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Diagnosis of runny nose in a child
Last reviewed: 06.07.2025
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Diagnosis of rhinitis is based on epidemiological history, clinical picture and rhinoscopy data.
Laboratory diagnostics
In severe cases of acute nasopharyngitis (runny nose) and in cases of hospitalization, which is most typical for children in the first three years of life, a peripheral blood test is performed, which in uncomplicated cases reveals a normal leukogram or a tendency towards leukopenia, lymphocytosis.
Identification of viral pathogens of acute nasopharyngitis is carried out only in severe cases of the disease in cases of hospitalization of the child. To determine viral antigens, the reaction of immunofluorescence of prints from the nasal mucosa is used. In recent years, it has become possible to use the polymerase chain reaction (PCR) to identify a wide range of respiratory viruses.
Serological diagnostics of rhinitis is based on the use of the hemagglutination inhibition reaction (HIR), the direct and indirect hemagglutination reaction (DIHAR, NIHAR). complement fixation reaction (CFR) in paired venous blood sera. However, these data are of epidemiological rather than clinical significance.
Methods of etiological diagnostics of acute respiratory infection in children
Viruses |
Immunofluorescence with antigens |
RPGA, RNGA, RTGA |
RSC |
Flu |
+ |
+ |
+ |
Parainfluenza |
+ |
RTGA |
+ |
Adenovirus |
+ |
RTGA |
+ |
Rhinovirus |
- |
RPGA |
|
PC virus |
+ |
RPGA |
+ |
Reovirus |
+ |
- |
- |
Enterovirus |
- |
- |
+ |
In cases of protracted course with the ineffectiveness of conventional methods of therapy, it may be necessary to identify mycoplasma, chlamydial or other infections. For this purpose, PCR of pharyngeal and/or nasal smears and sowing of discharge from the pharynx and nose on conventional nutrient media and Sabouraud's medium (to identify mycoses) are used.
Instrumental methods
In all situations, especially in severe or complicated cases, rhinoscopy is performed, which reveals swelling, edema and hyperemia of the nasal mucosa, as well as mucous or mucopurulent discharge.
Differential diagnosis of rhinitis
Usually, differential diagnostics of acute nasopharyngitis is indicated only in its protracted course, when it is necessary to exclude the non-infectious nature of the disease - allergic and vasomotor rhinitis, hay fever, nasal diphtheria, foreign body in the nasal cavity. Of primary importance are the anamnesis, ENT examination, including endoscopy of the nasal cavity, radiography of the nose, and sometimes the nasopharynx (fibroscopy), ultrasound scanning.
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