Acute rhinitis (acute runny nose) - Symptoms

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

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

Each of these stages is characterized by specific complaints and manifestations, so the approaches to treatment will be different.

The dry stage (irritation) usually lasts several hours, rarely 1-2 days. Patients report a feeling of dryness, tension, burning, scratching, tickling in the nose, often in the throat and larynx, sneezing bothers them. At the same time, malaise, chills occur, patients complain of heaviness and pain in the head, more often in the forehead, an increase in body temperature to subfebrile, less often to febrile values. At this stage, the nasal mucosa is hyperemic, dry, it gradually swells, and the nasal passages narrow. Breathing through the nose is gradually impaired, a deterioration in the sense of smell (respiratory hyposmia), a weakening of the sense of taste are noted, a closed nasal voice appears.

The serous discharge stage is characterized by increasing inflammation, the appearance of a large amount of transparent watery fluid in the nose, oozing from the vessels. Gradually, the amount of mucus increases due to increased secretory activity of goblet cells and mucous glands, so the discharge becomes serous-mucous. Lacrimation and frequent development of conjunctivitis are noted. Breathing through the nose becomes even more difficult, sneezing continues, noise and tingling in the ears are disturbing. Serous-mucous discharge from the nasal cavity contains sodium chloride and ammonia, which have an irritating effect on the skin and mucous membrane, especially in children. At this stage, redness and swelling of the skin in the area of the entrance to the nose and upper lip are often observed. With anterior rhinoscopy, hyperemia of the mucous membrane is less pronounced than in stage 1. In stage 2, pronounced edema of the mucous membrane is detected.

The stage of mucopurulent discharge occurs on the 4th-5th day from the onset of the disease. It is characterized by the appearance of mucopurulent, initially grayish, then yellowish and greenish discharge, which is due to the presence of formed elements of the blood in the discharge: leukocytes, lymphocytes, as well as rejected 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, acute rhinitis passes.

In acute rhinitis, moderate irritation spreads to the mucous membrane of the paranasal sinuses, as evidenced by the appearance of pain in the forehead and bridge of the nose, as well as thickening of the mucous membrane of the sinuses, recorded on radiographs. Inflammation can also spread to the lacrimal ducts, auditory tube, and lower respiratory tract.

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

In early childhood, the inflammatory process in acute catarrhal rhinitis often spreads to the pharynx with the development of acute nasopharyngitis. Often in children, the pathological process also spreads to the larynx, trachea and bronchi, that is, it has the nature of an acute respiratory infection. Due to the structural features of the nose, the disease can be more severe in children than in adults. First of all, it should be noted that the nasal passages of a newborn are narrow, which, under conditions of inflammation, contributes to increased nasal congestion, which does not allow the child to suckle normally. A newborn has a reduced ability to adapt to new breathing conditions; he cannot actively remove discharge from the nasal cavity. After several sips of milk, the child, with the development of acute rhinitis, abandons the breast to take a breath, so he quickly gets tired and stops sucking, and is undernourished. This can lead to dehydration, weight loss, and sleep disorders. In this connection, signs of gastrointestinal dysfunction may appear (vomiting, flatulence, aerophagia, diarrhea). Since it is easier to breathe through the mouth with a stuffy nose with the head thrown back, false opisthotonus with tension of the fontanelles can be observed.

In infancy, acute otitis media often develops as a complication against the background of acute nasopharyngitis. This is facilitated by the spread of inflammation from the nasopharynx to the auditory tube due to the age-related anatomical features of the latter. At this age, the auditory tube is short and wide,

Acute catarrhal nasopharyngitis usually occurs more severely in children with hypotrophy. Both in early and late childhood, acute catarrhal nasopharyngitis in this category of children can have a descending character with the development of tracheitis, bronchitis, pneumonia.

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