Atypical angina. Atypical angina: myths and reality. Consequences and complications

On the Internet you can find many types of different sore throats, it is easy to get confused in them. Some forms are not official, but exist for the purpose of convenient philistine communication, or to designate a dominant symptom, for example, allergic tonsillitis.

We list the main types, based on several classifications of such famous professors as B.S. Preobrazhensky, J. Portman, A.Kh. Minkovsky and several textbooks on otorhinolaryngology (V.I. Babiyak, V.T. Palchun).

Classification according to the course (nature) of the disease:

Classification according to the form of the disease(also referred to as banal or vulgar tonsillitis, and most often caused by hemolytic streptococcus):

Type of angina
catarrhal	General intoxication (headache, high body temperature, weakness), pain when swallowing, redness of the tonsils. Plaque on the tonsils may be absent. Bilateral lesion of the tonsils The duration of the disease is from 5 to 7 days.
Follicular	High temperature up to 39 ° C, sore throat, yellowish plaque and purulent plugs on reddened tonsils. Bilateral lesion of the tonsils. Duration more than 7 days.
Lacunar	Very high temperature up to 40 ° C, unbearable sore throat, extensive purulent areas on the reddened tonsils. Bilateral lesion of the tonsils is characteristic. Duration about 8 days.
Fibrinous (pseudodiphtheria)	Occurs against the background of catarrhal, follicular or lacunar tonsillitis or as a consequence of them. The symptoms are similar, but a film forms on the tonsils. Duration from 7 to 14 days.
Phlegmonous (as a complication of various types of tonsillitis)	Intolerable pain when swallowing. Heat. Great enlargement of one tonsil. The surface of the tonsil is as if stretched.

Classification by cause of disease:

Type of angina	Characteristic symptoms and signs
Bacterial(tonsillitis, as a manifestation of infectious diseases caused by bacteria).
Diphtheritic (caused by bacillus Loeffler)	Bilateral lesion of the tonsils. Pain when swallowing, fever. Typical diphtheria plaque in the form of a grayish-white film. The film is difficult to remove, dense, sinks in water.
Scarlet fever (caused by toxigenic group A streptococcus that produces erythrotoxin)	Against the background of the symptoms of scarlet fever: high body temperature, headache, raspberry tongue, red punctate rash on the face, tongue, and body (to a lesser extent). There are signs characteristic of angina vulgaris (catarrhal, follicular, lacunar): pain when swallowing, purulent plugs or plaque on reddened tonsils, pain when swallowing.
Streptococcal (most often manifested as catarrhal, follicular, lacunar or fibrinous tonsillitis)	High body temperature. Pain when swallowing. Redness and coating on reddened tonsils. Purulent plugs in the follicular form. Extensive accumulations of pus with lacunar form. Films in fibrinous form. (details see above)
Staphylococcal (caused by Staphylococcus aureus)	Manifestations are similar to streptococcal tonsillitis. Plaque on the tonsils in the form of films, purulent plugs or islets. The pain when swallowing is very severe. The course is more severe and prolonged than that of angina vulgaris.
Simanovsky-Vincent (also referred to as ulcerative membranous or ulcerative necrotic, caused by fusiform bacillus and spirochete)	Occurs against the background of exhaustion of the body. Unilateral lesion of the tonsils. Can flow without heat. Greyish-yellow films with ulcers on the tonsils. Putrid odor from the mouth. Duration from 7 to 20 days.
Syphilitic (caused by Treponema pallidum)	Rapid rise in body temperature to 38 ° C, pain when swallowing. Unilateral lesion of the tonsil in the form of redness and enlargement. Enlarged cervical lymph nodes.
Viral(tonsillitis, as a manifestation of infectious diseases caused by viruses).
Measles (caused by the paramyxovirus family)	Pain when swallowing, fever, against the background of inflammation of the respiratory tract and skin rash. Swelling of the tonsils. Redness may be in the form of spots or bubbles. Enlarged lymph nodes.
With HIV infection	Increased body temperature, pain when swallowing, purulent plaque on the tonsils, one-sided lesion is possible. The flow is lingering.
Herpetic (caused by the herpes buccopharyngealis virus, herpetic fever virus)	A characteristic feature is blisters on the mucous membranes of the oral cavity and pharynx, and may also appear on the lips and skin. The body temperature is very high up to 41 °C. The defeat is bilateral.
Infection of the pharynx by the herpes zoster virus	A rash of bubbles is characteristic only on one side and on the tonsil. Pain can be given to the nasopharynx of the eye and ear. Duration 5-15 days.
Herpangina (cause - Coxsackie enterovirus)	Sudden start. Body temperature up to 40 °C. Small bubbles on the tonsils, which burst after 2-3 days and leave erosion. Pain when swallowing. Bubbles may appear on the feet and hands.
fungal(mycosis of the pharynx).
Candidiasis (caused by fungi of the genus Candida)	Acute start. Moderate temperature. Pain when swallowing, sensation of a foreign body in the throat. On the tonsils there are curdled masses in the form of separate islands.
Leptotrixose (caused by the fungus Leptotrix, a rare form)	There are numerous small white dots on the entire surface of the pharynx and on the base of the tongue. There is practically no pain, the body temperature is not high.
Actinomycosis (caused by actinomycetes, very rare form)	It is a consequence of actinomycosis of the tongue or facial area. Difficulty opening your mouth completely. Difficulty swallowing (a lump of food does not immediately go away). Local swellings of the mucous membrane, which then break through with the expiration of pus.
Angina, as a manifestation of blood diseases.
Agranulocytic (refer to the appearance of ulcerative necrotic)	General malaise, high body temperature, severe sore throat. Ulcerative changes in the tonsils. Putrid odor from the mouth. Characteristic blood changes.
Monocytic (the cause of the disease is not completely clear)	Sore throat, fever. Enlargement of the liver, spleen and cervical lymph nodes. Long-term (raids remain for several weeks and even months). Characteristic blood changes.
Angina with leukemia	Occurs against the background of leukemia (blood cancer). Enlarged cervical lymph nodes. Swallowing disorder. Ulceration of the tonsils. Bad breath.
Angina, as a manifestation of systemic diseases.
allergic	Swelling of the oral mucosa, tonsils. Redness of the pharynx. Not accompanied by plaque and fever. The connection with the use of any substance inside or the presence of flowering of allergenic plants is characteristic.
mixed forms.
Stomatitis (can be caused by bacteria, viruses and even fungi)	There may be various manifestations depending on the causes and pathogens. As a rule, signs of stomatitis are characteristic: swelling of the oral mucosa, ulcerative lesions in the oral cavity.

