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Nasopharyngitis

What Is It, Causes, Treatment, and More

Author:Anna Hernández, MD

Editors:Alyssa Haag,Emily Miao, PharmD,Kelsey LaFayette, DNP, ARNP, FNP-C

Illustrator:Jessica Reynolds, MS

Copyeditor:David G. Walker


What is nasopharyngitis?

Nasopharyngitis is an inflammation of the nasal passages and pharynx most commonly caused by viruses and is known as the common cold but can be caused by bacteria in some cases. It usually affects young children and adolescents and is typically more common during the fall and winter months when people spend more time indoors and pathogens can spread more easily. Although nasopharyngitis is generally a benign and self-limiting condition, many people seek medical advice, use supportive medications, and may miss work or school days due to feeling unwell.

Woman coughing into her elbow.

What causes nasopharyngitis?

Nasopharyngitis is most commonly caused by respiratory viruses; however, it may also occur from infection by certain bacteria. Common viruses include the rhinovirus, respiratory syncytial virus (RSV), parainfluenza virus, adenovirus, and coronaviruses. These viruses are usually transmitted through respiratory droplets generated when coughing or sneezing. Droplets can land in the mouths or noses of individuals nearby or get inhaled into the upper airways. Most of these viruses can also survive on surfaces for a few hours, so it is possible to contract the virus by touching a surface, like a contaminated doorknob or faucet, and subsequently touching one’s eyes, nose, or mouth. Following transmission, the virus colonizes the upper airways and causes the release of inflammatory cytokines, leading to the various symptoms of the common cold. 

Although nasopharyngitis can occur anytime during the year, it is most common in the fall and winter months as children and adolescents tend to spend most of their time indoors and in groups. In addition, many respiratory viruses thrive in the low humidity of the winter months.

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What are the signs and symptoms of nasopharyngitis?

Nasopharyngitis is generally a benign, self-limiting condition that usually resolves within  one to two weeks. Common symptoms include nasal congestion and discharge, moist and productive cough, sneezing, and sore throat. Low-grade fever, headache, fatigue, and malaise are variably present. Common cold symptoms may be accompanied by conjunctivitis, which refers to the inflammation of the conjunctiva of the eye (i.e, the mucous membrane that covers the front surface of the eye and inner surface of the eyelids). Unlike the seasonal flu, the symptoms associated with nasopharyngitis are generally gradual in onset and tend to be less debilitating than those of influenza

Individuals with nasopharyngitis rarely develop any complications; however, occasionally, they may experience rhinosinusitis (i.e. inflammation of the nasal mucosa and paranasal sinuses); asthma exacerbations; acute otitis media; or lower respiratory tract infections, such as bronchitis, bronchiolitis, or pneumonia. These complications are more common in young children under the age of two and in individuals with a compromised immune system (e.g. those with HIV, individuals with cancer, etc.).

How is nasopharyngitis diagnosed?

Nasopharyngitis is typically diagnosed clinically if both symptoms of pharyngitis and upper respiratory tract infection are present. Determining the virus causing the infection is generally not necessary, though in rare cases, the virus is cultured from a nasopharyngeal swab or identified by enzyme-linked immunosorbent assay (ELISA) or polymerase chain reaction (PCR) assays that detect viral DNA. 

There are several other conditions that may resemble the symptoms of nasopharyngitis, including influenza, COVID-19 infection, bacterial pharyngitis, acute bronchitis, allergic rhinitis, and pertussis. However, these conditions usually can be differentiated from the common cold by history and physical examination. Clinically differentiating nasopharyngitis symptoms from COVID-19 infection can be challenging as there is a high degree of variability in the presentation of COVID-19 and many symptoms may overlap with those of nasopharyngitis. On the other hand, bacterial infections, such as acute bacterial pharyngitis, can be more easily differentiated by the presence of acute-onset sore throat, fever, pharyngeal edema, and patchy tonsillar exudates

How is nasopharyngitis treated?

Treatment for nasopharyngitis is mostly supportive and can include comfort measures like sipping cold or warm beverages, over-the-counter pain management with ibuprofen or acetaminophen as needed, drinking plenty of fluids, and bed rest. Other helpful measures include cessation of smoking, humidification of inspired air by vaporizers or humidifiers, raising the head of the bed at night with an extra pillow to allow the nasal passages to drain, and using saline nasal rinses. 

Effective measures to reduce the transmission of respiratory viruses  include minimizing contact with infected individuals, wearing a face mask when feeling ill, and washing hands frequently with soap and water.

People who experience frequent upper respiratory tract infections or who have persistent symptoms may be referred to an ear, nose, and throat (ENT) specialist for further evaluation.

What are the most important facts to know about nasopharyngitis?

Nasopharyngitis, also known as the common cold, is a self-limiting upper respiratory tract infection typically caused by respiratory viruses, like respiratory syncytial virus (RSV), adenovirus, rhinovirus, and coronaviruses. Common cold symptoms include nasal congestion, runny nose, sore throat, sneezing and coughing, general malaise, and low-grade fever. Diagnosis is clinical and treatment is mainly supportive consisting in rest, fluids, and pain medications. Mask-wearing and hand-washing are important measures to reduce the transmission of upper respiratory tract infections.

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Related links

Upper respiratory tract infection
Adenovirus
Rhinovirus

Resources for research and reference

Grief, S. N. (2013). Upper respiratory infections. Primary Care, 40(3): 757–770. DOI: 10.1016/j.pop.2013.06.004

Pappas, D. E. (2022). The common cold in children: Clinical features and diagnosis. In Uptodate. Retrieved August 13, 2022, from https://www.uptodate.com/contents/the-common-cold-in-children-clinical-features-and-diagnosis

Sexton, D. J. (2021). The common cold in adults: Diagnosis and clinical features. In UpToDate. Retrieved August 13, 2022, from https://www.uptodate.com/contents/the-common-cold-in-adults-diagnosis-and-clinical-features

Sexton, D. J. (2022). The common cold in adults: Treatment and prevention. In UpToDate. Retrieved August 13, 2022, from https://www.uptodate.com/contents/the-common-cold-in-adults-treatment-and-prevention