Infectious angina in adults. Angina - causes

Angina in adults does not always occur in its true form. Often, with any pain in the throat, patients make a diagnosis on their own and most often call a sore throat, not trying to deal with the true diagnosis.

Angina is most often confused with laryngitis, pharyngitis, and the common cold. In order to avoid such misconceptions, you need to know what are the signs of angina in adults and how it proceeds. Already in the presence of these signs, it is necessary to consult a doctor in order to receive adequate treatment.

The disease is mainly caused by staphylococci, less often pneumococci or a combined infection. Bacteria and viruses come both from the outside, and pathogens already present inside the body are activated. Usually they live in carious teeth, nasopharynx, maxillary sinuses. Their activation is facilitated by any weakening of the immune system: hypothermia, stress, colds, prolonged exposure to various allergens, contact with a sick person.

Causes

The most characteristic causative agents of infection include staphylococci, streptococci, pneumococci, some representatives of the genus diplococci and enteroviruses.

Routes of infection:

1. Endogenous (in patients suffering from gastroenteritis, purulent, and caries).
2. Airborne (the most common route of transmission).
3. Enteral (together with contaminated dairy products).
4. Hematogenous (with blood flow from organs and tissues infected with the pathogen).
5. Artificial (during surgical operations on the nasopharynx and nasal cavity).

Most often, angina affects people who have reduced sensitization and reactivity of the body, or there is a congenital immaturity of physiological systems or there are chronic pathological processes in the ENT organs. At the same time, the state of the tonsils and the virulence of the microflora play an important role in the development of the disease.

Classification

There are several forms of the disease:

• Catarrhal angina. It usually develops very quickly. The main symptoms are malaise, dryness and sore throat. Then there is swelling of the pharynx, pain when swallowing and in the lymph nodes. This type of angina is characterized by an increase in body temperature up to 39 ° C, the appearance of chills, body aches and severe migraine. After 3-5 days, the main symptoms of the disease disappear or go into another form - it all depends on the treatment.
• Lacunar angina. The first symptom is a sharp jump in temperature (up to 40 degrees). There are also sensations of pain in the region of the larynx, muscles, joints, heart. Significantly increased saliva production. In children, vomiting may occur due to intoxication. With this form, fluid accumulates in the lacunae (fibrinous exudate). The mucous surface of the pharynx and tonsils turns red, swells, yellowish islands appear, the tonsils are covered with a whitish coating, which is easily removed with a medical spatula. There is swelling of the cervical lymph nodes and pain in their locations. This type of sore throat lasts a period of 5 to 7 days. A slight temperature can be observed after an acute period.
• , unlike catarrhal, develops slowly, but passes no less painfully. Its danger is in complications: when your headache intensifies, your body temperature rises, your joints ache, you need to consult a doctor for diagnosis and recommendations for treatment. With this type of sore throat, it hurts a lot and the lymph nodes under the jaw increase. It should be treated in a hospital setting.
• Necrotic tonsillitis occurs with more severe symptoms than lacunar and follicular tonsillitis. It is accompanied by high fever, nausea, and vomiting. Blood tests for necrotic angina show pronounced leukocytosis, neutrophilia. Tonsils with this sore throat are covered with a yellow-green coating, less often - gray. Often, when plaque is removed, the mucosa bleeds, as tissue rejection occurs in the focus of infection under the influence of fibrin. This rejection can extend not only to the tonsils, but also to the surrounding areas - the arches, tongue, back wall of the pharynx.

Sometimes forms of angina can be combined, which greatly complicates the treatment. On one tonsil there may be lacunar, and on the other - follicular tonsillitis.

Common symptoms of angina

With the development of angina, the main symptoms in an adult appear depending on the severity of the clinical picture. The disease of an acute form is characterized by rapid development.

The first signs appear:

• hyperthermia (high temperature), impaired swallowing functions;
• enlargement and inflammation of the tonsils (tonsils), pustular foci are possible;
• a sudden syndrome of acute pain in the throat, a gradual increase in pain;
• hypertrophy and inflammation of the lymph nodes of the submandibular zone.

