Coding of acute pharyngitis in the ICD

Definition of disease

A pathology in which the mucous membrane of the nasopharynx, sinuses and middle ear is damaged is called nasopharyngitis.
This disease is characterized by the occurrence of two ailments at once - rhinitis and pharyngitis. More often than usual, nasopharyngitis occurs as an unpleasant consequence of a runny nose, ARVI or flu. Nasopharyngitis of the nasopharynx is diagnosed by the characteristic symptoms of rhinitis and pharyngitis. That is why treatment necessarily includes medications and therapeutic procedures. Nasopharyngitis is considered a fairly common disease in both childhood and adulthood during the cold season, so it is often not taken seriously, making a serious mistake. If symptoms of nasopharyngitis appear, it is necessary to promptly contact specialists to draw up an effective course of therapy.

Classification of pharyngitis

Almost any disease has several forms of progression; nasopharyngitis in children is no exception.

Forms of nasopharyngitis

Today, experts identify three main forms of the disease in childhood:

1. Chronic nasopharyngitis. This form is provoked by the activity of viruses, bacteria, and less often fungi. The chronic form of the disease, in turn, is divided into two additional ones: hypertrophic and atrophic (subatrophy). The first is characterized by swelling of the oral mucosa, soreness and light discharge from the nasopharynx. The atrophic appearance is absolutely opposite to the hypertrophic one: the throat is dry and has an unpleasant odor.
2. Acute nasopharyngitis. Rhinopharyngitis of this type is viral in nature, less often bacterial. Acute forms of nasopharyngitis also include rhinitis and rhinorrhea, which are caused by an allergic reaction.
3. Meningococcal nasopharyngitis. Formed as a result of exposure to meningococcal infection, which is characterized by polymorphism. Often this form is an independent disease, but rarely occurs in conjunction with meningitis.

Stages of nasopharyngitis

There are 4 stages of nasopharyngitis:

• incubation period (from the moment of infection until the appearance of signs of the disease). The duration of the incubation period is one week;
• prodromal period. The first symptoms appear: weakness, fever, drowsiness;
• peak period. At this time, severe symptoms are observed. This period lasts about a week;
• Exodus. The disease ends either with recovery or transition to a chronic form.

Treatment from Komarovsky's point of view

Dr. Komarovsky argues that an important part of the treatment of nasopharyngitis is the correct identification of the causative agent of the disease. HE insists that it is necessary to take a swab from the throat for microflora and a clinical blood test.

Only after receiving the results of these tests can adequate treatment be prescribed, which consists of the following measures:

1. Vitamin C intake.
2. Consumption of medicinal plants such as echinacea, goldenseal. They suppress infection well.
3. Homeopathic medicines prescribed by a doctor are also used.
4. Hydrotherapy is carried out: a piece of cloth is soaked in hot water and applied to the throat for several minutes, after which a cloth soaked in cold water is applied for a while. Here's how to rinse with Chlorophyllipt for a sore throat, and how effective this remedy is. This information will help you understand.
5. In some cases, antibiotics are prescribed.

For chronic nasopharyngitis, the following recommendations must be followed:

1. After each meal, gargle with antiseptic solutions based on medicinal plants.
2. Soak your throat with sprays containing antibiotics.
3. Take antibiotics orally if indicated.
4. Use antiseptic lozenges. The child must absorb them completely.

It is very important that in case of chronic nasopharyngitis the child is provided with special conditions:

1. Make sure that the humidity level is normal and regularly ventilate the room. (how to do inhalations with saline solution for a wet cough is described in great detail in this article)
2. Spend more time outdoors.
3. Make sure your child does not inhale dust or tobacco smoke.

Dr. Komarovsky says it is very important to pay special attention to disease prevention.

The child must be taught to observe the rules of hygiene, if the disease occurs in one of the close relatives, contacts must be limited, the child must be taught to cover his mouth when he sneezes or coughs, a sick child should not attend kindergarten or school until complete recovery.

It is almost impossible to completely prevent infection with viral infections. But timely treatment and compliance with all doctor’s instructions will help avoid serious complications.

