Rhinopharyngitis is an inflammatory disease of the respiratory system and pharynx. Appears as a complication of rhinitis and pharyngitis. The first disease is characterized by a runny nose and inflammation of the nasal mucosa. In the absence of complications, the disease goes away in 7-10 days. Pharyngitis often occurs more often due to the addition of a bacterial infection. It is characterized by a cough, sore throat and constant pain.
Rhinopharyngitis, ICD-10 code: clinical picture
The disease is characterized by the symptoms present in the diseases described above. The infected cells begin to produce histamine.
Blood flow to the affected area increases, which leads to swelling of the mucous membrane.
The infection is most severe in children due to the narrowness of the nasal passages and the small vertical size of the nose.
A more accurate name for the disease is acute catarrhal nasopharyngitis. According to ICD-10, it is classified as nasopharyngitis and has code J100. When repeated regularly, the disease develops into a chronic form with a hidden clinical picture beyond exacerbation.
Treatment of acute catarrhal laryngitis
The main thing in the treatment of patients with acute catarrhal laryngitis is a strict voice regime with the exception of voiced phonation. Whispered speech is permitted where necessary. The patient should be in a warm room with high humidity in a state of relative rest for 5-7 days. Spicy, salty, hot foods, smoking, and alcohol consumption are excluded. In mild cases, voice rest, a gentle diet (not spicy food), warm drinks, and antitussives and expectorants for coughs are sufficient. This is often enough for the patient to spontaneously recover. In cases of moderate severity, manifested by a severe cough, an increase in body temperature up to 37.5 ° C, general weakness, pain, complex treatment is prescribed, including physiotherapeutic, symptomatic medications, decongestants and antibacterial agents, mainly of local action. In case of profuse viscous sputum, inhalation of proteolytic enzymes is prescribed.
Physiotherapeutic agents include semi-alcoholic warming compresses on the anterior surface of the neck, in some cases, if there is a suspicion of aggravation of the inflammatory process, UHF on the larynx area in combination with antihistamines and local antibiotics (bioparox). V.T.Palchun et al. (2000) recommend an effective mixture for infusion into the larynx, consisting of 1% menthol oil, hydrocortisone emulsion with the addition of a few drops of 0.1% adrenaline hydrochloride solution. The means of choice are dosed aerosol preparations Cameton and Camphomene, a combined local drug Laripront, which contains lysozyme and dequalinium chloride, which has antimicrobial and antiviral properties. In case of profuse and viscous sputum with the formation of crusts in the larynx, mucolytic drugs are prescribed, in particular, mistabron for inhalation in diluted form, etc., as well as thermopsis preparations, ammonia-anise drops, bromhexine, terpene hydrate, ambroxol, etc. At the same time, vitamins (C) are prescribed , pentavit), calcium gluconate, antihistamines (diazolin, diphenhydramine).
In severe acute catarrhal laryngitis with a protracted course and a tendency to generalize the process towards the lower respiratory tract, the treatment is the same + broad-spectrum antibiotics at the beginning of treatment, and then in accordance with the antibiogram.
Causes
The following can lead to the development of the disease:
- hypothermia,
- viral (ARVI) and bacterial infections.
The acute form is often found in children of primary and preschool age. Especially if the child is at risk, has a weak immune system or diathesis. Infectious pathogens include rhinoviruses, adenoviruses, their own microflora, and cocci.
Dr. Komarovsky talks about the causes of runny nose in children:
Why does chronic laryngitis occur?
It is not always possible to accurately identify the causes of laryngitis. Doctors identify several main factors that provoke the occurrence of an inflammatory process in the larynx:
- Infection. The mucous membrane can be affected both primarily after contact with an infectious agent directly on the mucous membrane of the larynx, and secondarily as a result of the spread of pathogens from foci of chronic infection (sinusitis, bronchitis). Once in the larynx, the infectious agent releases toxic substances, which damages the integrity of the protective barriers and destroys the cells of the mucous membrane. In response, the body launches an inflammatory response and attracts immune defense cells to eliminate the pathogen.