In the subacute form, the disease proceeds sluggishly. Weak severity of symptoms manifests itself and varies in duration from 1 to 3 months. Both adults and children experience:

• changes in the intensity of pain manifestations;
• halitosis (not a fresh smell of a mouth);
• slight hypertrophy (enlargement) of the tonsils;
• offensive discharge of a viscous structure from the tonsillar niches;
• change in taste.

The chronic form usually develops in patients who regularly tried to treat angina on their own at home, who suffered the disease “on their feet”, without bringing the treatment to full recovery. The symptoms are intermittent - they come and go. Are noted:

• slight swelling of the lymph nodes;
• slight signs of reddening of the tonsils, their slight increase;
• periodic manifestation of pain symptoms in the throat.

The symptomatology of the disease in adult patients and in children is the same, since, due to its contagiousness, one sick family member can infect all household members, including children.

What does angina look like: photo

The photo below shows how the disease manifests itself in adults.

What are the symptoms of purulent tonsillitis?

With angina, a person weakens, the body temperature rises to 40 degrees, it is impossible to swallow, severe pain in the throat disturbs, a headache occurs, the throat becomes very red. When the doctor examines the throat, he notices that the tonsils are enlarged and covered with plaque from above, often aching joints. If the disease is treated in time, the person becomes better after 5 days. Often, instead of a sore throat, doctors diagnose acute respiratory infections, but remember, if the temperature is above 39 degrees, this means that the throat is very inflamed. At the same time, the patient cannot drink, eat, he speaks heavily, then he begins to quickly get tired.

If the tonsillitis is purulent, the lymph nodes are significantly enlarged, the tonsils located on the soft palate change, abscesses begin to appear on them.

How long does the temperature last with angina?

Angina is a clear cause of an increase in body temperature. A distinctive feature of an acute infectious disease is a sharp rise in temperature, which persists for a short time. Visible symptoms of angina - sore throat, plaque on the tonsils, general weakness. On average, the high temperature lasts up to 5 days. The duration of the disease depends on the nature of the angina:

• catarrhal - duration is 1-2 days;
• follicular - 3 - 4 days;
• lacunar - 4 - 5 days;
• herpes sore throat (herpangina) - 1-3 days;
• Simanovsky-Plaut-Vincent's angina - 1 - 2 days or passes without fever.

Natural changes in indicators should be taken into account due to the individual characteristics of the organism, especially immunity and general susceptibility to viruses. Different types of angina have similar signs of the disease, differing in the placement of purulent areas. The absence of temperature with tonsillitis indicates a decrease in the protective functions of the body, an inability to resist the disease on its own.

How to treat angina?

• Bed rest. Transferring a sore throat on the legs often leads to the development of complications.
• Plentiful drink. It is necessary to remove intoxication and remove pathogens and their metabolic products from the body. You can drink water, tea, compotes, fruit drinks, juices. The main thing is that they are warm.
• Antiseptics. All kinds of lollipops, lozenges and aerosols for sore throat are used in case of severe pain as a means of symptomatic therapy.
• Antipyretics. They are taken if the temperature has risen above 38 degrees and it becomes difficult for the patient to endure it.
• Gargling with angina. Helps to get rid of white plaque, which is a source of inflammation. Gargle with sore throat is recommended every hour.

In most cases, angina is caused by streptococci, so the main drugs for angina are penicillin antibiotics. The most effective of them is benzylpenicillin. If the patient is allergic to penicillins, then macrolides (Azithromycin, Erythromycin) may be prescribed. Tetracyclines and sulfonamides are ineffective in angina.

Folk remedies

Traditional medicine offers a large number of recipes for the treatment of such a complex disease as tonsillitis at home. In acute tonsillitis, it is necessary to wash the microbes from the pharyngeal mucosa, and for this purpose it is recommended to use herbal infusions and decoctions.

The following procedures give a good effect:

• frequent rinsing of the mouth with a solution of sea water helps to get rid of pain in the throat.
• you can get rid of the unpleasant symptoms of the disease in a few days with the help of garlic, using it for compresses, inhalations and rinses.
• drinking a decoction of oregano throughout the day will help get rid of hoarseness.
• at the very beginning of the development of tonsillitis, it is recommended to chew the zest of a lemon along with the pulp and gargle with a solution of lemon juice.
• in the event that a sore throat is accompanied by an increase in body temperature and chills, then warm tea with the addition of lingonberries, lemon or raspberries helps to alleviate the condition.

