Infectious angina. Infectious angina treatment. Symptomatic therapy of viral tonsillitis in children

– acute inflammation lymphoid tissue of the pharyngeal (usually palatine) tonsils in a child, which is of an infectious-allergic nature. Angina in children occurs with high fever, pronounced signs of intoxication, pain when swallowing, an increase in submandibular and cervical lymph nodes, purulent plaque on the tonsils. Diagnosis of angina in children is carried out by a pediatric otolaryngologist using a physical examination, pharyngoscopy, examination of a smear from the pharynx for microflora, blood ELISA. Treatment of angina in children includes pathogenetic therapy (antibiotics, antiviral agents), symptomatic therapy (antipyretic, desensitizing drugs) and local therapy (aerosols, gargles with antiseptics and herbs).

General information

Angina in children ( acute tonsillitis) is an infectious-allergic disease in which the palatine tonsils become inflamed. The incidence of angina in the pediatric population ranges from 4.2 to 6.7%, second only to SARS in frequency. Due to the high prevalence and contagiousness of angina in children, the disease is the subject of close attention of pediatrics and pediatric otolaryngology. Angina in a child is dangerous for its early (otitis, paratonsillar, lateral-pharyngeal and retropharyngeal abscesses) and long-term complications, among which are rheumatism, rheumatoid arthritis, glomerulonephritis, etc.

Causes and pathogenesis of angina in children

In most cases, tonsillitis in children is caused by bacterial or viral infection. In 80-85% of cases, the causative agent is group A β-hemolytic streptococcus; at 10 o'clock% - Staphylococcus aureus; less often - pneumococcus, Haemophilus influenzae, viruses (enteroviruses, adenoviruses, herpes virus, Epstein-Barr virus, etc.), mycoplasmas, chlamydia, fungi, mixed infection. As a rule, angina in children under 3 years of age is associated with viral pathogens; predominates in children older than 5 years bacterial infection. The highest incidence streptococcal angina children are aged 5-10 years. Intracellular pathogens are the cause of tonsillitis and pharyngitis in preschool children in 10% of cases. In some cases, angina in children can be caused conditionally pathogenic bacteria living in the oral cavity, in a situation of their massive growth and high density microbial cells.

The predominant route of infection in the tonsils is exogenous (airborne, contact-household, enteral). Traumatic tonsillitis often develop after operations on the nasopharynx and back departments nasal cavity (for example, after adenotomy in children). Endogenous autoinfection is possible with exacerbation of chronic tonsillitis, dental caries, sinusitis, gastroenteritis.

Predisposing factors for the development of angina in children are constitutional anomalies (lymphatic-hyperplastic constitution), changes in regional and general immunity during hypothermia, a sharp change in climate, beriberi, etc.

At the heart of the development of angina in children is the reaction of the allergic-hyperergic type. The lacunae of the tonsils contain a rich non-pathogenic flora, pathogenic microorganisms and products of protein breakdown, which can act as sensitization factors of the body. Against the background of preliminary sensitization, various endogenous or exogenous infectious agents can initiate the development of tonsillitis in children. Numerous exotoxins released by pathogens cause an immune response with the formation of CECs that affect the tissues of the heart muscle, kidneys, etc. internal organs.

The local reaction of the tonsils to the introduction and reproduction of pathogens is characterized by swelling of the lymphoid tissue, purulent fusion of the follicles, accumulation of purulent masses in the lacunae, necrosis of the epithelium, and in some cases, the tissue of the tonsils.

Classification of angina in children

Taking into account the causes of inflammation of the tonsils, primary, secondary and specific tonsillitis in children are distinguished. In primary angina, the infection initially develops in the tonsils. Secondary or symptomatic tonsillitis in children is often found in other infectious diseases: scarlet fever, measles, diphtheria, mononucleosis, etc. Specific tonsillitis in children includes tonsil lesions caused by specific flora - pathogens of gonorrhea, mycoplasmosis, chlamydia, candidiasis, etc. The course of angina in children can be acute, often recurrent and chronic.

Depending on the nature of the change in the tonsils, among the clinical forms of angina in children are the following: catarrhal, follicular, lacunar, fibrinous, phlegmonous and gangrenous.

At catarrhal angina in children, examination of the pharynx reveals an increase and hyperemia of the tonsils, as well as palatine arches. Purulent plaque is absent; against the background of loose and desquamated epithelium is determined thin layer serous whitish plaque. Microscopically, a dense infiltration of the epithelium of the tonsils with lymphocytes and neutrophils is detected.

Diagnosis of angina in children

If a child has a temperature and sore throat, you should contact a pediatrician or pediatric otolaryngologist. Objective signs characteristic of angina pediatrician detects already when examining the mucous membrane of the pharynx, palpation of the submandibular and cervical lymph nodes.

In the general blood test, there is neutrophilic leukocytosis, a stab shift to the left, an increase in ESR. A study of a smear from the pharynx on the microflora allows you to identify the causative agent of tonsillitis in children. If necessary, serological diagnostics (ELISA) is carried out: detection of antibodies to mycoplasma, candida, chlamydia, herpes virus, etc.; the presence of β-hemolytic streptococcus is confirmed by the determination of ASL-O.

Pharyngoscopy in children determines diffuse hyperemia of the tonsils and arches, infiltration, the presence of plaque, the nature of which makes it possible to judge the clinical form of angina. Purulent plaque with angina is easily removed with a spatula, rubbed on glass and does not leave a bleeding surface (unlike hard-to-remove plaque in diphtheria).

Treatment of angina in children

Mild and moderate forms of angina in children are treated on an outpatient basis; in severe cases of angina, hospitalization in the infectious diseases department may be required.

In the treatment of angina in children, it is important to observe bed rest and rest, isolate a sick child, use individual care items (dishes, towels), organize sparing meals and drink plenty of water.

With bacterial tonsillitis in children, systemic antimicrobial therapy is prescribed with drugs to which the pathogen is sensitive (with the isolation of β-hemolytic streptococcus - penicillins, macrolides, cephalosporins, carbapenems). Along with antibacterial therapy, antihistamines, B vitamins and ascorbic acid, immunomodulators.

An important place in angina in children is occupied by local treatment: gargling with antiseptic solutions (nitrofural, miramistin) and decoctions of herbs (calendula, chamomile, sage), spraying aerosols into the throat.

Prevention of tonsillitis in children requires limiting contact with infectious patients, increasing overall resistance, sanitation of purulent foci, and providing a full fortified diet.

Infectious tonsillitis or infectious tonsillitis is a serious and rather complex disease that patients can tolerate. different ages. untimely and not proper treatment able to lead serious complications, therefore, it is so necessary to start a timely and correct therapy leading to the recovery of the patient.

What is infectious angina?

Infectious angina is characterized by severe inflammation of the tonsils and redness of the throat, which cannot be removed with conventional medicines. Two types are known: viral and, the first of which proceeds in the form.