Dr. Komarovsky is confident that the effectiveness of treatment depends on how correctly the pathogen is identified. To determine it, a swab taken from the throat and a blood test are performed. Based on the results of the tests, appropriate treatment is prescribed.

Here's how you can treat nasopharyngitis:

• vitamin C;
• extracts of echinacea and goldenseal;
• homeopathic medicines prescribed by a doctor;
• hydrotherapy (moisten a cloth with hot water and apply it to the throat, then make an application with a cloth that has been soaked in cold water);
• antibiotics for bacterial diseases.

A few more tips from Dr. Komarovsky:

• use antiseptic herbal solutions to gargle after each meal;
• irrigate the throat with aerosols containing antibiotics;
• take antibiotic tablets if prescribed by a doctor;
• dissolve antiseptic lozenges.

In addition, Evgeny Olegovich Komarovsky recommends creating special conditions:

• monitor air humidity (this is especially important if the child has developed chronic nasopharyngitis);
• ventilate the room;
• provide walks in the fresh air;
• ensure that children do not inhale dust, polluted air, or tobacco smoke.

Prevention

Nasopharyngitis can be avoided if the following conditions are met:

• during seasonal infections, do not visit places with large crowds of people, use a medical mask in public transport;
• stop smoking;
• take multivitamin complexes, eat right.

Nasopharyngitis, the symptoms and treatment of which in children and adults are described in the article, is one of the most common diseases in the practice of an otolaryngologist. It is important to begin treatment of acute nasopharyngitis in a timely manner and not to endure it “on your feet,” otherwise you cannot avoid the disease becoming chronic, in which all systems of the body suffer from hypoxia.

Causes

The child’s immune system is constantly exposed to pathogenic microorganisms and environmental factors, resulting in the formation of a favorable environment for the development of acute nasopharyngitis. The causes of this disease are generally considered to include:

• Complication after a runny nose.
• Virus or bacteria.
• Constant inflammation of the nasopharyngeal mucosa.
• Hypothermia.
• Lack of vitamins.
• Weak immunity.
• Lack of room hygiene.
• Trauma to the nose or deviated nasal septum.
• Disturbance of neuroendocrine regulation in blood vessels.
• Complications of the heart, liver, kidneys.

Symptoms of the disease

There are many types of acute nasopharyngitis, depending on the pathogen. Manifestations of the disease in children and adults are slightly different.

If nasopharyngitis occurs in a child, you can observe:

1. Severe nasal congestion.
2. Redness and swelling of the nasal mucosa.
3. Difficulty breathing.
4. Impaired perception of smell.
5. Headache.
6. Unpleasant sensations in the ears and hearing loss.
7. Increased body temperature.

Video of acute nasopharyngitis:

Adults react to the disease more easily. There may not even be a fever, so rarely does anyone go to the doctor. Most people manage symptoms of the disease on their own with home remedies.

Acute nasopharyngitis often occurs in pregnant women against the background of weakened immunity during pregnancy.

In this case, the disease manifests itself with the following symptoms:

1. Unpleasant sensations in the throat, a feeling of soreness and dryness, difficulty swallowing.
2. Body temperature rises greatly.
3. The lymph nodes in the neck become enlarged and painful.
4. Swelling and redness of the posterior pharyngeal wall are observed.
5. The voice becomes hoarse and hoarse.

During pregnancy, acute nasopharyngitis can be a very dangerous problem. If it appears in the first weeks of pregnancy, a miscarriage may occur; in the third trimester, the disease can cause fetal hypoxia. Therefore, at the first signs it is necessary to urgently go to a specialist.

This article will help you understand what to do when a child’s nasal congestion does not go away, and what medications should be used in this case.

But how chronic swelling of the nasal mucosa is treated, and what can be used at home, is indicated here in the article.

What causes of swelling of the nasal mucosa exist and how to identify them is described in this article: https://prolor.ru/n/simptomy/otekaet-slizistaya-nosa-prichiny.html

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Traditional methods

Inhalation with extracts of medicinal plants (chamomile, calendula, eucalyptus) helps eliminate the disease. Instead of herbs, soda solution and potato decoction are used to prepare inhalations. Inhalations are done to infants carefully, making sure that the hot steam does not cause burns to the mucous membranes.