- Physical reasons. General or local hypothermia, eating too cold or hot food, breathing through the mouth, occupational hazards, constant vocal strain - all this leads to damage to the cellular structure of the mucous membrane and the development of inflammation, which, without eliminating the cause, becomes chronic.
- Autoimmune factors. In rare cases, an inflammatory process in the throat can be a manifestation of an allergy, when the cells are attacked by immune defense cells. Basically, the autoimmune type of the disease is observed against the background of systemic autoimmune pathologies (amyloidosis, systemic lupus erythematosus).
- Other reasons. Laryngitis can occur due to stomach contents entering the larynx. This condition develops due to weakness of the esophageal sphincters, which prevent gastric contents from entering the pharynx and larynx.
The child has
Children can get chronic laryngitis if the room is too dirty and only dry warm air comes in when breathing. Also, inflammation in a child begins due to constant strain on the voice, when he screams often and for a long time.
In other cases, the disease appears due to the following factors:
- Cold.
- Flu.
- Bronchitis.
- Pneumonia.
- Allergy.
- Chemical damage to the mucous membrane.
- Hypothermia.
In an adult
The disease develops in adults in the following cases:
- Frequent acute laryngitis. This point also includes other diseases that are localized in the nasopharynx (for example, rhinitis, tonsillitis, sinusitis).
- Presence of GERD (gastroesophageal reflux disease).
- Prolonged tension of the vocal cords and larynx.
- Smoking, alcohol abuse. They are predisposing factors to the appearance of laryngitis, and can also worsen the course of the acute form of the disease, which leads to its transition to chronic.
Symptoms
In almost all cases, the symptoms manifest themselves as unpleasant sensations in the nasopharynx. Mucous discharge forms and it becomes difficult to breathe. when it spreads to the mucous membrane of the auditory tubes, pain in the ears and general hearing loss occur. In adults, the temperature does not always rise.
Acute catarrhal
This form is characterized by the development of general swelling and penetration of infection into the mucosa. The dilation of blood vessels occurs, blood intensively flows to the nasopharyngeal cavity.
At the same time, blood flow passes to the mucous membrane. The disease in this form is characterized by:
- Formation of mucous discharge.
- Reducing the timbre of the voice.
- Tearing.
- Constant feeling of tickling.
- Increased body temperature.
Chronic
Chronic pharyngitis appears during an untreated acute phase. Often the cause is carious teeth and the spread of chronic sinus infections. The mucous membrane becomes loose and swollen in the area of the tonsils. Lymph nodes enlarge in the area of the posterior wall. The temperature may remain normal or may be slightly elevated.
Subatrophic
At an early stage, redness of the throat mucosa appears. There is pain when swallowing, soreness, and an unproductive cough. The back wall is constantly in an irritated state, thinning of the mucous membrane is observed. Due to damage to the nerve endings, the swallowing reflex is disrupted and salivation increases. The temperature rises to 37.2-37.5. The mucous membrane has a pale appearance. It becomes dry and abundantly permeated with vessels.
Atrophic
Unpleasant sensations appear in the throat. The voice becomes hoarse, and the mucous membrane acquires a varnished sheen and pallor. Sore throat does not go away after drinking hot tea.
Allergic
Symptoms of allergic pharyngitis occur under the influence of an allergen, which should lead to a decrease in contact with it. The mucous membranes of the nose, nasopharynx and throat swell. It all starts from the nose, gradually descending into the throat. Among the main features:
- Nasal congestion.
- Inflammation of the pharynx.
- Feeling of discomfort in the throat.
- Cough.
Often an allergic reaction is associated with inflammatory processes.
In the photo there are types of pharyngitis
Symptoms and treatment of acute and chronic pharyngitis in adults and children at home
Pharyngitis is an inflammation of the mucous tissue in the larynx area. The name of the disease comes from the word “pharyngos” - “throat” + “itis” - the designation of the inflammatory process. It can be acute or chronic.