The disease is especially often manifested in the cold season, when the human immune system is particularly susceptible to attack by viruses. Therefore, try to take vitamins and minerals that will support the general condition of the body.

In some cases, the appearance of infectious tonsillitis can be associated with inflammatory processes in the oral cavity, dental diseases (for example, caries). In this case, the focus is first eliminated, the original cause, and then the disease itself.

Tonsillitis can also manifest itself due to the weakening of the affected organism. To prescribe and completely get rid of the disease, you must immediately consult a doctor and follow all the recommendations given by the specialist.

Symptoms of the disease

For each person, infectious angina can manifest itself in different ways, but the main symptoms are quite similar. Among them:

• Severe sore throat, especially when swallowing
• Heat
• Redness of the tonsils
• Plaque on the tonsils (usually yellow or white)
• Chills
• Swollen lymph nodes

When the patient discovers these symptoms, the doctor takes a smear with rear wall throat. Sowing demonstrates whether there is streptococcus in the smear: if it is found, the probability of illness is almost 100%.

In severe cases, the patient's voice may change. If your work is directly related to communication, it is recommended to immediately call a doctor and take a sick leave, since it is almost impossible to conduct a full-fledged activity if you lose your voice.

These signs can be supplemented by some others: it all depends on the degree of inflammation, the patient's personal characteristics and the state of the body.

Angina refers to an infectious disease that occurs as a result of the penetration of various microbes into the mucous membrane of the oral cavity. As a result of this process, the region of the pharynx and tonsils is affected. The tissues of the mucous membrane become very red and swollen. In this case, the patient has a strong painful sensation when swallowing and talking.

When a sore throat occurs, the etiology lies in the settling of the infection on the tonsils. Often, the causative agent of tonsillitis is beta-hemolytic streptococcus, which belongs to group A. In rare situations, other microbes in the form of staphylococcus, pneumococcus, green-type streptococcus, fungi and viruses can cause the manifestation of the disease. Ulcerative angina occurs as a result of a spirochete or spindle-shaped rod entering the respiratory tract.

Pain in the throat can be manifested by different reasons. As a result, you should immediately seek help from a doctor. ARVI appears as a result of the fact that the body is attacked by various viruses. Infectious tonsillitis occurs due to the fact that bacteria settle on the tonsils. There is another problem. Colds are often accompanied by a secondary infection, which is bacterial in nature. But the diagnosis of angina is made on such a basis as the formation of plaque and pus on the tonsils. The throat with ARVI can only blush and swell slightly.

Unfortunately, self-diagnosis is not possible. In order to determine the pathogen, you need to undergo an examination, take a smear and blood for analysis.

It is also worth noting that with angina, the pain sensation is very strong. The thing is that the tonsils and lymph nodes increase significantly in size, which leads to difficulties with swallowing function. With sore throat, various rashes and blisters can form. It all depends on what pathogen caused the disease.

To recognize tonsillitis, it is necessary to examine the throat. You can do these manipulations for both an adult and a child. First of all, you need to sit near a window or a source of bright light. Then open your mouth and shine a flashlight on your throat. On examination, attention should be paid to the tonsils. If they have greatly increased in size and have a bright red color, then this is a sore throat. Also on the pharynx will be located small pustules. Such formations are quickly opened, so their appearance can be missed. After that, plaque forms on the tonsils.

With tonsillitis, a runny nose and nasal congestion are very rarely manifested. But with SARS, these symptoms are among the first signs.

Many patients are interested in how to distinguish a sore throat from a cold. The difference between these two diseases is significant.

So what is the difference between angina and SARS? Tonsillitis affects only the tonsil area. The disease can manifest itself due to hypothermia, eaten ice cream or the penetration of microbes. As a result of this process, the patient develops strong pain in the pharynx, due to which the swallowing function is disturbed. The temperature rises to 39-40 degrees, there is a feeling of chills and a feverish state. High rates with angina can last more than three days, while falling gradually. Also, with tonsillitis, cervical and submandibular lymph nodes.

Angina is usually divided into several types, which include the following diseases.

1. Catarrhal angina. This type of disease is considered the most relieved and belongs to the initial forms of manifestation of tonsillitis. The disease is characterized by severe reddening of the throat and pain when swallowing. The temperature often rises no higher than 37.5 degrees. If the patient does not take appropriate measures, then the sore throat goes to another stage.
2. Follicular angina. With this type of disease, suppuration occurs on the follicles of the tonsils. In this case, small abscesses of a yellowish tint will be located on the pharynx. When the formations break, a purulent plaque forms on the mucous membrane. The patient has an increase in temperature up to 39 degrees.
3. Lacunar angina. The inflammatory process is located on the lacunae of the tonsils. In this case, during the formation of plaque, a certain pattern of lines is formed. The resulting film is quite easy to remove. There is an increase in temperature to forty degrees.
4. Phlegmonous angina. The inflammatory process occurs in the thickness of the tonsils. Suppuration leads to an abscess of a paratonsillar or intratonsillar nature. Pain in the throat often radiates to the ear. In this case, there is a strong increase in the lymph nodes, and the voice is lost and becomes nasal. Arises sharp redness and tissue swelling. And the tongue moves to the side.
5. Ulcerative angina. This type of disease affects only one side, which leads to tissue necrosis. Plaque forms on the tonsils greenish color. Body temperature rises to 37.5 degrees, and there is also a slight increase in lymph nodes. The patient's blood test revealed leukocytosis.

SARS occurs when exposed to several causes.

• Hypothermia or overheating of the body.
• Frequent contact with sick people.
• Unfavorable environment.
• Weakened immune function.
• Lack of vitamins and minerals.
• Penetration of viruses on the mucous membrane of the upper respiratory tract.

With SARS, a strong increase in temperature is rarely observed and it reaches 38 degrees. At the same time, after two days it subsides and returns to the previous figures. In this case, ARVI is characterized by the appearance of nasal congestion, runny nose, cough.

Even by an experienced doctor, angina, infectious diseases and influenza can be confused. To accurately determine the disease, the doctor must prescribe a thorough examination.

You can distinguish a sore throat from a cold by the complications that have arisen. It is believed that tonsillitis causes more serious consequences than a cold.
The main complications after ARVI are usually attributed to the following.

• Purulent lymphadenitis.
• Mastoiditis.
• Sinusitis.
• Nephritis of focal character.
• Appendicitis.
• Myocarditis.
• Pyelonephritis.
• Glomerunefrit.
• Rheumatoid arthritis.
• Chronic pneumonia.
• Cholecystitis.

With SARS, other complications develop.

• Otitis.
• Meningitis.
• Encephalitis.
• Bronchitis.
• Pneumonia.
• Pneumonia.
• Sinusitis.
• Sinusitis.

Oddly enough, but a cold or flu can lead to a sore throat. And tonsillitis of an acute nature, with incorrect or incomplete treatment, turns into acute stage. Also, angina most often leads to complications of internal organs, but SARS affects closely located organs.

