Angina is the cause of the disease. What complications can angina cause? Adverse factors that increase the risk of disease

On the Internet you can find many types of different sore throats, it is easy to get confused in them. Some forms are not official, but exist for the purpose of convenient philistine communication, or to designate a dominant symptom, for example, allergic tonsillitis.

We list the main types, based on several classifications of such famous professors as B.S. Preobrazhensky, J. Portman, A.Kh. Minkovsky and several textbooks on otorhinolaryngology (V.I. Babiyak, V.T. Palchun).

Classification according to the course (nature) of the disease:

Classification according to the form of the disease(also referred to as banal or vulgar tonsillitis, and most often caused by hemolytic streptococcus):

Type of angina
catarrhal	General intoxication (headache, high body temperature, weakness), pain when swallowing, redness of the tonsils. Plaque on the tonsils may be absent. Bilateral lesion of the tonsils The duration of the disease is from 5 to 7 days.
Follicular	High temperature up to 39 ° C, sore throat, yellowish plaque and purulent plugs on reddened tonsils. Bilateral lesion of the tonsils. Duration more than 7 days.
Lacunar	Very high temperature up to 40 ° C, unbearable sore throat, extensive purulent areas on the reddened tonsils. Bilateral lesion of the tonsils is characteristic. Duration about 8 days.
Fibrinous (pseudodiphtheria)	Occurs against the background of catarrhal, follicular or lacunar tonsillitis or as a consequence of them. The symptoms are similar, but a film forms on the tonsils. Duration from 7 to 14 days.
Phlegmonous (as a complication various kinds angina)	Intolerable pain when swallowing. Heat. Great enlargement of one tonsil. The surface of the tonsil is as if stretched.

Classification by cause of disease:

Type of angina	Characteristic symptoms and signs
Bacterial(tonsillitis, as a manifestation of infectious diseases caused by bacteria).
Diphtheritic (caused by bacillus Loeffler)	Bilateral lesion of the tonsils. Pain when swallowing, fever. A typical diphtheritic plaque in the form of a grayish film white color. The film is difficult to remove, dense, sinks in water.
Scarlet fever (caused by toxigenic group A streptococcus that produces erythrotoxin)	Against the background of the symptoms of scarlet fever: high body temperature, headache, raspberry tongue, red punctate rash on the face, tongue, and body (to a lesser extent). There are signs characteristic of angina vulgaris (catarrhal, follicular, lacunar): pain when swallowing, purulent plugs or plaque on reddened tonsils, pain when swallowing.
Streptococcal (most often manifested as catarrhal, follicular, lacunar or fibrinous tonsillitis)	High body temperature. Pain when swallowing. Redness and coating on reddened tonsils. Purulent plugs in the follicular form. Extensive accumulations of pus with lacunar form. Films in fibrinous form. (details see above)
Staphylococcal (caused by Staphylococcus aureus)	Manifestations are similar to streptococcal tonsillitis. Plaque on the tonsils in the form of films, purulent plugs or islets. The pain when swallowing is very severe. The course is more severe and prolonged than that of angina vulgaris.
Simanovsky-Vincent (also referred to as ulcerative membranous or ulcerative necrotic, caused by fusiform bacillus and spirochete)	Occurs against the background of exhaustion of the body. Unilateral lesion of the tonsils. Can flow without heat. Greyish-yellow films with ulcers on the tonsils. Putrid odor from the mouth. Duration from 7 to 20 days.
Syphilitic (caused by Treponema pallidum)	Rapid rise in body temperature to 38 ° C, pain when swallowing. Unilateral lesion of the tonsil in the form of redness and enlargement. Enlarged cervical lymph nodes.
Viral(tonsillitis, as a manifestation of infectious diseases caused by viruses).
Measles (caused by the paramyxovirus family)	Pain when swallowing, fever, against the background of inflammation of the respiratory tract and skin rash. Swelling of the tonsils. Redness may be in the form of spots or bubbles. Enlarged lymph nodes.
With HIV infection	Increased body temperature, pain when swallowing, purulent plaque on the tonsils, one-sided lesion is possible. The flow is lingering.
Herpetic (caused by the herpes buccopharyngealis virus, herpetic fever virus)	A characteristic feature is blisters on the mucous membranes of the oral cavity and pharynx, and may also appear on the lips and skin. The body temperature is very high up to 41 °C. The defeat is bilateral.
Infection of the pharynx by the herpes zoster virus	A rash of bubbles is characteristic only on one side and on the tonsil. Pain can be given to the nasopharynx of the eye and ear. Duration 5-15 days.
Herpangina (cause - Coxsackie enterovirus)	Sudden start. Body temperature up to 40 °C. Small bubbles on the tonsils, which burst after 2-3 days and leave erosion. Pain when swallowing. Bubbles may appear on the feet and hands.
fungal(mycosis of the pharynx).
Candidiasis (caused by fungi of the genus Candida)	Acute start. Moderate temperature. Pain when swallowing foreign body in the throat. On the tonsils there are curdled masses in the form of separate islands.
Leptotrixose (caused by the fungus Leptotrix, a rare form)	There are numerous small white dots on the entire surface of the pharynx and on the base of the tongue. There is practically no pain, the body temperature is not high.
Actinomycosis (caused by actinomycetes, very rare form)	It is a consequence of actinomycosis of the tongue or facial area. Difficulty opening your mouth completely. Difficulty swallowing (a lump of food does not immediately go away). Local swellings of the mucous membrane, which then break through with the expiration of pus.
Angina, as a manifestation of blood diseases.
Agranulocytic (refer to the appearance of ulcerative necrotic)	General malaise, high body temperature, severe sore throat. Ulcerative changes in the tonsils. Putrid odor from the mouth. Characteristic blood changes.
Monocytic (the cause of the disease is not completely clear)	Sore throat, fever. Enlargement of the liver, spleen and cervical lymph nodes. Long-term (raids remain for several weeks and even months). Characteristic blood changes.
Angina with leukemia	Occurs against the background of leukemia (blood cancer). Enlarged cervical lymph nodes. Swallowing disorder. Ulceration of the tonsils. Bad breath.
Angina, as a manifestation of systemic diseases.
allergic	Swelling of the oral mucosa, tonsils. Redness of the pharynx. Not accompanied by plaque and fever. The connection with the use of any substance inside or the presence of flowering of allergenic plants is characteristic.
mixed forms.
Stomatitis (can be caused by bacteria, viruses and even fungi)	There may be various manifestations depending on the causes and pathogens. As a rule, signs of stomatitis are characteristic: swelling of the oral mucosa, ulcerative lesions in the oral cavity.

The medical meaning of the word "catarrhal" comes from the Greek "kataralis", which means swelling, expiration. This term well describes this sore throat, which is manifested by swelling, redness and the formation of a serous (clear or slightly cloudy) substance on the mucous membrane of the palatine tonsils.

Catarrhal angina is often not an independent form, but the initial stage of follicular or lacunar angina, and less often manifests itself as a separate pathology, as a rule, it proceeds easily and quickly (on average 6-7 days).

Symptoms

Symptoms appear suddenly:

• body temperature may not be very high (37-38 ° C),
• the first subjective signs are usually dryness and a feeling of soreness in the throat,
• when swallowing a food bolus, pain is felt,
• characteristic redness of only the tonsils and the palatine arches surrounding them (see the figure above),
• enlarged tonsils peeking out from behind the palatine arches,
• tonsils can be covered with a delicate, cloudy and easily removed film,
• it is important that there should be no manifestations and other violations of the structure of the tonsils,
• pain on palpation of regional lymph nodes.

Despite the ease of flow, catarrhal angina is a potential threat to the general health of a person, it can be complicated by nephritis (kidney disease), myocarditis (heart disease), rheumatoid arthritis (joint disease). Therefore, in no case should you self-medicate or neglect the recommendations of a doctor.

Treatment

It is desirable that the treatment of catalytic angina occurs under the supervision of a physician. Usually assigned:

• Antibacterial drugs, including sulfonamides. They are the main treatment for angina.
• Gargling can be done with antiseptics (furatsilin), and preferably with saline (salt solution in water: 1 teaspoon of salt per liter of warm water).
• Antipyretic drugs at body temperature above 38 ° C.
• Pain-relieving sprays and sucking tablets are used to relieve symptoms.
• Together with the start of the use of antibiotics, it is necessary to carry out, since it enhances the effect of drugs, improves lymph flow, removes toxins from affected areas, cleanses tissues and stimulates the immune system to fight infection.

During treatment, you need to keep the cardiovascular system under control, take urine and blood for analysis several times, for the timely detection of possible complications.

Follicular angina

Follicular angina (ICD code 10 - J03) is the most common form of angina, in which purulent inflammation spreads to the structural components of the tonsils - follicles. This pathology is more severe than catarrhal tonsillitis.

Causes

The cause can be various kinds of bacteria, but in 90% of cases it is streptococcus. Interestingly, this type of microorganism is continuously present on our mucous membranes throughout our lives, without causing harm. But as soon as the local and general are weakened, the microbe begins to multiply uncontrollably in the tonsils.

Symptoms

1. An increase in body temperature to 39 ° C is not a specific symptom, but at the same time, follicular tonsillitis cannot proceed without temperature.
2. Pain while eating can radiate to the ear area.
3. Intoxication is expressed in the form of pain in the head, malaise, chills, pain in the lumbar region and joints is also possible.
4. Enlarged lymph nodes in the neck.
5. During a visual examination of the throat:
   • distinct redness of the tonsils and palatine arches;
   • enlarged and puffy tonsils;
   • numerous festering follicles are observed on the surface of the tonsils: yellowish-white spots 1-3 mm, which make the mucous membrane tuberous;
   • follicles are opened 2-4 days after the appearance with the formation of erosion.
6. In the general blood test:
   • an increase in the number of leukocytes,
   • increased ESR (up to 30 mm/h).

Treatment

Treatment of follicular angina is carried out, as a rule, on an outpatient basis at home. It is desirable to isolate the patient as much as possible from the surrounding people and from common household items (dishes). It is very important to observe strict bed rest.

The main components of effective treatment of angina:

1. Antibacterial therapy is the most important part of the treatment, with which you need to start and finish the treatment of angina. The use of antibiotics for follicular angina eliminates the occurrence of deadly consequences.
2. Together with antibiotic therapy, procedures should be started.
3. Bed rest.
4. Frequent drinking of warm drinks (tea, fruit drink) contributes not only to the replenishment of fluid in the body, but also moisturizes the mucous membrane of the tonsils, weakening pain.
5. Gargling with antiseptic solutions (furatsilin) ​​or saline solution (0.9% saline solution 1 teaspoon of salt per liter of warm water).
6. Symptomatic therapy (relief of the condition):

• pain-relieving sucking tablets or sprays (alcohol-free),
• antipyretic (at a long-term high temperature of more than 39 ° C),
• mucolytics (with viscous, hard-to-remove mucus on the tonsils).

Lacunar angina

Lacunar tonsillitis (ICD code 10 - J03) is the most severe form, characterized by widespread purulent inflammation and accumulation of pus in the lacunae (grooves between the structural elements of the tonsils).

