How to distinguish teething from a cold or other inflammatory diseases? Features of symptoms depending on the cause. Consequences and complications

Young children are susceptible to many diseases and ailments, which are sometimes difficult for even the most experienced pediatrician to understand. Unlike an adult, a baby cannot explain what exactly is bothering him or which area of the body needs attention, so young parents often confuse one problem of his well-being with another.

For example, there are regularly cases when a baby is brought in for examination with a complaint of a cold, when in fact he was bothered. But how to distinguish one from the other?

In some cases, the process of teething in children is asymptomatic, but sometimes the baby is exposed to discomfort and even unpleasant sensations due to pain when teeth move out of the gums. Teething is sometimes accompanied by a number of other symptoms, which may not necessarily appear all together, but their combination indicates quite clearly the cause of the problem:

swelling and redness of the gums;
disrupted eating and sleeping patterns;
sudden changes in mood;
expressed desire to put foreign objects into the mouth;
slight redness of the ears and cheeks;
excessive salivation, sometimes leading to coughing;
occasionally small hematomas on the gums;
slightly elevated temperature.

Teething often brings serious discomfort to the baby.

Individually, each of these signs may not indicate teething, so if a child has any of the described symptoms, it is necessary to conduct a diagnosis in order to detect others. The primary one is an increase in temperature, which is why it is sometimes difficult to distinguish an erupting thrush from a cold. This also includes spoiled appetite and sleep.

Etiology of the common cold

From a medical point of view, a cold should be called directly only the cooling of the body, leading to one of the probable diseases, but in colloquial speech they call it a cold a whole series diseases. And although they all have a different nature of occurrence, based on such a provocative factor as hypothermia, they are usually combined into a common group:

rhinitis;
ARVI;
pharyngitis (nasopharyngitis);
laryngitis.

All these diseases have a different clinical picture with some general symptoms, and even though in some ways they may resemble the symptoms of a malaise in which the baby is teething, there should be no problems with how to distinguish one from the other.

Differences from rhinitis

There are more differences than similarities between rhinitis and teething conditions. In the acute course of this disease, the nasal mucosa becomes inflamed, which is accompanied by active sneezing, tearfulness and general malaise. When going to chronic stage Rhinitis, on the contrary, provokes nasal congestion with obvious swelling, as well as regular mucopurulent discharge.

As can be seen from the above, none of these symptoms are characteristic of those that accompany teething. The only one common feature you can call a rise in temperature, but this coincidence is clearly not enough to diagnose rhinitis in an infant. It should be added that this disease is a frequent companion to more severe diseases such as measles and scarlet fever.

The only common feature is an increase in temperature.
Important! Rhinitis, unlike teething, can cause headaches, but it is impossible to diagnose it in the case of infants without special equipment.

Differences from ARVI

ARVI (acute respiratory viral infection) is what doctors call inflammatory diseases caused by pneumotropic viruses. This list includes pathogens such as:

influenza and parainfluenza;
adenoviruses;
rhinoviruses;
respiratory syncytial virus;
reoviruses;
coronaviruses;
herpes simplex;
enteroviruses;
mycoplasma;
pathogenic bacteria.

In general, this is a very broad group of diseases, the most common of which in terms of colds are influenza and herpes simplex. The first of them cannot be confirmed without laboratory tests, since influenza in its symptoms is very similar to any other disease from the list of acute respiratory viral infections.

But even with mild forms of this disease, doctors note a sharp rise in body temperature to 38 - 40 degrees, which is completely different from teething. Moreover, the flu is accompanied by chills and weakness, as well as a dry and tense cough: a baby with cutting milk mucus cannot have all of this (except for a cough, but even that is not dry, but very wet, since the baby coughs up excess saliva).

Pay attention! Only in people with strong immunity The flu goes away smoothly within a few days, while in people at risk (including infants) it often provokes pulmonary or extrapulmonary complications. At severe forms The disease may cause vascular collapse and cerebral edema.

Even with mild forms of this disease, doctors note a sharp rise in body temperature to 38 - 40 degrees, which is completely different from teething.

Regarding herpes simplex, then it distinctive feature is a rash of characteristic blisters on the skin and mucous membranes. It is sometimes called a “cold on the lips” because of the visible symptoms, but this disease has little in common with the common cold. It is very difficult to confuse herpes with.

Difference from pharyngitis

Pharyngitis can also act as a concomitant disease with ARVI, but being an independent disease, it is, first of all, an inflammation of the mucous membrane of the mouth and throat. IN acute form This disease is characterized by a sore throat, pain and a dry, painful cough.

