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Types of sore throats


Sore throat - a disease of the upper respiratory tract, and, very ancient. In the writings of Hippocrates, Avicenna, and other ancient sages-healers, there is a description of a patient-suffocating disease. The name of the disease received from the Latin word "ango", which means "strangle, compress." It is these feelings that the patients experience immediately after the onset of the ailment.

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

So what is a sore throat? This is the popular name for acute tonsillitis or an infectious disease that primarily affects the pharyngeal ring and tonsils (glands). In the overwhelming majority of cases, a sore throat (doctors call it “vulgar,” that is, ordinary) is caused by pyogenic microorganisms: staphylococci or streptococci. However, pathogens can be fungi, a symbiosis of spirochetes and spindles, injuries. All these pathogens cause different forms of the disease, which require different treatment, the use of different types of antibiotics. However, the primary symptoms may be similar in all types of disease. Most often the patient feels:

  • Feeling of pain in the gol, which interferes with making swallowing movements. The pain can be of a different nature: from mild "scratching", "soreness" to feeling physical disturbance in the throat.
  • A sudden chill (or heat), a sharp increase in temperature (sometimes up to 41 °). Pain and temperature may occur as early as the second day after infection.
  • General malaise. Feeling of impotence (physical), dizziness, incessant headaches, pain and discomfort throughout the body may accompany the patient throughout the illness, but they are most pronounced at the onset of the ailment.
  • Contrary to popular opinion, a cough in many forms of angina may be absent or appear far from the first day after the onset of the disease.

With the appearance of at least two symptoms of all of the above, the patient should immediately seek medical help: a sore throat is dangerous not so much by the course of the illness itself, as by subsequent complications.

If the condition of the patient does not cause concern for his life, the district physicians most often write out for the treatment of broad-spectrum antibiotics of the penicillin group. However, it should be remembered that, despite the fact that bacterial sore throat is most common, the causative agent of the disease may not be just streptococci. Therefore, before the appointment of antibiotics, the doctor must conduct a study of a smear taken from the surface of the pharynx or tonsils to determine the exact cause of the ailment and select the most effective drugs.

Types of sore throats

Depending on the pathogen that caused the disease, doctors distinguish various forms of tonsillitis:

  • Catarral,
  • Lacunar,
  • Follicular
  • Phlegmonous,
  • Fibrinous
  • Necrotic ulcer
  • Herpetic,
  • Fungal.

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

Catarrhal sore throat

Many doctors consider this lightest form of a sore throat as the initial stage of other, more complex and severe forms. Her signs are familiar to everyone, but not everyone who is ill has their entire complex. Often the disease is characterized by the presence of 1-2-3 manifestations. What signals may indicate the onset of catarrhal angina?

Symptoms of catarrhal angina

  • Intoxication and general malaise. Unlike other forms, in catarrhal lesions, they appear earlier than the main clinical signs. The patient may feel weak, mild nausea.
  • Abdominal pain.
  • Headaches, often very severe, pains that are progressive, if the ailment is not diagnosed in time and its treatment is not started.
  • Tonsillitis. Most often, they are increased in size, have a bright red color, but there is no purulent discharge on them. In rare cases, they are covered with a thin film that is easily removed or removed by rinsing. Sometimes a very small infiltrate is visible on the glands (accumulation of bleeding or lymphatic secretions).
  • Inflammation and swelling of the pharynx, tongue, larynx, etc. At the same time, the patient has a feeling of "dry throat". The patient complains of scratching, scratching or burning. When swallowing, all unpleasant manifestations increase, a "lump in the throat" appears, making breathing difficult. Cough may not appear.
  • Swollen and tender lymph nodes.
  • On the second or fourth day after the onset of the disease, the symptoms reach a maximum, the person's temperature rises. Most often with catarrhal sore throat it is subfibril (not exceeding 37.5 °), but sometimes lasts more than a week. A higher temperature may indicate the development of sepsis (getting pathogens into the blood), septicemia.

Usually, the condition of the patient with catarrhal angina begins to improve on day 6-8 from the onset of the disease, but only if it is treated promptly. If the treatment is prescribed incorrectly or completely absent, Qatar can develop into more severe forms or cause complications.