Symptoms

To get a complete picture of a disease such as lacunar tonsillitis, the doctor collects an anamnesis and draws up a medical history, in which the following symptoms:

1. 40 ° C - the temperature can be so high in this disease.
2. There is unbearable pain while eating.
3. In the throat and neck, pain can be even in a relaxed state.
4. The state of poisoning with toxins produced by streptococcus (intoxication):
   • feeling unwell,
   • pain in the head,
   • chills,
   • pain can appear in the lower back and joints.
5. The cervical lymph nodes are greatly enlarged.
6. When examining the throat:
   • redness of the tonsils and surrounding tissues;
   • enlargement and swelling of the tonsils (in severe cases, it can cover most of the pharynx);
   • islands of yellowish-white plaque, which can cover the entire tonsil;
   • there may be simultaneous manifestations of both follicular and lacunar tonsillitis;
   • plaque is easily removed with a spatula without damaging the mucous membrane.
7. General analysis blood:
   • leukocytosis (an increase in white blood cells),
   • increased ESR (erythrocyte sedimentation rate).

Treatment

With lacunar angina, it is very important to take antibiotics, given the severity of this form of angina, the refusal of antibacterial drugs can lead to very dangerous consequences, both general (heart problems, inflammation of the kidneys and joints) and local (peropharyngeal abscess, phlegmon, etc.) .

All other methods and procedures have helper function, but this does not mean that they are not important and can be ignored:

• it is necessary to transfer the disease only in the supine state;
• repeated warm (not more than 40 ° C) drink;
• vibroacoustic therapy with;
• gargling with antiseptic solutions (furatsilin) ​​or saline (1 teaspoon of salt per 1 liter of water) will provide pain relief by moistening the surface of the tonsils;
• symptomatic therapy (relief of symptoms) only if necessary: ​​antipyretics (prolonged fever with a temperature of more than 39 °), anti-inflammatory, painkillers (with unbearable pain).

fibrinous

Fibrinous tonsillitis (pseudomembranous, diphtheroid) - inflammation of the upper layers of the tonsil, characterized by the formation of a grayish film (plaque), which is difficult to separate.

Causes

In some cases, follicular and lacunar tonsillitis can turn into a fibrinous form, the causative agents are pneumococcus, streptococcus, less often staphylococcus.

Symptoms

• Body temperature rises sharply and can reach 39 ° C.
• Signs of the presence of toxins in the blood (headache, weakness, chills).
• Characteristic pain during swallowing.
• The cervical lymph nodes are often enlarged.
• The tonsils are covered with a light film, which may extend beyond the tonsils, it is difficult to separate and, after removal, may leave ulcers, this symptom is identical to that of diphtheria.

No wonder this disease is called diphtheroid angina, the symptoms are very similar, so it is urgent to conduct a bacteriological study in order to exclude the presence of diphtheria bacillus, due to its high contagiousness (contagiousness).

Treatment

Fibrinous tonsillitis is treated in the same ways as ordinary bacterial tonsillitis:

• therapy with the help of taking antibacterial drugs;
• compliance with the regime of the day with a predominance of sleep (bed rest);
• it is necessary to drink a lot and often a warm liquid in the form of tea or raspberry juice;
• frequent gargling greatly relieves pain, to prepare a solution in 1 liter of warm water, dissolve 1 teaspoon of ordinary salt;
• if necessary, symptomatic treatment (antipyretic, painkillers);
• physiotherapy

However, if the causative agent is staphylococcus, then it is necessary to make an individual selection of antibiotics, due to its resistance to the penicillin series.

Phlegmonous

Phlegmonous tonsillitis or acute paratonsillitis is the most severe form, manifests itself as a complication 1-3 days after the onset of follicular or lacunar tonsillitis. It is characterized by inflammation of the peri-almond tissue.

There are three forms:

• edematous;
• infiltrative;
• abscessing.

They, in fact, are the stages of phlegmonous tonsillitis, which end with an abscess or extensive phlegmon.

Symptoms

• In most cases, the process is one-way.
• The body temperature is very high up to 40°C.
• Regional (cervical) lymph nodes are greatly enlarged and painful.
• Pain during swallowing is so severe that the patient is forced to refuse any food, even liquid.
• The patient takes a forced position with the head tilted forward and towards the affected part.
• The mouth opens with difficulty only a few millimeters due to contracture (restriction of movement) of the temporomandibular joint on the side of the lesion.
• Appears bad smell from the mouth with hints of acetone.
• Severe redness of the affected tonsil,
• The tonsil protrudes strongly, and the surface is stretched in the area of ​​​​the abscess (accumulation of pus in a limited capsule).
• After opening the abscess, the patient's condition improves dramatically.

Treatment

• Surgical opening or puncture of the abscess, depending on the condition.
• Broad spectrum antibiotic therapy action spectrum.
• Painkillers.
• Antipyretic drugs.
• At the stage of recovery, physiotherapy is indicated, it promotes rapid regeneration after surgery and enhances the effect of antibiotics.

Agree, you can get confused in this endless list of similar symptoms, for this in this table we present the most important features sore throats:

Purulent tonsillitis

What is purulent angina? This is a general descriptive term characterizing the totality of symptoms of a purulent-inflammatory process. Purulent can be called follicular, lacunar, fibrinous, staphylococcal and other tonsillitis, manifested by purulent dots or plaque. What purulent tonsillitis looks like can be seen in the figure below:

Causes

Purulent tonsillitis is most often caused by streptococcus, but general blood diseases or a decrease in immunity due to various types of viruses can serve as the cause.

Due to a sharp decrease in the local in the throat area, the normal microflora of the oral cavity, in which streptococcus is constantly present, joins almost any infection.

Normally, the population of this bacterium is restrained by immune cells (lymphocytes and leukocytes), and with an infectious load, a deficiency of protective cells and immune proteins occurs, as a result, streptococcus begins to multiply uncontrollably.

Purulent tonsillitis in adults and children can also occur for additional indirect reasons that affect the overall weakening of the immune forces (decrease in the activity and number of lymphocytes):

• it can be systemic blood diseases (mononucleosis, leukemia),
• unhealthy lifestyle (smoking, alcohol, drugs),
• sharp seasonal fluctuations in conditions external environment (),
• tonsil injury,
• otorhinolaryngologist, doctor of medical sciences, professor Palchun V.T. notes that sore throats often occur as a result of a monotonous protein diet, which once again confirms the effectiveness without protein.
• existing for a long time bacterial foci in the mouth and nose (caries, chronic sinusitis, pulpitis, etc.).

Symptoms and signs

Signs of purulent tonsillitis that occur in adults depend on the causative agent of the infection. As a rule, they correspond to the symptoms of follicular or lacunar tonsillitis, the cause of which is in most cases streptococcus.

• The increase in body temperature varies from 38 to 40°C. At the same time, purulent tonsillitis is extremely rare without temperature. It is impossible to say exactly how many days the temperature lasts, approximately, it subsides 1-3 days after the start of antibiotics.
• Sore throat during meals is due to the cause and the form of the disease can be mild or unbearable.
• Almost always manifested by an increase in regional cervical nodes, which can be painful when palpated.
• Symptoms of general intoxication are characteristic: headache, fever, general weakness, lack of appetite.
• The tonsils are enlarged, covered with yellowish dots (purulent plugs), or may be partially or completely covered with pus, which should be easily removed with a wooden spatula.

How many days does purulent tonsillitis last?

Purulent tonsillitis is very diverse for its reasons, in addition, the state of the body strongly affects the duration of the disease, so it is difficult to answer this question exactly. One can only say that the duration of the disease should not be more than 20 days and less than 6, otherwise you are dealing with another pathology. With a follicular or lacunar form, recovery occurs in about 10 days.

Is purulent tonsillitis contagious?

Contagiousness (infectiousness) largely depends on the causative agent of the infection. Ordinary streptococcal tonsillitis, occurring in the form of follicular or lacunar, will not affect others, since exactly the same strains of streptococcus are present in the oral cavity of each person. But this does not relieve the patient and his loved ones from anxiety for the following reason.

It is possible to accurately identify the causative agent of the disease only after visiting a doctor and clinical research, diphtheria can never be ruled out in advance, therefore, for any sore throat, a set of quarantine measures must be observed:

• providing the patient with separate utensils and food,
• when relatives come into contact with the patient, it is advisable to wear cotton-gauze bandages (do not forget to change the bandages every 2-3 hours),
• exclude the use of common household items,
• wash hands often (to the sick and loved ones),
• exclude contact of the patient with children, because they are especially susceptible to angina.

It is especially important that the cotton-gauze bandage fits snugly to the face without leaving gaps, since purulent tonsillitis is transmitted mainly through the air (airborne droplets) and, a little less often, through unwashed hands and dishes.

How and how to treat purulent tonsillitis in adults?

Purulent tonsillitis before treatment is studied for signs inherent in a particular pathogen. It is necessary to fully collect an anamnesis (a set of signs and complaints), conduct a full diagnosis and find out the cause of the disease, since there are pathogens that require highly targeted antibiotics.

Before treating purulent tonsillitis in an adult, it is important to accurately determine the form of the disease and identify the pathogen. Most purulent tonsillitis are vulgar forms (follicular, lacunar or fibrinous), and doctors prescribe treatment aimed at eliminating the most likely cause - streptococcus. To do this, use broad-spectrum antibacterial agents, as a rule, the penicillin series.

Medical treatment

Medications for purulent tonsillitis:

• antibacterial (more on that below),
• antiseptics for gargling (furatsilin),
• antiseptics for mechanical cleaning of the tonsils from pus (Lugol),
• antipyretics (most often paracetamol),
• anti-inflammatory,
• painkillers (sprays, sucking tablets),
• antiviral drugs (for a viral infection).

Antibacterial therapy is perhaps the most important part of the treatment of most sore throats and is the exact answer to the question: "how to quickly cure purulent sore throat?". The most commonly used antibiotic for purulent sore throat is penicillin and its derivatives, since it accurately affects the common cause of the disease - streptococcal infection. But the uncontrolled use of antibiotics has led to the fact that penicillin-resistant strains of streptococcus are increasingly appearing (by the way, in Europe, antibiotics are not sold without a prescription).

With a reduced sensitivity of streptococcus to the entire penicillin series, or with allergic reactions to penicillin, antibacterial drugs from the group are selected:

• cephalosporins,
• macrolides,
• sulfonamides (very rarely, unless other groups of antibacterial agents cannot be used for one reason or another).

Only a doctor should decide which antibiotic to use and what to do with purulent sore throat. This is due to the very high toxicity of most drugs. Moreover, with an illiterate calculation of the dosage and duration of use, there is a risk of “educating” resistant strains of streptococcus or another microbe and, thereby, complicating treatment.

In order to enhance the effect of the antibiotic, the body needs to provide a more intense blood supply to the affected areas (throat) and good lymph flow. All this makes it possible to carry out, which, due to sound waves, provides a deep and directed increase in blood circulation in the throat area, as a result, the effectiveness of antibiotics and the body's resistance increases significantly.

What is the best way to gargle?

Before gargling with purulent sore throat, you should figure out why this procedure is necessary. Rinsing has two purposes:

1. Throat moisturizing. This provides softening and lubrication of the parched mucosa, which helps to relieve the pain of purulent sore throat.
2. Removal of pus and plaque from the mucous membrane of the tonsils.

In addition to these two goals, the task of suppressing the growth of bacteria (antiseptic) is usually added, but the main problem of angina is that all microorganisms are inside the tonsil, where the antiseptic cannot get, so rinsing with antiseptics will not give a serious effect.

Almost all possible solutions will fulfill these goals, for one simple reason: the basis of any solution is water, because it is it that allows you to remove pus and alleviate the course of purulent tonsillitis. So the best remedy for gargling - this is lightly salted water (1 teaspoon of salt per liter of water)

It happens that on the Internet it is suggested to use hydrogen peroxide for gargling with purulent sore throat, we do not recommend using this remedy for other purposes, you can study in more detail about the mechanisms of the effect of hydrogen peroxide on the human body

How to smear the throat with purulent sore throat?