To cleanse the nose, prepare drops from beets or Kalanchoe. To do this, juice is squeezed out of plants. The throat is gargled with beetroot or Kalanchoe juice, extracted garlic (a clove of garlic is ground, poured with boiling water, left to cool, filtered).

General restorative therapy is recognized as an excellent assistant. The functions of the immune system are stimulated by tea with the addition of lemon and honey. This tea should not be given to children who have an allergic reaction to citrus fruits and honey.

It is impossible to exclude infection with viral and bacterial infections. Therapeutic treatment and adherence to medical recommendations help to cope with the disease and avoid serious complications.

Treatment of rhinopharyngitis in children

If your baby is ill, to make the disease easier, do not neglect the advice of the famous pediatrician Komarovsky. He believes that on such days the baby needs:

• Maintaining the room temperature no more than 20 degrees;
• Mandatory ventilation, 2-3 times a day and air humidification;
• Maintaining bed rest;
• Drink plenty of fluids (natural fruit drinks, jelly, vitamin teas);
• Carrying out daily wet cleaning using disinfectants.

Under no circumstances treat the baby yourself; consult a doctor. Children are usually treated on an outpatient basis. But if inpatient therapy is recommended, you should not refuse it.

Drug therapy

How to treat nasopharyngitis in a child? The therapeutic course is based on removing intoxication and suppressing the effects of the pathogen. For different types of disease, different medications are selected. In case of acute viral illness, the doctor may prescribe:

1. Antiviral drugs: “Interferon”, “Anaferon”, “Ergoferon”, “Viferon”, “Amiksin”, oxolinic ointment.
2. Vasoconstrictor and softening drops: “Vibrocil”, “Nazivin”, “Otrivin”, “Galazolin”, “Farmazolin”, “Pinosol”.
3. Means to reduce fever: Nurofen, Paracetamol.
4. Compositions for lubricating, irrigating and rinsing the throat: “Rotokan”, “Lugol”, “Chlorophyllipt”, “Miramistin”, “Tantum Verde”, “Hexoral”, “Furacilin”, preparations with sea salt.

Antibiotics are used if a secondary bacterial infection has occurred or if the disease was initially caused by pathogenic bacteria. The doctor decides which antibiotic pharmaceutical to choose, depending on the age of the baby and the nature of the pathogen. Older children can use absorbable lozenges and tablets for sore throats and sore throats. Inhalations on the recommendation of a doctor are more effectively carried out using a special inhaler - a nebulizer.

Physiotherapy procedures, in addition to inhalations, may prescribe UHF for the nasal sinuses and ultraviolet irradiation of the pharynx.

Therapy for allergic rhinopharyngitis is carried out only as prescribed by a doctor. An indispensable condition for therapy is the removal of the allergen. Nasal drops “Vibrocil” and “Sanallergin” are recommended. Anti-allergy pharmaceuticals with general effects are also used: “Tavegil”, “Claritin”, “Gismanal”, “Clarinase”. In difficult cases, hormonal drops can be used. In case of exacerbation, a variety of enterosorbents are used to quickly rid the baby’s body of toxins.

Symptoms

The initial stage of the disease is characterized by difficult nasal breathing, the voice becomes nasal. During the development of acute nasopharyngitis, a large amount of mucus appears, which, irritating the back wall of the pharynx, causes a cough. Later, the child experiences an increase in body temperature. Children from 3 months to 3 years initially experience a sharp increase in body temperature, irritability, agitation and sneezing.

When the disease occurs, nasal discharge appears, which often disrupts the breathing process in infants. During the first 2-3 days, the eardrum may become swollen and fluid may form behind it. Breathing becomes deep and heavy, the child's mouth is always open. Children acquire irritability, insomnia and habitual appetite.

In rare situations, children may vomit. Dryness occurs in the nasal cavity, and less often in the throat. A sick child develops chills, the baby complains of muscle pain and pain in the head. The mucus released from the nose most often becomes thick, and in rare cases even purulent. The acute form of nasopharyngitis passes within 3-4 days, and an improvement in the general condition of the child is noted.

