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Acute (catarrhal) nonspecific runny nose

 
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Last reviewed: 05.07.2025
 
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Acute (catarrhal) non-specific rhinitis is the most common disease in otolaryngology, characterized by pronounced seasonality and significant individual predisposition to its occurrence. This is an acute contagious catarrhal inflammation of the nasal mucosa, equally common in men and women at any age. The disease often takes the form of a seasonal epidemic during summer-autumn and autumn-winter transitions. It is most often observed in weakened individuals, convalescents, with hypovitaminosis, overwork. It often occurs when infected in public transport, in crowded places, etc. Risk factors for acute rhinitis include unfavorable hygienic and environmental conditions, cooling of the body, dampness, drafts. Residents of large cities or people who first come to new teams (kindergartens, barracks, production) are more likely to suffer from rhinitis. Workers in chemical and "dust" industries are more susceptible to the disease.

Acute rhinitis is accompanied by activation of saprophytic microorganisms contained in the nasal cavity. After birth, the nasal cavities of the newborn remain sterile for several hours, then, starting from the first day after birth, various microorganisms penetrate into them, which can be represented by streptococci, white or golden staphylococci, various diphtheroid bacteria, pneumococci, hemolytic influenza bacteria, etc. The specified microbiota saprophytes in the nasal cavity, but under various unfavorable conditions can become active and cause various diseases characteristic of its pathogenic properties.

Causes of acute non-specific rhinitis

For one reason or another, saprophytic microorganisms become active, acquiring pathogenic properties and causing catarrhal inflammation of the nasal mucosa. According to many authors, activation of saprophytic microbiota occurs after the introduction of a special filterable adenovirus, weakening the immune barriers of the nasal mucosa, resulting in activation of saprophytes with subsequent development of the inflammatory process.

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Pathogenesis of acute nonspecific rhinitis

As a result of the decrease in the bactericidal properties of nasal secretion (a decrease in the concentration of lysozyme - a group of proteins that are part of the tissues of the body of animals and plants and have a specific ability to cause lysis of some microorganisms; lysozyme is contained in eggs, blood, tears, saliva, nasal secretion, turnips, horseradish, cabbage, primrose, etc.) and the activation of microorganisms, dysfunction of the vasomotor mechanisms of the nasal mucosa occurs, manifested by hyperemia of the vessels and increased secretion of nasal mucus. A large role in the pathogenesis of acute nonspecific rhinitis is attributed to the factor of cooling the body, and in particular the legs and head. In this regard, some authors (E. Rajka) suggest the presence of so-called cold allergy, which contributes to the occurrence of acute nonspecific rhinitis. B. Hogton and G. Braun (1948) found that cold in some people promotes the release of a significant amount of histamine into the blood, and E. Trocher (1951) found that histamine is contained in the secretions of acute nonspecific rhinitis. Many authors have established a connection between acute nonspecific rhinitis and allergies, which led to the method of antihistamine treatment for acute nonspecific rhinitis.

Acute non-specific rhinitis, in fact, is not an isolated disease of the nasal mucosa only, but to one degree or another affects the mucous membrane of the nasal cavity, in which similar processes occur as in the nose. Most often, this concerns the cells of the ethmoid bone, less often the maxillary and frontal sinuses. With the elimination of the inflammatory process in the nasal cavity, these repercussion processes in the paranasal sinuses also pass.

Pathological anatomy

In the first phase of acute nonspecific rhinitis, pronounced vascular paresis, hyperemia and edema of the nasal mucosa, perivascular and periglandular infiltration and diapedesis of blood cells, and hypofunction of the mucous glands are observed. The second phase is characterized by hypersecretion of nasal mucus, which contains desquamated epithelium, fragments of destroyed leukocytes, and microorganisms. Sometimes nasal discharge is bloody, which may indicate a viral etiology of rhinitis, in which the endothelium of the blood capillaries is affected. The third phase is characterized by thickening of the discharge, the appearance of a large number of leukocytes in it, and a gradual cessation of the inflammatory process.

