Sore throat: symptoms, treatment
- Causes of angina
- Sore throat classification
- Symptoms of angina
- Other varieties of angina
- Possible complications
- Diagnosis of angina
- Treatment of angina
Infectious disease, accompanied by acute inflammation of the tonsils and / or other lymphoid formations of the pharynx, in clinical practice is called angina. In the absence of adequate treatment, this pathological process can lead to the development of complications and damage to various internal organs.
Angina is a disease that has been known to mankind since ancient times. Description of operations to remove the tonsils were found in the writings of the legendary Paracelsus. Based on this, we can assume that in those days, angina was one of quite serious and dangerous diseases.
After the introduction of bacteriological methods of angina research into medical practice, they began to be classified according to the pathogen that provoked the development of a pathological condition, and after Edwin Klebs discovered a diphtheria bacillus in 1884, it became possible to differentiate angina from diphtheria.
Causes of angina
The most characteristic causative agents of infection include staphylococci, streptococci, pneumococci, some members of the genus diplococci and enteroviruses.
Ways of infection:
- Airborne (the most characteristic route of transmission).
- Enteral (with contaminated dairy products).
- Hematogenous (with blood from infected pathogen organs and tissues).
- Endogenous (in patients with gastroenteritis, purulent sinusitis, chronic tonsillitis and caries).
- Artificial (when performing surgical operations on the nasopharynx and nasal cavity (traumatic tonsillitis)).
Most often, sore throats are affected by persons who have reduced sensitization and reactivity of the body, or there is congenital immaturity of the physiological systems or there are chronic pathological processes in the ENT organs. However, an important role in the development of the disease is the state of the tonsils and the virulence of the microflora.
With the development of an acute inflammatory process in patients, there is swelling of the mucous membrane of the nasopharynx, hyperemia and impaired lymph drainage. Next, the development of vascular thrombosis occurs, which leads to the formation of microabscesses and the formation of ulcerative lesions.
Sore throat classification
- Catarrhal sore throat (the mildest form, in which only the tonsil mucosa is involved in the inflammatory process);
- Lacunar angina (formation of inflammation in the gaps of the tonsils);
- Follicular sore throat (pathological condition, accompanied by suppuration of the follicles);
- Combined forms of inflammation.
Symptoms of angina
Symptoms of catarrhal angina
This pathology is characterized by an acute onset, with an increase in body temperature of up to 38 C. Patients complain of indisposition, headache, chills, and other signs of general intoxication. Some time after the onset of symptoms, there is pain in the throat, which is aggravated by swallowing (a distinctive feature of the sore throat is severe pain that occurs when the throat is empty).
During the diagnostic examination, there is a significant redness of the mucous membrane, loosening and an increase in the tonsils, dryness, and coated tongue.
On palpation revealed enlarged and painful lymph nodes. Blood counts, as a rule, in this state are little changed or are within the normal range. With adequate treatment, the duration of catarrhal angina is 3-5 days. However, sometimes there are cases when the disease goes into the next form, which is characterized by a deeper lesion of the tonsils.
Symptoms of lacunar tonsillitis
The most characteristic feature of this form of angina is the accumulation in the gaps of fibrinous exudate. At the same time, on the edematous and hyperemic mucous surface of the tonsils whitish raids are formed, localized in the mouths of the lacunae. More often, they are separate formations, less often they merge together and cover most of the surface of these organs. These attacks do not spread beyond the tonsils, are easily removed, but after a while they appear again.
Symptoms of follicular angina
This form of inflammation is characterized by the appearance of multiple purulent islands on the mucous membrane of the tonsils, resembling millet grains in their appearance and shape. These ill-defined formations are nothing but festering follicles.
Over time, the pustules begin to grow, and their opening into the laryngeal cavity is often observed. In clinical practice, there are cases when lacunar develops on one of the tonsils, and the other - follicular tonsillitis. At the same time, the patient has pronounced symptoms of intoxication, headache, weakness, severe sore throat, chills and fever.
