.
3. Aracanobacterium hemolyticum and mycoplasma also produce
In the usual case there is reddening and slight edema of the naso
pharyngeal mucosa with reactive enlargement of the related lymphoid
1. Fever, malaise, and anorexia with moderate throat pain.
2. Hoarseness, cough and rhinits are also common.
3. Exudates may appear on lymphoid follicles of the palate and
4. The cervical lymphnodes are enlarging.
5. Laryngeal involvement is common.
1. In a child over 2yr often begins with complaints of headache,
abdominal pain and vomiting.
2. Fever, sore throat.
3. Tonsilar enlargement exudation and pharyngeal erythema are found.
4. Anterior cervical lymphadenopathy.
2. Infectious monoucleosis.
4. Allergic rhinitis.
5. Gonococcal pharyngeal infections.
1. Viral infections the complication rate is low
2. Purulent bacterial otitis media.
3. Debilated children both viral and streptococcal infection may lead to
large ulcer in the pharynx.
4. Mesentric adenitis