In acute nasopharyngitis, other disturbing features of the course of the disease may appear:

• There is a disturbance in daytime and night sleep.
• The child does not want to eat because of a sore throat.
• The child experiences groundless tearfulness.

Due to the fact that the child's mouth is always open, pronounced deep breathing may be observed. In this case, breathing through the mouth is not only visible, but also clearly audible. Often, against the background of acute nasopharyngitis in children, another disease develops - sinusitis, which is characterized by purulent mucous discharge from the nose.

In older children, nasopharyngitis is characterized by dryness and inflammation in the nasal cavity, and sometimes in the pharynx. Soon, the main symptoms of the disease include sneezing, chills, muscle pain, nasal discharge, and sometimes coughing. Over time, mucous discharge acquires a thicker structure, and sometimes purulent.

Causes of the disease

In the vast majority of cases, the cause that causes acute nasopharyngitis is an adenovirus, which, when it enters the mucous membrane of the nasal cavity, begins to spread rapidly and affects the nasopharynx and pharynx located in the immediate vicinity.

Somewhat less frequently, this disease develops under the influence of bacteria such as beta-hemolytic streptococcus type A, Haemophilus influenzae, and Staphylococcus aureus. A combination of several types of pathogenic microorganisms is often found. Streptococcus belongs to a group of bacteria that are normally present in the nasal cavity, throat, intestines, and organs of the urinary system.

The pathogenic effect of streptococci on the body is restrained by the immune system, so when its functioning is disrupted, bacterial inflammation develops. In addition, with weakened immunity, susceptibility to various types of adenovirus increases. So, acute nasopharyngitis can provoke:

Rhinopharyngitis in children Most often, the doctor prescribes treatment immediately, without conducting any additional examinations. However, in some cases, the clinical picture of acute nasopharyngitis is similar to the symptoms of other, much more dangerous diseases. Differential diagnosis is necessary if the following diseases are suspected:

• Diphtheria. A distinctive feature of this pathology is the formation of a characteristic plaque on the pharynx.
• Sore throat is manifested by a sharp increase in temperature, severe pain when swallowing and talking.
• Scarlet fever. On the second or third day after the appearance of a sore throat and fever, a rash appears on the body.
• Allergic runny nose. With allergies, there is no sore throat, fever, and nasal discharge is abundant and clear.

It is also worth noting that if the cause of acute nasopharyngitis is bacterial inflammation, it is recommended to undergo a bacterial culture from the pharynx and nasopharynx. The fact is that chronic streptococcal infection is fraught with the development of systemic complications, including autoimmune diseases. Therefore, if streptococcus is detected, further monitoring over time and appropriate long-term antibacterial therapy are required.

Treatment of acute nasopharyngitis

There are various methods and means of treating acute nasopharyngitis: medicinal and folk.

If a child develops symptoms of nasopharyngitis, he must be shown to an otolaryngologist and an allergist to confirm or refute the diagnosis and prescribe treatment. There is no narrowly targeted treatment for acute nasopharyngitis; only symptomatic treatment is prescribed - pharmaceutical drugs are taken to treat individual symptoms of the disease. The following assignments must be completed:

• Bed rest is recommended for the child.
• If the temperature increases significantly, take antipyretics that will reduce the child’s excitability.
• For effective and high-quality treatment of acute nasopharyngitis in a child, it is necessary to take measures to restore breathing. Obstruction of the nasal passages brings painful suffering to the child. Therefore, from the very beginning of the disease it is necessary to clear the nose of mucus. In infants, excess secretions can be removed using a sterile isotonic sodium chloride solution (“Aqua Maris”, “Physiomer”). Drops are used 15-20 minutes before feeding and before bedtime. Since swelling of the mucous membrane of only the anterior parts of the nose is relieved, it is recommended to additionally administer 1-2 drops after 5-10 minutes. Less commonly used is suctioning mucus with a soft bulb. For older children, it is recommended to use drugs in the form of aerosols.
• In case of severe congestion and difficulty breathing, you can drip 2-3 drops of a vasoconstrictor into each nostril (for example, a solution of adrenaline 1: 10,000), and lubricate the skin under the nose and the mucous membrane of the wings of the nose with oil (vaseline, almond, fish oil), watch To keep your nose clean, wipe it with a flagellum lubricated with Vaseline or almond oil. If a child cannot suckle at all or soon abandons it, it is necessary to feed or supplement him with expressed breast milk from a spoon and often drink boiled water or tea in order to avoid dry mouth.
• Antihistamines “Cetirizine”, “Loratadine”, “Tavegil”.
• Washing the oral cavity with sea water, “Aquamaris”, “Aqualor” and “Physiomer”.
• Washing the throat with drugs - Miramistin, Lugol and Chlorhexidine.
• Antibiotics for bacterial diseases.
• Antitussive medications.