In addition to rinsing, there are procedures for mechanical cleaning of the tonsils with Lugol. This antiseptic adjuvant kills microorganisms found only on the surface of the tonsils. Unfortunately, the antiseptic does not penetrate deep into the tissues, where the bulk of bacteria such as streptococcus is located, but, in general, lugol helps fight purulent tonsillitis.

It is important to know:

• Lugol should not be used more than twice a day, because in large quantities it can damage the mucosa of the esophagus and stomach;
• lugol is not desirable during pregnancy and lactation;
• Lugol is contraindicated in thyrotoxicosis and in case of allergy to it.

Inhalations

On the Internet, inhalations are actively promoted for any diseases of the upper respiratory tract, both steam and with the help of nebulizers. However, the effectiveness of inhalation with purulent sore throat is doubtful. From steam, you can get a burn of an already damaged mucous membrane, and through a nebulizer, inhalations are completely useless, since the bulk of the devices create too small particles that do not settle in the mouth and throat.

Consequences and complications

From a philistine point of view, angina - mild illness which should not be given much attention. Unfortunately, this simple pathology can create very complex health problems that can result in both systemic pathologies and local complications.

Systemic complications:

Can be expressed in the form of diseases of the kidneys, joints and heart. It would seem, where is the throat and where are the kidneys? But the fact is that proteins ( structural elements) the causative agent of angina, are similar in structure to the proteins that make up our heart, kidneys and joints.

Immunity, in this case, is the main culprit of complications. Every time it enters the body of bacteria, it triggers the synthesis of protective proteins (antibodies), which selectively attach to foreign substances (streptococcus proteins) in such a way that they lose all their properties (destroy).

An antibody is a substance (protein) with a simple chemical program to attach to a specific sequence of amino acids. The antibody does not distinguish its own from the foreign, therefore, while performing its functions, it attaches both to streptococcus and to the tissues of the joints, heart and kidneys. As a result, the destruction of both streptococcus and our cells occurs. This is manifested by myocarditis, nephritis or rheumatism.

Local complications:

The purulent process can spread from the tonsils to the surrounding tissues, which causes the following complications:

• Paratonsillitis. Purulent inflammation penetrates into the tissue surrounding the tonsil. Long-term antibiotic treatment is required.
• Retropharyngeal, parapharyngeal and other abscesses. The most severe complications are characterized by a massive accumulation of pus in a limited space near the pharynx. Surgical treatment.
• Phlegmonous tonsillitis (see the relevant section in the article).
• Phlegmons of various locations. Phlegmon is an infiltration (impregnation) of tissues with pus. An extremely serious complication that requires immediate surgical intervention and aggressive antibiotic therapy.

If you let the treatment take its course or “profess” a fundamental rejection of antibiotics, then just 9 days are enough and a sore throat can become deadly!

infectious

There are many varieties of infectious sore throats. In some cases, the defeat of the tonsils can be a primary disease, and in some cases, tonsillitis occurs against the background of systemic pathologies or as a result of weakening. Let's look at specific examples.

Mononucleosis

It occurs in the information space as monocytic, mononuclear, mononuclear angina. All this manifestation of such an infectious disease as mononucleosis, which is transmitted by airborne droplets or household contact, is characterized by damage to the system of mononuclear phagocytes (cells responsible for the destruction of the bacterial agent).

Causes

The reasons are not clear to this day. There are two theories, one bacterial (the role of the pathogen is attributed to B. monocytogenes homines), the other is viral (the pathogen is considered to be a special lymphotropic Epstein-Barr virus).

In any case, this disease is common, affecting the entire body with a primary lesion of the blood system. With mononucleosis, tonsillitis almost always joins, since the disease weakens the protective cells of the immune system. As a result, immunity is sharply reduced at strategically important points - the oral and nasal cavities, and streptococcus begins to multiply uncontrollably on the surface of the tonsils, causing a sore throat.

Symptoms

Clinical signs of this pathology are divided into three groups:

1. Fever:
   • elevated body temperature 39-40 ° C,
   • headache,
   • weakness.
2. Angina-like changes:
   • inflammatory changes in the pharynx and palatine tonsils,
   • significant enlargement of the palatine tonsils,
   • plaque on the tonsils resembles diphtheria,
   • possible development of purulent tonsillitis.
3. Blood changes (hematological signs):
   • the appearance in the blood of monocytes with a modified structure (60-80%),
   • increase in ESR.

Treatment

Mononucleosis angina carries many problems for medical science: there are no drugs that affect the etiological (causal) factor, because there is no proven theory about the causative agents of the disease. All treatment is reduced to symptomatic (elimination of consequences):

• antibiotic therapy in the development of purulent tonsillitis, but if there is no pus - antibiotics are not needed;
• gargling with antiseptics;
• physiotherapy procedures, including vibroacoustic therapy using the apparatus "";
• hormone therapy, to relieve severe inflammation.

Viral angina

Viruses are common cause angina, including bacterial ones. Almost always, they strongly suppress local immunity in the throat and open the way for the attachment of a secondary infection in the form of streptococcus.

Viral tonsillitis can also be a consequence of a general disease of the body, for example, very often tonsillitis develops with Measles or HIV infection.

Measles

Measles is an acute contagious (contagious) infectious disease characterized by intoxication, skin rash, inflammation of the mucous membranes of the respiratory tract and the lymphoid pharyngeal ring (tonsils). It is transmitted by airborne droplets.

One of the frequent manifestations of measles is measles tonsillitis, which can proceed easily with a slight reddening of the tonsils, but sometimes streptococcus joins and the tonsillitis becomes purulent.

Causes

By airborne droplets through the mucous membranes of the respiratory tract and eyes, an infectious agent from the paramyxovirus family enters the body.

The measles virus causes T-cell immunodeficiency (decreased immunity) that persists for 30 days. Against this background, almost any infection (including streptococcus) can join, therefore measles is often accompanied by purulent tonsillitis, the incubation period of measles lasts 9-14 days (the time of virus reproduction without external manifestations of the disease).

Symptoms

At the onset of the disease are characteristic:

• lethargy, headache;
• swelling of the face, eyelids;
• tearing from the eyes;
• photophobia;
• nasal congestion;
• cough;
• increase in body temperature up to 39 ° C.

For 2-3 days:

• small red spots appear on the soft palate;
• small dot spots appear on the mucous membrane of the cheeks; resembling semolina (Filatov-Koplik symptom), they persist for 1-3 days and then disappear during the appearance of a rash on the skin.

For 4-5 days:

• a rash appears, first on the face and neck, and during the day spreads to the body;
• at this time may appear measles sore throat:
• enlargement and redness of the tonsils,
• the presence of purulent plugs or purulent easily removable plaque,
• pain when swallowing;

On the 8-10th day, the disease subsides, the rash turns pale, cough and tonsillitis (if any) disappear.

Treatment

Means acting directly on the measles virus does not yet exist, therefore, treatment is mainly symptomatic (relieving symptoms), aimed at preventing complications and the addition of secondary infections. Treatment with antibiotics before bacterial infection occurs is not required.

Many doctors, including Dr. E.O. Komarovsky advises to start treating such a disease as purulent tonsillitis with measles by creating the right microclimatic conditions: cool (18-20 ° C), humid (50-70%), clean (ventilation) air.

• antibiotic therapy aimed at eliminating a secondary infection (streptococcus),
• bed rest,
• plentiful warm drink,
• rinsing the mouth and throat with a solution of salt (1 teaspoon per liter of water) or furacilin.

With HIV infection

Frequent manifestations of HIV infection are pathologies of the upper respiratory tract and infections of the external mucous membranes (eyes, mouth and nose).

Due to defeat immune system(human immunodeficiency virus), angina is most likely to be caused by a bacterium from the normal microflora of the oral cavity (streptococcus). And it will manifest itself in the form of symptoms characteristic of purulent tonsillitis in the form of follicular, lacunar, fibrinous, etc. (see the corresponding section).

Herpangina (herpangina)

With herpetic, herpes and herpangina, the situation is very confusing. In view of the similarity of symptoms (vesicles or papules), similar names have historically developed, but the causative agents can be completely different viruses. Many medical schools also vary in name, with the Internet adding fuel to the fire in the form of many incompetent articles on the topic of viral sore throats.

In order not to completely get confused, we will consider separately:

1. Herpangina (herpangina).
2. Herpes sore throat.
3. Infection of the pharynx with the herpes zoster virus.

Causes

Pathogen herpetic sore throat(herpangina) is Coxsackie enterovirus (enteroviral angina). It is so named after the city of Coxsackie (USA), in which there was a hospital with examined children. The American virologists G. Doldorf and G. Sickles working there in 1948 described the properties of the new virus for the first time.

Symptoms

Since there are several types of the Coxsackie virus, the symptoms may differ in different cases. The main signs that cause suspicion of herpetic sore throat are:

• sudden onset with an increase in body temperature up to 39-40 ° C;
• after 2-3 days, the temperature also drops sharply;
• on the 1-2 day of illness in the area of ​​​​the tonsils, arches, uvula and palate, characteristic small papules (bulges) 1-2 mm in size appear, then turn into vesicles;
• on day 2-3, the bubbles burst, leaving behind erosion covered with a grayish-white coating;
• the appearance of bubbles is accompanied by pain when swallowing, and profuse salivation;
• enlarged cervical lymph nodes;
• for 5-7 days in most patients, all changes in the throat disappear.

The final diagnosis can be made only with a virological study, which in most cases is not done.

Treatment

If herpetic sore throat is not complicated, then treatment is practically not required, it all comes down to alleviating the condition and reducing the risk of complications:

• bed rest,
• physiotherapy » (acceleration of recovery and reduction of the risk of complications),
• plentiful drink,
• antipyretic (at a long-term high temperature of 39 ° C),
• vitamin therapy (effervescent vitamin C),
• providing cool (18-20°C), humid (50-70%), clean indoor air,
• antibiotics are not needed (if there are no complications).

Herpetic angina, says doctor E.O. Komarovsky, not such a terrible disease as mothers imagine, is described in more detail in the video:

herpes sore throat

In some textbooks on otorhinolaryngology, such a form as herpes sore throat is distinguished, the causative agent of which is the Herpes buccopharyndealis virus. A microorganism of the same class as Herpes simplex, however, is several times more toxic to living beings.

Symptoms

The salient features are:

• a sharp and stormy onset with an increase in body temperature even up to 41 ° C;
• severe pain when swallowing;
• violation of the swallowing process (the food bolus does not leave well);
• on the 3rd day of the disease: the entire mucous membrane of the pharynx is evenly hyperemic (red); an accumulation of small rounded white vesicles appears in the region of the tonsils and pharynx;
• over the next 3 weeks, the bubbles burst, ulcerate and suppurate, but this process may not be;
• herpetic eruptions appear on the mucous membrane of the cheeks, lips, and even on the skin of the face.

Treatment

Mostly symptomatic (relieving condition):

• gargling with saline solution (1 teaspoon of salt per 1 liter of water),
• plentiful drink,
• antiviral drugs (such as acyclovir),
• if a secondary infection joins, then broad-spectrum antibiotics are prescribed,
• antibiotics are not needed (if there are no complications),
• physiotherapy is used to improve local immunity and speed up the healing process.

Throat infection with herpes zoster virus

Usually the virus spreads along the course of the intercostal nerves, but the trigeminal nerve is also affected, which is in particular responsible for the functions of the oropharynx.

Symptoms:

The salient features are:

• the occurrence of pathology in adults and the elderly, in contrast to herpetic sore throat, which affects mainly children;
• vesicles (vesicles) appear on one side of the affected nerve;
• pain when swallowing gives to the eye from the side of the affected nerve.