When diagnosing acute tonsillitis, it is important to consume as much fluid as possible, which will help remove all accumulated toxins from the body and restore water balance.

How to gargle?

Local treatment of tonsillitis is no less effective than taking general drugs. Gargling with solutions (furatsilin, eludril, soda + iodine + salt), decoctions (sage, calendula) helps to eliminate pain and relieve inflammation of the tonsils.

Gargle should be at least 1 time in 2 hours, this process ensures the cleansing of the pharyngeal mucosa from the waste products of pathogens, washes away pus from its surface, and fights inflammation.

You can also watch a video recording of the program "Live Healthy" about the treatment of angina.

Complications of angina

Angina is very dangerous for its complications. One of them is a paratonsillar abscess, which is a continuation of a sore throat. It seems that recovery has come, but suddenly the patient has a severe sore throat, which is constantly increasing. After 2-3 days, swallowing becomes impossible, the temperature rises, salivation increases. Soon the patient's condition worsens so much that during swallowing, as a result of swelling of the soft palate, food can enter the nasopharynx and nose. Difficulty breathing. In this case, only urgent hospitalization and surgical intervention will help.

There are other complications as well. There are local and general manifestations. Acute purulent lymphadenitis (inflammation of the lymph nodes), neck phlegmon belong to the local ones. Common complications are rheumatism, infectious polyarthritis, sepsis,. That is why after a sore throat, it is imperative to double-check the blood, urine and make an electrocardiogram to make sure that there are no complications.

Angina is a disease that begins very quickly, so you should pay attention to the first signs of angina:

• a sharp increase in body temperature;
• sore throat and not only when swallowing;
• plaque or ulcers on the tonsils.

Angina can be transmitted by airborne droplets or by contact. The likelihood of getting a sore throat increases in spring and autumn due to hypothermia or occur as a result of tonsillitis, rhinitis or sinusitis.

When examining the throat, one can observe a white coating on enlarged tonsils, an increase in lymph nodes, reddening of the tonsils, and the palate. The incubation period can last from 10 hours to 2-3 days.

Angina can occur in the following forms:

• primary form suggests a normal course of the disease. As a rule, the disease develops rapidly and is of an acute inflammatory nature. The focus of the lesion is the lymphadenoid ring of the pharynx.
• secondary form when a sore throat develops as a result of past illnesses or during an illness - against the background of scarlet fever, diphtheria, or with diseases of the circulatory system (leukemia, agranulocytosis).
• Specific sore throats- the cause is in the specific course of the disease (Simanovsky-Plaut-Vincent's tonsillitis or ulcerative necrotic tonsillitis, fungal tonsillitis).

Types of angina depending on the symptoms and nature of the course of the disease

There are the following types of angina:

Catarrhal angina. It usually develops very quickly. The main symptoms are malaise, dryness and sore throat. Then there is swelling of the pharynx, pain when swallowing and in the lymph nodes. This type of angina is characterized by an increase in body temperature up to 39 ° C, the appearance of chills, body aches and severe migraine. After 3-5 days, the main symptoms of the disease disappear or go into another form - it all depends on the treatment.

Purulent tonsillitis, which is divided into lacunar and follicular:

• Follicular angina, unlike catarrhal, develops slowly, but passes no less painfully. Its danger is in complications: when your headache intensifies, your body temperature rises, your joints ache, you need to consult a doctor for diagnosis and recommendations for treatment. With this type of sore throat, it hurts a lot and the lymph nodes under the jaw increase. It should be treated in a hospital setting.
• Lacunar angina accompanied, as a rule, by a deterioration in the general condition of the body, headaches, body temperature can reach 40 ° C. Swallowing food or liquid causes very strong pain. Lacunar tonsillitis lasts 5-7 days, the symptoms are very active, and after they subside, the body temperature can still remain elevated. To diagnose lacunar angina, you should pay attention to the mucous membrane of the tonsils - it swells and acquires a red tint, plugs form from a light yellow plaque in the lacunae. One of the distinguishing symptoms of angina of this form is increased salivation, and in children it may be accompanied by vomiting.

Ulcerative angina, proceeds against the background of low temperature, the general state of health of the patient is satisfactory, the process of swallowing is not painful.

