Adenoiditis natural history, complications and prognosis

Adenoiditis Microchapters
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Natural History, Complications and Prognosis
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History and Symptoms
Physical Examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahshid Mir, M.D. [2]

Overview

If left untreated, most of the patients with recurrent adenoiditis may progress to develop chronic adenoiditis, recurrent sinusitis and recurrent otitis media. Common complications of adenoiditis include sleep apnea, sinusitis, speech abnormalities, and otitis media. Acute adenoiditis is usually self limited. With medical and surgical treatment, the prognosis of adenoidtis is usually good.

Natural History

• Acute adenoiditis will usually present with:
  • Erythema and
  • Edema of the adenoids
  • Symptoms, including within 24 hours of infection include:
  • Fever and
  • Sore throat

• It is usually combined with tonsilitis due to close anatomical location.
• Acute adenoiditis usually runs its course without complications and resolves within three to four days.
• It is common to see the disease's symptoms in infants before 6 months.
• Recurrent adenoiditis will usually not resolve itself and will require:
  • Antimicrobrial therapy or
  • Adenoidectomy
• If left untreated, recurrent adenoiditis may persist and recur over periods of time and lead to infectious complications.

Complications

Complications of adenoiditis are caused by persistence and/or spread of the responsible pathogen - usually bacteria. The complications of adenoiditis include the following:

• Speech abnormalities
• Otitis media
• Acute sinusitis
• Pneumonia
• Adenoid hyperplasia
• Peritonsillar abscess
• Sleep apnea
• Scarlet fever
• Rheumatic fever and cardiomyopathies
  • Mostly due to streptotoxin
• Glomerulonephritis
• Tonsilloliths

Prognosis

• The prognosis for acute adenoiditis without treatment is usually good; the disease is usually self-limited and will resolve itself within 3-4 days.
• The prognosis for recurrent adenoiditis varies based on the presence of complications.
• With treatment, the prognosis of acute and recurrent adenoidtis is usually good.