Treatment:

As with most viral infections, it is mostly symptomatic:

• antiviral drugs,
• antibiotics are prescribed only if a secondary infection joins,
• rinsing with a solution of salt (1 teaspoon per 1 liter of water) or furacilin,
• symptomatic treatment (anti-inflammatory, painkillers, etc.),
• (locally enhances immune protection in the throat area and contributes to a general increase in immunity).

bacterial

Bacterial tonsillitis is an infectious lesion of the palatine tonsils by various kinds of bacteria, usually streptococcus. It manifests itself in the form of a follicular, lacunar or fibrinous form with all the symptoms and signs characteristic of them (see the relevant sections above).

Different infectious agents (bacteria) have some similar symptoms and complaints, but there are also characteristic differences, which we will consider further.

Streptococcal angina

The main part of bacterial tonsillitis is streptococcal tonsillitis, while this term in official medicine does not exist. The fact is that the causative agent of most types of tonsillitis is streptococcus (various strains of group A beta-hemolytic streptococcus), so this name does not reflect the main characteristics of the disease.

Most often, streptococcal angina manifests itself in the form of the main forms of the disease (disassembled at the beginning of the article) is:

• catarrhal
• follicular,
• lacunar,
• fibrinous,
• phlegmonous.

And also a streptococcal infection can join any sore throat:

• viral,
• fungal,
• ulcerative necrotic,
• mononucleosis, etc.

Streptococcal angina is characterized by the following symptoms:

• body temperature may vary depending on the severity of the disease (38-40 ° C),
• tonsils enlarge and turn red, may be covered with a film, purulent plaque or purulent plugs,
• lymph nodes in the neck may be enlarged to varying degrees,
• sore throat during meals, and in severe cases even at rest.

scarlet fever

Many mothers know firsthand about such a disease as scarlet fever. Against the background of it, angina almost always occurs. various forms(catarrhal, follicular or lacunar)

Scarlet fever is an acute infectious disease characterized by angina, punctate rash and a tendency to purulent processes on the skin.

Causes

There are many different strains of streptococcus, and only a few of them are particularly toxic and produce erythrotoxin, which causes certain symptoms (more on them later).

The causative agent is transmitted by airborne droplets from patients. After an infection enters the body, it can take from 1 to 12 days before the first symptoms appear (incubation period).

Symptoms

Scarlatinal tonsillitis begins abruptly, with an increase in body temperature to 39 ° C and a sore throat, then the following symptoms appear:

• after a few hours, a small-dotted rash occurs almost throughout the body (reaction to erythrotoxin);
• the general skin tone becomes reddish;
• the skin feels like sandpaper to the touch;
• the tongue becomes crimson with sharply enlarged papillae;
• bright hyperemia of the pharynx and tonsils;
• purulent plaque or plugs on the tonsils.

Treatment

It is extremely important to prescribe antibiotics of the penicillin series first of all, and in a day there will be a noticeable improvement.

The key point is that when treated with antibiotics, in 99% of cases, scarlet fever ends in recovery, and without them, complications almost always occur in the form of rheumatism, heart or kidney damage.

Complementary treatment is:

• bed rest,
• plentiful warm drink,
• gargling with salt water (1 teaspoon per liter of warm water),
• physiotherapy " » it is prescribed together with antibiotics, as it significantly enhances their effectiveness, as well as the body's immune response.

It is advisable to limit contact with the patient during treatment, do not use common utensils, wear cotton-gauze bandages when communicating. After recovery, to avoid re-infections it is advisable to limit the child's social contact for 2 weeks.

diphtheria

Diphtheria is an acute infectious disease manifested by damage to the oropharynx with the formation of fibrinous plaque on the tonsils and possible defeat cardiovascular and nervous systems. The cause is the causative agent diphtheria bacillus(Bacillus Loeffler). It is transmitted by airborne and household routes, the incubation period is from 2 to 10 days. There are diphtheria of the skin, eyes, genital organs, nasopharynx and oropharynx (diphtheritic angina).

Symptoms

In 70-80% of cases, the course of the disease is very similar to a common sore throat.

• It begins acutely with a rise in temperature, usually it is lower than with angina, but the patient's condition is felt as more severe.
• From the first hours, a sore throat begins to bother, and on the second day it becomes very pronounced.
• Enlargement of the cervical nodes.
• There are signs of intoxication (headache, weakness, chills).
• There is a sweetish bad breath.
• Despite the fever, the skin of the face is pale, which is not typical for ordinary sore throats, in which a slight blush appears on the cheeks.
• Swelling and redness of the tonsils are characteristic.
• Grayish-white plaques appear on the tonsils, which may look like islands or completely cover the tonsils and even spread beyond them to the oral mucosa.
• An important distinguishing feature is the characteristics of plaque. They are difficult to remove with a spatula and, after removal, are re-formed in the same place. The removed fibrinous film is thick and dense, does not rub and does not dissolve in water, sinks quickly.

Treatment

If diphtheria is suspected, urgent hospitalization in the infectious diseases department is necessary.

The clinic produces:

• treatment with anti-diphtheria antitoxic serum, which is especially effective in the early stages of the disease;
• antibiotics are prescribed to prevent complications
• apply, if necessary, symptomatic (relieving the condition) means: antipyretics, antihistamines, painkillers.

After the cure, it is necessary to conduct a three-fold analysis of the mucus from the nose and throat for the absence of the pathogen, and after that the patient can be considered non-infectious.

Staphylococcal

Staphylococcal tonsillitis is a purulent inflammation of the mucous membrane of the palatine tonsils as a result of their defeat by Staphylococcus aureus.

Symptoms

The manifestations of the disease are not specific, it is extremely difficult to see staphylococcal in the usual purulent tonsillitis:

• high body temperature 39°C;
• intoxication is strongly pronounced (headache, weakness, chills);
• unbearable pain when swallowing;
• purulent plaque on the tonsils, which is easily removed with a spatula;
• enlarged and painful when probing the cervical lymph nodes,
• the course of the disease is usually more severe than with streptococcal infection;
• weak effect of broad-spectrum antibacterial drugs.

Treatment

Bacterial staphylococcal angina is more difficult to treat than streptococcal. Basic treatment with broad-spectrum antibiotics may not work. Therefore, in order to select the most effective treatment, it is necessary to conduct a bacteriological study, as well as to study the sensitivity of the strain to specific drugs.

Along with the start of antibiotics, auxiliary treatment is prescribed:

• physiotherapy with help, enhance the effect of antibiotics and the functioning of the immune system,
• bed rest,
• plentiful drink,
• gargling with a solution of salt (1 teaspoon per 1 liter of water) or furatsilina.

Ulcerative membranous (necrotic)

Doctors call this pathology Simanovsky-Plaut-Vincent's angina.

Ulcerative necrotic angina is a characteristic lesion of one palatine tonsil in the form of the appearance of areas of necrosis (death) of the mucous membrane of the tonsil and the formation of ulcers. The causative agents are fusiform bacillus and oral spirochete. It is quite rare and occurs against the background of a decrease in general and local.

Symptoms

• It is characteristic that such a sore throat is one-sided, pathological processes occur only on one tonsil.
• On the side of the same name, the cervical lymph nodes are enlarged.
• The patient complains only about the sensation of a foreign body when swallowing.
• There is often a putrid odor from the mouth.
• Body temperature is normal in most cases.
• The duration of the disease is from 1 to 3 weeks (sometimes months).
• On the surface of the affected tonsil, grayish-yellow or greenish masses, after removal of which an ulcer is found.

To make a final diagnosis of Simanovsky-Plaut-Vincent's angina, it is necessary to conduct a histological examination of a biopsy specimen from an ulcer (a piece of tissue).

Treatment

• Antibacterial therapy with penicillin drugs.
• Complete sanitation (cleansing) of all possible foci of infection in the oral cavity is necessary.
• Mechanical cleansing of ulcers on the tonsil from necrosis and treatment with an antiseptic.
• Professor Palchun V.T. notes that the fight against beriberi (complex vitamins) and the restoration of immunity () are urgently needed.

syphilitic

This disease develops against the background of the defeat of pale treponema. As a rule, the main pathological processes occur at the site of entry of the pathogen into the human body, if the mouth is the gate, then it is very likely that syphilis will manifest itself in an anginal form.

Symptoms

• Unilateral prolonged inflammation of the tonsils (more than 10 days).
• An increase in body temperature up to 38 ° C.
• Enlarged painless cervical lymph nodes.
• Moderate pain when swallowing.
• A primary chancre (painless ulceration) appears in the pharynx.

In general, the symptoms are not specific and it is difficult to clearly identify syphilitic tonsillitis from them, so such a diagnosis can only be made after a laboratory test.

Treatment

Syphilitic tonsillitis is treated only in the dermatovenerological department with antibacterial drugs and auxiliary procedures.

Fungal angina

Fungal angina - inflammation of the mucous membrane of the palatine tonsils, caused by various kinds infectious fungi. There are several types of pathology, the most common of them is candidal tonsillitis, the causative agent of which are fungi of the genus Candida.

Symptoms

Fungal tonsillitis, as a rule, proceeds without temperature or with a slight increase. The following signs are also characteristic:

• There are practically no signs of intoxication (headache, weakness, chills), or they are weakly expressed.
• Soreness and soreness in the throat when swallowing.
• Sensation of incomplete swallowing of food.
• Hyperemia (redness) of the mucous membrane of the tonsils.
• Islands (specks) of curdled masses on the surface of the tonsils, the back wall of the pharynx and the root of the tongue.
• In a smear under a microscope, yeast-like clusters of cells are visible.
• The course is long, often in the form of a chronic pathology.

Treatment

Often, fungal tonsillitis occurs against the background of the usual or after it. If a course of antibiotic treatment is prescribed, then it must be stopped and prescribed:

1. antimycotics:
   • ingestion of medications active ingredients: fluconazole, ketoconazole others;
   • locally lubricate the affected areas with a solution or ointment with active ingredients: natamycin, terbinafine, etc.
2. physiotherapy, which will significantly enhance the effect of antimycotic drugs and natural human immunity.

laryngeal

Laryngeal angina is a disease of the pharynx, characterized by damage to the lymphoid tissue near the larynx (part of the respiratory tract, located below the pharynx). It differs from laryngitis in the depth of inflammation and the predominant lesion of lymphoid tissue. Laryngitis, unlike laryngeal tonsillitis, is characterized by inflammation of only the mucous membrane of the larynx.

Causes

The reasons why such angina occurs:

• reduced immunity after viral infections (flu, measles, etc.)
• as a complication of common angina,
• as a complication of peripharyngeal phlegmon,
• as a complication of laryngitis (inflammation of the mucous membrane of the larynx).

To understand the difference between ordinary angina and laryngeal, let's look at the illustration:

The figure shows that the larynx is located below and is the entrance to the respiratory system of the body, which immediately leads to concerns about the possibility of swelling of this department, with all the ensuing consequences - difficulty breathing. This arrangement creates another problem - the inability to see pathological changes during a normal examination of the throat (look at the location in the figure).

Symptoms

Laryngeal angina is a diagnosis that only a doctor can make. Symptoms can only indirectly indicate the possibility of this pathology:

• Hoarseness (or any change in the sound of the voice). The larynx is the organ that allows us to produce sounds, so damage to the larynx is almost always accompanied by problems with the voice, up to the inability to pronounce any sound (aphonia).
• Dryness, itching and sensation of a foreign body in the throat.
• Pain when swallowing.
• Elevated body temperature up to 39°C.
• Enlarged cervical lymph nodes.
• History of laryngitis (in the history of a person's disease).
• In severe cases, respiratory failure, shortness of breath.

