Acute (catarrhal) nonspecific rhinitis

Acute (catarrhal) nonspecific rhinitis is the most common disease in otorhinolaryngology, characterized by pronounced seasonality and a significant individual predisposition to its occurrence. This is an acute contagious catarrhal inflammation of the nasal mucosa, which is equally common in men and women at any age. Often the disease takes the form of a seasonal epidemic in summer-autumn and autumn-winter transitions. More often observed in persons with weakened, convalescent, hypoavitaminosis, overfatigue. Often occurs when infected in public transport, with large crowding of people, etc. The risk factors for acute cold are unfavorable hygiene and environmental conditions, body cooling, dampness, drafts. Most common colds of residents of large cities or people who first come to new collectives (kindergartens, barracks, production). Workers of chemical and "dust" manufactures are more subject to disease.

In acute rhinitis, saprophytic microorganisms activated in the nasal cavity are activated. After birth, the nasal cavity of the newborn remains sterile for several hours, then from the first day after birth, various microorganisms penetrate them, which can be represented by streptococci, white or golden staphylococcus, various diphtheria bacteria, pneumococcus, hemolytic bacteria, influenza, etc. This microbiota saprophytes in the nasal cavity, but under different adverse conditions it can activate and cause various, characteristic for its pathogenic properties in, disease.

Causes of acute nonspecific rhinitis

For one reason or another, saprophytic microorganisms are activated that acquire pathogenic properties and cause catarrh of the nasal mucosa. According to many authors, the activation of the saprophyte microbiota occurs after the introduction of a special filtering adenovirus that weakens the immune barriers of the nasal mucosa, as a result of which the activation of saprophytes and subsequent development of the inflammatory process occurs.

[1], [2]

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 make up the tissues of the organism of animals and plants and possessing a specific ability to cause lysis of certain microorganisms, lysozyme is found in eggs, blood, tears, saliva, nasal secretions, turnips, 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 release of nasal mucus. A significant role in the pathogenesis of acute nonspecific rhinitis is attributed to the cooling factor of the organism, and in particular of the legs and head. In this regard, some authors (E.Rajka) suggest the existence of a so-called cold allergy, which contributes to the emergence of an acute nonspecific rhinitis. W. Naughton and G.Braun (1948) established that the cold in some individuals promotes the release of a significant amount of histamine into the blood, and E. Troch (1951) revealed that histamine is present in the secretions in an acute nonspecific rhinitis. Many authors have established a connection between acute nonspecific rhinitis and allergy, which led to the method of antihistamine treatment in acute non-specific rhinitis.

Acute nonspecific rhinitis, in fact, is not an isolated disease only mucous membrane of the nose, but to some extent affects the mucous membrane of the nasal cavity in which there are similar processes that occur in the nose. Most often this applies to the cells of the latticed bone, less often the premaxillary 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 paresis of the vessels, hyperemia and edema of the nasal mucosa, perivascular and periglundular infiltration and diapedesis of the blood constituents, hypofunction of the mucous glands are observed. The second phase is characterized by hypersecretion of nasal mucus, in which desquamated epithelium, fragments of destroyed leukocytes, microorganisms are found. Sometimes discharge from the nose is bloody, which may indicate a viral etiology of the common cold, in which the endothelium of the blood capillaries is affected. The third phase is characterized by a thickening of secretions, the appearance in them of a large number of leukocytes and a gradual cessation of the inflammatory process.

Symptoms of catarrhal nonspecific rhinitis

Signs of acute nonspecific rhinitis are divided into local and general. Local subjective symptoms include: in the first phase, dryness in the nose, itching, burning sensation in the back of the nose and pharynx, frequent sneezing, stuffiness of the ears, blowing at the tubercular sound effects (squeaking, whistling, feeling of presence of fluid in the ears), related with a violation of the ventilation function of the auditory tube. Nasal breathing is disrupted, and obstructive hypo- and anosmia, eye conjunctival hyperemia and lacrimation develop. In 24 hours there comes a period of the height of the disease, which can last up to 7 days. In this period serous discharge is replaced by mucopurulent, gradually thickening and stopping. In the third and final period, subjective symptoms gradually pass away and recovery comes. Local objective symptoms are determined by pathomorphological changes in the nasal mucosa in accordance with the phases of development of the common cold: hyperemia, edema, narrowing of nasal passages, an abundance of mucous and mucopurulent discharge. If the mucopurulent discharge lasts more than 2 weeks with a general poor health, headache, weakness, it should be assumed that there is a complication in the form of sinusitis.

Common signs of acute nonspecific rhinitis are characterized by an increase in body temperature to subfebrile values, mild fever, malaise, loss of appetite, insomnia, headache, etc.

Diagnosis of acute nonspecific rhinitis

Diagnosis of acute (catarrhal) nonspecific rhinitis in the usual course of acute nonspecific rhinitis is not difficult. Differentiate it from vasomotor and allergic rhinitis, rhinogens manifestations of the initial period of acute sinusitis, as well as influenza rhinitis, a common cold that occurs in common infectious diseases.

Complications (side effects): nasal bleeding, prolonged hypo- and anosmia, parosmia, acute sinusitis, conjunctivitis and dacryocystitis, inflammation of the lymphadenoid apparatus of the pharynx. Sometimes, especially with epidemics of acute nonspecific rhinitis, tracheitis, bronchitis, and even bronchopneumonia and pneumo-pleuritis can be observed.

The prognosis is generally favorable, with complications determined by their nature.

[3], [4], [5], [6], [7]

Treatment of acute nonspecific rhinitis

Treatment of acute nonspecific rhinitis is effective only in the stage of initial manifestations; The treatment started in the subsequent stages only moderates the clinical manifestations and prevents complications, but the entire clinical cycle described above remains unchanged. Various authors have proposed a variety of treatment options for acute nonspecific rhinitis, but to date there is no effective treatment for this disease. When an acute (catarrhal) nonspecific rhinitis occurs, accompanied by malaise, an increase in body temperature, expressed by local subjective phenomena, bed rest, mustard plasters on the calf muscles, warmers to the feet, hot tea with raspberry jam, per os calcex, aspirin, sedatives. The skin of the upper lip and the vestibule of the nose is constantly lubricated with zinc infusion, baby cream, sometimes liniment of synthomycin to prevent maceration and secondary infection. Assign multivitamins, the diet is mainly carbohydrate.

As an abortive treatment with initial subjective manifestations of the runny nose, it is advisable to let in the drops of water-diluted human interferon, alternating them with vasoconstrictors (naphthyzine, galazoline, sanorin, ephedrine, etc.), administration of per os antihistamines (dimedrol, suprastin, diazolinum and others .), calcium gluconate and ascorbic acid. Not lost its importance is the classical propiska of N.P. Simanovsky, who proposed in 1917 a particularly effective ointment for acute nonspecific rhinitis:

• Rp .: Mentholi japan 0.1-0.2
• Cocaini hydrochloridi 0,2-03
• Zinci oxydi 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 AS Kiselev (2000), this ointment has a number of advantages over many modern vasoconstrictors. It reduces the maceration of the mucus membrane and the vestibule of the nose, has an anesthetic and long-lasting vasoconstrictive effect, blocks pathological reflexes from the inflammation zone. The replacement of cocaine with ephedrine or epinephrine reduces the effectiveness of this ointment.

Syndromes of acute rhinitis in infectious diseases. In this class of diseases, the common cold enters as one of more or less permanent syndromes, which should be differentiated from banal inflammation by the nasal mucosa, as well as from vasomotor and allergic processes.