To recognize SARS or tonsillitis, you need to undergo an appropriate examination. It includes the following analyses.

1. bacteriological research.
2. Cytological study.
3. Virological research.
4. Mycological research.
5. Serological study.
6. Blood donation for general and biochemical analysis.
7. Skin testing for allergies.
8. Carrying out X-ray examination.
9. Conducting electrocardiography.
10. Ultrasound diagnosis of the kidneys and bladder.

It is also necessary to conduct a differential diagnosis in order to distinguish tonsillitis from diphtheria, infectious mononucleosis and herpangina. ARVI and tonsillitis can occur along with other diseases in the form of typhoid fever, tuberculosis, blood diseases, scarlet fever, mycosis.

It is very important to correctly diagnose the disease, since the treatment process, the absence of complications and a quick recovery depend on it.

Since ARVI is caused only by viruses, the treatment includes the mandatory intake antiviral agents. Patients are often prescribed Arbidol, Ingavirin, Kagocel. To increase immune strength and interferon in the blood, experts recommend using drugs in the form of Anaferon and Ergoferon in tablets, Viferon in suppositories, Grippferon or Interferon in tablets. Duration treatment course is five days.

With SARS in extreme cases resort to the use of antipyretics, since the temperature usually rises no more than 38 degrees. If the temperature is very high, you can take Paracetamol, Ibuprofen, Aspirin or Analgin. AT childhood mono resort to wiping with warm water.

Since a cold is always accompanied by a runny nose and nasal congestion, patients are advised to resort to drops. Help relieve swelling in the nose vasoconstrictors in the form of Nazivin, Otrivin, Vibrocil. To quickly eliminate a runny nose, you can use Pinosol. It contains essential oils. Don't forget to flush your nasal passages various solutions from soda and salt, furacilin and herbal infusions. You need to carry out the procedure up to six times a day.

Often a cold is accompanied by a cough. To eliminate it, you need to take drugs in the form of Ambrobene, Ascoril and Dr. Mom.
Treatment of acute tonsillitis differs significantly from colds. Since in eighty percent of cases angina is caused by bacteria, antibacterial agents are prescribed. The duration of taking antibiotics is at least five days. Abruptly cancel the drug without the knowledge of the doctor upon the onset of improvements is strictly prohibited. If these conditions are not met, the patient risks getting complications. Antibiotics are often prescribed in the form of Augmentin, Amoxiclav, Azithromycin and Erythromycin.

Along with acceptance antibacterial agents it is necessary to carry out rinsing of a throat. For such purposes, soda-saline solution, furatsilin, infusions are used. medicinal herbs. The procedure in the first days of the disease should be carried out up to ten times a day.

You also need to irrigate the throat with antiseptic agents. The doctor may prescribe Hexoral, Tantum Verde or Miramistin. The procedure should be carried out up to four times a day.

To relieve pain, you can take absorbable tablets. Many of them contain anesthetics. They have anti-inflammatory, antiseptic and analgesic properties. These include Grammidin-Neo, Strepsils Plus, Pharyngosept. Total duration treatment is seven to ten days.

But do not self-medicate, because this can lead to adverse consequences. At the first signs of the disease, to clarify the diagnosis, you need to contact a specialist.

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This disease manifests itself in the form of inflammation of the tonsils caused by infection. Infectious sore throat can be viral or bacterial, depending on the type of pathogen. A viral infection of the throat often occurs as pharyngitis and usually begins with a sudden sore throat and pain when swallowing.

In each person, the disease manifests itself in different ways. Some of the main symptoms of the disease are given below:

temperature

very sore throat

redder than usual, tonsils

yellow or white coating on the tonsils

swollen lymph nodes in the neck

bad smell from the mouth

The disease can be diagnosed by conducting a rapid test for streptococcus. To perform the test, the doctor will use a cotton swab to swab the surface of the back of the throat. This test will determine if you have a streptococcal disease or a viral throat infection.

Symptoms of the development of a viral infection in the throat

Typical signs of a viral infection in pharyngitis:

temperature;

swollen lymph nodes on the sides of the neck (cervical lymphadenopathy);

white spots on the tonsils and throat (exudate on the tonsils).

Manifestations of a viral infection that may occur with tonsillopharyngitis :

sudden onset of sore throat;

headache;

odynophagia (painful swallowing);

nausea, vomiting, abdominal pain;

red, swollen soft palate (uvula);

Nonspecific signs of a viral infection

conjunctivitis (redness of the eyes);

runny nose (rhinitis)

skin rash (rash or small patchy rashes);

malaise;

muscle pain;

The rash is caused by toxins that are released from bacteria and not necessarily due to the spread of an infection on the skin. This rash is also known as scarlet fever, which can affect up to 10% of children with a sore throat infection and usually starts on the face and neck and can spread to the rest of the body.

Symptoms of bacterial infectious angina

The disease caused by streptococci can have a number of manifestations associated with inflammation of the throat and nearby structures of the throat. Symptoms usually appear within a few days (1-4 days) after infection (incubation period). These include:

sore throat,

red swollen throat

white spots on the back of the throat and tonsils, indicating the presence of pus.

The presence of temperature and enlarged lymph nodes on the sides of the neck,

and no cough.

All these symptoms may raise suspicion of bacterial angina, and not of the viral origin of the infection.

Treatment depends on whether the sore throat was caused by a virus or a bacterium. If the illness is caused by streptococcal bacteria (streptococci), the doctor will prescribe antibiotics. If the sore throat is caused by bacteria, antibiotic treatment usually clears up the infection within 1 week. However, it may take several weeks to return to normal size tonsils and swollen tonsils.

Your body will fight a viral infection on your own. In this case, only the assignment is shown symptomatic remedies. If infectious angina is caused by viruses, the time of illness depends on which virus in question. Typically, people recover almost completely within 2 weeks.

Sometimes infectious angina often recurs and can cause difficulty in breathing. Your doctor will then recommend a procedure to remove your tonsils, called a tonsillectomy.