The main signs of the disease are pain in the throat area when eating, coughing, and in severe cases, talking. The disease is treated by an ENT doctor, also known as “ear, nose and throat” (otolaryngologist = otolaryngologist).
Pharyngitis is often rightly associated with a cold. Rhinopharyngitis refers to viral lesions in the nasopharynx. There are also tonsils, the inflammation of which is called tonsillitis.
The main symptoms of acute and chronic pharyngitis
The acute form is characterized by severe pain, which, unknowingly, can be mistaken for a sore throat. But the diseases are significantly different: with pharyngitis, the tonsils and palate are not affected.
Distinctive symptoms of acute pharyngitis:
- pain caused by swallowing or coughing;
- increase in body temperature;
- the occurrence of throat looseness;
- formation of gray plaque.
Chronic inflammation manifests itself sparingly. Many people note an unpleasant sore throat and a painful desire to constantly cough up during periods of decreased immunity, or after consuming very cold foods and drinks.
General recommendations
If possible, it is worth taking sick leave. A few days of rest will help you recover faster.
It is necessary to completely eliminate the consumption of alcoholic beverages and smoking. Bad habits irritate the pharyngeal mucosa, which complicates the recovery process.
The patient is also advised to drink more fluids. As a relief drink, you can use decoctions of medicinal herbs or mineral water.
Treatment with drugs
The most common treatments for pharyngitis are syrups and sprays. Medical sweets help restore the mucous membrane. As a rule, they have an analgesic effect and make you feel more comfortable.
Treating a sore throat at home
According to many experts, “grandmother’s methods” can be an auxiliary means of treating pharyngitis at home. These are decoctions of herbs that have calming properties, for example, chamomile, sage or thyme. You can drink the infusion or rinse your mouth with it.
Warm milk with honey and soda will also help restore the mucous membrane.
Treatment of this disease most often does not require hospital observation. With the right medications, complete restoration of the pharyngeal mucosa occurs within a week and a half.
Treatment of pharyngitis in children
Before treating children with drugs, it is necessary to undergo the necessary tests to determine the cause of the disease.
Without a correct diagnosis and without the right drug, you can harm your health and the health of your child. Avoid self-medication!
Gargling
The doctor selects medications depending on the causative agent of the infection. When infected with streptococcus, pneumococcus and other bacteria, appropriate antibiotics and antiseptic rinses are prescribed. If suitable ones are not available, you can rinse with a solution of salt and soda. Adding a couple of drops of iodine to the solution will also be helpful if there is no reaction to iodine.
You need to rinse a glass of solution in a maximum of 5-6 steps. Only rinsing deeply enough with a large sip of the solution will be effective so that the liquid can be distributed. It is recommended to rinse your nose with the same solution before rinsing.
You can use saline solution or saline nasal spray, Aquamaris and its analogues.
Viral pharyngitis is treated with antiviral drugs. Allergic - antihistamines. And if there is candida fungus in the mouth and throat, use antifungal agents.
Before a medical examination, it may be acceptable to take natural tonics, vitamins and nutrients, and drugs to strengthen the immune system, to which there is no individual intolerance. It is possible to take topical immunostrengthening drugs, such as Imudon.
Heartburn as a cause of the disease
Inflammation is not always caused by pathogenic microorganisms. It may occur due to allergies or heartburn.
With reflux heartburn, the acidic contents of the stomach can reach the wall of the pharynx, irritate the mucous membrane and cause a sore throat. Then medications are prescribed that reduce the acidity of gastric juice.
Novocaine and lidocaine are used for pain relief (as prescribed by a doctor).
Elena Malysheva about the symptoms and treatment of pharyngitis ()
In this video, Elena talks about how to treat inflammation of the nasopharynx.
