Adenoiditis acute: causes, diagnosis, symptoms and treatment

The reason that parents practically do not face the problem of acute adenoiditis, until the child is three years old, is not in the selectivity of age preferences of pathology. A certain boundary is at the intersection of two periods - home, when the child is protected from infections by practical isolation from the causative agents of the pathogenic environment, and social. The second of these stages of the child's life implies his stay with his peers. As a consequence, the potential danger of infection becomes greater, and the load on the baby's body increases many times.

Tonsils and adenoids

The transition to social life in a child begins, as a rule, sharply, against the background of a weakened immune apparatus. Faced with a huge number of unfamiliar bacterial irritants, not accustomed to such an onslaught, the child's natural protection begins to suffer.

In the nasopharyngeal system of a small person there is an amygdala that performs a barrier function between an external microbial environment and a fragile baby organism. The possibilities of a protective organ are not unlimited, and when under the influence of provoking factors the load on the amygdala increases, it begins to grow rapidly, forming into adenoids.

At the beginning of puberty adenoids atrophy themselves, and it is extremely rare to find them in an adult. But while their functionality is at the peak of activity, any strong provocation can lead to inflammation and the formation of acute adenoiditis.

At this stage, find and stop the process - the first task of parents and health professionals. The lost time with the conniving attitude to the health of the child leads to irreversible pathologies in the formation of the facial part of the skull, chronic rhinitis, tonsillitis, inhibition of general development and other disorders.

Forms and degrees of adenoiditis

Classification of adenoiditis implies the division of the disease according to the form of the course, the type of lesion and the degree of severity of the condition:

1. Acute adenoiditis. The temperature at a long current rises to 38 degrees, while all the segments of the lymphatic ring fall into the area of inflammation. The acute form is observed after the diagnosis in the child of ARVI and other infectious or bacteriological infections. In the presence of congenital abnormalities of tonsils, adenoiditis in the subacute can be recorded in infants.
2. Chronic adenoiditis is marked by increased duration, from six months. Symptomatology can be significantly erased by multiple signs of concomitant ENT diseases, since this type of inflammation of adenoids covers all parts of the respiratory tract and a number of located organs.

Further, on the scale of the complexity of the disease and the amount of damage, the nasopharynx tonsils assess the level of the pathological condition:

1. I degree - the inflamed tonsil obstructs the third part of the nasal septum and airways.
2. II degree - adenoid obstructed the second part of the septal bone.
3. III degree - free from the inflamed organ remains one third of the septum.
4. IV degree - means complete inability to breathe through the nose due to the extensive coverage of the nasal septum with inflammation.

Symptoms

Acute adenoiditis in children is expressed so obvious signs that it is impossible to notice the process at the very beginning. Even before the enlarged lymph nodes under the lower jaw become replacements and begin to react with pain to the touch, the breath of the child in the dream will be interrupted by snoring, and the discharge from the nose will change the consistency and color of the thick, unpleasantly smelling mucus.

Other symptoms will include:

• Temperature jumps, or a steady increase to 38 degrees;
• The child begins to pronounce the sounds in a "gundosym" voice, "google";
• There is a worsening of the child's hearing - he re-requests several times and perceives what is heard worse;
• In the morning, the baby coughs without the phlegm;
• A child who can clearly explain his condition, can complain that a lump in the throat is constantly felt, sometimes this feeling is accompanied by pain.

The so-called "adenoid face" appears in the child due to extreme ignoring of all the preceding signs by the parents. Such children are always noticeable by a special, as if senseless or surprised expression on the face, in which the mouth is always ajar, and between the upper raised lip and the nose is formed a swollen tubercle. With increased salivation, the chin of such children is always wet from the secreted salivary fluid.

Over time, if in this case the measures are not taken, the configuration of the skull is changed. From the inadequate respiratory process, the lungs and bone structure of the thorax suffer.

Causes of the disease

The disease does not arise from scratch, it is always preceded by inflammation of the nasopharyngeal tonsil. The causative agents of the process are pathogenic fungi or agents of viral infections, such as Staphylococcus aureus and Streptococcus bacteria. An important degree of predisposition of the child to a response to the defeat of microorganisms. Therefore it is very important not to miss the start of the process and always consider the circumstances that can lead to the formation of pathology:

• There is a danger of contracting SARS from another person;
• The child froze;
• Frequent illnesses caused immunodeficiency;
• A history of severe infectious diseases: scarlet fever or measles;
• There are chronic rhinitis, respiratory diseases;
• Malnutrition is observed;
• Living conditions do not meet general hygiene standards;
• In the presence of a child smoke;
• There is a pronounced allergic susceptibility.

Based on the authoritative opinion of Dr. Komarovsky (treatment of acute adenoiditis in children was the theme of his separate videoconference), it can be argued that the vast majority of recorded cases of the transition of the disease to a chronic form is due to inferior therapy in ARVI.

Purulent adenoiditis

Under the influence of infectious agents of chlamydia, or based on a general immunodeficiency, due to which the body is not able to reject foreign cells, the adenoids begin to exude pus. After accumulation of a large amount of liquid matter, the discharge falls into the throat, spreads in the nasal sinuses, and getting into the blood vessels, even begin to travel through the body, settling on the filtration organs - the liver and kidneys.

It is worth remembering that this stage of the disease is a natural continuation of the bright symptomatology of the acute course, which means that the stage of putrefaction of the inflamed tonsil could be prevented.