As a rule, one tonsil falls under the blow and the inflammatory process on it manifests itself in the form of a serous plaque with ulcerative areas.

Necrotic angina proceeds with more pronounced symptoms than lacunar and follicular tonsillitis. It is accompanied by high fever, nausea, and vomiting. Blood tests for necrotic angina show pronounced leukocytosis, neutrophilia.

Tonsils with this sore throat are covered with a yellow-green coating, less often - gray. Often, when plaque is removed, the mucosa bleeds, as tissue rejection occurs in the focus of infection under the influence of fibrin. This rejection can extend not only to the tonsils, but also to the surrounding areas - the arches, tongue, back wall of the pharynx.

Only a doctor can tell how to quickly cure a sore throat, since different treatments are prescribed depending on the form of the disease.

How to identify a sore throat and not confuse it with other diseases

Very often, angina is confused with the usual SARS. How to identify a sore throat and not confuse it with a cold? A doctor's visit will help.

As a rule, angina is diagnosed by feeling the mandibular lymph nodes with your fingers, checking for swelling and pain. With angina, the lymph nodes enlarge, and a urinalysis can show the presence of blood in it and the release of protein.

Treatment of angina: can it be cured without antibiotics

Treatment of angina requires the use of antibiotics - this is the basis of treatment, and without their use it will not be possible to completely cure this disease.

After a thorough diagnosis of angina, the doctor prescribes antibacterial agents. The choice depends on which antibiotics have previously had a therapeutic effect and whether they cause allergies.

Of course, antibacterial therapy can be reinforced with gargles for sore throats, the use of anti-inflammatory aerosols, inhalations and syrups, but it will not work to completely remove the bacterial environment.

Among the antibiotics for angina, drugs of the penicillin group are distinguished. When an allergic reaction occurs, new generation cephalosporins are prescribed. Catarrhal angina, as a rule, does not require antibiotic treatment - they are used for lacunar and follicular angina.

With mild to moderate angina, a penicillin group, cephalosporins or macrolides are prescribed.. Among the most popular are ampioks, amoxicillin, doxycycline, cephalexin, macropen or others.

If the disease is severe, antibiotics are used in injections.: penicillin, cefazolin, ceftriaxone, etc. The course of antibiotic treatment is 7 days. In addition to antibiotics, sulfonamides are prescribed for angina. The most popular among them are biseptol or groseptol, sulfadimethoxin, sulfalene.

Comprehensive treatment of angina should include antihistamines. These include suprastin, diazolin.

If a sore throat is accompanied by a very high fever and headaches, it is recommended to relieve these symptoms. antipyretics and painkillers- suitable aspirin, citramon, analgin, paracetamol.

When deciding how to treat a sore throat in a child and how to treat a sore throat in an adult, the doctor evaluates a large number of factors.

At home, antibiotic therapy can be strengthened throat gargles solutions of ectericide, iodinol, propolis, furacilin, alcohol solution of chlorophyllipt, decoctions of sage or chamomile can be used. Ordinary saline solutions have proven themselves well when rinsing.

After rinsing, the application will be effective tableted antiseptics: antiangina, sebidin, strepsils, septolete, falimint, pharyngosept, septefril or the use of aerosol preparations (bioparox spray, hexaspray, inhalipt, cameton). It is necessary to remember the use of homeopathic remedies in the treatment of angina: tonsilotren, angina-hel, angina-grana.

It is important to know

In addition to effective treatment, bed rest should be observed for angina. You need to eat broths, mashed potatoes, dairy products - food containing vitamins and minerals that increase immunity and do not injure inflamed tonsils.

You can not eat hot or cold food and you need to exclude spicy food from the diet for the duration of the illness.

Angina- this is a common infectious disease of the whole organism, characterized by acute inflammation of the lymphadenoid tissue of the pharynx, and local manifestations are most often expressed in the palatine tonsils, while other tonsils are involved in the inflammatory process relatively less frequently.
Therefore, in medical practice, it is customary to use the term "angina" to mean tonsillitis of the palatine tonsils.

What causes angina? It is caused by microbes of the pyogenic group, mainly streptococci and staphylococci. Much less often, the cause of angina are adenoviruses, spirochetes and fungal flora.

Microbes can enter the body with food, with droplets of the patient's saliva when he coughs, or through poorly washed dishes, with food contaminated with staphylococcus aureus.