Treatment at home for a viral infection in the throat

Various diseases of a viral infection in most cases begin unexpectedly. The temperature rises sharply, the throat begins to hurt, lacrimation, runny nose, headache, weakness, vomiting, diarrhea. You need to take certain measures for the first time during the illness. Call a doctor at home and of course do everything to make the patient's condition somehow improve. Such diseases can be treated as modern medical means, and grandmother's methods proven over the years. How to treat the disease with folk remedies, find out right now.

slippery elm (powder) - five grams, cinnamon - five grams. Mix thoroughly, send to the back of the tongue. Drink water. The disease will recede after the second application. Children can add five grams of red pepper to the mixture.

to prevent the process of dehydration in the body with symptoms of infectious sore throat, a salt solution will help. To make such a solution you will need: five grams of salt, twenty grams of sugar per liter of water.

effective folk remedy, perfectly replacing Regidron: one hundred grams of raisins per liter of water, cook for thirty minutes. Add five grams of salt, five grams of soda, twenty grams of sugar. Boil everything again. You need to drink medicine often, in small sips. If the raisins are ground, the solution will come out more saturated.

ten grams of St. John's wort brew for two hundred and fifty milliliters of boiling water. For adults - half, for children - a third of a glass. Not recommended for children under three years of age.

with diarrhea, a decoction should be made from a two-year-old aspen: ten grams per three hundred milliliters. Drink portions of ten grams, five times a day.

gives positive results and potato starch. Five grams of crushed starch per hundred grams of cold boiling water, drink in one gulp. After vomiting stops, the patient should be given rice porridge on water, carrot and apple puree, rice water instead of water.

if your throat bothers, use infusions for rinsing: herbal infusions calendula, chamomile, sage. It is advisable to carry out the treatment procedure before meals.

The disease of viral origin is usually spread from person to person through contact or contact with the nasal fluid of an already infected person. The most common way to get sharp shape virus is contact with an infected person.

In close contact by airborne droplets from an infected person, you can become infected with streptococcal infectious angina in the same way. enclosed spaces, such as college dormitories, kindergartens, military installations, schools provide ideal conditions to transmit disease from one person to another. The risk of infection from an affected family member approaches 40%. The risk of being infected with streptococcal bacteria decreases to a great extent after proper antibiotic treatment is started.

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• Symptoms of the disease
• Other treatments

On the background inflammatory reactions angina appears in the body - an infectious disease caused by different kind pathogens affecting the lymphoid tissue of the larynx and regional lymph nodes. Angina refers to diseases that have a high degree of contagiousness and are transmitted by airborne and alimentary routes. The main causative agents of this disease are streptococci, staphylococci, pneumococci, fungi, viruses. great attention doctors devote to the treatment of angina and all its causes, since the complexity of the consequences that may result from an incorrect therapeutic approach can provoke damage to many organs. Therefore, it is very important not to start the disease.

Symptoms of the disease

The main route of infection throughout the body is the mucous membrane of the surface of the tonsils - formations of lymphoid tissue that are located in the nasopharynx and oral cavity. This infectious disease can have a recurrent form of development in the presence of allergic factors.

Angina begins abruptly with the appearance of a feverish state, chills. Often the first signs of the disease are fever and pain when swallowing. With bacterial-fungal angina, the temperature may not be observed, especially in the early days, but you should not delay treatment even if it is not. Doctors recommend to go full examination, since there is no sore throat without fever, and such symptoms may indicate a more serious illness or very poor immunity. The characteristic symptoms, due to which angina is confused with other viral and infectious diseases, appear as:

• swelling and hyperemia of the tonsils;
• pain when swallowing;
• suppuration on the surface of the tonsils;
• prolonged fever (5-6 days);
• intoxication.

Infectious angina often accompanies such ailments as scarlet fever, typhoid fever, mononucleosis, influenza, herpangina, syphilis, diseases of the circulatory system, tonsillitis. The component of angina in children and adults implies its seasonal appearance, since the main cause is such factors as temperature changes, seasonal beriberi and weakening of the protective properties of the body.

In the event of a sore throat as a result of the development of one of the infectious diseases, parents should conduct an accurate diagnosis before starting treatment procedures. Therapeutic measures for common sore throat and her infectious form have completely different treatments. In some cases, the patient is hospitalized.

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Treatment of angina in children with antibiotics

After conducting a differentiated diagnosis and determining the causes of the appearance of infectious sore throat, doctors begin to work on the elimination of the infectious focus. In this case, preference is given to the use of antibiotics. Despite the negative reviews and the appearance of possible complications, the use of these drugs is the most effective method of treatment.

When using antibiotics, especially in children, it is necessary to follow the rules for their administration, dosage and optimal duration of use. Incorrect selection of the remedy, its uncontrolled use lead to a violation of the intestinal microflora and tonsils. As a result, the patient is faced with the development of a fungal infection, which has its own difficulties in treatment. This contributes to the aggravation of the course of the underlying disease and causes great harm condition of the tonsils. Do not forget that healthy tonsils are a protective barrier for foreign pathogenic organisms. In severe cases, dysbacteriosis may appear.

Parents make a big mistake when they see signs of improvement general condition child, stop antibiotic treatment. The infection becomes untreated, and the pathological microflora gradually adapts to the substances that are part of the drugs, thereby provoking the progression of the disease and its transition to chronic stage. In the future, the type of antibiotic used will be powerless against infectious sore throat, it will need to be replaced with a stronger drug.

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Other treatments

There are norms prescribed for the treatment of angina, which is of an infectious nature. Following them makes it possible to conduct high-quality treatment without complications and side effects.

With a clearly established diagnosis of "infectious tonsillitis", it is imperative to contact a pediatrician who will prescribe the correct treatment. If necessary, the child can be hospitalized in the infectious diseases department of the hospital.

If treatment procedures are carried out at home, parents should, when giving antibiotics to children, strictly follow the dosage prescribed by the doctor and follow the rules for taking the drug, without reducing or increasing the timing of its use.

AT without fail children need to consume a sufficient amount of liquid, which contributes to the rapid removal of toxic substances from the body, as well as metabolic products after taking synthetic drugs. It is better if children drink more fortified drinks Flavigran, Vitamix, Florenta.

Good local remedy external symptoms sore throats and withdrawal of pathogens are warm gargles several times a day. The best are solutions of "Esobel", "Shirline", Miramistin, infusions of calendula and chamomile. In no case should you give hot solutions, this can provoke an increase in the inflammatory process.

Antipyretics help bring down the temperature of more than 38 ° C with angina. To eliminate infectious angina, the best are the means, which include antibiotics, especially in its purulent form. The course of their reception is from 7 to 10 days.

To prevent complications in the form of dysbacteriosis, doctors recommend taking drugs with bifidobacteria - lactobacterin, linex and others.

To eliminate swelling of the tonsils, apply antihistamines loratadine, claritin, suprastin.

In order to improve metabolic processes in the liver, it is necessary to take hepatosol, which helps to improve the deactivation of dead microorganisms.

If sore throat is one of the flu symptoms, then antibiotics in this case may be useless, since they do not act on the cause of the underlying disease - the influenza virus.

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Features of the development of tonsillitis

After suffering an infectious sore throat, a disease such as chronic tonsillitis may develop. Compared with angina, it may be absent brightly. severe symptoms. Only after some time, the pus accumulated in the almond lacunae, forming purulent plugs, can cause bad breath due to decomposed microorganisms. Parents often confuse it with other oral problems and, consulting dentists, lose the time needed for treatment. initial stage diseases. Tonsillitis has characteristics development:

1. Microorganisms settled on the tonsils begin the process of tonsillogenic intoxication, which leads to fatigue, muscle and joint pain. In some cases, this may be accompanied by an increase in temperature.
2. Frequent illnesses of a cold nature can provoke stress, hypothermia, overwork.
3. A child with chronic tonsillitis may be exposed to frequent allergic diseases.
4. An infection that has occupied the tonsils, entering the circulatory system, can affect many organs. In the future, this disease may even cause reproductive dysfunction in women.