These symptoms direct the doctor's thoughts towards laryngeal angina, while all of them can be with ordinary follicular angina (see details in the corresponding section above). Therefore, additional instrumental research in the ENT office. Usually, for this, the doctor performs manipulations with a mirror (indirect laryngoscopy) or with a laryngoscope (a special tube for examining the larynx).

Treatment

The decision to treat laryngeal tonsillitis can be difficult to make in favor of home conditions. The main problem is the potential risk of laryngeal edema (direct entry into the respiratory tract), the consequences of such edema can even be fatal. Therefore, with such a sore throat, it would be quite reasonable to protect yourself and decide on hospitalization for several days.

The main methods of treatment of laryngeal angina:

• antibacterial therapy (penicillin series, cephalosporins, macrolides);
• antihistamines to reduce the risk of swelling;
• with edema diuretics;
• hormone therapy (corticosteroids), to reduce the risk of severe swelling;
• antipyretic, at a high temperature of more than 39 ° C,
• bed rest,
• sparing mode of communication (once again do not talk),

Recovery from laryngeal angina can last from 14 to 20 days. The disease is serious and with untimely and unprofessional treatment can turn into the following consequences:

• the transition of inflammation to the deep layers of tissue (muscles, fiber, and even to the epiglottal cartilage);
• purulent complications in the form of abscesses (accumulations of pus limited to the capsule) or phlegmon (impregnation of tissues with pus);
• narrowing of the entrance to the respiratory system (stenosis of the larynx), with the risk of complete obstruction of the airways and death from suffocation.

Stomatitis

Stomatitis is an inflammation of the oral mucosa. Probably, various microorganisms (bacteria, viruses, fungi) can serve as the reasons, and in some cases it is a manifestation of an allergic reaction to a product. Until now, this pathology has not been fully studied, especially, difficulties arise in identifying the causes.

Stomatitis sore throat occurs as a consequence or complication of prolonged stomatitis, which greatly weakens local immunity, as a result, control over the reproduction of streptococcus in the oral cavity is lost and tonsils are damaged.

Symptoms

Stomatitis angina is characterized by all the symptoms inherent in bacterial angina (follicular, lacunar, fibrinous):

• elevated body temperature,
• intoxication (headache, weakness, chills)
• pain when swallowing
• enlarged cervical lymph nodes
• redness of the mucous membrane of the tonsils,
• purulent plugs or plaque on the surface of the tonsils.

Treatment

Stomatitis angina, first of all, requires antibiotic therapy to suppress and contain the growth of all pathogenic and opportunistic microorganisms that enter the oral cavity.

But this is a treatment for the consequences of stomatitis, antibiotics may not have an effect on the root cause.

With stomatitis, local immunity in the oral cavity is significantly reduced, therefore, together with antibiotic therapy, it is necessary to prescribe, which will strengthen immunity and increase the effectiveness of drugs.

For a complete treatment, full examination in a medical institution.

allergic

Allergic angina is not an independent disease, it is a manifestation of the general pathology of the body - allergies.

As a result of exposure to an allergen (food or pollen), an allergic reaction occurs in the form of:

• hyperemia (redness) of the tonsils and pharynx,
• swelling of the tonsils and pharynx,
• may be accompanied
• there is no fever and signs of intoxication.

Treatment

• Allergen detection.
• Exclusion of contact with the allergen.
• If necessary, antiallergic drugs (antihistamines).
• helps to reduce allergic reactivity.

Chronic

All of the above types of angina mainly occur in an acute form, that is, they quickly arise, last no more than one month and eventually end in recovery.

Chronic tonsillitis is a long-term (more than 1 month) inflammation of the mucous membrane of the tonsils, which does not end in complete recovery and is accompanied by periodic exacerbations.

Treatment of chronic angina, depending on the causes, severity and variety, is:

1. Medication (most often antibacterial),
2. Surgical:
   • tonsil removal,
   • sanitation of foci of infection in the tonsils (partial removal),
3. Physiotherapy:
   • laser therapy,
   • quartzization,
   • (actually produced in conjunction with antibiotic therapy and after surgical treatment).

Conclusion

Summing up all the sore throats, we can draw several important conclusions:

1. Angina is not a mild cold that can be carried on the feet.
2. With a raid on the tonsils, severe pain with swallowing and high body temperature (38-39 ° C), it is vital to visit a doctor.
3. Angina can give severe complications to the heart, kidneys or joints that occur when ignoring the doctor's instructions about antibiotic therapy.
4. Angina in most cases is very well treated with broad-spectrum antibiotics. Relief occurs on the second day.
5. Together with antibiotic therapy, physiotherapy is performed to improve lymphatic drainage and blood circulation. In addition to the obvious physical effect of vibroacoustic therapy, there is also a hidden biochemical effect that cannot be felt immediately. It consists in saturating our body. It is present in our body continuously, and is necessary for the implementation of immune processes, protein biosynthesis (metabolism - metabolism), cleaning and tissue regeneration. During an illness in the body, the need for microvibrations of tissues increases, which can be filled by the only medical one that currently exists.
6. For bacterial sore throats, no amount of rinsing, lubrication, inhalation or sucking of tablets will replace antibiotics.
7. Not all sore throats require antibiotics for treatment, be careful and do not take them unnecessarily.

Bibliography:

1. Babiyak V.I. Clinical otorhinolaryngology: A guide for physicians. - St. Petersburg: Hippocrates, 2005
2. Ovchinnikov Yu.M., Gamov V.P. Diseases of the nose, pharynx, larynx and ear. Textbook. - M.: Medicine, 2003
3. Palchun V.T., Magomedov M.M., Luchikhin L.A. Otorhinolaryngology. - M.: GEOTAR-Media, 2011
4. Berezov T.T., Korovkin B.F. Biological chemistry: Textbook. - M.: Medicine, 1998
5. Novitsky V.V., Goldberg E.D., Urazova O.I. Pathophysiology: textbook. - M.: GEOTAR-Media, 2009
6. Fedorov V.A., Kovelenov F.Yu., Kovlen D.V., Ryabchuk F.N., Vasiliev A.E. body resources. Immunity, health and longevity. - St. Petersburg: Vita Nova, 2004
7. Semenov V.M. Guide to infectious diseases - M.: MIA, 2008

You can ask questions (below) on the topic of the article and we will try to answer them competently!

Many are familiar with such a disease as tonsillitis, but most people do not know why this ailment occurs. It is important to understand that angina is an acute respiratory disease, namely, an infectious process in the tonsils, which is provoked by various pathogenic microbes and is transmitted from a sick person to a healthy one. In medicine, the disease is also known under another term - acute tonsillitis.

It is microbes and viruses that cause disease, and not walking in the cold without a hat or eating ice cream on a hot day. The causative agent of angina (bacteria or virus) begins to multiply actively at a time when a person's immunity is weakened. And this can occur against the background of hypothermia, beriberi, the presence of other acute infections in the patient, physical and mental overwork, psycho-emotional stress, etc.

The causes of the pathological process lie in the ingestion of bacteria that cause angina (most often it is streptococcus, less often Staphylococcus aureus and pneumococcus) in the throat of a person when communicating with a patient or in close contact with his things. Streptococci are normally present in the microflora of the pharynx, however, under the influence of an unfavorable factor, their number begins to grow uncontrollably, which causes tonsillitis.

Regular irritation of the mucous membrane of the pharynx with smoke, dust, alcohol can act as a cause of angina in adults. The presence of pathologies of the nasopharynx in a person, which cause disturbances in nasal breathing, can also become a cause for angina.

A sick person, in order to avoid the spread of infection, should, if possible, be isolated from other people until complete recovery, since acute tonsillitis is a very contagious disease. Dishes from which the patient eats and drinks should not be used by healthy people in order to reduce the risk of the spread of pathology.

The causes of frequent attacks of the disease can still be associated with purulent inflammation in the nasal, oral cavity and maxillary sinuses. Consider how to recognize a sore throat among all kinds of respiratory diseases by a number of signs and how to deal with this disease.

Symptoms of the pathological process

Symptoms and treatment of angina are interrelated things, because it is the symptoms of pathology that largely determine the characteristics of therapy. The first symptoms of angina develop after 10 hours - 3 days incubation period. Acute tonsillitis can be divided into several varieties, and each will have 1-2 characteristic symptoms. But all types of this pathology are united by a common symptom - a difficult act of swallowing due to severe pain. This is due to the inflammatory process in the tonsils, which, in some types of illness, can be covered with white bloom or numerous ulcers.

Symptoms of angina in an adult always include an elevated body temperature in the region of 38-40ºС. It is clear that against this background, the general well-being of the patient deteriorates sharply, he develops migraines.

To have the right idea of ​​how to treat angina quickly and effectively, it is important to understand that this process is not local. This acute respiratory disease greatly affects the work and condition of the whole organism, and therefore the effective treatment of the disease should be comprehensive. To fully recover and avoid the occurrence of severe complications, the patient needs strict bed rest and correct treatment.

Pathogenic microorganisms, living and multiplying in the pharynx and larynx, release waste products in the form of toxins into the external environment for them. These substances are carried with the bloodstream throughout the body, resulting in serious damage to parts of the nervous and cardiovascular systems.

Knowing how the disease manifests itself, at the first alarming symptoms, you should consult a doctor (therapist, otolaryngologist or infectious disease specialist). He, after listening to the patient's complaints and conducting an initial examination, should send the patient for blood and urine tests to confirm or refute the diagnosis of "acute tonsillitis". If the patient's body temperature returned to normal, the pain in the throat disappeared when swallowing, that is, the first signs of angina in adults disappeared, does not mean that the person has fully recovered from a serious infectious disease. Acute tonsillitis affects not only the tonsils. In addition to them, inflammation can spread to the tissues of the larynx. Acute or severe sore throat usually lasts about 7 days.

To obtain a holistic clinical picture, it is necessary to conduct additional tests: pharyngoscopy, studies of mucus bakposev from the surface of the pharynx and tonsils. They are necessary to make sure that the chosen therapy is correct.

Different types of illness

An important point in diagnosing the type of disease is to determine what pathogen it is caused by - a bacterium or a virus? It depends on how to treat angina in adults in a particular case. There are a number of signs that allow you to conditionally determine bacterial tonsillitis:

• there is a light coating on the mucous membrane of the tonsils;
• there is an increase and soreness of the submandibular lymph nodes;
• body temperature exceeds 38ºС;
• the patient has practically no cough;
• more common in adolescents than adults.

If the signs of angina coincide with at least three of the above, then the probability that the disease is of a bacterial nature is 50%. If 1 or 2 points are present in the clinical manifestations, the pathological process is most likely caused by a non-bacterial microorganism.

There is a classification of the disease according to the nature and intensity of the lesion of the tonsils. According to her, doctors distinguish 4 types of pathology:

The catarrhal form, which is also called acute pharyngitis, is considered the easiest. There is damage to the superficial tissues of the tonsils. In most cases, the disease proceeds in 3-4 days, while the symptoms of angina in adults disappear one day after the acute period. In the catarrhal form of the pathology, the patient has a slight increase in temperature up to 37.5ºС, while a slight chill is felt. Migraines, aching pains in the joints, enlargement and redness of the tonsils are possible. Intoxication is expressed poorly. When analyzing blood, slight changes from the norm are noted.

The lacunar type of the disease is characterized by a more vivid clinical picture. Beginning inflammatory process proceeds with a high temperature (39-40ºС). Intoxication of the body is pronounced, because the patient feels severe weakness, acute pain in the heart, muscles and joints. When examining the pharynx, the doctor can observe the formation of a light plaque on the tonsils and in the recesses next to them - lacunae. In this case, plaque can be easily removed with a spatula. This type of disease lasts longer - 4-5 days. When analyzing blood, you can see a shift in the leukocyte formula with an increased ESR. In urine, amino acid residues, red blood cells are found.

