Adenoiditis
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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
Adenoiditis means inflammation of the adenoid tissue. Infection of the adenoid tissue, usually a viral infection, is the most common cause of its inflammation. Bacteria can also cause adenoiditis. Adenoiditis may present with cold like symptoms. The symptoms of adenoiditis can last for 10 or more days, and may usually present as a discharge of pus from the nose. Medications (antibiotics or steroids) or surgical approach may be required for the management of adenoiditis, depending on the causative agent.
Causes
Bacterial Causes
Bacterial causes include
- Streptococcus pyogenes
- Streptococcus pneumoniae
- Moraxella catarrhalis
- Various species of Staphylococcus including Staphylococcus aureus
Viral Causes
Viruses that may cause adenoiditis include the
Epidemiology and Demographics
Age
Adenoiditis occurs mainly in childhood, often associated with acute tonsillitis. Incidence decreases with age, with adenoiditis being rare in children over 15 years due to physiological atrophy of the adenoid tissue.
Natural History, Complications and Prognosis
Complications
Complications of acute adenoiditis can occur due to extension of inflammation to the neighboring organs.
History and Symptoms
Symptoms
Acute adenoiditis is characterized by:
- Fever
- Nasal airway obstruction resulting in predominantly oral breathing
- Snoring and sleep apnea
- Runny nose with serous secretion in viral forms and mucous-purulent secretion in bacterial forms.
In cases due to viral infection symptoms usually recede spontaneously after 48 hours, symptoms of bacterial adenoiditis typically persist up to a week. Adenoiditis is sometimes accompanied by tonsillitis. Repeated adenoiditis may lead to enlarged adenoids.
Other Imaging Findings
Optical fiber endoscopy can confirm the diagnosis of adenoiditis in cases of doubt by directly visualizing the inflamed adenoid tissue.
Medical Therapy
Pharmacotherapy
Antibiotics for bacterial. A steroidal nasal spray may also be prescribed in order to reduce nasal congestion. Severe or recurring adenoiditis may require surgical removal of the adenoids.
In cases of viral adenoiditis, treatment with analgesics or antipyretics is often sufficient. Bacterial adenoiditis may be treated with antibiotics, such as amoxicillin - clavulanic acid or a cephalosporin. In case of adenoid hypertrophy, adenoidectomy may be performed to remove the adenoid.