So that tonsillitis does not provoke complications, it is necessary to start its treatment on time, guided by medical advice. In the treatment of chronic tonsillitis, it is necessary to use those methods that are prescribed for the treatment of infectious tonsillitis.

If such therapy does not bring results, doctors suggest performing a tonsillectomy - removal of the tonsils. It is advisable to carry out drug therapy immuno-strengthening measures - hardening, taking vitamins, massages with Florenta cream 2 times a year.

Angina(synonyms of the disease: acute tonsillitis) is an acute infectious disease that is caused by various pathogens, mainly streptococci, characterized by pronounced inflammatory changes in the lymphoid tissue of the pharynx, regional lymph nodes and is manifested by fever, sore throat, often the formation of raids on the tonsils.

Angina has been known since the time of Hippocrates. AT late XIX in. N. Simanovsky (1889) described a special form of ulcerative necrotic angina, which, as N. Plaut (1894) and N Vincent (1896) proved, entailed fusospirochetal symbiosis. W. Schultz in 1922 and V. Friedenann in 1923 described agranulocytic and monocytic angina. The name of the disease comes from the Greek. aticho or lat. angere - to squeeze, choke, crush.

Most often, the causative agent of angina is group A beta-hemolytic streptococcus. Less commonly, the cause of the disease can be staphylococcus aureus, pneumonia streptococcus (pneumococcus), green streptococcus, fungi, spirochetes, viruses. Ulcerative tonsillitis of Simanovsky-Plaut-Vincent is caused by a symbiosis of the usual spirochete of the oral cavity and the fusiform rod. AT recent times in the etiology of angina, the role of staphylococci has increased, which is associated with a change in the usual microflora of the palatine tonsils due to wide application antibiotics and sulfa drugs.

The role of viruses in the occurrence of angina is being intensively studied, which, in addition to their independent etiological significance, can activate the microflora of the tonsils.

The source of infection are patients (convalescents) with tonsillitis, acute respiratory diseases, chronic tonsillitis during an exacerbation, scarlet fever, and (less often) carriers of hemolytic streptococcus.

The contagiousness of patients with angina is high. Underestimating the importance of isolating such patients can lead to a significant spread of the disease. In addition to exogenous, endogenous infection of the tonsils is also possible due to the activation of bacteria and viruses that permanently or temporarily vegetate on the mucous membrane of the pharynx (autoinfection). main path exogenous infection- airborne. Much less often, there is an alimentary route of infection through food products infected with streptococcus, accompanied by outbreaks of tonsillitis in groups.

The incidence of angina can be both sporadic and in the form of epidemic outbreaks. For the spread of this disease is second only to SARS. The highest incidence of tonsillitis is recorded from October to March - April.

Those who have had a sore throat do not have immunity; often, on the contrary, appears hypersensitivity pathogen and prone to recurrence.

Angina is a common disease of the body, and although the significance of the pathogen in the occurrence of the disease is undeniable, its development largely depends on the functioning of the system of general and immune homeostasis. The main gate of infection is the mucous membrane of the free surface of the tonsils. A hematogenous mechanism for the development of angina is also possible.

The tonsils become the main breeding site for the pathogen, where a septic focus is formed, from which the infection can spread in the body, which leads to various complications.

With angina that recurs (exacerbations of chronic tonsillitis), important role plays an allergic factor (sensitization to microorganisms and their toxins).

Histological changes in the tonsils with tonsillitis are characterized by hyperemia, an increase in lymphatic follicles, massive small cell infiltration, peeling of the integumentary epithelium of the tonsils, the veins of which are often tamped. If the sore throat is catarrhal, only hyperemia and swelling of the tonsils are observed; follicular - suppuration of lymphatic follicles, which look like dotted white-yellow protrusions; lacunar - accumulation of pus in the lacunae and on the surface of the tonsils (raids). In the case of ulcerative tonsillitis, a tissue defect covered with plaque is found in some areas of the tonsils. With phlegmonous angina inflammatory process covers tissues not only of the tonsils, but also adjacent ones (paratonsillitis). After 2-3 days, an abscess is formed, located outside the tonsils - above it, in the region of the anterior or posterior palatine arch (peritonsillar abscess). The formation of an abscess of the tonsil is much less common.

According to the pharyngoscopic picture, the following forms of angina can be distinguished: catarrhal, follicular, lacunar, fibrinous, phlegmonous, and ulcerative necrotic (gangrenous). Changes in form are also observed. Phlegmonous tonsillitis (paratonsillitis), although it is a complication of acute tonsillitis, but according to its features clinical manifestations and treatment tactics can be separated into a separate form.

The incubation period lasts from several hours to 2-3 days. The disease begins acutely with chills, increased d? Temperatures of the body up to 38-40 ° C. Sometimes the temperature may remain subfebrile.

There is a growing visual obstruction and sore throat when swallowing. Regional lymph nodes increase and become painful. Possible reflex otalgia, increased salivation, bad breath. There is a headache, aching limbs, weakness, malaise. Children of the first year of life sometimes have vomiting, meningeal symptoms, convulsions. On the part of the circulatory organs, tachycardia, muffled heart sounds, systolic murmur, changes in the ECG are possible.

The feverish period with uncomplicated angina lasts up to 4-5 days. The nature of angina is determined by local changes that are detected during pharyngoscopy.

In patients with catarrhal tonsillitis, edema and hyperemia of the tonsils, often palatine arches, and soft palate are found. There may be a slight increase and soreness of regional lymph nodes, fever, signs of intoxication. Catarrhal angina is not uncommon, although such a diagnosis is sometimes made with any reddening of the pharynx, which can be either a symptom of another disease, or a consequence of a change in the color of the mucous membrane (non-inflammatory) with various diseases and states.

Follicular tonsillitis is the result of suppuration of the lymphatic follicles of the tonsils. Against the background of these changes, yellowish-white (with a pinhead) subepithelial abscesses are noticeable, which appear through the mucous membrane and rise slightly above the surface of the tonsil ( diagnostic feature). In the event of a breakthrough of such an abscess, small raids of the same size are found, which can merge into larger ones. The same process is possible in lacunae, where accumulation occurs purulent exudate and as a result, follicular-lacunar tonsillitis develops.

The mechanism of development of lacunar angina may be different. The inflammatory process leads to the accumulation of manure in the lacunae - desquamated epithelium, mucus, microorganisms, leukocytes in the form various forms yellowish, yellowish white purulent plugs or plaque at the mouth of lacunae. Plaques can merge (solid plaque or film - fibrinous tonsillitis), be on one or both sides, easily removed without leaving a bleeding surface. The raids usually do not extend beyond the tonsils. Lacunar angina is observed much more often than follicular, although doctors make the latter diagnosis unreasonably often. In patients follicular angina often significant intoxication and exposure to local and common complications due to the accumulation of purulent exudate in the follicles and the difficulty of its outflow.