Pharyngitis codes according to ICD 10
ICD 10 class: CLASS X Respiratory diseases (J00-J99)
ICD Section 10: Acute respiratory infections of the upper respiratory tract (J00-J06)
Acute pharyngitis code (J02)
Included: acute sore throat
- abscess: peritonsillar (J36)
- pharyngeal (J39.1)
- retropharyngeal (J39.0)
- acute laryngopharyngitis (J06.0)
- chronic pharyngitis (J31.2)
J02.8: Acute pharyngitis caused by other specified pathogens
If necessary, identify the infectious agent, use an additional code (B95-B98)
- enteroviral vesicular (B08.5)
- caused by herpes simplex virus (B00.2)
- infectious mononucleosis (B27.-)
- influenza virus: identified (J09, J10.1)
- unidentified (J11.1)
J02.9: Acute pharyngitis, unspecified
- NOS
- gangrenous
- infectious NOS
- purulent
- ulcerative
Diagnostic features
The diagnosis is made based on history and examination. Hyperemia of the pharynx is detected, sometimes mucus begins to flow down the back wall. During the examination, the doctor must differentiate the disease from laryngitis and tonsillitis. With these diseases, the throat suffers more. A runny nose does not appear with the bacterial nature of these ailments.
With nasopharyngitis, unlike tonsillitis, purulent foci do not appear on the throat. Therefore, the doctor can easily make the correct diagnosis based on a visual examination. Differential diagnosis is also carried out with diphtheria nasopharyngitis, when a dirty gray coating appears.
During the study, the period of the disease is determined. In case of a long process, a clinical blood test, bacterioscopy, nasopharyngeal smears using ELISA and PCR are prescribed. In chronic forms, it is recommended to prescribe x-rays of the nasopharynx and sinuses, as well as nasal endoscopy.
Treatment and preventive measures
Treatment of both forms of the disease begins with the elimination of irritating factors that develop inflammation. During illness, you should breathe through your nose, the affected area should be rinsed with saline solutions, and sprays should also be used. In general, you need to carry out the procedures prescribed by your doctor.
In addition, you should remember about preventive measures, because the disease is always easier to prevent:
- Smoking, alcohol abuse, a penchant for spicy foods - all this accelerates the development of the disease. Dry and polluted air is harmful to the throat. Therefore, it is imperative to ventilate the room several times a day.
- When working on dusty objects, you must use respiratory protection.
- You should sleep with your mouth closed, taking in air through your nasal passages.
- Before going to bed, you should not load your stomach with food and drinks.
- Excess stomach acid irritates the sore throat even more.
- It is necessary to use only clean towels and change your toothbrush often. These items accumulate harmful microbes very quickly.
Treatment
If you have nasopharyngitis, you should not apply compresses or warm the throat. In children (up to 3 years), aerosol forms of drugs are not used, as they can provoke convulsions and spasms. It is not recommended to get carried away with vasoconstrictor drugs.
General recommendations
During illness, it is necessary to maintain an optimal level of indoor humidity (about 60%) and temperature (19-20 degrees). The patient should drink up to 2.5 liters of fluid per day. You can’t eat hot, cold or spicy. Doctors recommend eliminating all possible allergens from the diet.
Treatment begins with regular rinsing of the mucous membrane and inhalation. Since coughing during illness occurs against the background of mucus draining along the back wall, medications for this disease are not prescribed.
Medication
For treatment, topical drugs are used:
- Antiseptic lozenges.
- Iodine-based products.
- Preparations with herbal ingredients and essential oils.
- Aerosols.
If symptomatic treatment does not bring relief, there is a suspicion of a bacterial infection, then an antibiotic is prescribed. It is selected depending on the characteristics of the clinical picture.
In the chronic form, there is no need for constant treatment. Drug therapy is prescribed only during exacerbations. In any case, treatment depends on the form of the disease. In case of allergies, the prescription of antihistamines is mandatory.
In all cases, rinsing of the mucous membrane with Aquamaris, Aqualor and saline is prescribed. The doctor may prescribe immunostimulants and vitamins.
Folk remedies
This treatment complements drug therapy well. You can rinse your nose to clear mucus and relieve swelling with chamomile, calendula and string. It is possible to combine these means. To prepare the decoction, take 1 large spoon of herb, which is brewed with a glass of boiling water.