A child with pharyngitis may also suffer from a slight (low-grade) fever, but it is the presence of a cough against the background of obvious redness of the throat that makes it easy to distinguish such a disease from the symptoms that characterize erupting baby teeth.

Difference from laryngitis

Laryngitis in its clinical picture is very similar to pharyngitis, while the main difference between them is the localization of the inflammatory process. Laryngitis affects the larynx, not the mucous membrane of the pharynx. Otherwise, the symptoms are similar: dryness and sore throat, dry (which then changes its character due to phlegm), headache and relatively slight fever– up to 37.5 degrees.

A distinctive feature of laryngitis is the appearance of hoarseness or hoarseness in the voice, up to its loss, which is directly related to inflammation of the larynx. Obviously, baby teeth cannot erupt with such a set of symptoms, so this disease can easily be crossed off the list of probable causes of a child’s illness.

Treatment

Obviously, the main reasons why parents confuse teething with colds are the child’s slightly elevated temperature and disturbances in nutrition and behavior. However, the temperature itself can indicate tens of various ailments, as well as disruptions in the baby’s daily routine.

An experienced doctor will be able to quickly identify everything without any doubt. key symptoms and combine them into general diagnosis, although parents are able to pre-conduct correct analysis clinical picture which they observe in their child. And yet, most the right decision If you suspect a disease, you will visit the clinic to prevent possible complications.

As for the treatment necessary for teething in a baby, it is, as a rule, if required, only symptomatic. The fact is that the process of teeth appearing is natural for a baby, and it would be wrong to try to somehow stop it because the child is feeling negatively.

For this reason, pediatricians usually advise limiting the use of anesthetic gels to the baby's gums, as well as simple home methods to reduce the temperature (in particular, applying a cool towel to the baby's cheeks and gums).

There is no need to bring down the temperature with medication, as it will subside naturally soon. You should also remember that only the first few teeth are the hardest to erupt, and the body can cope better with the eruption of the rest.

Additional information: in the first months of their life, young children almost never get sick with ARVI, since they have innate immunity inherited from the mother transplacentally (if she also had immunity to viral diseases). However, over the next couple of years, children can catch the virus up to 10 times a year for a number of objective reasons.

Teething is a physiological act and, as a rule, is not accompanied by any pathological phenomena, neither general nor local. However, there is still an idea among the population and some doctors that during teething, a number of disorders occur in children: convulsions, diarrhea, bronchitis, pneumonia, skin rash, fever, etc. This point of view is rejected by modern researchers.

Old term " tooth fever", widely used in the past as an indicator feverish state, associated with teething, is currently considered untenable. Occurring at an early age during teething general diseases should be seen as a coincidence and not as a consequence of this process. Most diseases have nothing to do with teething. They are the result of malnutrition, toxic dyspepsia, latent spasmophilia, any general infection, etc. The diagnosis of “complications of teething” can cause great harm, as it sometimes interferes with diagnosis serious illnesses. Often the coincidence of some diseases with teething is the result of the fact that it occurs during the period of complementary feeding, when the protective influence is excluded mother's milk, vitamin deficiency occurs, and therefore the child’s susceptibility to various diseases, including infectious ones.

In fact, with so-called teething diseases, be careful, experienced doctor more or less easily finds any independent disease. Such diseases are tonsillitis, retronasal pharyngitis, otitis, etc. Often the diseases gastrointestinal tract are associated not with teething, but with the beginning of feeding the baby and the errors made during this process, most often with overfeeding.

Often mothers, in order to calm a capricious child, breastfeed him more often than he should, which also leads to gastrointestinal disorders. It is also important that children at this age put various objects into their mouths, often contaminated and infected. TO local symptoms Problems that are incorrectly associated with teething include drooling. Meanwhile, the increase in salivation during the eruption of baby teeth is associated with the following circumstances: a) in this period due to general development child, as well as with complementary feeding and transition to solid food function is enhanced salivary glands; b) oral cavity in children infancy not deep; c) the child has not yet learned to swallow saliva, and therefore it accumulates and flows out; d) what is unusual for the child plays a certain role vertical position, to which he is accustomed at this time; e) it is also important to keep toys, orris root and other items in the mouth that are given to the child to eliminate, as they think, itching in the gums. Biting these objects reflexively irritates the sensitive endings of the trigeminal and glossopharyngeal nerves, which leads to increased salivation.