Often, angina occurs due to the activation and increased reproduction of microbes located in the lacunae of the tonsils, and this may be due to a weakening of the body due to overwork, poor nutrition, or another disease, such as influenza.

Predisposes to the disease general and local hypothermia. Remember - the ice cream was so delicious and the cold drink was so good on a hot summer day. Well, in the cold seasons of the year - the feet got wet, they froze and a cold with a sore throat will not take long.

There are such main types of angina: catarrhal, lacunar, follicular, ulcerative membranous.

There are also specific tonsillitis in acute infectious diseases and diseases of the blood system.

With catarrhal angina predominantly superficial layers of the tonsils are affected. It begins with a feeling of dryness, sore throat, which gradually develops into pain, general malaise, headache. Sometimes this pain can be given to the ear when swallowing.

The body temperature rises slightly (quite often in practice there are non-temperature catarrhal sore throats), but there may also be chills. Slightly increase and hurt the lymph nodes near the angle of the lower jaw. Looking into the throat, you can see that the tonsils are very reddened and enlarged. In children, all of the above can be expressed more sharply. Such a sore throat lasts 3-5 days, after which all the phenomena subside or the sore throat passes into another form.

It starts with a sharp rise in body temperature to 39-40 degrees, chills, general malaise, severe pain in the throat, head, joints, muscles and even in the heart. A lot of saliva is produced. Children may vomit.

When examining the tonsils, it can be seen that they are very reddened and enlarged, and yellowish-white islands or plaque films appear on their surface that do not extend beyond the tonsils. Cervical lymph nodes enlarge and hurt. Such a sore throat usually lasts 5-7 days. It runs rough. Low temperature can continue even after the subsidence of the main symptoms of the disease.

Follicular angina begins with a sudden chill and fever up to 40 degrees and severe sore throat. With swallowing movements, pain can be felt in the ear, although the doctor does not find any changes when examining the ear. The phenomena of general intoxication are expressed: general weakness, headache, pain in the heart, joints and muscles.

The lymph nodes under the jaw are very sore and enlarged. On sharply reddened and edematous tonsils, whitish-yellowish, limited formations the size of a pinhead are visible.

These forms of angina basically represent different stages of the same process. They are distinguished on the basis of the predominance of certain symptoms.

Ulcerative membranous angina(it is also called: Simanovsky-Plaut-Vincent's angina), proceeds almost without disturbing the general condition of the body: the temperature is low, the general state of health is more or less satisfactory, swallowing is not painful. On the tonsils (very often only one), you can see a dirty gray coating with ulcerative areas.

To distinguish the listed types of angina from other diseases with similar symptoms is the task of your doctor. And you need to be treated and get well soon.
Treatment of angina is carried out at home and only in severe cases - in an infectious diseases hospital.

The experience of treating angina led some experts to the conclusion that angina as an acute disease, subject to rest, the rules of the regime and some therapeutic measures for 5 to 10 days, ends with a clinical recovery without the use of any drugs administered through the mouth or by injection.

One could agree with this if there were no potential danger of complications of angina, which, especially in children, can be quite severe.

That is why it is necessary to carry out this or that drug therapy. It is necessary to treat complexly and intensively even the most "light" catarrhal sore throat, remembering that the disease is insidious with its complications.

Many patients suffering from rheumatism or rheumatoid arthritis will say that the disease began with a sore throat. In addition, you need to know that angina can give such a “local” complication as a paratonsillar abscess (an abscess located near the tonsil).

The main tasks of the patient and the doctor in the treatment of angina.

1. Creating favorable conditions for the body to overcome the phenomena of general intoxication, which should facilitate the activity of its defense mechanisms in the fight against infection
(Scheme point - 1, 9).
2. General anti-inflammatory treatment
(points of the scheme - 2, 3, 4.9).
3. Local treatment (scheme points - 5, 6, 7, 8, 9)

The scheme of treatment of angina.

1. Strict bed rest.

It is needed not only for a period of high temperature, but also for 2-3 days after its normalization. Rest is important, as angina often reveals disorders in the cardiovascular, genitourinary and other body systems. Do you need complications? Better lie down.