How to determine angina follicular type? Quite simply: purulent follicles will begin to appear on the enlarged inflamed tonsils. They look like bright formations the size of a match head. Opening, the follicles form a purulent plaque that does not go beyond the borders of the tonsils. With a follicular course, the following signs of angina in an adult are noted: an increase and redness of the tonsils, swelling of the submandibular lymph nodes. In many ways, the symptoms of follicular acute tonsillitis are similar to those of the lacunar form of the disease.

The necrotic variety of the disease is considered the most severe, since it is very difficult to quickly get rid of its vivid clinical manifestations. It is characterized by the severity of fever, clouding of consciousness, vomiting. Sore throat begins as standard - with a sore throat and fever. Tonsils are coated with a patchy texture of gray or green hues. When you try to remove plaque, bleeding may occur.

There is another classification of pathology, according to which they distinguish:

1. Primary angina, appears as an independent disease, its symptoms are associated mainly with the defeat of the pharyngeal ring.
2. Secondary sore throat, which can begin, as another infectious process in the body is treated for a long time.
3. A specific type of disease that was triggered by a fungal infection or spirochete.

In young children, pathologies can often appear, the causative agent of which are the Echo and Coxsackie viruses. This form of the disease will begin quickly, immediately with elevated temperature around 38-40ºС. The child may be disturbed by pain not only in the throat, but also in the abdomen. This variety of acute tonsillitis got its name due to its external similarity with the manifestations of herpes: small red bubbles appear on the mucous membranes of the tonsils, palate, and posterior pharyngeal wall. If your child has developed what to do? First of all, call the doctor at home. After a few days, the rash disappears, and the inner surface of the throat returns to normal.

Complications caused by the disease

Treatment of angina is a very crucial moment, since with incorrect therapy, pathology can give serious complications to many organs and systems. Undesirable consequences of the disease are usually divided into general and local.

As a disease, angina can provoke such general complications:

• development of rheumatism;
• pathological processes in the kidneys that can cause kidney failure;
• the transition of the infectious process to the organs of the chest;
• development of meningitis;
• infectious-toxic shock caused by poisoning of the body with toxins that are secreted by microbes;
• diseases of the digestive system, which can be manifested by appendicitis;
• sepsis is when an infection enters the bloodstream and spreads throughout the body.

Also, angina in adults, if it is treated incorrectly, can lead to local complications:

• development of an abscess of adjacent soft tissues;
• the formation of phlegmon (extensive accumulation of purulent mass);
• ear infection;
• swelling of the larynx;
• bleeding of the tonsils.

In order to avoid the above health problems, at the first symptoms of pathology, it is necessary to seek help from a qualified specialist who knows what a sore throat is and how to treat it.

General treatment regimen

Accurate adherence to the course of treatment prescribed by a qualified doctor will lead to the speedy complete recovery of the patient without possible complications.

Treatment of acute tonsillitis is highly discouraged when the patient is highly active. In order for the body to quickly restore strength to fight the disease, the patient must observe strict bed rest, isolating as much as possible from healthy people. How much angina is treated depends on the general condition of the patient, his age, the severity of the pathology and other factors.

First aid for acute tonsillitis

First aid can be provided before the arrival of the doctor. It lies in the frequent inflamed throat. In no case should you carry out warming procedures for the throat in the form of compresses, inhalations and rubbing. If you do not know exactly what to do with angina, wait for qualified medical help.

Gargling with warm helps to treat the throat, which has an antibacterial effect and reduces swelling of the throat. Even with sore throat, decoctions of chamomile flowers and sage for gargling can help. But before treating the disease with decoctions based on plants, you need to make sure that the patient does not have an allergic reaction to them.

Since it is necessary to treat angina under the condition of the patient, it may be necessary to take an antipyretic. If the need arises, first aid can be provided in the form of 1 antipyretic tablet before meals. In an adult, the temperature above 38.5ºС must be artificially reduced.

With angina, the symptoms subside due to absorbable tablets with menthol-based preparations. Instead, you can use special aerosols. Their use contributes to the removal of pain syndrome, which is subject to the throat with angina.

Features of the diet during treatment

Since it is possible to get rid of the disease only in a complex way, the patient must have a special diet. Doctors advise sticking to a diet rich in dairy products and plant foods. Because it is necessary to treat a sore throat in an adult with a decrease in body temperature to a normal level, the patient needs to drink plenty of fluids. This helps to remove toxins from the body and restore water balance. Berry fruit drinks, tea with lemon, rosehip broth, freshly squeezed juices and mineral water help to cure. It is impossible to take food and liquids very hot or cold, since it is necessary to properly treat a sore throat with the use of food and drink at room temperature.

Medications

With bacterial angina in adults, therapy provides for the mandatory use antimicrobials. However, an independent choice of drugs by the patient can only harm the body, because angina can only be cured with a specific pathogen. How many days, in what way, and what dosage of the medicine should be taken, the attending physician prescribes.

Medicines are prescribed to the patient, depending on what symptoms he has. In the case of severe pain, he needs to take anesthetics.

Remember that it is impossible to cure a sore throat in 1 day. In such a short period of time, it is possible to only partially or completely remove the symptoms of pathology. Even after the onset of significant relief, the patient is highly discouraged from immediately returning to an active life, because his immunity is very susceptible to various kinds of pathogens. How many days the full course of treatment will take will be shown by repeated blood and urine tests.

There is a radical way to get rid of a sore throat forever - an operation to remove the palatine tonsils in childhood. But this method has both pros and cons that need to be discussed with experts. It is better not to think about how to quickly cure a sore throat, to prevent this disease, maintaining immunity at the proper level.

Angina is a fairly common infectious disease caused by bacteria, viruses or fungi, a characteristic feature of which is the defeat of the palatine tonsils. Also, the inflammatory process can develop in the nasopharyngeal, laryngeal and lingual tonsils; then sore throat, respectively, will be nasopharyngeal, laryngeal or lingual. Infection happens both with one's own microbes and from outside and occurs in two ways: food and airborne droplets. However, most often internal infection occurs from the pharynx or oral cavity (carious teeth, chronic inflammation of the palatine tonsils, etc.)

Angina causes

In most cases, angina is caused by streptococci, staphylococci or pneumococci, which mainly fall into the throat from household items (dirty dishes, etc.), which were previously used by a person with a sore throat. Also, the occurrence of this disease can be facilitated by all kinds of irritating substances that systematically enter the throat (dust, smoke, etc.) and the presence of diseases of the nasopharynx (adenoids, etc.), in which nasal breathing is impaired. Purulent inflammatory processes that take place in the nasal cavity, its paranasal sinuses (sinusitis, etc.) and the oral cavity (carious teeth) also quite often lead to the occurrence of tonsillitis.

Predisposing factors for the occurrence of angina are general or local hypothermia, mental stress, overwork, past infectious diseases, sensitization of the body, beriberi

Angina symptoms

- Acute pain in the throat when eating and swallowing

- Weakness and general malaise

- Enlarged lymph nodes

- Pain in the joints

– Increase in body temperature up to 38*-39*С

- The soft palate, tonsils, uvula and palatine arches in the first days of the development of the disease are painted bright red

- Directly on the tonsils there may be pustules, or small areas of accumulation of pus

The duration of the incubation period is from ten hours to three days. The disease always begins acutely: chills occur, the general body temperature rises, characteristic pains appear when swallowing, become painful and regional lymph nodes increase.

The main symptoms of a sore throat are quite similar to the symptoms of a common cold, however, with sore throat, the sore throat is much sharper, lasts longer and is much more difficult to tolerate.

Types of sore throat

Angina can be primary, secondary and specific.

Primary. An acute inflammatory disease in which only the lymphadenoid ring of the pharynx is affected.

Secondary. Tonsils are affected due to acute infectious diseases (diphtheria mononucleosis, diphtheria, scarlet fever, etc.), as well as diseases of the blood system (leukemia, alimentary-toxic aleukia, agranulocytosis, etc.).

Specific. The provoking factor is a specific infection (fungal tonsillitis or angina Simanovsky - Plaut - Vincent)

Types of angina

Depending on the depth and nature of the lesions of the tonsils, tonsillitis is divided into: lacunar, follicular, catarrhal and necrotic

Lacunar angina

Tonsils are affected in the area of ​​lacunae, followed by the spread of purulent plaque on the surface of the palatine tonsils. During pharyngoscopy, there is infiltration and swelling of the tonsils, severe hyperemia and expansion of lacunae. Fibrinous - purulent yellowish - white content of lacunae on the surface of the tonsils forms a loose plaque in the form of a film or small foci, which is easily removed without leaving a bleeding defect

Follicular angina

The follicular apparatus of the tonsils is predominantly affected. At the same time, the tonsils are edematous and hypertrophied, festering follicles are visible through the epithelial cover (pale yellowish formations up to five millimeters in diameter). Festering follicles are opened, thereby forming a purulent plaque that does not extend beyond the tonsils

Catarrhal angina

It is characterized by superficial lesions of the tonsils. Body temperature rises to 37 * - 38 * C, blood changes are insignificant or completely absent. The tonsils are enlarged due to infiltration and swelling. During pharyngoscopy, a bright diffuse hyperemia is observed, which captures the hard and soft palate, as well as the back wall of the pharynx. The disease proceeds from one to two days, after which the inflammatory manifestations in the pharynx subside, or the tonsillitis flows into another form (follicular or lacunar)

Necrotic angina

This form is characterized by more pronounced local and general manifestations than in other forms (persistent pronounced fever, confusion, repeated vomiting, etc.). In blood tests, there is a significant increase in ESR, neutrophilia, leukocytosis. The affected tissues of the tonsils are covered with a gray or greenish-yellow coating that goes deep into the mucous membrane with a dull, uneven surface. Due to impregnation with fibrin, quite often the affected areas become denser, and when they are removed, the surface bleeds. Also, rather deep, irregularly shaped tissue defects (up to two centimeters in diameter) are formed due to rejection of necrotic areas.
Necrosis can also spread beyond the tonsils: to the back wall of the pharynx, uvula and arches

Diagnostics

Pharyngoscopy is the main diagnostic technique for suspected angina. In addition, the general symptomatic picture, patient complaints and anamnesis of the disease are taken into account.

It is also necessary to differentiate angina with diphtheria, scarlet fever, acute catarrh of the upper respiratory tract and acute blood diseases. For this, in doubtful cases, additional diagnostic procedures are carried out: diagnostic puncture, bacteriological analysis of plaque on the tonsils, additional tests blood, etc.

Angina treatment

In most cases, the treatment of angina is carried out on an outpatient basis, however, in the case of a severe course, the patient is hospitalized in the infectious diseases department. A sparing diet enriched with vitamins B and C is attributed, and plenty of fluids are required. The basis of the treatment of angina is antibacterial therapy, which includes the use of amoxicillin with clavulanic acid, phenoxymethylpenicillin, cephalosporins (zinate, cefaclor, etc.), macrolides (azithromycin, erythromycin) and sulfonamides (cotrimaxazole, etc.). For local treatment, bioparox (fuzafunzhin), pharyngosept, gramicidin C, rinsing with decoctions of medicinal herbs (calendula, chamomile, etc.), irrigation of the tonsils (ingalipt, cameton, sebidin, etc.), rinsing with antiseptic solutions (furatsilin, nitrofural) are used.