Symptoms of catarrhal non-specific rhinitis

The symptoms of acute non-specific rhinitis are divided into local and general. Local subjective symptoms include: in the first phase, dryness in the nose, itching, a burning sensation in the back of the nose and throat, frequent sneezing, ear congestion, and when blowing the nose - tubal sound effects (squeaking, whistling, a feeling of fluid in the ears) associated with a violation of the ventilation function of the auditory tube. Nasal breathing is impaired, and obstructive hypo- and anosmia, hyperemia of the conjunctiva of the eyes and lacrimation develop. After 24 hours, the peak period of the disease begins, which can last up to 7 days. During this period, serous discharge is replaced by mucopurulent discharge, gradually thickening and stopping. In the third, final period, subjective symptoms gradually pass and recovery occurs. Local objective symptoms are determined by pathomorphological changes in the nasal mucosa in accordance with the phases of rhinitis development: hyperemia, edema, narrowing of the nasal passages, abundance of mucous and mucopurulent discharge. If mucopurulent discharge continues for more than 2 weeks with general poor health, headache, weakness, then one should assume the presence of a complication in the form of sinusitis.

General symptoms of acute non-specific rhinitis are characterized by an increase in body temperature to subfebrile values, mild chills, malaise, loss of appetite, insomnia, headache, etc.

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Diagnosis of acute non-specific rhinitis

Diagnosis of acute (catarrhal) non-specific rhinitis in the usual course of acute non-specific rhinitis is not difficult. It should be differentiated from vasomotor and allergic rhinitis, rhinogeic manifestations of the initial period of acute sinusitis, as well as from influenza rhinitis, rhinitis that occurs with general infectious diseases.

Complications (side effects): nosebleeds, prolonged hypo- and anosmia, parosmia, acute sinusitis, conjunctivitis and dacryocystitis, inflammation of the lymphadenoid apparatus of the pharynx. Sometimes, especially during epidemics of acute non-specific rhinitis, tracheitis, bronchitis and even bronchopneumonia and pneumopleurisy may be observed.

The prognosis is generally favorable; complications are determined by their nature.

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Treatment of acute non-specific rhinitis

Treatment of acute nonspecific rhinitis is effective only at the initial stage of manifestations; treatment started at subsequent stages only moderates clinical manifestations and prevents complications, but the entire clinical cycle described above remains unchanged. Various authors have proposed many treatment options for acute nonspecific rhinitis, but to date there is no effective treatment for this disease. In the event of acute (catarrhal) nonspecific rhinitis, accompanied by malaise, fever, pronounced local subjective phenomena, bed rest, mustard plasters on the calf muscles, foot warmers, hot tea with raspberry jam, per os calcex, aspirin, sedatives are indicated. The skin of the upper lip and vestibule of the nose is constantly lubricated with zinc infusion, baby cream, sometimes synthomycin liniment to prevent maceration and secondary infection. Multivitamins are prescribed, the diet is mainly carbohydrate.

As an abortive treatment for the initial subjective manifestations of rhinitis, it is advisable to instill drops of human interferon diluted with water into the nose, alternating them with vasoconstrictors (naphthyzinum, galazolin, sanorin, ephedrine, etc.), the use of antihistamines (diphenhydramine, suprastin, diazolin, etc.), calcium gluconate and ascorbic acid per os. The classic prescription of N.P. Simanovsky, who proposed in 1917 a particularly effective ointment for acute non-specific rhinitis, has not lost its significance:

  • Rp.: Mentholi Japan 0.1-0.2
  • Cocaine hydrochloride 0.2-03
  • Zinc oxide 0.6-1.0
  • Lanolini 15.0
  • Vaselini 10.0 M. f. ung.
  • D. In tubula mctallica S. Ointment in the nose

As noted by the famous Russian rhinologist A.S. Kiselev (2000), this ointment has a number of advantages over many modern vasoconstrictors. It reduces maceration of the mucous membrane and vestibule of the nose, has an anesthetic and long-lasting vasoconstrictive effect, blocks pathological reflexes from the inflammation zone. Replacing cocaine with ephedrine or adrenaline reduces the effectiveness of this ointment.

Acute rhinitis syndromes in infectious diseases. In this class of diseases, rhinitis is included as one of the more or less constant syndromes that should be differentiated from banal inflammation of the nasal mucosa, as well as from vasomotor and allergic processes.

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