Question about itching and pain in the gums during teething must be decided on the basis of theoretical considerations only. Since eruption is associated with the passage of the tooth through periodontal tissue, innervated by the branches of the trigeminal nerve, which is easily excitable at an early age, some authors admit the occurrence of itching, which is confirmed, in their opinion, by the fact that the child seeks to soothe it by biting hard objects. However, during the eruption of primary molars, which appear in the oral cavity in the 2nd and 3rd years of a child’s life, there is virtually no itching in the area of innervation of the branches of the same trigeminal nerve. During the eruption of permanent teeth, which occurs during the period of the child’s conscious life, none of the children notice itching or pain in the gums. Teething occurs completely unnoticed by a child, teenager or adult.

An undoubted complication associated with increased salivation is colds that arise due to the wetting of the child’s underwear with flowing saliva, which leads to cooling.

TO local complications associated with the eruption of primary teeth should be attributed rare cases inflammation of the gums. When primary molars erupt, the anterior chewing cusps appear first, then the posterior ones. Sometimes on chewing surface There is a gum bridge between the tubercles, around which food remains are retained and in which, if injured or infected, an inflammatory process can develop. Inflammation of the gums also occurs due to trauma and infection with hard objects that the mother gives to the child. In addition, children grab all kinds of contaminated objects and pull them into their mouths, often injuring the mucous membrane. In this case, inflammation of the gums can lead to inflammation of other areas of the mucous membrane, spread to the upper respiratory tract and cause the development of laryngitis, bronchitis, etc.

Complications associated with teething include purple protrusions, which are extremely rare on the mucous membrane of the gums. These formations appear 2-3 weeks before teething on the corresponding dental mounds and resemble hematomas or ecchymoses in the scurf. In reality, they are bubble-like changes in the gums, filled with bloody fluid. These changes are apparently associated with the pressure of the erupting crown on the mucous membrane and, as a consequence, with vascular disorders. We observed 3 children aged 8-10 months with the described changes on the gums in the area where the upper central primary incisors should have erupted. Gradually, the mucous membrane in these places turned pale and teeth erupted painlessly. A similar picture is observed extremely rarely during the eruption of permanent teeth.

After the lower primary incisors erupt, ulcers sometimes appear on the tongue. During breastfeeding, the tongue comes into contact with the sharp edges of the teeth. As a result, the integrity of the mucous membrane is damaged and it becomes infected. More or less severe inflammatory infiltration and ulcer formation occur. In these cases, it is necessary to file down the sharp edges of the teeth.

Sore throat in infants is accompanied by a runny nose, elevated temperature, refusal of food. Unfortunately, treatment of pharyngitis in infants is complicated by the limited choice of drugs. Most medications intended to relieve sore throat in older patients should not be used. Parents buying medicine for their infants should carefully read the instructions, familiarize themselves with the dosages and find out the duration of use.

The disease should begin to be treated at early stage, the success of therapy depends on this and reduces the risk of complications. With adequate use of medications and a gentle feeding regimen, pharyngitis in infant passes quickly. In the absence of treatment or if medications are used incorrectly, the development of otitis, trachitis, bronchitis, and pneumonia is possible.

The essence of the problem, how to treat pharyngitis in a baby, is clear to every mother. Children under the age of 3–5 years do not know how to dissolve tablets. To treat a sore throat in children under one year of age, do not use a rinse solution, spray or aerosol.

If you suspect pharyngitis in an infant, you should take the child to the pediatrician. You can call pediatrician to your home if you have a baby high temperature. The patient needs rest and requires more warm drinks than on other days. To treat a throat, you can use some local antiseptics and anti-inflammatory drugs. At bacterial nature pharyngitis in an infant will require antibiotic therapy.

Symptoms and treatment

Viruses are the most probable cause sore throat and runny nose in children. The main symptoms and treatment of pharyngitis in infants are due to imperfection immune system. Therefore he can join very quickly bacterial infection. For uncomplicated catarrhal form illness, body temperature is normal or rises slightly, sore throat goes away within a few days.

Symptoms of pharyngitis in infants:

refusal to eat;
redness of the throat;
anxiety, crying;
increase in body temperature to 38–39.5°C;
bright red nodules on the mucous membrane of the oropharynx (with granulosa pharyngitis);
runny nose (optional);
dry cough.

An infant's refusal to eat is explained by pain when swallowing. Discomfort in the throat is felt more strongly in the evening and in the morning.

