Differentiating Rhinitis in the Paediatric Population by Giving Focus on Medical History and Clinical Examination

Doulaptsi, Maria; Aoi, Noriaki; Kawauchi, Hideyuki; Milioni, Athanasia; Karatzanis, Alexander; Prokopakis, Emmanuel

Viral infections are the most common cause of acute infectious rhinitis and these episodes can last up to 7-10 days and are usually self-limited. Human rhinovirus (more than 100 serotypes) is the most common cause, accounting up to 50% viral rhinitis episodes in children and adults. Respiratory syncytial virus (RSV), influenza virus, parainfluenza virus, adenovirus, enterovirus, and coronavirus have also been implicated in the pathogenesis of acute infectious rhinitis [11] [12] [13] . It is estimated that an infant can typically have up to 11 upper respiratory tract infection episodes per year. The number usually diminishes with age, with generally around eight episodes at preschool age and four at school age [10] . Bacterial contamination can prolong the course of acute viral rhinitis. Studies have reported that up to 10% of viral rhinitis cases can be complicated by superadded bacterial infections [14] . Streptococcus pneumoniae, Moraxella catarrhalis, and Haemophilus influenzae are the most frequent micro-organisms in bacterial rhinosinusitis. Polymicrobial flora is present in about one-third of cases, while anaerobes are often present in odontogenic infections in older children [14] .