The above forms of angina are a manifestation of a single pathological process which can stop at any stage.

Inflammatory process either in the thickness of the tonsil (intratonsillitis), or, more often, in the paratonsillar tissue and adjacent tissues (paratonsilitis). Suppuration leads to the formation of an intratonsillar or paratonsillar abscess, respectively, usually on one side. At the same time, a sharp throbbing pain in the throat increases, which spreads to the ear. Significantly limited mouth opening. The voice is nasal, regional lymph nodes are enlarged and painful. Pain is felt during movements of the head and neck. There is a sharp redness and swelling of the tissues of the oropharynx. The tonsils are enlarged, significantly bulging, as a result of which the anterior palatine arch is smoothed (diagnostic sign). The palatine uvula is displaced to the opposite side.

"Maturation" of the abscess can be determined with a protrusion of a yellowish mucosal area or softening and fluctuation when probing with a finger. In children, phlegmonous tonsillitis is much less common than in adults, but there are cases of its development even in children of the first year of life.

Simanovsky-Plaut-Vincent's angina may develop as a result of an exogenous or endogenous infection. Changes are observed, as a rule, on the one hand. Necrosis leads to the formation of deep ulcers with uneven edges, the bottom of which is covered with a dirty greenish-gray coating. The film is easily removed, but quickly restored. The process can extend beyond the tonsils. Body temperature is often subfebrile, sore throat does not always bother the patient. Regional lymph nodes are slightly enlarged, moderately sensitive. Palatine tonsils - a typical localization of angina. Less commonly, there is a lesion of the tongue, pharyngeal and tubal tonsils, lateral folds of the pharynx.

When examining blood in patients with acute tonsillitis, neutrophilic leukocytosis and increased ESR are characteristic.

Complications can develop after any form of angina. In addition to paratansiditis, purulent lymphadenitis, otitis media, mastoiditis, sinusitis, focal nephritis, appendicitis, thrombophlebitis are possible. jugular vein, endo-, myo-, pericarditis, mediastinitis, sepsis, etc. In addition, at a later date, the so-called lonsilogenic diseases are possible: rheumatism, acute diffuse glomerulonephritis, rheumatoid arthritis,. Chorea. The presence of a focus of infection in the region of the lymphadenoid ring is sometimes associated chronic pneumonia, cholecystitis, appendicitis.

The prognosis, if there are no complications, is favorable. The main symptoms of the clinical diagnosis of acute tonsillitis are the acute onset of the disease with chills, fever up to 38-40 ° C, increasing sore throat when swallowing, enlargement and soreness of regional lymph nodes, with catarrhal tonsillitis - edema and hyperemia of the tonsils, with follicular - the presence of they have small subepithelial abscesses (suppuration of the lymphatic follicles), with lacunar - accumulation of pus in the lacunae, with phlegmonous - an inflammatory process in the thickness of the tonsil or in the paratonsillar tissue and adjacent tissues, with Simanovsky-Plaut-Vincent's angina - necrosis

3 formation of deep ulcers with uneven edges, the bottom of which is covered with a dirty greenish coating.

Specific diagnosis is based on the use of bacteriological, bacterioscopic, virological, mycological, serological, cytological studies. In some cases, skin allergy tests are used.

The differential diagnosis should be made with diphtheria, (see ("Diphtheria"), infectious mononucleosis, herpangina. Listeriosis, anginal-bubonic form of tularemia, as well as with lesions of the pharynx and tonsillitis with scarlet fever, influenza and other acute respiratory viral infections, typhoid fever, tuberculosis, syphilis, blood diseases, mycoses, tumor processes.

Patients with a severe course of the disease, as well as those who work in closed institutions, are subject to mandatory hospitalization. Recommended bed rest. All patients, regardless of the severity of the disease, are prescribed intramuscularly benzylpenicillin at 100,000-200,000 IU / kg per day every 3-4 hours for 3-4 days. Oxacillin, tetracyclines are effective. Timely use of antibiotics in sufficient doses and frequency of administration and, especially, intramuscular injection benzylpenicillin is a prerequisite for the prevention of rheumatism. Only if it is impossible to use the above treatment regimen at home, you can prescribe bicillin-1 at 5000-10,000 IU / kg 1 time per week with simultaneous reception sulfanilamide preparations, the most effective of which is Bactrim (biseptol-480) 2 tablets 2 times a day for adults, children biseptol-120 in age doses for 7-10 days. If another etiology of angina is established, an appropriate antibiotic therapy. Local treatment may be limited to gargling with a warm solution of sodium bicarbonate, potassium permanganate, etc. It is advisable for all patients with angina to prescribe moderate doses of sodium salicylate. With staphylococcal tonsillitis, in addition to antibiotics (erythromycin, semi-synthetic penicillins, cephalosporins), you can prescribe protistaphylococcal immune preparations. Antibiotics (benzylpenicillin, tetracyclines), metronidazole are used to treat patients with Simanovsky-Plaut-Vincent's angina.

Prevention consists in the early detection and isolation of patients with tonsillitis, the identification and treatment of patients with chronic tonsillitis, hardening. The occurrence of an epidemic outbreak in a closed community requires a final disinfection. In the case of Simanovsky-Plaut-Vincent's angina, the patient is isolated, the persons who were in contact with him are examined. In closed groups, carriers of fusospirochetal symbiosis are isolated into a separate group and healed.

Young children often get colds in the spring and autumn seasons. During these periods, the child's body suffers from beriberi, the temperature outside is unstable, and this increases the risk of morbidity at times. Usually everything is limited to a cold, but in some cases a sore throat appears. It has a complex course and is characterized by rapid development, treatment should be immediate. If this is not done in time, then the disease will turn into a chronic form, where the throat will suffer first of all.

Description of the disease

Angina is an acute infectious and inflammatory disease (acute tonsillitis). Pathogens: staphylococci, pneumococci, streptococci, less often - fungal flora, other pathogenic viruses and bacteria. The formation of pathology occurs in the presence of favorable environment for breeding, for example:

• hypothermia;
• poor nutrition;
• avitaminosis;
• inactive lifestyle;
• constant physical and psychological stress;
• viral infections.

The lesion extends to the palatine tonsils - inflammation begins with hyperemia, an increase in size, and edema. Parents do not always understand the severity of angina.

The whole body suffers from intoxication and the rapid course of pathology. It becomes difficult for the patient to breathe: if you do not apply for medical assistance and do not treat Small child(especially up to a year) is at risk of dying from asphyxia.