Especially hard follicular tonsillitis occurs in childhood. Sick children develop enhanced salivation and there is a frequent need for swallowing. However, due to severe pain, the child tries not to swallow. As a result, the soft palate does not completely enclose the nasopharyngeal space, due to which saliva begins to fall into the nasal cavity and flow through the nose.
The voice in children and adults suffering from follicular sore throat, becomes nasal, because of the increase in tonsils, there is a temporary decrease in hearing and breathing is difficult. In severe cases, develop heart and joint pain. On palpation, there is pain and a significant increase in regional lymph nodes. Also there are significant deviations in the clinical analysis of blood (increased ESR, leukocytosis, leukocyte shift to the left). Often in the urine traces of protein are found.
Symptoms of follicular sore throat continue to increase for four to five days, after which, with adequate treatment, the patient begins to recover. In case of complications, the disease may be delayed and become chronic.
Combined sore throat: symptoms
Combined, or fibrinous sore throat is an inflammatory process that occurs with the simultaneous development of lacunar and follicular angina. In this state, an extensive yellowish-white plaque occurs on the mucous membrane of the tonsils, often extending beyond this organ. The combined form of pathology begins acutely, with a high body temperature and symptoms of general intoxication. In some cases, patients suffering from fibrinous sore throat, signs of clinical meningeal syndrome that develops during irritation of the meninges.
Other varieties of angina
Angina of the tongue tonsil
This is a rather rare disease, occurring in the type of catarrhal, phlegmonous or follicular inflammation. This form of pathology is characterized by the same clinical manifestations as for other types of angina. Its distinguishing feature is severe pain that occurs when pressing on the root of the tongue, swallowing and movement of the tongue. As the pathological process develops, the inflammation begins to spread to the intermuscular tissue, and, in the absence of adequate treatment, may cause the development of interstitial purulent inflammation of the tongue. With the development of phlegmonous tonsillitis of the lingual tonsil, the patient’s general condition deteriorates significantly, the body temperature rises, then a purulent deposit appears on the surface of the lingual tonsil, and painful pains occur in the root area of the tongue, which are aggravated by swallowing.
Acute adenoiditis (retrosis angina)
This form of pathology is most common in children at the stage of development of the pharyngeal tonsil. It can occur on the background of various infectious diseases, as well as become a complication of inflammation of the paranasal sinuses and the nasal cavity.
Acute adenoiditis is characterized by a sharp violation of nasal breathing, accompanied by high body temperature and an obsessive cough. The most characteristic complaints include pain, localized behind a soft palate, extending to the ears and back of the nasal cavity, headaches, as well as discomfort or difficulty in swallowing and indigestion.
During the medical and diagnostic examination, the patient is diagnosed with edema, severe redness of the pharyngeal tonsil, the presence of plaque and a viscous mucopurulent secretion in its furrows.
This is an inflammation that affects the lymphoid tissue of the laryngeal morgue's ventricles, pear-shaped sinuses, and the laryngeal folds. Often the pathological process can spread to the submucosal layer. Most often, infectious pathogens, provoking the development of laryngeal tonsillitis, penetrate the larynx due to injury, thermal or chemical burns, as well as contact with a foreign body. At the same time, hypothermia, a pharyngeal abscess or paratonzillitis can provoke the development of this pathological condition.
Laryngeal sore throat is quite a serious disease, occurring with a significant violation of the general condition, an increase in body temperature to high elevations, severe pain when turning the neck and swallowing, difficulty breathing and hoarseness. With a favorable course of the week comes recovery. In the case of the development of complications, the formation of phlegmonous laryngitis, suppurative inflammation of the submucosal layer, perichondrium and intermuscular tissue is possible. This pathological condition can cause purulent abscess and the development of asphyxia.
