The Types of sore throat
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Types of sore throat


Angina is a disease of the upper respiratory tract, moreover, very ancient. In the writings of Hippocrates, Avicenna and other ancient sages-healers, a description of the patient's "dying" is found. The name got the disease from the Latin word "ango", which means "choke, squeeze." It is these feelings that the patient feels immediately after the onset of malaise.

Ancient doctors could even do intubation (insertion of a tube into the larynx or trachea) and tracheotomy (a small operation on the trachea) to save the patient from suffocation in angina.

So what is angina? This is the popular name for acute tonsillitis or an infectious disease that affects, first of all, the pharyngeal ring and tonsils (tonsils). In most cases, angina (doctors call it "vulgar", i.e. ordinary) is caused by pyogenic microorganisms: staphylococci or streptococci. However, the pathogens may be fungi, symbiosis of spirochetes and spindle-shaped wand, trauma. All these pathogens cause different forms of the disease, which require different treatment, the use of different types of antibiotics. However, the primary signs may be similar in all types of disease. Most often the patient feels:

  • Feeling pain in the goal, which prevents swallowing movements. Pain can be of a different nature: from slight "scratching", "sadness" to a sense of physical hindrance in the throat.
  • A sudden chill (or fever), a sudden increase in temperature (sometimes up to 41 ° C). Pain and temperature can occur as early as the second day after infection.
  • General malaise. Feeling of impotence (physical), dizziness, unceasing headaches, pain and discomfort throughout the body can accompany the patient throughout the disease, but they are most pronounced at the beginning of the ailment.
  • Contrary to popular opinion, cough in many forms of angina may be absent or appear not on the first day after the onset of the disease.

If there are at least two of the signs listed above, the patient should immediately seek medical help: the sore throat is not so dangerous as the actual course of the disease, but rather as subsequent complications.

If the patient's condition does not cause fear for his life, district therapists often prescribe antibiotics for a broad spectrum of action of the penicillin group for treatment. However, it should be remembered that, despite the fact that bacterial angina occurs most often, the causative agent of the disease can be not only streptococci. Therefore, before prescribing antibiotics, the doctor should conduct a study of a smear taken from the surface of the pharynx or tonsils to pinpoint the cause of the indisposition and to select the most effective drugs.

Types of sore throat

Depending on the pathogen that caused the disease, doctors differentiate and different forms of sore throat:

  • The cathartic,
  • Lacunar,
  • Follicular,
  • Phlegmonous,
  • Fibrinous,
  • Ulcerative-necrotic,
  • Herpetic,
  • Fungal.

Treatment of each form of the disease requires a special approach, and the symptoms of the disease are different.

Catarrhal angina

This is the easiest form of angina, many doctors consider the initial stage of other, more complex and severe forms. Signs of it are familiar to everyone, but not every ill person manifests their entire complex. Often the disease is characterized by the presence of 1-2-3 manifestations. What signals can indicate the onset of catarrhal angina?

Symptoms of catarrhal angina

  • Intoxication and general malaise. Unlike other forms, with catarrhal lesions they manifest earlier than the main clinical signs. The patient may feel weakness, mild nausea.
  • Pain in the abdomen.
  • Headaches, often very strong, are pains that progress, if the illness is not diagnosed in time and its treatment is not started.
  • Tonsillitis. Most often they are enlarged in size, have a bright red color, but there is no purulent discharge. In rare cases, they are covered with a thin film, which is easily removed or removed by rinsing. Sometimes on the glands there is a very small infiltration (congestion of bloody or lymphatic secretions).
  • Inflammation and swelling of the pharynx, tongue, throat, etc. In this case, the patient has a feeling of "dry throat". The patient complains of perspiration, a sensation of scratching or burning. When swallowing all unpleasant manifestations increase, there is a "lump in the throat", making breathing difficult. Cough may not appear.
  • Increase and soreness of the lymph nodes.
  • On the second or fourth day after the onset of the disease, the symptoms reach a maximum, a person's fever rises. Most often, in catarrhal angina, it is subfibril (not exceeding 37.5 °), but it sometimes lasts more than a week. A higher temperature can indicate the development of sepsis (the entry of pathogens into the blood), septicemia.

Usually, the condition of a person with catarrhal angina begins to improve on the 6-8th day after the onset of the disease, but only on condition of timely treatment. If the treatment is prescribed incorrectly or completely absent, the Qatar can develop into more severe forms or cause complications.

Treatment of catarrhal angina

Despite the fact that the external manifestations of catarrhal angina differ markedly from other forms, the doctor must take a swab from the throat and glands of patients before treatment to identify the pathogen. While the smear is being examined, the patient is required to comply with all medical prescriptions.