ethnoscience

Traditional therapy for acute nasopharyngitis in children is popular due to its simplicity and accessibility. To treat children, they do not use aggressive methods and means, namely garlic, alcohol tinctures. The most effective means are:

• Warm milk along with honey and butter has excellent properties.
• Feet float in water with chamomile and spruce flowers, after drying, put on warm socks.
• Viburnum fruits are ground, honey is added and ground, poured with hot water and filtered, and consumed instead of tea.
• Grate the carrots on a fine grater and mix with lemon juice and honey, let it sit in your mouth for a few minutes, then spit it out and repeat the procedure several times.
• Tea with honey, lemon and ginger.

As a rule, an older child who is sick is at home. However, with a severe viral infection, newborn children are usually hospitalized.

To combat the causative virus, a combination of a set of hygiene procedures and medications is used.

Baby care

Bed rest is a prerequisite. Since a viral infection can cause intoxication in the body, the child must be given plenty of water, warm tea, non-sour fruit juice or compote. Nutrition must be rich in vitamins and beneficial microelements.

When the baby is in bed, as well as during sleep, it is best to use a high pillow to facilitate breathing. It is quite important to avoid dry air in the room, maintain a temperature of 20-22 degrees and cleanliness. Daily wet cleaning is mandatory.

Nasal rinsing

A child with nasopharyngitis needs to restore nasal breathing as quickly as possible. Why is the nasal cavity cleansed of mucus and swelling removed? For older children, washing with homemade or pharmaceutical preparations is suitable. Solutions of simple salt and also baking soda are used - one teaspoon is needed per glass of warm boiled water.

It is quite important to rinse your nose properly. The child opens his mouth, takes out his tongue and tilts his head over the sink. An adult takes the prepared mixture into a rubber bulb, inserts the tip of the bulb into the opening of the child’s nose and squeezes it, gently increasing the pressure. Rinsing is effective and useful when the child leaves the composition through the mouth.

For infants, you can use twisted cotton wool, as well as a bulb to suck out mucus.

Gargling

To get rid of allergens, as well as mucus that flows down the throat, gargling is required. You can rinse by diluting salt or soda in a glass of warm water. You can add a few drops of iodine to the solution to enhance its healing effect.

In addition, you can use decoctions of various medicinal herbs: sage, calendula, chamomile.

This therapy is aimed at ridding the child of a viral infection, as well as, if necessary, lowering the temperature. Vasoconstrictor drugs are prescribed when the child’s breathing is very difficult and other methods do not give the required effect. Antiseptics are used to gargle as prescribed by a doctor. Antibiotics are prescribed for the bacterial etiology of nasopharyngitis or during the presence of concomitant diseases, for example, bronchitis.

It is advisable to use the drops in oil form, but only after clearing the nasal cavity of mucus. The nose should be instilled no longer than 5-6 days.

In addition to eliminating foci of infection, gargling, and rinsing the nose, physiotherapy is performed.

Electrical heating of the nasopharynx, irradiation with quartz, and electrophoresis sessions are prescribed.

Much attention is paid to improving the child’s immune system: immunostimulants and vitamin complexes are selected.

Is homeopathy used during nasopharyngitis? Its use is possible, and pharmacies have a huge range of homeopathic remedies for the treatment of runny nose.