Plentiful warm drink. Tea with lemon, fruit drinks, fruit jelly, juices, mineral water such as Borjom, etc., up to 1-1.5 liters per day. Frequent drinking helps to eliminate toxic products that accumulate in the body, especially during periods of high temperature.
A sparing, predominantly dairy-vegetable diet rich in vitamins, especially vitamin C and B.
Avoid spicy, very hot and cold foods.

2. The use of antibiotics.

Despite their many side effects, it can still be difficult to do without them.

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, such a local manifestation of the disease concerns precisely 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 with a number of antigenic structures of streptococcus. Toxins, which are the waste product 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 of the necrotic form worsen the general condition of the patient, this is persistent, often repeated 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 can be local and general hypothermia, dusty and gassy atmosphere, increased dryness of rooms, decreased immunity, etc. In most cases, angina develops after suffering, which reduce protective functions. in the respiratory tract, thereby 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. Drug therapy, local treatment, sparing, plentiful drinking are prescribed. 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, frequent relapses are possible, 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 prolonged course, antibiotic therapy is prescribed, mainly .

Treatment of angina in children

First of all, parents should realize that angina is a serious disease, 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. To prevent allergic reactions, the general treatment of angina also includes taking medications. , 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 the most suitable drink for a sore throat is a sour, sparse jelly from various 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 of treating angina with folk remedies that can be used as additional ways to get rid of an unpleasant ailment. 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.

Diet, nutrition with angina

List of sources

• Otorhinolaryngology: textbook / Ed. I.B. Soldatov, V.R. Hoffmann. - St. Petersburg: ELBI, 2000.
• Kazantsev A.P. Handbook of infectious diseases / A.P. Kazantsev, V.S. Matkovsky. - 3rd ed., revised. and additional - M.: Medicine, 2005. - 320s.
• 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, both in adults and in children, is acute, with varying degrees of severity, which depends on the etiological agent, the form of the disease and the presence of concomitant pathologies.

What is angina? Angina, or acute tonsillitis, is an infectious and inflammatory disease affecting one or more components of the lymphadenoid pharyngeal ring, most often the palatine tonsils (tonsils).

Classification

The inflammatory process can be primary and secondary. Primary acute tonsillitis is subdivided into catarrhal, lacunar, follicular and ulcerative membranous.

Secondary inflammation of the palatine tonsils can occur in acute infectious diseases - diphtheria, scarlet fever, measles, tularemia, typhoid fever, infectious mononucleosis. It also occurs against the background of diseases of the blood system, including with agranulocytosis, alimentary-toxic aleukia, leukemia.

Depending on the etiological agent, a bacterial, viral, fungal and syphilitic form of angina is isolated.

ICD-10 code - J03:

• J0 - with streptococcal etiology of the disease;
• J8 - with a specified other etiology of the disease;
• 9 - with an unknown pathogen.

Reasons for the development of pathology

Etiology of primary acute tonsillitis

In 70-80% of cases, the cause of inflammation of the tonsils is group A beta-hemolytic streptococcus, or pyogenic streptococcus. It is a gram-positive, facultative anaerobic microorganism that is transmitted by airborne droplets, food and contact.

The peak incidence occurs in the winter-spring period, when the overall resistance of the body decreases. The entrance gate is the mucous membrane of the upper respiratory tract. The incubation period averages 1-2 days.

In addition to pyogenic streptococcus, the causative agent of angina can be staphylococci, other types of streptococci, meningococcus, pneumococci, Haemophilus influenzae, Klebsiella, mycoplasmas, chlamydia, adenoviruses, etc.

To reduce the load on the cardiovascular system, bed rest is recommended. The diet should be sparing, with the exception of spicy, coarse food, which can irritate the mucous membranes.

Psychosomatics

From the point of view of psychosomatics, tonsils check everything that gets inside the body: food, energy, information, situation, problem. They are a sensor that gives feedback on what passes through them. Often tonsillitis develops in a person who cannot argue with society, from which he is very dependent on the opinions of others.

So, frequent sore throats, which are difficult to distinguish from SARS (acute respiratory viral infection), are found in people who work in corporations where they are pressured, as a result of which their own beliefs break down.

This is especially evident in children who are brought up in a family where they are not interested in their desire, and any resistance or attempt to express their opinion is suppressed either by force or manipulation.