The procedure should be carried out 3-4 times a day. Herbal decoctions can also be used for gargling. Eucalyptus is also used for these purposes.
It is possible to do inhalations with essential oils, drop freshly squeezed beet or Kalanchoe juice into the nose.
Features of the treatment of nasopharyngitis in our video:
Physiotherapy
It is prescribed more often for the chronic form of the disease. Electrophoresis is possible. This method allows drugs to quickly penetrate the mucous membrane under the influence of electrical impulses. Alkaline inhalations and irradiation of the affected area are prescribed.
Surgical methods
Surgeries are not performed for this type of disease. Sometimes rhinitis occurs due to an incorrectly positioned septum, which does not provide proper air circulation and is a place for bacteria to live. In this case, operations are prescribed to restore its physiological position.
Acute nasopharyngitis code according to ICD 10 in children
RCHR (Republican Center for Health Development of the Ministry of Health of the Republic of Kazakhstan) Version: Archive - Clinical protocols of the Ministry of Health of the Republic of Kazakhstan - 2007 (Order No. 764)
Short description
Acute rhinitis is an acute catarrhal inflammation of the nasal mucosa, accompanied by sneezing, lacrimation and copious secretion of watery mucus, usually caused by a virus.
Allergic rhinitis is rhinitis associated with hay fever (hay fever).
Atrophic rhinitis - chronic rhinitis with thinning of the nasal mucosa; often accompanied by crusting and foul-smelling discharge.
Caseous rhinitis is a chronic rhinitis characterized by the filling of the nasal cavities with a foul-smelling, cheese-like substance.
Eosinophilic nonallergic rhinitis is hyperplasia of the nasal mucosa with an increased content of eosinophils, not associated with contact with a specific allergen.
Hypertrophic rhinitis is chronic rhinitis with hypertrophy of the mucous membrane.
Membranous rhinitis is a chronic inflammation of the nasal mucosa, accompanied by the formation of fibrinous crusts.
Purulent rhinitis is chronic rhinitis with profuse purulent discharge.
Vasomotor rhinitis is swelling of the nasal mucosa without infection or allergy.
Treatment
Drug treatment: the most effective as a prophylactic agent are antiviral drugs; during fever, rimantadine is prescribed 0.3 g on the first day, 0.2 g on the second and 0.1 g on subsequent days. Interferon - alpha-2-a, beta-1, alpha-2 in the form of powders for inhalation and instillation into the nasal passages, oxolinic ointment 0.25% into the nasal passages and eyelids 3-4 times a day.
If there is a fever, the safest paracetamol is prescribed 500 mg 2-3 times a day, up to 4 days. Acetylsalicylic acid - 500 mg 2-3 times a day, up to 3 days. Drink plenty of warm drinks.
Antibiotic treatment for adults with a nonspecific upper respiratory tract infection does not speed recovery and is not recommended.
In acute viral rhinitis, rest is indicated. Paracetamol 0.5-1 g orally every 4-6 hours, but not more than 4 days, or aspirin 0.325-1 g orally every 4-6 hours, but not more than 4 g/day is prescribed.
For persistent dry cough, cough mixture ambroxol 0.03 g 3 times a day, syrup 15 mg/5 ml, 30 mg/5 ml are prescribed. In the first 2-3 days, 10 ml 3 times a day, then 5 ml 3 times a day.
For a sore throat, gargle with diluted lemon juice, antiseptic solutions, or warm herbal decoctions. Ascorbic acid is prescribed, 2 g/day. orally in powders or tablets.
source
Acute respiratory infections of the upper respiratory tract (j00-j06)
Excludes: chronic obstructive pulmonary disease with exacerbation of NOS (J44.1)
Included:
- Runny nose (acute)
- Acute catarrh of the nose
- Nasopharyngitis:
- Rhinitis:
Included:
- abscess acute, sinus (adnexal) (nasal)
- acute empyema, sinus (adnexal) (nasal)
- acute infection, sinus (adnexal) (nasal)
- acute inflammation, sinus (adnexal) (nasal)
- acute suppuration, sinus (adnexal) (nasal)
If it is necessary to identify the infectious agent, an additional code (B95-B98) is used.