The multicomponent drug Coryzalia in the form of tablets relieves swelling of the nasopharyngeal mucosa and reduces the intensity of discharge from the nasal cavity, including in acute nasopharyngitis. Method of use: sublingual (absorption under the tongue).

Required dosage: on the first day of the course of therapy - one tablet once an hour, but not more than 12 tablets per day. In the next three days, the intervals between uses are increased to 2 hours. Often an allergic reaction occurs to this drug, and contraindications include age under 2 years and pregnancy.

The drug Cinnabsin contains extracts of Echinacea and Canadian goldenseal plants, highly toxic potassium dichromate (Kalium bichromicum), mercury sulfide (cinnabar), which is widely used in homeopathy.

The method of using Cinnabsin is the same as the previous drug, but at intervals of two hours. After improvement, daily use is limited to three tablets.

A side effect is increased salivation (hypersalivation).

During allergic nasopharyngitis, homeopaths recommend the drug Rhinital, which contains tropical plants galphimia and cardiosperum, whose phytosterols have an antipruritic effect.

Dosages, method of use, contraindications and side effects are similar to Corizalia.

Types of disease

Nasopharyngitis can take chronic and acute forms. Acute nasopharyngitis, which manifests itself against the background of a viral infection, is cured within 12 days, occurs in the form of an allergy, has pronounced symptoms and is almost always viral in nature. The first signs appear an hour after infection.

When treatment is carried out incorrectly, the acute course of the disease becomes chronic. The chronic form can be of two types:

• atrophic – expressed in bad breath, thinning of the mucous membrane and dry throat;
• hypertrophic - in this case, light discharge from the nose, swelling of the mucous membrane, sore throat, and lacrimation are noted.

The causes of chronic inflammation, in addition to improper treatment of the nasopharynx, are:

• decreased immunity;
• persistent acute respiratory viral infections;
• presence of sources of infection – otitis media, caries;
• anomalies occur in the structure of the nasopharynx - nasal injuries, enlarged adenoids, as well as a deviated nasal septum;
• poor room hygiene - dry air, lack of ventilation, infrequent cleaning;
• diseases of the kidneys, heart, liver;
• periodic hypothermia.

Symptoms of acute nasopharyngitis

In children at different ages, the disease manifests itself differently. Children under three years of age experience the following symptoms:

• sneezing;
• temperature – at the onset of the disease increases to 38.5°C;
• vomiting – when placed to the breast, newborn children swallow air due to the inability to breathe through their nose;
• nasal discharge - breathing through the nose is impossible, the baby breathes through the mouth, difficulties appear with feeding;
• restless behavior - the baby is capricious, stops eating and sleeping, and is agitated and irritated.

Nasopharyngitis in older children is expressed by the following symptoms:

• general deterioration of the condition – loss of appetite, muscle and headaches, chills;
• temperature – often only slightly elevated;
• in some cases, a dry cough occurs;
• pain and tingling in the throat, soreness, dryness;
• light discharge from the nose, later turning into thick discharge.

If a child at any age has a profuse flow from the nose, then the disease has a viral etiology, but when the nose is stuffy, then it is bacterial.

Symptoms of chronic nasopharyngitis

At the chronic stage , the disease makes itself known with constant symptoms:

• there is constant tickling, tingling or soreness in the nasopharynx;
• sometimes pain when swallowing, feeling of a coma in the throat;
• the appearance of an unpleasant odor from the mouth;
• dry throat - there is a constant desire to drink;
• discharge of clear mucus in the morning.

During an exacerbation, nasopharyngitis occurs as acute.

Allergic nasopharyngitis

Includes allergy symptoms : cough, swelling of the mucous membranes, lacrimation, excessive nasal discharge, swelling of the eyelids, itching of the nose, redness of the throat.

Meningococcal nasopharyngitis

Inflammation of the nasopharynx, which is caused by meningococcal infection , can occur as an independent disease and in this case it has symptoms of acute nasopharyngitis with a temperature of up to 38.5 ° C.

When the disease appears as a result of meningitis, the child experiences convulsions, photophobia, skin rashes, fever, back pain, and diarrhea.