Both an adult and a child can have a sore throat with frequent relapses until the true cause of the pathology can be determined.

Signs of angina in adults and children

Acute catarrhal tonsillitis occurs in a mild form. The disease begins acutely. The first sign of inflammation of the tonsils may be an increase in body temperature and the appearance of sore throat.

In the catarrhal form, the pain syndrome is insignificant. There are complaints of moderately severe headache, weakness, malaise and aching joints. Regional lymph nodes slightly increase in size and become moderately painful. The duration of the catarrhal form of angina is 2-3 days, after which it ends with recovery or passes into another type of disease.

The follicular form of the pathology is characterized by an increase in body temperature above 38 ° C, intense sore throat, chills, sleep and appetite disturbance, pallor of the skin, muscle and joint pain, and headache. Regional lymph nodes are enlarged and sharply painful. In children, against the background of intoxication, there may be drowsiness, convulsions, vomiting, and a violation of the stool. Symptoms increase for 2-3 days. The duration of the disease averages 7-8 days.

What a sore throat looks like can be seen in the photo of the throat taken during pharyngoscopy. With catarrhal tonsillitis, hyperemia of the mucous membrane of the palatine tonsils, palatine arches and soft palate is noted. In a clinical blood test, there is a slight increase in the number of leukocytes, an increase in ESR (erythrocyte sedimentation rate).

The catarrhal form of tonsillitis must be differentiated from viral pharyngitis, in which cough, runny nose are often observed and there is no enlargement and soreness of the lymph nodes.

With follicular sore throat during pharyngoscopy, there is a bright hyperemia and swelling of the palatine arches and tonsils, on which festering follicles are in the form of yellowish, rounded elevations. The tongue is dry and coated with white. In a clinical blood test, leukocytosis is noted with a shift of the leukocyte formula to the left due to an increase in the number of neutrophils, accelerated ESR. In the general analysis of urine, traces of protein and a small number of red blood cells appear.

With the lacunar form of tonsillitis, there is hyperemia of the mucous membrane of the palatine arches and tonsils and their increase in size. A white-yellow coating covering the entire surface of the tonsils is located at the mouths of the lacunae, but does not extend beyond the tonsils. Plaque is easily separated with a spatula. At the same time, the lateral folds of the pharynx, which become edematous, hyperemic, may be involved in the process. In a clinical blood test, leukocytosis with a neutrophilic shift to the left and accelerated ESR.

The spread of the purulent process into the peritonsillar tissue leads to the formation of a paratonsillar abscess, and when it passes into the peripharyngeal space and mediastinum, it leads to mediastinitis.

In the ulcerative membranous form, during pharyngoscopy, an ulcer is visualized on the affected tonsil, covered with a gray-yellow coating, after removal of which clear edges of the ulcer are determined. Ulceration can be on the soft palate, posterior pharyngeal wall, vestibular larynx, which leads to bleeding, perforation of the palate, damage to the periosteum.

To confirm the diagnosis and further correct the treatment, a bacteriological examination of scrapings from the surface of the tonsils and oral mucosa, including a bacteriological examination for the Leffler bacillus (to exclude diphtheria), is prescribed.

It is very important to recognize the streptococcal etiology of the disease in a timely manner for adequate therapy. Express diagnostics of streptococcal antigen from the surface of the tonsils is carried out using test strips. The study takes 5 minutes, the specificity and sensitivity reaches 98%.

In the ulcerative-membrane form of angina, in controversial cases, a biopsy of the tonsil tissue is performed along the edge of the ulcer, followed by histological and cytological studies.

Due to the risk of complications, after suffering acute tonsillitis, the following are indicated:

• control clinical examination of blood and urine;
• determination of C-reactive protein;

Treatment

With angina, a home or stationary regimen is recommended, depending on the severity of the patient, social conditions. In severe and moderate course, hospitalization in the infectious diseases department is indicated. This is especially true for patients with severe symptoms of intoxication against a background of febrile temperature (above 38 ° C), when infusion therapy is necessary to replenish fluid in the body and detoxify.

To reduce the load on the cardiovascular system, bed rest is recommended. The diet should be sparing, with the exception of spicy, coarse food, which can irritate the mucous membranes. Preference is given to a dairy-vegetable diet rich in vitamins. Plentiful warm drink is recommended: mineral water, compotes, lingonberry and cranberry fruit drinks.