To detect acute purulent adenoiditis will help such characteristic features:

• Permanent nasal congestion of the child with an uninterrupted release of dark, earthy mucus;
• Deterioration in the quality of sleep, the child often wakes up, and does not cover the mouth completely during sleep;
• The temperature is kept within 37.5 degrees;
• There are persistent headaches;
• Hearing loss is observed;
• In small children, burping pass to a copious vomit, older children complain of frequent nausea, visits to the toilet become irregular due to frequent constipation or diarrhea.

For the treatment of acute adenoiditis in purulent form, multiple flushing of the nasopharyngeal apparatus is used and a full course of antibiotics is prescribed.

Subacute adenoiditis

Subacute adenoiditis, as well as chronic, is a state of unstable symptoms, with stages of remissions and relapses. But in the case of rapidly adopted remedial measures, noticeable improvements with the dynamics of the inflammatory decline come in two weeks. This complication of acute adenoiditis at the beginning of the process goes in parallel with the development of lacunar angina.

The temperature of a child with a subacute adenoiditis may persist for some time after the disappearance of the rest of the symptoms, and even during recovery. Physical examination reveals enlarged, with painful sensations during palpation of cervical and submandibular lymph nodes.

Diagnostics

If children have symptoms of adenoiditis, treatment and supportive measures do not always keep up with the true diagnosis. In cases where the increase of the submandibular lymph nodes is a pronounced sign, the parents rush to show the child to the dentist. Complete sanitation of the oral cavity sometimes takes a lot of precious time, whereas the correct therapy for acute adenoiditis should begin immediately.

A specialist who should address complaints when there are at least two symptoms from the upper lists is an otolaryngologist. The ENT doctor's arsenal has all the necessary tools for endoscopic examination, but parents need to be prepared for the fact that radiologic and laboratory tests will be needed to clarify the diagnosis.

A major problem for many children is a simple physical examination, in which the doctor probes the adenoids with a contact, finger method. But this method is rarely practiced, since viewing the pathological growths by methods of posterior rinsoscopy (by a mirror, through the oral cavity) or a fibroscope (flexible endoscope) gives a fairly complete picture of the level and complexity of the disease.

A typical clinic that allows to diagnose pathology and determine whether a child needs to remove adenoids is indicated in the degree of edema of the pharyngeal tonsil, the formation of suppuration and the structure (friability, density) of the diseased organ.

If adenoiditis occurs repeatedly, and there is a suspicion that the microflora of the tonsils does not perceive treatment, a smear from the mucosa is taken to seed a bacterial environment in order to select adequate antibacterial therapy.

Treatment of adenoiditis

The main task facing the doctors in diagnosing the symptoms of adenoiditis in children is treatment of a leading disease, which most often is ARVI. This is part of general-purpose activities, and local measures are actions aimed at stopping the painful manifestations.

The removal of anxiety symptoms and adenoiditis pain syndrome is facilitated by:

• Rinsing of the nasopharynx with saline solution or with preparations made on its basis. In order not to irritate the mucous membrane, salt rinses are recommended to alternate with infusions and decoctions from medicinal plants, which have proved to be antimicrobial. Such are: salvia, chamomile, calendula, St. John's wort.
• To stop the discharge of mucus from the nose, use (with a course of not more than a week) of means for local narrowing of the vessels. They are: "Rinostop", "Tanos", "Nazol", "Naphtizin" (for children). Forms of release can be any, but aerosol irrigation has the advantage of a uniform distribution of the liquid.
• Of local antibiotics, children's doctors continue to prescribe the tested "Albucid", but the burning sensation that occurs in children when using the drug makes the therapy painful for both the child and parents. Therefore, an alternative to the old drug has long and successfully sprays: "Isofra", "Bioparox" (it has two nozzles in the kit - for irrigation of the nose and throat), "Polidex".

The appointment of nasal steroids for the treatment of adenoiditis is considered as an obligatory measure as the use of antibiotics, especially in recent times, when the choice of funds allows for maximum consideration of the individual characteristics of the child's body. Among such medicines stand out "Nazofan", "Avamis", "Fliksonase". The drug "Nazonex" deserves special attention. In acute adenoiditis in children, the use of this remedy is justified by clinical recommendations. Also good compatibility with most drugs of narrow and wide spectrum of action.

What a child has to treat acute adenoiditis of the second and third degree of complexity, the attending physician decides, but only after all the conservative methods have been tried and the result is lower than expected, the question of removing the inflamed tonsils by an operative intervention may arise.

Complications and consequences

Acute adenoiditis in children, which has passed into the chronic phase, acts depressingly also on the psychoemotional state of the child. The environment becomes noticeably rapid "roll" of his school performance, loss of interest in games, especially among peers.

In adolescents, the appearance of adenoiditis is a rare phenomenon, but it is just as pronounced and can not hide from attentive eyes. The kid becomes restless, during the crying he suffocates, refuses to take food. Already consumed food often comes in the form of profuse eructations or even vomiting.

With advanced forms of the disease, it is possible to diagnose the most dangerous complication of acute purulent adenoiditis in a child - sepsis.

Prevention

Prevention of adenoiditis should begin with the birth of the baby, and continue all the time until the child reaches adolescence. In addition to constant monitoring of the behavior of the child during sleep (with a closed or open mouth, it sleeps, snores, or suffocates), it is necessary from time to time to arrange sanation of the nasopharynx with weak saline solutions. The measure is particularly relevant for influenza epidemics or when a child visits a kindergarten, where rhinitis is ubiquitous.

Great importance in preventing the load on the tonsils is the timely treatment of any respiratory diseases caused by viruses.