Background: Although infections of the nasopharynx are common in childhood due mainly to adenoid
disease, nasopharyngitis in adults is not usually considered a diagnosis per se.
Case Report: A 40-year-old woman presented to the outpatient clinics with a long history of postnasal
drip and pain in the nasopharynx and oropharynx. The patient had had several courses
of antibiotics over the previous 2 years with minimal effect. On examination the nasopharynx
was inflamed and a crust of thick mucopurulent discharge was sitting in the posterior
wall of nasopharynx. The crust was sent for culture and cytological examination and
the results were Serratia and S. aureaus. Sinus CT scan was unremarkable. Following proper antibiotic treatment the symptoms
initially resolved for 1 month. Six weeks later the symptoms recurred with the same
clinical findings in the nasopharynx and a negative swab. Symptoms resolved again
with broad spectrum antibiotics. A new CT scan showed diffuse swelling in the nasopharynx
and a biopsy was performed, which showed nonspecific inflammation. Symptoms recurred
for a third time and a further culture showed Serratia, S. aureus, and E. coli, the latter being sensitive only to Meronem. This was prescribed in combination with
Augmentin. Following this, our patient remains free from symptoms over the last 6
months.
Discussion and Conclusions: The term adult nasopharyngitis is not widely used and the literature on this subject
is scarce. The symptoms can vary, but usually there is erythema and inflammation on
nasopharyngoscopy and cultures are positive for bacteria. In our patient the recurrent
infection and irritation of the area was attributed to the inhalations of detergents
as this patient is a domestic cleaner. The combination of nasal douches, nasal steroid
spray, and antibiotics resolved the symptoms.