Tonsillitis of the mouth
Angina floor of the mouth, also called angina Ludwig - is an inflammatory process that affects the submandibular salivary glands, neck tissue and the floor of the mouth. At the early stages of the pathological process, the patient experiences tension and discomfort when swallowing and talking in the area of the mandibular angle. Then the body temperature rises, and symptoms of general intoxication increase. As inflammation develops, painful infiltration occurs, gradually filling the entire submental space and descending to the side or middle part of the neck. The skin in the area of inflammation is strongly hyperemic and edematous. Also, the patient develops oral edema. Speech becomes slurred, there are limitations and pain when opening the mouth. In the case when the infiltrate begins to squeeze the cervical vessels and trachea, the patient develop shortness of breath and face cyanosis appears. Ludwig's angina is quite a serious disease that can lead to the occurrence of such dangerous complications as sepsis, mediastinitis, meningitis and asphyxiation.
Inflammation of the lymphoid tissue of the back of the pharynx
This pathology, which is also called acute pharyngitis in medical terminology, affects patients of any age. As a rule, inflammation occurs in persons with reduced immunity, with the presence of concomitant diseases of the nasal cavity, as well as with sharp fluctuations in ambient temperature. The pathological process begins with acute catarrhal inflammation of the mucous membranes of the nose and pharynx with a gradual spread to its middle part. At the same time, patients complain of dryness and sore throat, obsessive cough and pain when swallowing. Sometimes the disease can lead to the development of a purulent mediastinitis or a pharyngeal abscess.
This is a rather rare pathology, which in the war years was called trench angina. This disease can occur sporadically, most often at a young age, in individuals with reduced body resistance, with a general depletion or with vitamin deficiency.
As a rule, the inflammatory process covers one side, bilateral lesions are much less common. At the same time, on the background of normal or low-grade fever, gradually increasing pain in the throat occurs. Further, yellowish-white or grayish films of soft consistency appear on the surface of the tonsils, surrounded by an inflammatory rim and resembling stearin spots. These films are quite easily removed with a cotton swab, leaving behind a bleeding ulcerated surface with clearly defined edges. Initially, the ulcerative defect is superficial, however, as the pathological process progresses, it deepens, extends beyond the amygdala and takes the form of a volcanic crater. Often, inflammation can penetrate into the deeper layers, affect the mucous membrane of the gums, tongue and periosteum. The disease proceeds with a characteristic putrid odor from the mouth. With a favorable course in 1-2 weeks recovery occurs, however, often relapses occur, and sometimes the pathological process can be delayed for months.
In severe cases, patients with angina may develop peritonsillar or parafaryngial abscesses. However, a frequent complication is otitis media, laryngitis , pyelonephritis, laryngeal edema, neck phlegmon, rheumatic heart disease, tonsillogenic sepsis, articular rheumatism, metastatic processes in various organs and tissues, mediastinitis and meningitis.
Diagnosis of angina
When making a diagnosis, the clinical picture of the disease, anamnesis data is taken into account, and the patient is prescribed pharyngoscopy and cultural bacterial research. It is mandatory to conduct a differential diagnosis of angina with acute respiratory viral infections, acute pharyngitis and pharyngeal diphtheria.
Treatment of angina
Treatment of angina is carried out in a complex, which includes symptomatic, antibacterial and pathogenetic therapy. The patient is recommended bed rest, a sparing milk-vegetable diet, and abundant warm drink.
As etiotropic treatment, the patient is prescribed sulfanilamide, antibacterial and anti-inflammatory drugs of local and systemic action. It is mandatory to conduct regular gargling with a solution of baking soda, hydrogen peroxide (2 tbsp per 200 ml of water), herbal decoctions (sage, chamomile, calendula), boric acid or furatsilin.
As a symptomatic treatment, antipyretic, analgesic and antirheumatic agents are used. Also, dry warm compresses on the region of regional lymph nodes, UHF and microwave therapy have proved to be a good idea for treating sore throats.
After recovery, the patient is assigned a control laboratory study, and, in the event of signs of complications, consultation and subsequent treatment with a specialist is strongly recommended.
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