Treatment of catarrhal angina

Despite the fact that the external manifestations of catarrhal angina are markedly different from other forms, the doctor is obliged to take a smear from the throat and glands of patients before starting the treatment in order 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 temperatures.
  • Gargle with herbal decoctions (chamomile, calendula, etc.), as well as medication prescribed by a doctor.
  • With enlarged lymph nodes wear a warm dressing during the day and put a warming compress (alcohol, honey, etc.) at night.
  • To soften the throat and eliminate the "lump" when swallowing, make warm inhalations.
  • Take vitamins and immunoprotectors prescribed by the doctor to strengthen the immune system.

According to medical statistics, in most cases, pathogens of catarrhal forms 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 the ability to function normally, poisoning them.

For the treatment of catarrhal angina caused by bacterial causes, the doctor may prescribe penicillin or cephalosporin antibiotics.

Lacunar angina

Lacunar tonsillitis most often affects people with tonsils (glands) removed, although there are exceptions. It is considered contagious because its pathogens are streptococci, staphylococci and adenoviruses. It can develop with dental diseases, after surgical operations in the oral cavity, sometimes - with hypothermia, dampness, long stay in polluted air. It is given both by airborne droplets and by contact (more often in children).

Symptoms of lacunar tonsillitis

  • An unbearable, cutting pain in the throat, which is magnified by swallowing.
  • Characteristic purulent plaque on the glands. At the onset of the disease, purulent yellow-white individual lesions on the tonsils are easily removed, and later a dense purulent plaque covers the tonsils entirely.
  • The sharp rise in temperature to critical levels.
  • Pain in the calf muscles, lower back, aches in the whole body.
  • Strong, easily noticeable increase in lymph nodes.

In especially severe cases, the symptoms appear and intensify extremely sharply. Purulent plaque for 1-2 days can cover not only the tonsils, but also the entire oral cavity. The patient develops swelling of the nasopharynx, swallowing is so complicated that it can be life threatening. General sleepiness, sharp eye pain, tachycardia , severe headaches, cramps develop. The condition threatens the life of the patient, therefore, requires urgent medical advice, often - hospitalization.

Follicular sore throat

Follicular sore throat - one of the most common diseases in Russia that arise when the seasons change. Like the previous forms, it is caused by strepto-or staphylococci, sometimes by adenoviruses. Its flow at first resembles the course of a lacunar variety, and often two forms of angina affect the patient at the same time. However, in case of follicular sore throat, the infection affects the 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 angina:

  • The appearance of pain when swallowing, dryness, sore throat, turning into a sharp, difficult to stop cough.
  • General weakness, high fever, long-lasting, high temperature, which is difficult to reduce (38 ° -40 °).
  • Swelling of the tonsils, the appearance of point abscesses in the form of white, yellow or green bumps.
  • General intoxication: headache, weakness, body aches.
  • Constipation, nausea.
  • Possible heart pain, heart rhythm disturbances.
  • The strongest increase in lymph nodes, preventing the patient from turning his head or making swallowing movements.


Herpes sore throat or enterovirus vesicular pharyngitis is caused not by Cocci, but by Coxsackie viruses. Most often affects young children. When late treatment can cause complications, including meningitis, encephalitis, inflammation of the lining of the heart.

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

Symptoms of herpetic angina:

  • Rapid increase in temperature.
  • Sharp, progressive sore throat.
  • Inflammation of the pharynx, pain when swallowing.
  • Appearance of vesicles (cellular "bags" or small fluid-filled vesicles resembling herpetic formations) on the back of the throat and palate, and their subsequent ulceration.
  • Often: nausea, vomiting.
  • Muscle aches.
  • Runny nose, nasal congestion.


Phlegmonous sore throat or peritonsillitis is the most severe complication (or, according to some experts, the next stage) in time for not cured lacunar or follicular sore throat. More often it occurs 2-3 days after a sore throat vulgar, but sometimes it occurs as a primary disease. Most often affects people aged 15-40 years who have not begun timely treatment. Occurs if the pyogenic microorganisms penetrate from the affected tonsils into the tonsillar tissues. More often is one-sided.