How to treat pharyngitis in infants

Group of drugs	Titles
Antibiotics in the form of a suspension or syrup.	Amoxicillin + Clavulanic acid, Amoxiclav, Augmentin, Sumamed.
Non-steroidal anti-inflammatory drugs to reduce fever and pain (NSAIDs in the form of syrup, suspension, rectal suppositories).	Paracetamol, Ibuprofen, Nurofen, Panadol, Calpol, Efferalgan, Tsefekon-D.
Antihistamine drops for oral administration.	Fenistil, Zyrtec, Loratadine, Zodak.
Probiotics.	Rotabiotic baby, Lactobacterin.
Drops for nasal congestion and runny nose.	Aquamaris, Otrivin, Isofra.
Local antiseptics for processing oral cavity and throat.	Vinilin, Aqualor, Miramistin.

The child is given medications with ibuprofen and paracetamol in children's dosages. If the baby is less than 7 months old, then it is preferable to use rectal suppositories. Nurofen syrup can be taken by children from 3–6 months. Ibuprofen in this drug has an antipyretic and analgesic effect. Such drugs are used only to eliminate symptoms for a limited time (no more than 3 days).

The baby is given water chamomile tea. This safe remedy improves the condition of the pharyngeal mucosa and has an anti-inflammatory effect. In addition, drinking plenty of fluids helps eliminate toxins.

The use of rectal suppositories does not depend on food intake. The product begins to act within 30–40 minutes. If you give syrup to a baby with food or after eating, then in the blood active substance will be in 1 hour or later. Antihistamines enhance the effect of antipyretics. Babies older than 1 month can take Fenistil drops, after 6 months - Zyrtec drops.

Local treatment

Safe spray for sore throat for infants - Aqualor. Pediatricians do not recommend injecting the product into the oral cavity of a baby if the child is less than 2–3 years old. Instead, moisten a gauze pad with liquid and wipe the inside of the cheeks and tongue. Together with saliva, the liquid enters the back wall of the pharynx and has an anti-inflammatory effect.

Shostakovsky ointment (Vinilin) is applied to infants with pharyngitis. You can use painkillers for children dental gels, which are used for teething.

Antibiotics for pharyngitis in infants

In 70–90% of cases, sore throat under the age of 1 year is caused by viruses, and a bacterial infection develops against the background of ARVI. Pharyngitis can be caused by streptococci, pneumococci, and staphylococci. In this case, the use of antibiotics is required. Antibacterial drugs stop the reproduction and development of microbes (bacteriostatic drugs), or affect pathogen cells, causing their death (bactericidal drugs)
.

If pharyngitis in newborns occurs against the background of the development of candidal infection, then it is treated with antifungal agents. Candidiasis manifests itself in the form of white spots on the mucous membrane of the cheeks, on the surface of the tonsils and soft palate.

A fungal infection often develops in a baby after he or his mother is treated with antibiotics. In this case antibacterial therapy cancel and prescribe antimycotic drugs. It is also necessary to give vitamins and use antiseptics Miramistin and Vinilin to treat the mouth and throat.

Some liquid medicines for oral administration can be mixed with mother's milk, adapted formulas, added to tea, non-acidic juice. Infants older than 8 months are given tea with lime color, compote, if you are not allergic to fruits and berries. For a child over 9 months old, you can prepare clarified chicken breast broth.

Pharyngitis is an inflammatory process localized on the back wall of the pharynx. Main symptom of this disease One of the things a child may complain about to parents is pain and discomfort in the throat. In most cases, pharyngitis develops against the background of acute respiratory infections, together with other catarrhal processes in the nasopharynx and upper respiratory tract, much less often as an independent pathology. It occurs in children of all ages. How smaller child, the more severe the course of the disease and harder choice medicines.

Content:

Causes of the disease

Pharyngitis in children can develop as an independent disease or be a consequence of some other disease. In most cases, inflammation of the pharynx occurs against the background of damage to the body by acute respiratory viral infections (influenza virus, parainfluenza, adenovirus, rhinovirus, coronavirus) and other viruses (cytomegalovirus, Epstein-Barr virus). Less commonly, bacterial pathogens (streptococci, staphylococci, Haemophilus influenzae and diphtheria bacillus, meningococci). The greatest risks of pharyngitis occur in children attending kindergartens and schools in the autumn-winter period during seasonal epidemics of influenza and other acute respiratory viral infections.