Systemic antibiotic therapy plays a key role in the treatment of acute bacterial tonsillitis. The drugs are selected depending on the alleged pathogen, and the correction of treatment, if necessary, is carried out after receiving the results of bacteriological culture of the tonsils discharged from the surface.

Given the prevalence of streptococcal infection, as well as its natural sensitivity to penicillins, the drugs of choice are Phenoxymethylpenicillin or Amoxicillin. You can also use cephalosporins I-II generation: Cefadroxil, Cefuroxime Axetil.

If the patient has previously received antibiotics, Amoxiclav is preferable, which includes amoxicillin with clavulanic acid.

But before prescribing this or that antibacterial agent, the doctor must make sure that the patient does not have an allergic reaction to this group of drugs. If you are allergic to penicillins or cephalosporins, macrolides are prescribed: Azithromycin, Clarithromycin, Roxithromycin or Josamycin.

Non-steroidal anti-inflammatory drugs are used as antipyretic and analgesic drugs: Paracetamol, Ibuprofen, Cefecon, Analgin, Ketonal.

Patients with a tendency to allergic reactions and with severe swelling of the mucous membranes are shown antihistamines: Loratadine, Cetirizine.

Local treatment of angina consists in the targeted delivery of the active substance to the focus of inflammation. It is recommended to rinse the oropharynx with an alkaline or saline solution, decoctions of calendula, sage or chamomile.

Painkillers and antiseptics are actively used: Anti-angin (chlorhexidine, tetracaine, ascorbic acid), is an antibiotic of the tyrothricin group, it is practically not absorbed from the gastrointestinal tract and does not penetrate into the general bloodstream. The mechanism of action is to increase the permeability of the cytoplasmic membrane of a bacterial cell, which causes its death. Gramicidin C has a pronounced antimicrobial effect (bacteriostatic and bactericidal) on staphylococci, streptococci, neisseria, anaerobic agents and other microorganisms, while the development of resistance is not observed.

The follicular form of the pathology is characterized by an increase in body temperature above 38 ° C, intense sore throat, chills, sleep and appetite disturbance, pallor of the skin, muscle and joint pain, and headache.

The drug Grammidin, in addition to the antimicrobial action, has an antiviral, antifungal and anti-inflammatory effect. As a result of activation of the synthesis of interferons, local immunity is stimulated. Also, discomfort in the throat is softened, swallowing is facilitated. It is very important that the drug is characterized by low toxicity, does not affect the normal microflora and does not cause dysbacteriosis.

Possible Complications

What is the danger of the disease in the early and late stages? The consequences of acute tonsillitis can occur both during the active inflammatory process and after the resolution of the disease.

Possible complications include:

• paratonsillitis and paratonsillar abscess;
• purulent cervical lymphadenitis;
• mediastinitis;
• rheumatism;
• peripharyngeal (lateropharyngeal) or pharyngeal abscess;
• acute poststreptococcal glomerulonephritis;
• tonsillogenic sepsis;
• acute otitis media.

The spread of the purulent process into the peritonsillar tissue leads to the formation of a paratonsillar abscess, and when it passes into the peripharyngeal space and mediastinum, it leads to mediastinitis. Often, with the development of purulent complications, emergency surgery is required. In severe cases, tonsillogenic sepsis may occur.

Prevention

To prevent the development of angina or recurrence of inflammation, it is recommended to follow the necessary preventive measures.

You need to lead a healthy, active lifestyle that will help strengthen the immune system. Hardening is also shown, which is very important to do correctly. The body should be accustomed to temperature changes in stages, starting with wiping with warm water in the morning, and then lowering its temperature by one degree a day. Thus, you can gradually learn to douse yourself with cold water.

Other preventive measures:

1. Observe oral hygiene: brush your teeth twice a day, use dental floss and irrigator, rinse your mouth after each meal, visit the dentist and carry out professional hygiene once every six months.
2. Wash hands thoroughly before eating.
3. Monitor the quality of food: nutrition should be balanced, correct, which will provide the body with the necessary vitamins and minerals.
4. Actively ventilate the premises, use a humidifier.

With the development of various diseases, you should contact the relevant specialists in a timely manner. This will help to avoid chronicity of the process and the development of complications.

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