Symptoms of phlegmonous sore throat

  • Sharp, hardly tolerated pains on one side of the throat, preventing any swallowing movements. Ill can not even drink.
  • Liquid food may leak from the nose when trying to swallow.
  • The development of nasal voices, slurred pronunciation of sounds.
  • Development of contracture (inability to perform movements) from the affected side. The patient can not open his mouth, forced to tilt his head in the direction of the painful area, giving the characteristic direction of the neck.
  • Harsh, purulent, mixed with acetone, breath odor.
  • For 5-8 days in the upper sky there is a noticeable protrusion shifted in the direction of the patient tonsil.
  • An abscess (abscess) begins to form under the gland, displacing the amygdala away from its normal position.
  • As the abscess ripens, its shell becomes thinner, the pus becomes clearly visible. At the same time, all the mucous membranes in the mouth are bright red, swollen.
  • The general condition of the patient: weakness, headaches, temperature (up to 41 °), pain in muscles and joints.

Complications of phlegmonous sore throat

Late or improper prescribed treatment can cause formidable complications that threaten the patient’s life. Most common:

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

Phlegmonous sore throat is a serious disease that threatens a person’s life and requires long-term scrupulous treatment.

Fibrinous sore throat

Fibrinous sore throat is another type of lacunar or follicular sore throat. It got its name from the formation of film on the affected places. Develops unexpectedly, rapidly, within a few hours.

Symptoms and treatment of fibrinous sore throat

  • Sharp temperature increase, chills.
  • Sudden occurrence of sore throat, which often gives to the ear.
  • Painful swollen lymph nodes.
  • The state of general intoxication: vomiting, dizziness, pain in the body, sometimes - stupefaction.
  • The appearance on the glands of purulent yellow-white "islands", which, quickly merging, cover the tonsils entirely, and, sometimes, the surrounding tissues.

Quite rarely there are situations when the appearance of a raid does not affect the general well-being of the patient. But in this case, in addition to auxiliary actions (rinsing, heating), a course of antibiotics is shown to the patient. Most often, doctors prescribe Amoxicillin , Benzylpenicillin, etc.

These antibiotics cannot be taken without a doctor's prescription for several reasons.

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

Complications of fibrinous sore throat can be the same as in the case of a phlegmonous variety.

Ulcerative necrotic tonsillitis

Despite its name "angina", the disease is not caused by adenoviruses and cocci, but by completely different pathogens. The course of the disease also little resembles a vulgar sore throat.

Ulcerative necrotic tonsillitis most often develops on the basis of weakened immunity. Its pathogen is conditionally pathogenic flora in the mouth. This means that a certain number of microorganisms, including pathogens, are present in the mouth of each person. However, the flora in a healthy person is balanced in such a way that all microorganisms are in a balanced state and do not cause any diseases. With a violation of immunity, some organisms die, while others begin to actively develop, causing disease. So necrotizing sore throat causes a symbiosis of spindle-shaped sticks and spirochetes. Most often, people with heart or chronic diseases, those who do not monitor the condition of the gums and teeth, are prone to the disease.

Symptoms of necrotizing tonsillitis

  • Discomfort when swallowing, which is not very pronounced.
  • Unpleasant purulent smell from the mouth.
  • A slight increase in the lymph node on the part of the affected tonsil.
  • The gradual formation of black and green plaque on the tonsil. When removing it, bleeding ulcers on the glands are clearly visible.

Attention! Weakness, sore throat. Temperature and other manifestations characteristic of vulgar (ordinary) angina with ulcer-necrotic form are absent! Angina Simanovsky-Plaut-Vincent (this is another name for the disease) can last from a week to several months. If untreated, the condition worsens, the temperature rises, signs of intoxication appear. Purulent lesion can go on the whole mouth, lead to tooth loss, sepsis.

For the treatment prescribed antibacterial drugs of a wide profile, fortifying drugs. Local treatment has a particularly important role in the elimination of the ailment: washing, treating with special solutions, powders.

| November 6, 2014 | | 1 931 | ENT diseases