Incubation period and infectiousness of angina

Angina is contagious to others of any age. With a weakened immune system, a short contact with a person who is a carrier of the pathogen is sufficient. Infection is also possible during the incubation period, that is, the period of time from the penetration of the infection into the body until the first symptoms appear. The duration of the incubation period depends on:

• etiology of the pathogenic agent;
• general condition of the body;
• the patient has chronic diseases;
• types of angina;
• the degree of functioning of the immune system.

Depending on these factors, the incubation period of angina in children varies in duration from 12 hours to 12 days. Over this time pathogenic bacteria and microorganisms settle in the oral cavity and begin active reproduction. Infection is possible not only in the midst of pathology, a sore throat in a child is contagious to others during therapy and taking antibiotics.

The initial stage of the disease

When the incubation period passes, the child's well-being deteriorates sharply. On the early stage development of a sore throat, a runny nose, sore throat, body temperature rises, headaches and muscle spasms, "aches" all over the body.

On visual examination, there is an increase in the tonsils and hyperemia of the throat, the cervical and submandibular lymph nodes also become much larger than normal. At the initial stage of angina, the first thing to do is contact a pediatrician: he will establish a diagnosis and prescribe treatment, the focus of which depends on the causative agent of the disease and the form of pathology.

Further course of the disease

If, after the onset of the initial signs of angina, appropriate treatment was not carried out, then the disease progresses very quickly and is severe. The baby's appetite is sharply reduced or completely absent, he feels tired, naughty, shows minimal activity, behaves restlessly in a dream.

It is impossible to say exactly how long angina lasts in children. Intoxication extends to the entire body, and clinical picture additionally, it can be supplemented with the following features:

• nausea;
• disorder of the digestive system;
• diarrhea;
• fever;
• vomit;
• a white coating forms on the surface of the tongue;
• ulcers open on the tonsils.

In the photo you can see which rashes determine this infectious pathology.

Causes of angina

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The peak incidence of angina in children is observed in cold weather, due to sudden temperature fluctuations, immunity is noticeably reduced. Among other reasons, there are: poor nutrition, lack of vitamins and walks in the fresh air.

Tonsils do not perform protective function, it is very easy to provoke the reproduction of bacteria - just drink cold water. Do not forget that sore throat is contagious, so in this state you can catch the infection by airborne droplets. In addition, an infectious disease is provoked by:

• pathology of ENT organs and oral cavity;
• prolonged treatment with antibiotics;
• frequent infectious diseases;
• intestinal dysbiosis.

Classification of angina in children

According to the form of the pathology, two stages are distinguished. Acute angina develops very quickly and requires immediate treatment. If the disease is not cured, it will turn into a chronic form, and with the slightest ailment, the likelihood of a second exacerbation is very high.

What is angina in children?

Signs of a sore throat

Angina in children in terms of symptoms and course can vary significantly, it depends on the etiology of the disease. In the bacterial form, a whitish coating forms on the tonsils. If the type of lesion is viral, then catarrhal symptoms (cough, runny nose, etc.) are more pronounced.

The disease can be recognized by knowing characteristics tonsillitis in a child - an increase in the tonsils, ulcerative lesions on them. They can be in the form of red dots filled with liquid, or with pus inside. In addition, there is always hyperemia and swelling of the throat, the root of the tongue looks whitish.

Regardless of the pathology agent, there are common symptoms of angina:

• sharp rise body temperature from 37-40 degrees;
• acute sore throat;
• poor appetite/sleep;
• severe weakness;
• sometimes - nausea and vomiting;
• headaches and muscle pain;
• incubation period up to 12 days.

Diagnostics

When contacting a specialist, the pediatrician collects an initial history: interviews the patient and pharyngoscopy. In bright light, the doctor examines oral cavity, probes the lymph nodes on the neck and under the jaw. Then appropriate treatment is prescribed. Usually a visual and tactile examination is enough to establish the correct diagnosis, but sometimes additional studies are required:

• OAM, UAC;
• smear from the oral cavity;
• blood chemistry;
• allergy test;
• to assess the immune system - consultation of an ENT specialist and an immunologist.

The difference between angina and SARS

The initial signs of angina and ARVI are similar; it is difficult to determine which disease a child has without the help of a doctor.

At the same time, there is a huge difference between them. With tonsillitis, purulent sores usually form on the tonsils, the patient experiences severe pain that is permanent. By the way, with a herpes type of illness, children under 3 years old may not complain of discomfort, they have dyspepsia.

It is almost impossible to eat and talk. The body temperature is 38-40 degrees and lasts for several days, the whole body is exposed to intoxication. With ARVI, the fever is less pronounced and passes quickly, after which the child has a runny nose and cough.

Is angina possible in babies up to a year old?

Angina under the age of one year is quite rare. The causative agents are viruses, streptococci and staphylococci. It is more difficult to diagnose the disease in such babies, because they still cannot complain about what worries them.

The immunity of a one-year-old child is in the formative stage, because of which the sore throat develops rapidly, and all the symptoms are very pronounced. The child's body is defenseless against pathogenic bacteria. The course of the pathology is accelerated if the following factors are present:

• avitaminosis;
• underweight;
• abrupt climate change;
• insufficient child care (hypothermia, poor diet, etc.).

How to treat angina?

Angina of bacterial origin is necessarily treated with the use of antibiotics, without them it will not be possible to eliminate the inflammatory process and it will last much longer. Therapy should be carried out under the strict supervision of a physician, it is necessary to adhere to all his recommendations and prescriptions, otherwise the risk of complications remains (stenosis of the larynx - its formation leads to asphyxia).

In addition, the patient should observe bed rest, drink plenty of fluids (fruit drink, tea, fruit juice), rinse the mouth several times a day (especially after meals). There needs to be a constant supply fresh air into the room, if this is not possible, then it should be ventilated more often. List medications should include:

• antimicrobials for bacterial etiology;
• antiviral and immunomodulating agents for viral nature diseases;
• antihistamines;
• local medicines (sprays, lozenges);
• antipyretic and anti-inflammatory drugs;
• vitamin complex.

Features of the treatment of a child under 3 years

Treatment of children under 3 years of age is best done in a hospital, but if parents cannot be in the hospital with him, then doctors allow therapy at home. In this case, you should be scrupulous about all medical prescriptions.

It is important to drink full course prescribed medicines - it depends on how much the child will get sick, because there is a risk of not curing the disease. Since the baby does not know how to rinse his mouth before the age of 3, pediatricians allow the use of sprays and lozenges.

Eliminate from your daily diet solid food so that the sore throat is not irritated. You can give food and drinks to the baby only in the form of heat. hot food accelerates the growth of bacteria. It is also forbidden to use honey in pure form, it will be useful only after the main symptoms (plaque, ulcers) of angina pass.

First aid

If the child's health has deteriorated sharply, then the first thing to do is to call a doctor. It is forbidden to visit the clinic on your own, since sore throat is very contagious.