The following factors can contribute to the development of the inflammatory process on the back wall of the pharynx:

difficult nasal breathing, leading to inhalation of cold, unpurified air through the mouth and drying out of the mucous membranes of the mouth and throat;
posterior rhinitis, in which infected mucous discharge does not come out through the nasal passages when blowing the nose, but flows down;
hypothermia;
weakening local immunity;
frequent use vasoconstrictor drops in the treatment of runny nose, flowing down from the nasal cavity, irritating the mucous membrane back wall pharynx and reducing it protective properties;
exacerbation of some chronic diseases (rhinitis, adenoiditis, tonsillitis, sinusitis, stomatitis, caries);
removal of palatine tonsils, accompanied by atrophic changes mucous tissue of the pharynx;
lack of vitamins (A and group B);
gastroesophageal reflux, as a result of which stomach contents often enter the pharynx, causing irritant effect on its mucous membrane.

Sometimes the causes of pharyngitis are allergic reactions that occur in response to an allergen entering the mucous membrane of the throat. Inflammation of the pharynx can also be caused by mechanical damage its mucosa with foreign bodies or surgical operations, exposure to chemical solvent vapors, dust, tobacco smoke, hot air. Also, inflammation of the pharynx develops as a result of eating too hot, rough, spicy or sour foods.

Types of pharyngitis

Taking into account the etiological factor, pharyngitis in adults and children can be infectious (viral, bacterial, fungal), traumatic, allergic, or caused by contact of the pharyngeal mucosa with irritating factors. Treatment of the disease directly depends on its type.

According to the nature of the disease, the disease occurs in acute or chronic form. In the first case, children experience acute inflammation of the pharyngeal mucosa. Chronic pharyngitis is a sluggish inflammatory process that lasts several months or more and is characterized by phases of remissions and exacerbations. Most often it occurs as a result of incompletely cured acute pharyngitis or as an independent disease due to prolonged irritation of the pharyngeal mucosa by aggressive factors.

Depending on the severity of the inflammatory process, chronic pharyngitis occurs:

simple, or catarrhal, manifested in the form of hyperemia of the pharyngeal mucosa;
granulosa, or hypertrophic, accompanied by the proliferation of tissues affected by the inflammatory process;
atrophic, accompanied by drying or thinning of inflamed tissues;
mixed, in which there are simultaneously present on the back wall of the throat pathological changes mucous membranes, characteristic of the hypertrophic and atrophic type.

Symptoms

Symptoms of pharyngitis in children differ depending on the form of the disease and severity. A characteristic feature acute inflammation is:

redness and swelling;
sharp pain in the throat, noticeably increasing when swallowing, especially hard and hot food;
increase in body temperature up to 38°C;
hoarseness of voice;
coughing caused by a feeling of soreness and soreness in the pharyngeal mucosa;
irradiation of pain to the ears (if inflammation affects the tubopharyngeal ridges).

With chronic pharyngitis, the symptoms are less pronounced; there is dryness and a sore throat. This form of inflammation is not characterized by an increase in temperature and a change in general condition and child activity. However, during exacerbations, symptoms chronic pharyngitis intensify and the clinical picture is similar to acute pharyngitis.

With granulosa chronic pharyngitis, a viscous coating of thick mucus accumulates on the back wall of the pharynx, red swollen plaques form, which can be enlarged and painful on palpation submandibular lymph nodes, there is a nagging pain in the back of the head.

The atrophic form of chronic pharyngitis in children is diagnosed extremely rarely. It is characterized by pallor and dryness of the mucous membrane of the throat, the formation of crusts on it, which are dried mucus, and the appearance of a vascular pattern on the back wall of the pharynx.

Features of symptoms depending on the cause

With pharyngitis that occurs against the background of ARVI, the inflammatory process spreads to the entire pharynx, including the tonsils and soft palate. It is often accompanied by a runny nose, conjunctivitis, cough, and gastrointestinal disorders.

Pharyngitis caused by pathogenic bacteria, is characterized by a long course, headache, fever, tonsillitis. When the throat is affected by fungi, cracks and erosions form on the mucous membrane and in the corners of the mouth, a characteristic white cheesy coating appears on the back wall of the pharynx, and the posterior cervical lymph nodes become enlarged.

If the cause of pharyngitis is an allergen on the mucous membrane of the throat, it manifests itself in the form of a dry cough and is not accompanied by fever and severe sore throat.

Features of symptoms in young children

Parents can suspect pharyngitis in infants who cannot yet express themselves and show where it hurts based on the following signs:

moodiness, tearfulness;
restlessness and poor sleep;
periodic coughing;
decreased appetite and regurgitation after feeding;

For young children under 2 years of age, acute pharyngitis is severe. If its cause is ARVI, then it is combined with acute inflammation of the mucous membrane of the nasal cavity and nasopharynx, runny nose, cough, and is accompanied by a rise in body temperature, general weakness and lethargy, loss of appetite.