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As a disease, angina has been known since the days of ancient medicine. The term itself comes from the Latin word angere- to squeeze, squeeze. Many pathological changes in the oropharynx are associated with this disease. And although they differ in etiology, they are united by common symptoms, and they fall under the term - angina.

- a common infectious disease, which is characterized by acute inflammation of the components of the lymphadenoid pharyngeal ring. Most often this local manifestation the disease concerns palatine tonsils .

pathogenesis what is happening

The primary focus of inflammation is formed in the lymphoid tissue of the oropharynx, the tonsils are damaged due to the related lymphoid tissue next to antigenic structures streptococcus. Toxins, which are the product of the vital activity of microbes, enter the bloodstream, thereby causing damage to the nervous and cardiovascular systems. Therefore, angina is characterized not only by local damage to the tissues of the oropharynx, but also by a deterioration in the general condition of the patient.

Necrotic angina differs from other forms of the disease in a more severe course and more pronounced symptoms. With this form of the disease, pharyngoscopy reveals affected areas on the tonsils, covered with plaque that goes deep into the mucous membrane. It has an uneven pitted surface of a greenish-yellow or gray color. Such areas become hard, and after their removal, the surface bleeds. After rejection of such necrotic areas, deep defects remain on the tissues of the tonsils. Often, necrosis extends to the uvula, posterior pharyngeal wall, and beyond.

Symptoms of angina necrotic form worsen general state patient, it is persistent, often recurring vomiting, confusion, high fever. Laboratory blood tests reveal pronounced leukocytosis , a sharp shift of the leukocyte formula to the left, neurophilia . This form of the disease often leads to complications.

Causes of angina

The causes predisposing to the disease may be local and general hypothermia, dusty and gassed atmosphere, increased dryness of rooms, reduced immunity, etc. In most cases, angina develops after suffering, which reduce protective functions. in respiratory tract thus opening the way for infection.

Diagnosis of angina

If you suspect streptococcal tonsillitis , an accurate diagnosis is established according to the clinical picture, pharyngoscopy and laboratory tests. To clarify the pathogen, an additional diagnosis of angina is carried out, namely bacteriological and serological laboratory studies of mucus cultures from the oropharynx. All these data are needed to determine the class of the disease and prescribe effective treatment.

Treatment of angina

Treatment of angina of the primary form

Treatment of angina is carried out on an outpatient basis at mild stages and with uncomplicated forms of the disease. In case of a severe course of the disease, the patient must be hospitalized in the infectious diseases department. Medical therapy is prescribed local treatment, sparing , plentiful drink. The main drugs used in the treatment are antibacterial drugs, which are prescribed for a course of 5-7 days. Antibacterial therapy includes or with clavulanic acid, cephalosporins, macrolides, for example, and .

Local treatment of angina is carried out by rinsing with the use of antiseptic solutions, this can be , as well as decoctions of medicinal herbs with the same properties - chamomile, calendula, St. John's wort. Irrigation of the tonsils is also used with drugs such as, , . For topical use, and, and others. Rinses are effective for removing purulent deposits that distinguish follicular tonsillitis.

It is very important to observe preventive measures during treatment, isolation of the patient is mandatory in order to prevent the infection from spreading between people in contact with the patient. To prevent the disease, it is recommended to harden the body, eliminate such irritants as dust, smoke, excessive dryness of the air. It is necessary to eliminate foci of chronic infection in time, for example, sinusitis .

As for the prognosis of treatment, with catarrhal tonsillitis, the prognosis of treatment is favorable in all cases. Especially quickly the disease passes with timely treatment. Favorable prognosis in the treatment of follicular and lacunar tonsillitis. But still they can lead to development. Severe complications are caused by transferred necrotic tonsillitis of any form of complexity. Most often these complications are rheumatism and .

The doctors

Medications

Treatment of angina of a specific form

Fungal tonsillitis, first of all, requires the abolition of antibacterial drugs that were previously prescribed. Carry out courses of treatment, in combination with washing the tonsils with the same drugs. General strengthening therapy and vitamins of groups B and C, K are prescribed. The disease is characterized by a protracted course, possible frequent relapses Therefore, surgical removal of the tonsils is recommended.

Treatment of angina Simanovsky-Plaut-Vincent is carried out locally. Rinses are prescribed with 0.1% solutions ethacridine lactate and potassium permanganate, sometimes with a weak solution of hydrogen peroxide. Mucous membranes affected by ulcers are lubricated with a 2% solution of methylene blue or 1% boric acid. With a protracted course, appoint antibiotic therapy, primarily .

Treatment of angina in children

First of all, parents should realize that angina is serious illness, and its treatment should never be practiced at home, without first examining the child by a doctor and prescribing appropriate drugs. Before the treatment of angina in children begins, it is necessary to conduct a diagnosis, pass a series of tests. If a sore throat is suspected, swabs from the mouth and nose are taken from the child, urine and blood tests are performed. It is important to exclude other infectious diseases.

With appropriate forms of angina, the child is prescribed antibiotics, since the absence of such therapy can be dangerous in terms of the occurrence of complications later. So, angina can provoke a violation of the functions of the heart, liver, kidneys. Doctors often give children antibiotic pills that don't taste bad and are therefore easy to give to a child.

The prescription of antibiotics is made by the attending physician, guided by the severity of the disease. Basically, the course of treatment of angina with antibiotics lasts for five to seven days. If the form of the disease is very severe, then taking antibiotics sometimes lasts longer. As a rule, already on the third day the child's temperature returns to normal, and the general well-being of the patient becomes better. However, when treating angina in children with antibiotics, it should be taken into account that taking such drugs significantly disrupts the microflora in the child's body. Therefore, in parallel with antibiotics, the doctor, as a rule, prescribes medications that restore the flora. For a warning allergic reactions the general treatment of angina includes the use of drugs , and etc.

As a rule, tonsillitis in children is accompanied by a runny nose, therefore, to alleviate the condition of the child, it is also necessary to prescribe drops for the nose, sprays for irrigating the pharynx.

It is very important to provide a child who has a sore throat with plenty of fluids. At the same time, it is desirable that the baby drink warm and sour juices, compotes, decoctions. In this case, lingonberry and cranberry fruit drinks, decoctions of viburnum, wild rose, blackcurrant compotes are ideal. No less useful are fresh juices from vegetables and fruits, because with angina the body needs to replenish its vitamin reserve. But most a suitable drink for a sore throat is a sour, sparse jelly from different berries. The child will also benefit from warm milk with the addition of soda, butter and mineral water, natural broths from fish, cape, and vegetables. By the way, in the acute period of the disease, children, as a rule, refuse to eat at all or eat very little. Doctors do not advise forcing children to eat at this time - it is best to limit yourself to drinking plenty of water.

In addition, in the first, most difficult days of treating angina in children, it is desirable to provide the sick child with the opportunity to comply with bed rest. It is most difficult to achieve this if the child grows up as an active fidget. Still, by playing with him in bed and reading books to him, parents can achieve what they want and speed up the recovery process.

Treatment of angina folk remedies

There are also many methods for treating sore throat with folk remedies that can be used, like additional ways get rid of an unpleasant disease. Can be used to treat angina in children propolis , which is a very effective remedy even for the treatment of purulent tonsillitis. Propolis can be used in a variety of ways.

is another commonly used home remedy for sore throats in children. For this process, a basin filled with liquid for inhalation and a towel are suitable, with which you need to cover the child's head, tilted over the basin, for a while. In the process of inhalation while inhaling, you need to hold your breath for a few seconds. For inhalation, decoctions of chamomile, sage are suitable. You can also add to hot water a few drops of propolis infusion. It is important that the liquid for inhalation is hot. After a few sessions, the child will feel better.

Another folk remedy for the treatment of sore throat with sore throat is an infusion of elecampane. To prepare such an infusion, you need to take 50 grams of elecampane roots, pour them with half a liter of vodka and insist for three days. After the infusion is ready, half a teaspoon is poured into the throat so that the liquid covers both tonsils. You can cough a little so that the infusion is absorbed. It is highly recommended not to talk after the procedure. These actions should be repeated several times a day.

Fresh onion juice with angina is taken one teaspoon several times a day. You can also make a slurry of onions, honey and apples and take 3 teaspoons of it several times a day.

Treatment of angina with gargling

In addition, with angina, regular gargling with a variety of means is shown. It is believed that the process of gargling is available to a child from the age of two. Naturally, in order to teach the baby to gargle, you should apply some tricks, for example, gargle with him, turn the process into an entertaining game, etc. It is also important in the process to be sure to praise the child for the successful completion of this action.

Gargling with sore throat can be done as often as it is available to the child. The most common solutions for gargling, which are used to treat sore throats at home, are decoctions of herbs (sage, eucalyptus, chamomile are suitable), a weak solution , , . In addition, for gargling, it is recommended to use a decoction of onion peel (three teaspoons per half liter of water), garlic infusion (leave 100 g of chopped garlic for five hours in 100 ml of water at room temperature). Beetroot juice is also suitable for gargling a child: for this you need to grate the beetroot and squeeze out the juice, to which one tablespoon of vinegar is added. In addition, an excellent remedy for gargling is the juice or infusion of plantain, , diluted in half with water. Children will definitely like gargling with warm water and honey. In addition, all these solutions and decoctions are not dangerous if the child accidentally swallows a little
mouthwash liquids.

Treatment of angina with compresses

Compresses help not only alleviate the condition, but also effectively get rid of pain, quickly overcome other symptoms of angina. There are many folk recipes for making compresses. So, with a severe sore throat, it is advised to make a compress of breadcrumbs and garlic. Crackers should be poured with boiling water and crushed head of garlic should be added. After the crackers are saturated with water, the mass is transferred to a stocking, after draining the water. The stuffed stocking is applied to the throat and held until the pain subsides. After a few such compresses, the sore throat completely recedes.

Cabbage leaves can be applied to the child's throat, which should be changed to new sheets once every two hours. From above, the throat must be tied with a woolen scarf. To enhance the effect, a slurry of cabbage leaves is applied to the throat.

Angina is an acute infectious disease in which the child is affected by the tonsils of the pharynx. There are a number of varieties of this disease: angina is catarrhal , follicular , lacunar , fungal , diphtheria .

At catalytic sore throat the patient has a relatively low temperature, the child feels sick and lethargic, complains of pain during swallowing. With catarrhal angina, there is a small inflammatory process and, accordingly, soreness of the lymph nodes. As a rule, in the treatment of angina of the catarrhal form, the use of antibiotics is not practiced.

At sore throat follicular and lacunar there is pain, as well as difficulty in swallowing. In addition, the child will suffer from chills, his head hurts and the temperature rises significantly. Lymph nodes increase, there is a feeling of general weakness, he has symptoms of intoxication, pain in the back and joints.

If the child is sick follicular tonsillitis , then his tonsils immediately turn red and enlarge, round dots of a yellowish-white hue appear on them. occurs with the lacunar form of the disease. With these two forms of angina, the child is required to take . With the right treatment regimen with such drugs, inflammation decreases after a few days. Such forms of angina should always be treated with bed rest, otherwise the risk of complications increases.

Fungal angina occurs as a result of exposure to a pathogen - a yeast-like fungus. This form of the disease often develops as a result of too long and incorrect antibiotic treatment. All symptoms of the disease are similar to those of lacunar tonsillitis.

Another type of disease diphtheria sore throat , which is considered the most dangerous form of the disease. In this case, the causative agent is diphtheria bacillus . A sick child manifests itself, so the patient must constantly be under the supervision of specialists.

When prescribing a course of treatment for angina, the doctor necessarily takes into account what kind of form it takes place and corrects the complex of therapy.