  • Observe bed rest, especially at elevated temperature.
  • Gargle with herbal decoctions (chamomile, calendula, etc.), as well as prescribed medicines by medical products.
  • With enlarged lymph nodes wear a warm bandage during the day and put a warming compress (alcohol, honey, etc.) at night.
  • To soften the throat and eliminate the "lump" when swallowing do warm inhalation.
  • Take prescribed by the doctor vitamins and immunoprotectors to strengthen immunity.

Medical statistics say that in most cases, the causative agents of the catarrhal form of acute tonsillitis are staphylo- or streptococci. The danger of these bacteria is that they produce toxins that deprive the cells of the human body of the ability to function normally, poisoning them.

For the treatment of catarrhalic tonsil, caused by bacterial causes, the doctor can prescribe antibiotics penicillin or cephalosporin series.

Lacunar angina

Lacunar angina most often affects people with removed tonsils (glands), although there are exceptions. It is considered infectious, because its pathogens are streptococci, staphylococci and adenoviruses. It can develop with dental diseases, after surgical operations in the oral cavity, sometimes - under hypothermia, dampness, prolonged exposure to polluted air. It is betrayed by airborne as well as by contact (more often - in children).

Symptoms of lacunar angina

  • Intolerable, cutting pain in the throat, which is greatly amplified by swallowing.
  • Characteristic purulent coating on the glands. At the beginning of the disease purulent yellow-white individual foci on the tonsils easily removed, later a dense purulent coating covers the entire glands.
  • A sharp rise in temperature to critical levels.
  • Pain in calf muscles, lower back, body aches.
  • Strong, easily visible increase in lymph nodes.

In especially severe cases, symptoms manifest themselves and intensify extremely sharply. Purulent coating for 1-2 days can cover not only the tonsils, but also the entire oral cavity. The patient develops a swelling of the nasopharynx, swallowing is so complicated that it can endanger life. Develops general drowsiness, sharp pain in the eyes, tachycardia , severe headaches, convulsions . The condition threatens the patient's life, therefore requires urgent medical consultation, often hospitalization.

Follicular sore throat

Follicular sore throat is one of the most common diseases in Russia that occur when the seasons change. Like the previous forms, it is caused by strepto- or staphylococci, sometimes by adenoviruses. Its flow first resembles the course of the lacunar variety, and often two forms of angina affect the patient simultaneously. However, with follicular angina, the infection affects follicles (lymph nodes in the tonsils). The disease is manifested by small abscesses and the development of regional lymphadenitis (inflammation of the lymph nodes).

Symptoms of follicular sore throat:

  • The appearance of pain when swallowing, dryness, perspiration in the throat, turning into a sharp, hard-to-stop cough.
  • General weakness, severe fever, prolonged, high, poorly dropping temperature (38 ° -40 °).
  • Edema of the tonsils, the appearance on them of point abscesses in the form of white, yellow or green tubercles.
  • General intoxication: headache, weakness, body aches.
  • Constipation, nausea.
  • Possible pain in the heart, violation of the heart rate.
  • The strongest increase in lymph nodes, which prevents the patient from turning his head or performing swallowing movements.

Herpetic tonsillitis

Herpetic angina or enterovirus vesicular pharyngitis is caused not by cocci, but by Coxsackie viruses. More often it affects small children. If untimely treatment can cause complications, including meningitis, encephalitis, inflammation of the heart membranes.

The virus is contagious, transmitted by airborne droplets. The disease is sometimes called "leg-hand-mouth," because the infection can be transmitted through dirty hands.

Symptoms of herpetic sore throat:

  • Rapid temperature increase.
  • Sharp, progressive pain in the throat.
  • Inflammation of the pharynx, pain when swallowing.
  • The appearance on the back of the throat and sky of vesicles (cellular "bags" or small, fluid-filled vesicles resembling herpes formations), their subsequent ulceration.
  • Often: nausea, vomiting.
  • Pain in the muscles.
  • Runny nose, nasal congestion.


Phlegmonous tonsillitis or paratonzillitis is a severe complication (or, in the opinion of some specialists, the next stage) in time of untreated lacunar or follicular angina. It often occurs 2-3 days after vulgar vulgaris, but sometimes occurs as a primary disease. More often affects people aged 15-40 years who have not started timely treatment. Occurs if pyogenic microorganisms penetrate from the affected tonsils into tonsillar tissues. It is more often one-sided.