Diagnosis of the disease

If you suspect pharyngitis in children, parents should consult a doctor. Self-diagnosis and self-medication are fraught with complications, and why younger child, the more serious they may turn out to be. Confirmation of the presence of an inflammatory process on the mucous membrane of the posterior pharyngeal wall, as well as its form and causes, is established on the basis of:

complaints from the child or parents, if the child is small;
examination of the mouth and throat (pharyngoscopy);
palpating the lymph nodes in the neck;
results bacteriological culture throat swab.

With pharyngitis, there is moderate redness, swelling and infiltration of the posterior wall of the pharynx, velopharyngeal arches and, less commonly, the soft palate.

A sore throat can be a symptom not only of pharyngitis, but also of tonsillitis, measles, and scarlet fever. Unlike pharyngitis, angina is characterized by rapid dynamics of development of the clinical picture. The very next day appears purulent plaque and plugs on the tonsils, their redness and increase in size are observed, body temperature rises sharply to 40°C.

Treatment of pharyngitis

Drugs and procedures for the treatment of pharyngitis in children should be prescribed by a local pediatrician or pediatric otolaryngologist, taking into account the patient’s age, the cause of the disease and the severity of the patient’s condition. Treatment is carried out at home. In uncomplicated forms of the disease occurring against the background of ARVI, the inflammatory process subsides on its own within a few days.

Medications

For acute pharyngitis and exacerbation of chronic pharyngitis in children, the following medications are used for treatment:

preparations for preparing solutions for gargling (rotocan, furatsilin, chlorophyllipt);
solutions for lubricating inflamed mucous membranes (protargol, Lugol's solution);
lozenges and lozenges with antiseptic, emollient and analgesic effects (lizobact, septefril, faringosept, strepsils, imudon);
sprays and aerosols for irrigating the pharynx (hexasprey, ingalipt, jox, tantum verde, cameton, miramistin);
antibacterial drugs locally, less often systemically (with precisely established bacterial etiology diseases and determining the sensitivity of the pathogen to specific antibiotics);
immunomodulatory drugs for pharyngitis against the background of ARVI (viferon, laferobion, immunoflazid, aflubin);
solutions for inhalation (buffer soda, decasan, saline solution);
antipyretics based on paracetamol or ibuprofen when the temperature rises above 38°C.

To treat pharyngitis in a child under 3 years of age, do not use sprays and aerosols, since when injected they can provoke a reflex spasm of the larynx and an attack of suffocation, as well as gargling due to the difficulty self-execution this procedure for babies.

At fungal pharyngitis in children, treatment consists of treating the throat with local antifungal drugs. Inflammation of the pharynx caused by an allergic reaction is treated by taking antihistamines in the form of tablets, drops or syrups (fenistil, erius, zyrtec, cetirizine, zodak).

Folk remedies

From traditional methods treatment for pharyngitis, after consultation with a doctor, children can be given steam inhalations and gargling with decoctions medicinal plants(chamomile, sage, calendula, eucalyptus, St. John's wort, oak bark), which have antiseptic, anti-inflammatory and healing effects. For rinsing they also use simple saline solution(1 tsp salt per glass of water).

At night you can give the patient warm milk with honey or mineral water, which will have a warming and softening effect. However, before using such folk remedies, you should make sure that the child is not allergic to the herbs and honey used.

Features of patient care

Great value for speedy recovery the child has plenty of warm drinks ( mineral water still, tea, compote, berry fruit drinks) and fresh humid air, for which special attention Parents are advised by the famous pediatrician E. O. Komarovsky. All this will contribute to the effective moisturizing and cleansing of the affected pharyngeal mucosa.

To reduce injury and irritation of the inflamed mucous membrane of the throat during illness, the child should adhere to a gentle diet. It is not recommended to give him too rough, hard, spicy, salty, sour, hot or cold food.

Video: Pediatric ENT about symptoms and treatment of pharyngitis

Possible complications and prevention

In the absence of timely and proper treatment acute pharyngitis in children can lead to complications, the main of which are:

transition of the disease to a chronic form;
spread of infection to lower organs respiratory system(laryngitis, tracheitis, bronchitis);
peritonsillar and retropharyngeal abscess;
autoimmune diseases (rheumatism);
angina.

