Acute Naso Pharyngitis

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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


Clinical manifestations

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.

Differential Diagnosis

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.


1. Mastoiditis

2. Peritonsillar cellulits,

3. Sinusitis

4. Otitis media [ most common complication]

5. Tracheo bronchitis

6. Bronchiolitis

7. Viral naso pharyngitis is also a frequent trigger for asthma symptoms

in children

Acute pharyngitis

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



Viral pharyngitis:

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.

Streptococcal Pharyngitis

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.

Differential diagnosis

1. Diptheria.

2. Infectious monoucleosis.

3. Agranulocytosis.

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


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