Symptoms of phlegmonous sore throat

  • Sharp, hardly tolerable pains on one side of the throat, preventing any swallowing movements. The sick can not even drink.
  • Liquid food can leak from the nose when trying to swallow.
  • Development of nasal voices, indistinctness of utterance of sounds.
  • Development of contracture (impossibility to make movements) from the affected side. The patient can not open his mouth, is forced to tilt his head towards the painful area, giving a characteristic direction to the turn of the neck.
  • Sharp, purulent, with an admixture of acetone smell from the mouth.
  • On the 5th-8th day a noticeable protrusion appears in the upper sky, shifted toward the aching amygdala.
  • Under the tonsils begins to form an abscess (abscess), shifting the amygdala away from its normal place.
  • As the abscess ripens, its membrane becomes thinner, pus becomes well visible. In this case, all the mucous in the mouth are bright red, swollen.
  • General condition of the patient: weakness, headaches, temperature (up to 41 °), pain in the muscles, joints.

Complications of phlegmonous sore throat

Untimely or incorrectly prescribed treatment can cause serious complications that threaten the patient's life. The most common are:

  • Penetration of pus in other tissues, development of phlegmon (acute purulent inflammation of the intercellular space) of the neck, further penetration of pus into muscles.
  • Climbing of the infection to the base of the skull, brain damage, meningitis, abscess or thrombosis of the brain.
  • General sepsis.

Phlegmonous tonsillitis is a serious disease that threatens human life and requires a long, scrupulous treatment.

Fibrinous tonsillitis

Fibrinous angina is another variant of lacunar or follicular angina. Received its name due to the formation of a film on the affected areas. Develops unexpectedly, swiftly, within a few hours.

Symptoms and treatment of fibrinous sore throat

  • A sharp increase in temperature, chills.
  • Sudden occurrence of sore throat, which often gives into the ear.
  • Painful enlargement of the lymph nodes.
  • The state of general intoxication: vomiting, dizziness, pain in the body, sometimes - confusion of consciousness.
  • Appearance on the glands of purulent yellow-white "islands", which, quickly merging, cover the tonsils entirely, and, sometimes, and the surrounding tissues.

Quite rare situations occur when the appearance of a plaque does not affect the general well-being of the patient. But in this case, in addition to the auxiliary actions (rinsing, warming up), the patient is shown a course of antibiotics. Most often, doctors prescribe Amoxicillin , Benzylpenicillin, and the like.

Do not take these antibiotics without a doctor's appointment for several reasons.

  • An incorrectly selected drug will not kill the infection, but will make it more stable.
  • Too high dosage can be dangerous for health, and, sometimes, for the life of the patient.
  • Too low dosage increases the resistance of microorganisms to antibiotics. Treatment in this case can be very difficult.

Complications of fibrinous angina may be the same as in the phlegmonous variety.

Ulcerative necrotizing angina

Despite its name "angina" the disease is caused not by adenoviruses and cocci, but by quite different pathogens. The course of the disease is also not very similar to vulgar angina.

Ulcerative necrotic angina most often develops on the basis of weakened immunity. Her pathogen is a conditionally pathogenic flora in the mouth. This means that in the mouth of each person there is a certain number of microorganisms, including pathogens. However, the flora of a healthy person is balanced in such a way that all microorganisms are in a balanced state and do not cause any diseases. When immunity is impaired, some organisms die, while others begin to actively develop, causing the disease. So ulcerative-necrotic angina is caused by a symbiosis of a spindle-shaped rod and spirochetes. Most often, people with heart or chronic diseases, those who do not monitor the condition of gums and teeth, are susceptible to an ailment.

Symptoms of ulcerative-necrotic sore throat

  • A feeling of inconvenience in swallowing, which is not very pronounced.
  • Unpleasant-purulent smell from the mouth.
  • A small increase in the lymph node from the affected tonsil.
  • Gradual formation of black-green plaque on the amygdala. When it is removed, bleeding ulcers on the glands are clearly visible.

Attention! Weakness, sore throat. The temperature and other manifestations peculiar to vulgar (usual) angina with ulcerative necrotic form are absent! Angina Simanovsky-Plaut-Vincent (this is another name for the disease) can last from a week to several months. In the absence of treatment, the condition worsens, the temperature rises, and signs of intoxication appear. Purulent lesions can go to the entire mouth, lead to tooth loss, sepsis.

For treatment, antibacterial drugs of a wide profile, restorative medications are prescribed. Especially important role in the elimination of the disease has a local treatment: washing, treatment with special solutions, sifting.

| 6 November 2014 | | 1 931 | ENT diseases