To reduce the risk of acute or chronic pharyngitis in children, it is necessary to follow simple preventive measures, which are aimed primarily at increasing immunity and minimizing contact with potential pathogens. These include regular walks fresh air, good nutrition and rest.

Hypothermia should be avoided. In the room where the child lives, it is important to create a normal level of humidity and temperature regime(cool, moist air), avoid contact with polluted air, tobacco smoke, dust. It is necessary to promptly treat rhinitis, sinusitis, and adenoiditis to prevent prolonged nasal congestion and forced breathing through the mouth, as well as prevent contact with sick people during seasonal epidemics of ARVI.

– infectious-inflammatory process in the mucous membrane and lymphoid tissue oropharynx. Pharyngitis in children occurs with symptoms of dryness, burning, rawness, sore throat, coughing, and hoarseness. Diagnosis of pharyngitis in children is based on the pharyngoscopy picture and results microbiological research swab from the back of the throat. For pharyngitis in children, local therapy is usually carried out: gargling, lubricating the mucous membrane of the back of the throat with antiseptics, inhalation, irrigating the throat with aerosols.

General information

Pharyngitis in children is a manifestation of acute respiratory infection, occurring with inflammation of the mucous membrane and lymphoid structures of the posterior pharyngeal wall. In frequently ill children, pharyngitis accounts for about 40% of all cases of morbidity. In otolaryngology, chronic pharyngitis in children accounts for 9% of total number diseases of the upper respiratory tract. Given the tendency of children to diffuse damage respiratory tract, pharyngitis in a child is often combined with rhinitis, laryngitis, tracheitis, bronchitis.

Reasons

As an independent nosology, pharyngitis in children develops with the direct impact of infectious pathogens on the pharyngeal mucosa. In addition, acute pharyngitis can serve as one of the manifestations inflammatory diseases upper respiratory tract, common infections, intestinal infections, etc.

The greatest role in the etiology of pharyngitis in children belongs to viral infection(influenza and herpes viruses, adenoviruses, enteroviruses) and bacterial microorganisms (Haemophilus influenzae, moraxella, streptococci of groups A, C, G, diplococci, diphtheria corynebacteria), fungi, intracellular agents (mycoplasma, chlamydia). Acute pharyngitis of viral etiology in children accounts for 70% of cases, bacterial and others - 30%.

Acute pharyngitis in children can accompany the clinical course of ARVI, infectious mononucleosis, measles, scarlet fever. In some cases, the cause of pharyngitis in children may be burns and foreign bodies in the pharynx. Chronic pharyngitis in children is usually associated with other inflammatory diseases of the ENT organs (rhinitis, adenoiditis, sinusitis, stomatitis, tonsillitis, chronic tonsillitis), caries, dysbacteriosis, gastroesophageal reflux, allergic reactions. Tonsillectomy, performed at the age of 3-7 years, during the period of active immunogenesis, can stimulate compensatory hypertrophy of the lymphoid tissue of the posterior pharyngeal wall and the development of chronic pharyngitis in children.

The occurrence of pharyngitis in a child is predisposed by general and local hypothermia, exposure of the pharyngeal mucosa to various irritants (tobacco smoke, spicy food, cold or dusty air, etc.), constitutional anomalies, hypovitaminosis (vitamin A deficiency), endocrine disorders(hypothyroidism, diabetes mellitus).

Classification

Based on the nature of inflammation of the pharyngeal tissues, acute (lasting up to 1 month), protracted (lasting more than 1 month) and chronic pharyngitis in children (lasting more than 6 months with frequent exacerbations) are distinguished. Chronic pharyngitis in children can occur in catarrhal, hyperplastic (granulosa) and atrophic forms.

Since viral and bacterial agents have tropism for the epithelium of the upper and lower respiratory tract, pharyngitis in children usually does not occur in isolated form, and in the form of nasopharyngitis, pharyngolaryngitis, pharyngotracheitis, pharyngobronchitis.

Taking into account the influencing etiological factors pharyngitis in children can be viral, bacterial, fungal, allergic, or traumatic in nature.

Symptoms of pharyngitis in children

Signs of acute pharyngitis in children are a sudden burning sensation, dryness, soreness, rawness and pain in the throat when swallowing. Characterized by a shallow cough and hoarseness. Body temperature may be normal or low-grade; if pharyngitis in a child develops against the background of a viral infection, the temperature is usually high due to the underlying disease, headache, intoxication syndrome, and regional lymphadenitis are pronounced. In infants, pharyngitis is much more severe; in this case, general symptoms predominate: severe fever, sleep disturbance, loss of appetite, salivation, dysphagia, dyspepsia, runny nose, conjunctivitis, rash on the body.