Before the doctor arrives, you can give the child Paracetamol or another antipyretic in accordance with age dosage. The throat should be treated with a spray with an anesthetic effect (Tantum-Verde, Ingalipt, etc.) or additionally rinsed with saline solution(per 0.2 st. 1 tsp).

rinses

Gargling will help relieve the child discomfort(pain, perspiration), it also helps to reduce the pathogenic process. When rinsing, the inflamed mucous membrane of the tonsils is moistened and its softening, irritation and swelling will pass much faster.

For children, decoctions of chamomile and sage or soda solution are used. It is necessary to treat the throat in this way no more than 5-6 times a day, it can also be used to prevent the occurrence of angina.

Local funds

For topical treatment, lozenges and sprays are used. It is necessary to select a drug taking into account age. You should not buy the medicine that you usually use for a child with a sore throat, it is better to change it after consulting with a specialist in advance.

The following are perfect:

• sprays: Ingalipt, Hexoral, Stopangin, Tantum Verde, Miramistin, Hexaspray (we recommend reading:);
• lozenges: Faringosept, Lizobakt, Dr. Mom, Strepsils, Grammidin.

It is always necessary to treat the oral cavity after eating, so that the medicine has time to act. Before use, check the annotation to the medication, as some products are intended for children from 2.5 years old.

Antipyretic drugs

Angina is always accompanied by fever, to alleviate the condition of the child, antipyretic drugs are used. It is not recommended to bring down the temperature of less than 38.5 degrees, with its increase, the medicine should be given in accordance with the permitted single dose. For the treatment of children under the age of less than a year, Cefecon D suppositories, Paracetamol suspension or Nurofen are used.

If a child is older than 3-4 years, then other means can be given to him: Efferalgan, Viburkol. Between doses, it is necessary to withstand 3-4 hours, the daily dose should not be exceeded in any case. To enhance the effect, you can additionally drink antihistamines: Fenistil, Zirtek, Suprastin.

Antibiotics

Antibacterial drugs are used only as directed by a doctor.

They can be written in the form

Angina (acute tonsillitis) is an acute infectious disease in which the pathogen affects and inflames mainly the palatine tonsils. But inflammation can also affect neighboring accumulations of lymphoid tissue - the lingual tonsil, pharyngeal tonsil and lateral ridges and the larynx area. The causative agents of angina are bacteria (streptococcus, staphylococcus, meningococcus, Haemophilus influenzae, etc.), viruses (adenoviruses, herpesviruses), fungus genus Candida. Mostly children and young people are affected. The disease is promoted by a decrease in immunity, hypothermia, overheating of the body, polluted atmosphere. Sometimes angina begins after a mechanical injury to the tonsils.

The causative agent of angina can be transmitted in two ways:

• - airborne - upon contact with a patient with a sore throat
• - with food (alimentary route of transmission), for example, when drinking unboiled milk from a cow with purulent inflammation of the udder.

It is customary to distinguish between the following types of angina:

• - catarrhal.
• - Follicular.
• - Lacunar.
• - Phlegmonous.

With catarrhal sore throat, dryness and perspiration first appear in the pharynx, and within a few hours painful sensations are added when swallowing. In adults, body temperature rises in the range of 37-38 degrees, and in children it can be above 38 degrees. There is weakness, malaise, headache.

The palatine tonsils and adjacent areas become swollen, swollen. To distinguish catarrhal angina from acute pharyngitis, assess the condition of the soft palate and the posterior pharyngeal wall - with catarrhal angina, they are not changed. Nearby lymph nodes may be enlarged and painful. A general blood test reveals a slight increase in the number of leukocytes and a moderate increase in ESR.

With follicular and lacunar angina, the changes are more pronounced. The onset is acute - with chills and fever up to 39-40 degrees. Intoxication quickly increases, weakness, sweating, headache appear. Appetite disappears, ache appears in the lower back and joints. Puffiness and swelling of the palatine tonsils and adjacent areas of the soft palate are pronounced.

With follicular angina, festering follicles shine through the membrane of the tonsils. They look like white-yellowish small bubbles. With lacunar angina, areas of white-yellowish plaque appear at the mouths of lacunae, plaque can cover the entire surface of the tonsils. It should be noted that follicular and lacunar tonsillitis are rare separately, usually these two forms are found in the same patient. In the general blood test, a sharp increase in the number of leukocytes and an increase in ESR up to 40-45 mm per hour are revealed.

Phlegmonous tonsillitis usually does not develop independently, but against the background of one of the listed forms and, as a rule, in those who are sick with chronic tonsillitis. It's spicy purulent inflammation peri-almond tissue, which is accompanied by severe pain when swallowing, severe headache, chills, weakness, fever up to 39 degrees and above. There is an unpleasant smell from the mouth, profuse salivation. Enlarged and painful adjacent lymph nodes.

If treatment is not started in time, an abscess may form in the peri-almond tissue. It is usually located in front and above the palatine tonsil or in the tonsil itself. The patient's condition quickly improves after opening the abscess (on its own or surgically). With improper use of antibiotics, phlegmonous tonsillitis can drag on for a month or two with repeated abscessing.

Angina can give complications in the form of acute otitis media (inflammation of the inner, middle or outer ear), acute laryngitis (inflammation of the mucous membrane of the larynx), laryngeal edema, neck phlegmon (purulent inflammation of the subcutaneous or intermuscular tissue), peripharyngeal abscess, acute cervical lymphadenitis (inflammation of the lymphatic nodes). Treatment of angina usually does not require hospitalization.

Antibiotics are prescribed for follicular, lacunar and phlegmonous forms. Treatment with antibiotics without a doctor's prescription is not recommended, with fungal forms of angina, antifungal drugs are prescribed in doses depending on age, with viral forms- antiviral therapy if necessary. For rinsing, you can use decoctions of chamomile, sage, warm saline or soda solution, as well as solutions of potassium permanganate ("potassium permanganate"), furacilin. If the child still does not know how to gargle, he needs to be given a drink every half an hour or an hour. warm tea with lemon or warm fruit juice.

Shown also steam inhalation. With lymphadenitis, warming compresses are recommended at night and a warm dry bandage during the day. Treatment is carried out under laboratory control of blood and urine in order to identify complications and start treatment on time. With prolonged lymphadenitis, physiotherapeutic procedures are indicated as prescribed by a doctor. The patient should be hospitalized if heavy course angina and complications. Frequently recurring sore throats lead to the development of rheumatism and nephritis (an inflammatory disease of the kidneys).

Prevention of angina - rehabilitation (recovery) of foci of chronic infection in the mouth (treatment of dental caries, chronic tonsillitis, purulent diseases of the paranasal sinuses), as well as the elimination of causes that interfere with free breathing through the nose (adenoids). Nutrition should be balanced enough vitamins. Hypothermia, overheating and exposure to a polluted environment should be avoided.

Angina is an acute infectious disease, so the patient must be allocated separate dishes(it should be boiled after use) and avoid contact with children.