Complications of angina

Complications of angina can be early or late. In the first case, these are diseases that occur during illness, they are caused by the spread of inflammation to nearby organs. These complications are

Kunelskaya N.L., Turovsky A.B., Kudryavtseva Yu.S. Angina: diagnosis and treatment // Russian medical journal: scientific article. - 2010. - V. 18, No. 7. - S. 438–440.

Angina is an ailment of an infectious nature, as a result of the progression of which there is an acute inflammation of the palatine tonsils and other lymphoid formations of the pharynx. The following pathogenic microorganisms can provoke the development of pathology: viruses, bacteria and fungi. In the medical literature, this condition is also referred to as acute tonsillitis. It is worth noting that this is a fairly common disease that can begin to progress both in adults and in children.

So many people just need to get their feet wet or eat something cold, as they immediately begin to develop a sore throat. This is due to the fact that they have reduced the reactivity of the body. Also, the disease may begin to develop due to the presence of other diseases of the nasopharynx or the ingress of irritating substances into the throat, such as tobacco smoke, alcohol, dust, and so on. It is important to diagnose this disease in a timely manner and carry out its full treatment. If this is not done, then dangerous complications may develop. How to treat angina correctly can only be said by a highly qualified specialist. It is not worth doing the treatment of pathology at home.

Etiology

Angina is a pathology of an infectious nature, which means that its development is facilitated by the pathogenic activity of microorganisms. Most often, the role of the causative agent of pathology in children and adults is:

• enteroviruses;
• representatives of the genus diplococci.

Ways of penetration of pathogenic microflora:

• airborne. This route of transmission of bacteria is the most characteristic of angina;
• hematogenous. Pathogenic microorganisms can enter the pharynx with the blood stream from the foci of infection already existing in the human body;
• enteral. Pathogenic microflora enters the body with food, often with dairy products;
• endogenous. Angina often occurs in people who suffer from carious lesions of the teeth, purulent and other pathologies;
• artificial. Infection can occur during various surgical interventions in the nasal cavity and on the nasopharynx. In this case, there is a traumatic angina.

Factors that increase the risk of developing tonsillitis in adults and children:

• sudden changes in temperature;
• malnutrition and eating disorders;
• severe overwork;
• unfavorable ecological situation in the area where the person lives;
• severe hypothermia of the body;
• decrease in sensitization and reactivity of the body.

Types

Clinicians distinguish 3 types of this disease:

• primary. It is also called simple. In this case, the patient develops the disease with signs of damage exclusively to the lymphadenoid ring of the pharynx;
• secondary or symptomatic. There is a lesion of the tonsils in the pharynx against the background of such pathologies:, and so on;
• specific angina. The main etiological factor is a specific infection.

Varieties

Clinicians distinguish these types of angina:

• catarrhal;
• lacunar;
• follicular;
• fibrinous or diphtheroid;
• phlegmonous;
• necrotic;
• ulcerative membranous (tonsillitis without fever).

Symptoms

All symptoms of angina can be divided into two large groups - general and specific.

Common symptoms of angina:

• hyperthermia. Specific reaction of the human body to the pathogenic activity of bacterial agents. High temperature promotes the speedy removal of toxins from the body, enhances the immune response, and also reduces the rate of bacterial reproduction;
• chills;
• malaise;
• headache appears due to intoxication of the human body with the waste products of pathogenic microorganisms;
• increased fatigue;
• pain in the articular joints (a symptom is typical for both children and adults).

Specific signs of angina in children and adults:

• sore throat. characteristic feature sore throats. Manifested due to severe inflammation of the tonsils. Early in the progression of the disease pain syndrome it is weakly expressed, but as the pathology develops, the pain intensifies;
• tonsils are enlarged and hyperemic. Such changes are manifested due to the impact on these anatomical elements of infectious agents;
• enlargement of the submandibular lymph nodes.

The clinic of the disease may differ somewhat depending on which type of angina is diagnosed in the patient. The duration of the incubation period is different - ranging from 12 hours to 3 days. It is worth noting that the disease in children and adults begins acutely - there is hyperthermia to high numbers, chills, pain when swallowing and eating.

catarrhal form

With this form of pathology, the patient has only a superficial lesion of the tonsils. The intoxication syndrome is expressed moderately. Hyperthermia is minor. Visual examination reveals hyperemia of the soft and hard palate. It can also spread to the back of the throat. In rare cases, reddening of the epithelium is observed only on the palatine arches and tonsils.

The duration of this form of the disease in children and adults is usually 2 days, after which the inflammatory process gradually subsides. But its further progression and the transition of the catarrhal form of pathology into lacunar or follicular is not excluded.

Herpetic form

This form is more typical for children. The causative agent of the disease is a pathogenic microorganism - the Coxsackie A virus. The disease is very contagious, therefore, when diagnosing it in a child, it should be isolated from other children and adults. Infectious agents can be transmitted by airborne droplets. The herpetic form of the disease in children is acute and progresses rapidly. There are such symptoms:

• fever;
• hyperthermia up to 40 degrees;
• sore throat of varying degrees of intensity;
• pain in muscle structures located in the abdomen;
• nausea and vomiting.

At the first stage of development, specific red bubbles form on the soft palate, palatine arches and tonsils. On the 4th day, they open and dissolve on their own. The mucous throat takes on its natural appearance.

lacunar form

With the progression of this form of the disease in children and adults, there is a lesion of the tonsils in the region of the lacunae. The formed purulent plaque gradually spreads to the surface of the palatine tonsils. Symptoms are as follows:

• hyperthermia;
• pain in the joints;
• pain in the area of ​​the projection of the heart;
• headache.

During the examination, it can be found that the tonsils are infiltrated, swollen and hyperemic. The lacunae are dilated and contain fibrinous-purulent contents. Gradually, this content forms a film on the surface of the tonsils (it can be easily removed).

Follicular form

This form of the disease is characterized by damage to the follicular apparatus of the tonsils. Typical symptoms:

• hyperthermia;
• tonsils are hyperemic, edematous and infiltrated;
• upon visual inspection, it can be noted that festering follicles are visible through the epithelium of the tonsils. This symptom clinicians refer to starry sky". As the pathology progresses, the affected follicles open up, and a purulent plaque forms, which does not go beyond the borders of the tonsils.

fibrinous form

For this clinical form the appearance of whitish-yellow fibrinous deposits on the tonsils is characteristic, as well as regional. It is worth noting that the pathology can progress both independently and develop from lacunar tonsillitis. Symptoms are as follows:

• pronounced intoxication syndrome;
• pain when swallowing;
• the presence of a continuous fibrinous film on the tonsils;
• signs of brain damage (occur rarely);
• hyperthermia;
• chills.

Intratonsillar abscess (phlegmonous form)

A form of pathology that progresses extremely rarely, and is characterized by the melting of a certain area of ​​\u200b\u200bthe tonsil. It should be noted that this process is usually one-sided. Symptoms:

• sore throat when swallowing and talking;
• an increase in regional lymph nodes;
• hyperthermia;
• intoxication syndrome: nausea, pain in the articular joints, loss of appetite, etc.;
• the affected tonsil increases, its surface is hyperemic and tense. If you palpate the formation, then its soreness is noted;
• trismus of masticatory muscles;
• asymmetric pharynx.

Necrotic form

Symptoms in children and adults with this form are much more pronounced than with all the others. It is important to start treatment of this type of angina as soon as possible, because dangerous complications can develop. The following signs are noted:

• hyperemia;
• nausea and vomiting;
• disturbance of consciousness;
• the tonsils are covered with a greenish-yellow or gray coating;
• the affected areas can be impregnated with fibrin and change their structure to a denser one. If they are removed, a bleeding surface will remain;
• if the necrotic areas are rejected, then a defect up to 2 cm in diameter will remain in their place.

Blood picture:

• increase ;
• pronounced;
• neutrophilia.

Ulcerative membranous form

This form is often called angina without fever, since usually such a characteristic symptom as hyperthermia is not observed in patients. The etiological factor is the symbiosis of a spirochete and a spindle-shaped stick in the mouth. As a result, with angina without temperature, necrosis of the pharyngeal surface of the tonsil is observed with the formation of a specific ulcer. Symptoms of the disease are as follows:

• hyperemia is not observed;
• the patient notes that he has a feeling of a foreign body in the throat;
• putrid smell from the mouth;
• increased salivation;
• an increase in regional lymph nodes on the side of the lesion.

Angina without fever can last from 1 week to several months. It must be treated with antibiotics as soon as possible to prevent complications.

Complications

If you do not start treating angina in a timely manner or do not cure the pathological process to the end, then dangerous complications may develop. All their clinicians are divided into 2 groups: general and local.

• kidney damage;
• damage to the gastrointestinal tract;
• penetration of infectious agents from the throat into the chest;
• spread of infectious agents into the cranial cavity;
• - most severe complication sore throats.

• abscess of adjacent soft tissues;
• bleeding from affected tonsils;
• phlegmon;
• swelling of the larynx (may cause suffocation).

Diagnostics

Before starting to treat angina, a thorough diagnosis should be carried out, which will help to establish the type of pathology, the severity of its course, and also to identify the infectious agent. The standard diagnostic plan includes:

• visual inspection;
• clarification of symptoms and collection of anamnesis;
• taking a swab from the throat to identify the type of pathogen (sowing is carried out on culture media). The analysis is necessary to identify the sensitivity of pathogenic microflora to antibiotics. Usually, broad-spectrum antibiotics are prescribed before the results of the analysis are obtained, but later they can be replaced with more specific ones that affect certain microorganisms;
• MRI is ordered if necessary.

Therapeutic measures

It is best to treat angina in a hospital, so that doctors can monitor the patient's condition and, if necessary, adjust the treatment plan. Since the pathology is caused by bacterial agents, the main drugs for its treatment are antibiotics. Usually, preference is given to drugs from the penicillin series (benzylpenicillin). If a person is allergic to such antibiotics, then they can be replaced with macrolides - azithromycin or erythromycin. Antibiotics from the group of sulfonamides and tetracyclines do not have any therapeutic effect in angina.

In addition to taking antibiotics, the patient is prescribed plenty of fluids to relieve intoxication. If he cannot drink, an intravenous infusion of sterile solutions is performed. Analgesics are prescribed to lower the temperature.

Also included in the treatment of angina:

• multivitamin complexes;
• immunostimulants;
• probiotics;
• gargling with antiseptics;
• lozenges and lozenges with analgesic effect;
• at the final stages of treatment of angina, inhalations are prescribed.

Topical preparations - lozenges and lozenges for resorption - have proven themselves well in the treatment of sore throat, and complex preparations are more effective. For example, the drug Anti-Angin® Formula tablets / pastilles, which include vitamin C, as well as chlorhexidine, which has a bactericidal and bacteriostatic effect, and tetracaine, which has a local anesthetic effect. Due to the complex composition, Anti-angin® has a triple effect: it helps fight bacteria, relieve pain and helps reduce inflammation and swelling. (1,2)

Anti-angin® is presented in a wide range of dosage forms: compact spray, lozenges and lozenges. (1,2,3)

Anti-angin® is indicated for manifestations of tonsillitis, pharyngitis and initial stage sore throats, it can be irritation, tightness, dryness or sore throat. (1,2,3)

Anti-angin® tablets do not contain sugar (2)*.

1. Instructions for use medicinal product Anti-Angin® Formula in the dosage form of a lozenge.

2. Instructions for use of the drug Anti-Angin® Formula in the dosage form of a lozenge.

3. Instructions for use of the drug Anti-Angin® Formula in the dosage form spray for local use dosed There are contraindications. It is necessary to read the instructions or consult with a specialist.