What is this?

Acute nasopharyngitis is the most common respiratory infection in young children.

The agents responsible

The respiratory tract of the infant is small. This is why any obstruction caused by edema or mucus can become serious.

Signs of the disease

The newborn does not possess as a means of immune defense at birth only the antibodies (immunoglobulin G or IgG) of his mother who have crossed the placenta during his fetal life. This passive coverage will last 4 to 8 months. To develop its own defenses, it needs to come in contact with antigens (bacteria and viruses).

Evolution of the disease

In order to come into contact with these agents present in the external environment, in the ambient air which it breathes, on the nipple which it sucks, the simplest, the most immediate pathway is represented by the nose and Mouth.

Differential Diagnosis


The first infectious contacts of the infant are therefore at the level of the aerodigestive paths.

These pathways are lined with a mucosa rich in lymphoid tissue.This lymphoid tissue is the one that elaborates the antibodies

The antigen (virus or bacteria) enters the body through the respiratory (or digestive) route. It is deposited on the surface of the lymphoid tissue and especially where it is abundant, on the adenoids. An immune reaction takes place. The cells that elaborate the antibodies multiply and develop. The mucous membrane thickens, increases in volume. Vegetation becomes big.

The antibodies developed will have local action and general action. Locally, they will be present in the secretions and will fight the corresponding germs. Generally, lymphocytes will remember these germs and the organism will be able to fight them if they attack again.

We thus see that the hypertrophy of vegetations is not a disease but a normal reaction of an organism in process of immune maturation.

The viruses usually identified belong to the groups

In rare cases in infants, but much more frequently in older children, Group A beta-hemolytic streptococcus is responsible for this pathology. This bacterium is very dangerous because it is responsible for acute rheumatic fever (RAA) and acute glomerulonephritis (GNA). It is his fear that justifies the prescription of antibiotics in nasopharyngitis actually dominated by the innumerable viruses that surround us and which are themselves insensitive to antibiotics.

Fever is the most frequent reason for consultation.

The child is irritable and agitated. In the baby, obstruction of the nostrils may prevent feeding, as the infant can not breathe through the mouth and suck at the same time.

It sneezes and has a fluid nasal discharge, which eventually becomes purulent. These secretions often irritate the edge of the nostrils and the upper lip. It breathes with difficulty, mouth open, because of the congestion of the nasal mucous membranes.

The throat is red and painful. On the posterior wall of the pharynx, under the veil, and between the tonsils, a thick carpet of muco-pus is observed. The cervical and subangulo-maxillary lymph nodes increase in volume.

Vomiting and diarrhea are commonly associated. Anorexia, cough, fatigue, body aches are common.

In the absence of treatment and surveillance, complications from superinfections may occur: otitis media, mastoiditis, cerebral abscess, tracheobronchitis, bronchopulmonary diseases, pleurisy, etc.

The diagnosis of "cold" in a small child can be confusing because some infectious diseases can start with this table (measles, pertussis, poliomyelitis, congenital syphilis, etc.).

In the larger child, the nasal discharge of an allergic rhinitis may suggest the first symptoms of rhinopharyngitis, but is not followed by purulent discharge.

Rest is important: the child must be kept away from the sounds and activities of the siblings. Avoid crying that only increases the symptoms.

Hydration is fundamental. Since the child is unable to suck and breathe at the same time, he must be given several pauses when he takes his bottle. We split up the meals in a way less tiring.

The temperature of the room should be around 21 ° C. With a moisture level between 80% and 90% in order to liquefy the respiratory secretions and thus reduce the cough. Humidifiers are often useful.

Rhinopharyngeal disinfection (DRP) with nasal drainage is paramount. Drops of physiological saline are instilled into the nose, which is then removed with a baby fly or, if need be, a syringe or a bulb with aspiration of ENT secretions.

Before meals or at bedtime, nasal drops can be used if the nose is very clogged and provided you do not abuse it and with the advice of your doctor. Warning! Nasal vasoconstrictors are formally contraindicated in children

Antipyretic drugs cause the temperature to drop.

Antibiotics have no indication in banal rhino-pharyngitis. In case of bacterial superinfection or complications, they obviously become indispensable.

Most frequently myxoviruses (Para influenzae, Influenzae, Syncitial ...) Adenoviruses Enteroviruses Rhinoviruses