The pharyngoscopic picture is characterized by bright hyperemia and pronounced vascular injection of the posterior wall of the pharynx, velopharyngeal arches, and soft palate; the presence of protruding inflamed follicles in the form of red grains. With lateral pharyngitis in children, hyperemia and edema involve the lateral ridges of the pharynx and uvula.

Severe acute bacterial pharyngitis in children may be complicated by the development of a retropharyngeal abscess, purulent otitis media or purulent mediastinitis.

With chronic catarrhal pharyngitis, children are bothered by discomfort and sensation foreign body in the throat, obsessive cough. Upon examination, the mucosa is loosened, diffusely infiltrated and hyperemic.

Chronic hyperplastic pharyngitis is characterized by hyperplasia of the epithelium, submucosal layer and lymphoid elements. Children complain of sore and dry throat, accumulation of viscous mucous secretion with the urge to vomit, pain when swallowing, radiating to the ear. Hyperemia of the mucous membrane is moderate, but against this background there is noticeable thickening of the mucous membrane and lateral ridges, the presence of lymphoid granules or strands of lymphoid tissue, sometimes blocking the orifices auditory tubes and leading to the development of conductive hearing loss in children.

Atrophic pharyngitis V childhood It is rare and almost never occurs in isolation. It is usually accompanied by atrophic rhinitis, laryngitis, tracheitis, and clinical course accompanied by an obsessive dry cough and voice disturbance such as dysphonia. Endoscopy of the pharynx in children reveals a pale, dry (with a “varnish shine”), thinned mucous membrane with translucent vessels, dried and difficult to remove crusts.

Subjective symptoms of fungal pharyngitis in children (pharyngomycosis) do not differ from catarrhal and hyperplastic forms. Objectively, cracks and erosions in the corners of the mouth (candidiasis seizures), enlargement of the posterior cervical lymph nodes, and a cheesy coating in the posterior wall of the pharynx, under which a bright red, often eroded, mucous membrane is visible, are often detected.

Diagnostics

Recognizing pharyngitis in children is not difficult, but it should be distinguished from catarrhal tonsillitis, diphtheria and others infectious diseases. Therefore, a child with pharyngitis should be consulted by a pediatrician, pediatric otolaryngologist, pediatric infectious disease specialist, and pediatric allergist-immunologist.

When diagnosing pharyngitis in children, data from the anamnesis and pharyngoscopy picture are taken into account. To identify concomitant pharyngitis in children inflammatory processes Auscultation, rhinoscopy, otoscopy are performed. Examination of a smear from the pharynx for microflora makes it possible to clarify the causative agent of the infection in order to select etiopathogenetic therapy.

Treatment of pharyngitis in children

As a rule, for pharyngitis in children, they are limited to prescribing local therapy. During acute inflammation, irritating foods (spicy, sour, cold, hot) and exposure to nicotine should be excluded from the diet, comfortable temperature and humidity levels in the room should be ensured, and voice strain should be limited.

Local treatment of pharyngitis in children includes disinfectant gargles (herbal decoctions, antiseptics), treatment of the back of the throat with drugs (Lugol's solutions, iodinol, etc.), medicinal and alkaline inhalations, spraying anti-inflammatory aerosols, resorption of lozenges with an antibacterial, softening, analgesic effect . Young children who cannot rinse their mouths or dissolve tablets are prescribed plenty of fluids and endopharyngeal instillation of antiseptics. When there is a threat of development bacterial complications(descending infection, rheumatism), systemic antimicrobial therapy is indicated.

In case of severe hyperplasia of lymphoid tissue, laser treatment is performed on the granules of the pharynx, OKUF therapy. Treatment chronic tonsillitis in children can be carried out under the supervision of a pediatric homeopath.

Prognosis and prevention

With acute pharyngitis, children usually recover within 7-14 days. As part of the treatment of chronic pharyngitis in children, it is necessary to resort to regular symptomatic therapy or surgical tactics.

As measures to prevent pharyngitis in children, hardening procedures, strengthening the immune system, carrying out specific vaccine prevention of infections, maintaining a favorable microclimate in the room, and a nutritious diet are recommended. A child should not be allowed to develop chronic ENT pathology; It is necessary to treat diseases of the teeth, gums, and gastrointestinal tract in a timely manner.