Excludes: chronic sinusitis or NOS (J32.-)
Excluded:
- abscess: peritonsillar (J36)
- pharyngeal (J39.1)
- retropharyngeal (J39.0)
If it is necessary to identify the infectious agent, an additional code (B95-B98) is used.
Excluded:
- acute obstructive laryngitis [croup] and epiglottitis (J05.-)
- laryngism (stridor) (J38.5)
If it is necessary to identify the infectious agent, an additional code (B95-B98) is used.
Excluded:
- acute respiratory infection NOS (J22)
- influenza virus: identified (J09, J10.1)
- not identified (J11.1)
ICD-10 alphabetical indexes
External Causes of Injury - The terms in this section are not medical diagnoses, but rather a description of the circumstances under which the event occurred (Class XX. External Causes of Morbidity and Mortality. Heading Codes V01-Y98).
Medicines and chemicals - table of medicines and chemicals that have caused poisoning or other adverse reactions.
In Russia, the International Classification of Diseases
10th revision (
ICD-10
) was adopted as a single normative document for recording morbidity, reasons for the population’s visits to medical institutions of all departments, and causes of death.
ICD-10
introduced into healthcare practice throughout the Russian Federation in 1999 by order of the Russian Ministry of Health dated May 27, 1997 No. 170
The release of the new revision (ICD-11) is planned by WHO in 2022.
Abbreviations and symbols in the International Classification of Diseases, 10th Revision
Source: https://resart.ru/ostryy-nazofaringit-kod-po-mkb-10-u-detey/
Possible complications
Rhinopharyngitis can cause complications such as bronchitis and pneumonia. The acute form in children often leads to vomiting and diarrhea. As a result, the risk of dehydration increases. Due to the formation of gases, the diaphragm rises, which makes breathing even more difficult. If left untreated, otitis media and a retropharyngeal abscess develop.
The danger for newborns lies in the fact that to facilitate breathing, infants unconsciously begin to throw their heads back. This leads to overstrain of the fontanel and the development of seizures. The disease is dangerous for people suffering from asthma.
How to quickly cure a runny nose and sore throat without consequences:
Causes and symptoms of the disease
Chronic pharyngitis is a chronic inflammatory process of the mucous membrane of the throat. It is usually a consequence of untreated acute pharyngitis. The causative agents of the disease are staphylococci, streptococci, adenoviruses and herpes simplex viruses.
The chronic form can also appear as a result of fairly prolonged exposure to irritating substances on the mucous membrane, such as:
- Tobacco smoke, gases
- Dust
- Chemicals and other substances.
Complications of acute laryngitis
A common complication of acute laryngitis is acute stenosis. Also, if the treatment is incorrectly selected, the disease can develop into:
- diffuse form with damage to the vestibule of the larynx, bronchi and trachea;
- subglottic type with the appearance of symmetrical swelling in the subglottic area;
- laryngotracheitis or laryngotracheobronchitis - the inflammatory process spreads to the trachea and bronchial tree;
- malignant type of laryngotracheobronchitis with sputum discharge with bloody spots.
Causes of acute laryngitis
The main factor in the development of laryngitis are viruses and microorganisms. Also, the etiology of the disease is:
- overstrain of ligaments;
- mechanical and physical damage to the larynx;
- hypothermia;
- smoking;
- excessive consumption of alcoholic beverages;
- air pollution;
- allergy;
- contact with an infected person;
- penetration of infection from nearby areas;
- GERD is the regular reflux of the contents of the stomach and duodenum into the esophagus and larynx;
- surgical intervention.
Attention! The appearance of allergic laryngitis is provoked by a variety of chemicals, dust or smoke. Insect bites and food products can also trigger the disease.
