Acute rhinitis (acute runny nose): symptoms

In the clinical picture of acute catarrhal rhinitis, three stages are distinguished. Successively passing one, to another:

• dry stage (irritation);
• stage of serous discharge;
• stage of mucopurulent discharge (resolution).

For each of these stages, specific complaints and manifestations are characteristic, and therefore approaches to treatment will be different.

The duration of the dry stage (irritation) is usually several hours, rarely 1-2 days. Patients notice a feeling of dryness, tension, burning, scratching, tickling in the nose, often in the throat and larynx, worried about sneezing. At the same time, there is malaise, cognition, patients complain of heaviness and pain in the head, more often in the forehead area, fever to subfebrile, less often to febrile values. In this stage, the nasal mucosa is hyperemic, dry, it gradually swells, and the nasal passages narrow. Breathing through the nose is gradually broken, note the deterioration of the sense of smell (respiratory hyposmia), the weakening of taste, there is a closed nasal.

The stage of serous secretions is characterized by an increase in inflammation, the appearance in the nose of a large amount of transparent watery fluid, sweating from the vessels. Gradually, the amount of mucus increases due to increased secretory activity of goblet cells and mucous glands, so the removed becomes serous-mucous. They note lacrimation, frequent development of conjunctivitis. Breathing through the nose becomes even more difficult, sneezing continues, disturbing noise and tingling in the ears. Serous-mucous discharge of the nasal cavity contains sodium chloride and ammonia, which irritate the skin and mucous membranes, especially in children. At this stage, often observed the appearance of redness and swelling of the skin in the area of the entrance to the nose and upper lip. With anterior rhinoscopy, the hyperemia of the mucosa is less than that of the first stage. In the 2 nd stage, pronounced edema of the mucous membrane is revealed.

The stage of mucopurulent discharge begins on the 4th-5th day after the onset of the disease. It is characterized by the appearance of a mucopurulent, initially grayish, then yellowish and greenish discharge, which is due to the presence in the detachable formed elements of blood: leukocytes, lymphocytes, as well as detached epithelial cells and mucin. Gradually, the swelling of the mucous membrane disappears, nasal breathing and sense of smell are restored, and after 8-14 days from the onset of the disease, an acute cold runs through.

In acute rhinitis, mild irritation spreads to the mucous membrane of the paranasal sinuses, as evidenced by the appearance of pain in the forehead and nose, as well as thickening of the mucous membrane of the sinuses, recorded on radiographs. Inflammation can also pass to the tear ducts, the auditory tube, the underlying airways.

In some cases, with a good state of immunity, acute catarrhal rhinitis occurs abortively within 2-3 days. With a weakened state of the body's defenses, rhinitis can last up to 3-4 weeks with a tendency to transition to a chronic form. The course of acute rhinitis largely depends on the mucous membrane of the nasal cavity before the disease. If it is atrophic, the reactive phenomena (swelling, hyperemia, etc.) will be less expressed, the acute period will be shorter. In hypertrophy of the mucous membrane, on the contrary, acute phenomena and severity of symptoms will be much more pronounced.

In early childhood, the inflammatory process with acute catarrhal rhinitis often passes to the throat with the development of acute rhinopharyngitis. Often in children, the pathological process also extends to the larynx, trachea and bronchi, that is, it has the nature of an acute respiratory infection. Because of the peculiarities of the structure of the nose in children, the disease can be more severe than in adults. First of all, it should be noted the narrowness of the nasal passages of the newborn, which, under conditions of inflammation, increases the nasal congestion, which prevents the baby from sucking the breast normally. The newborn has a reduced ability to adapt to new breathing conditions, it can not be actively removed from the nasal cavity. After a few sips of milk, the child, with the development of acute rhinitis, throws his chest to inhale, so it quickly becomes tired and stops sucking, is undernourished. This can lead to dehydration, weight loss, sleep disturbances. In this regard, there may be signs of a violation of the functions of the gastrointestinal tract (vomiting, flatulence, aerophagia, diarrhea). Since to breathe with the mouth with the nasal stuff lighter with the head thrown back, one can observe a false opisthotonus with the fontanel stress.

In infancy, acute otitis media often occurs as a complication of acute rhinopharyngitis. This is facilitated by the spread of inflammation from the nasopharynx to the auditory tube in connection with the age-related anatomical features of the latter. At this age, the auditory tube is short and wide,

Acute catarrhal rhinopharyngitis is usually more severe in children with hypotrophy. As in early and in the early childhood, acute catarrhal rhinopharyngitis in this category of children can be descending with the development of tracheitis, bronchitis, pneumonia.

[1], [2], [3], [4], [5], [6]