Adenoiditis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Adenoiditis is the inflammation of the adenoid tissue, usually caused by an infection. Adenoiditis is treated using medication (antibiotics and/or steroids) or surgical intervention.
Adenoiditis may present with cold like symptoms. However, adenoiditis symptoms often persist for ten or more days, and often include pus like discharge from nose.
The infection cause is usually viral. However, if the adenoiditis is caused by a bacterial infection, antibiotics may be prescribed for treatment. 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 (adenotonsillectomy).
History and Symptoms
Symptoms
Acute adenoiditis is characterized by fever, runny nose, nasal airway obstruction resulting in predominantly oral breathing, snoring and sleep apnea, rhinorrhea 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.
Natural History, Complications and Prognosis
Complications
Complications of acute adenoiditis can occur due to extension of inflammation to the neighboring organs.
Causes
Bacterial Causes
Bacterial causes include Streptococcus pyogenes, Streptococcus pneumoniae, Moraxella catarrhalis and various species of Staphylococcus including Staphylococcus aureus.
Viral Causes
Viruses that may cause adenoiditis include adenovirus, rhinovirus and paramyxovirus.
Other Imaging Findings
Optical fiber endoscopy can confirm the diagnosis of adenoiditis in cases of doubt by directly visualizing the inflamed adenoid.
Medical Therapy
Pharmacotherapy
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.
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.