Adenoiditis acute: causes, diagnosis, symptoms and treatment

The reason that parents areface 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 the above stages of the child's life implies his stay with his peers. As a result, the potential dangers of infection become greater, and the load on the baby's body increases many times.

Tonsils and adenoids

The transition to social life in the 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 natural protection of the child begins to suffer.

In the nasopharyngeal system of a small personthere is an amygdala performing 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 adenoidsatrophy themselves, and find them in an adult man is extremely rare. 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, discover and dock the process -the first task of parents and medical workers. 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 flow rises to 38 degrees, while all the segments of the lymphatic ring fall into the area of ​​inflammation. The acute form is observed after diagnosing the child with 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 increasedduration, 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 tonsils of the nasopharynx 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 so pronouncedobvious signs that it is impossible to miss 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 repeatedly asks and hears what he has heard;
• 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 theThe child in view of extreme ignoring by parents of all previous signs. 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

Disease does not arise from scratch;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 they smoke;
• there is a pronounced allergic susceptibility.

Relying on the authoritative opinion of the doctorKomarovsky (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

Influenced by infectious agentschlamydia, or based on general immunodeficiency, due to which the body is not able to reject foreign cells, 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 when they get into the blood vessels, they 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 decay of the inflamed tonsil could be prevented.

To detect acute purulent adenoiditis will help such characteristic features:

• permanent nasal congestion of the child with the 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 washes of the nasopharyngeal apparatus are used and a full course of antibiotics is prescribed.

Subacute adenoiditis

Subacute adenoiditis, like chronic, isthe state of unstable symptoms, with the 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, a subacuteadenoiditis, may persist for some time after the disappearance of the rest of the symptoms, and even during the recovery period. Physical examination reveals enlarged, with painful sensations during palpation, cervical and submandibular lymph nodes.

Diagnostics

If children have symptoms of adenoiditis treatmentand supportive measures do not always keep up with the true diagnosis. In cases where the enlargement of submandibular lymph nodes is a pronounced symptom, parents hurry 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 complaintsif there are at least two symptoms from the upper lists, this 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 to make the diagnosis clearer, they will need X-ray and laboratory tests.

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

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

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

Treatment of adenoiditis

The main task facing doctors whendiagnosing the symptoms of adenoiditis in children - the treatment of the leading disease, which most often is ARVI. This is included in general-purpose measures, and local measures are considered to be actions aimed at stopping painful manifestations.

The removal of warning signs and pain syndrome of adenoiditis contributes to:

• Rinse the nasopharynx with saline ormeans made on its basis. In order not to irritate the mucous membrane, salt rinses are recommended to alternate with infusions and decoctions of medicinal plants that have proven to be antimicrobial. These are: sage, chamomile, calendula, St. John's wort.
• To stop nasal secretionuse (a course of not more than a week) means for local narrowing of blood vessels. These are: "Rinostop", "For the nos", "Nazol", "Naphthyzinum" (for children). Forms of release can be any, but aerosol irrigation has an advantage in terms of uniform distribution of the liquid.
• From local antibiotics, children's doctors continueprescribe a tested "Albucidum", but the burning sensation that occurs in children when using the remedy makes the therapy painful for both the child and the parents. Therefore, an alternative to the old drug for a long time and with success are the sprays: "Isofra", "Bioparox" (it has two nozzles in the kit - for irrigation of the nose and throat), "Polydex".

Prescribing Nasal Steroids for Treatmentadenoiditis is considered to be the same mandatory measure as the use of antibiotics, especially in recent times, when the choice of means allows to take into account the individual characteristics of the child’s body as much as possible. Among such drugs are "Nazofan", "Avamis", "Fliksonaze". Special attention deserves the drug "Nasonex". In acute adenoiditis in children, the use of this tool is justified by clinical recommendations. Also good compatibility with most drugs with a narrow and broad spectrum of action.

How to treat a child with acute adenoiditis second andthe third degree of complexity, decides the attending physician, but only after all conservative methods have been tried, and the result is lower than expected, the question of the removal of inflamed tonsils by surgical intervention may be raised.

Complications and consequences

Acute adenoiditis in children who passed intochronic phase, acts depressingly also on the psycho-emotional state of the child. Surrounding it becomes noticeable the rapid "roll" of his school performance, loss of interest in the games, especially among peers.

In infants, the occurrence of adenoiditis is a phenomenonrare, but it is also pronounced and can not hide from attentive eyes. The baby becomes restless, suffocates during crying, refuses to accept food. Already consumed food often comes in the form of abundant belching 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 withthe birth of the baby, and continue all the time until the child reaches adolescence. In addition to constant observation of the child’s behavior during sleep (with a closed or open mouth, he sleeps, snores, or suffocates), it is necessary from time to time to reorganize the nasopharynx with weak salt solutions. The measure is especially relevant in case of influenza epidemics or when a child visits a kindergarten where rhinitis is ubiquitous.

Of great importance in the prevention of stress on the tonsils is the timely treatment of any respiratory diseases caused by viruses.