The medical meaning of the word "catarrhal" comes from the Greek "kataralis", which means swelling, expiration. This term well describes this sore throat, which is manifested by swelling, redness and the formation of a serous (clear or slightly cloudy) substance on the mucous membrane of the palatine tonsils.

Catarrhal angina is often not an independent form, but the initial stage of follicular or lacunar angina, and less often manifests itself as a separate pathology, as a rule, it proceeds easily and quickly (on average 6-7 days).

Symptoms

Symptoms appear suddenly:

• body temperature may not be very high (37-38 ° C),
• the first subjective signs are usually dryness and a feeling of soreness in the throat,
• when swallowing a food bolus, pain is felt,
• characteristic redness of only the tonsils and the palatine arches surrounding them (see the figure above),
• enlarged tonsils peeking out from behind the palatine arches,
• tonsils can be covered with a delicate, cloudy and easily removed film,
• it is important that there should be no manifestations and other violations of the structure of the tonsils,
• pain on palpation of regional lymph nodes.

Despite the ease of flow, catarrhal angina is a potential threat to the general health of a person, it can be complicated by nephritis (kidney disease), myocarditis (heart disease), rheumatoid arthritis (joint disease). Therefore, in no case should you self-medicate or neglect the recommendations of a doctor.

Treatment

It is desirable that the treatment of catalytic angina occurs under the supervision of a physician. Usually assigned:

• Antibacterial drugs, including sulfonamides. They are the main treatment for angina.
• Gargling can be done with antiseptics (furatsilin), and preferably with saline (salt solution in water: 1 teaspoon of salt per liter of warm water).
• Antipyretic drugs at body temperature above 38 ° C.
• Pain-relieving sprays and sucking tablets are used to relieve symptoms.
• Together with the start of the use of antibiotics, it is necessary to carry out, since it enhances the effect of drugs, improves lymph flow, removes toxins from affected areas, cleanses tissues and stimulates the immune system to fight infection.

During treatment, you need to keep the cardiovascular system under control, take urine and blood for analysis several times, for the timely detection of possible complications.

Follicular angina

Follicular angina (ICD code 10 - J03) is the most common form of angina, in which purulent inflammation spreads to the structural components of the tonsils - follicles. This pathology is more severe than catarrhal tonsillitis.

Causes

The cause can be various kinds of bacteria, but in 90% of cases it is streptococcus. Interestingly, this type of microorganism is continuously present on our mucous membranes throughout our lives, without causing harm. But as soon as the local and general are weakened, the microbe begins to multiply uncontrollably in the tonsils.

Symptoms

1. An increase in body temperature to 39 ° C is not a specific symptom, but at the same time, follicular tonsillitis cannot proceed without temperature.
2. Pain while eating can radiate to the ear area.
3. Intoxication is expressed in the form of pain in the head, malaise, chills, pain in the lumbar region and joints is also possible.
4. Enlarged lymph nodes in the neck.
5. During a visual examination of the throat:
   • distinct redness of the tonsils and palatine arches;
   • enlarged and puffy tonsils;
   • numerous festering follicles are observed on the surface of the tonsils: yellowish-white spots 1-3 mm, which make the mucous membrane tuberous;
   • follicles are opened 2-4 days after the appearance with the formation of erosion.
6. In the general blood test:
   • an increase in the number of leukocytes,
   • increased ESR (up to 30 mm/h).

Treatment

Treatment of follicular angina is carried out, as a rule, on an outpatient basis at home. It is desirable to isolate the patient as much as possible from the surrounding people and from common household items (dishes). It is very important to observe strict bed rest.

The main components of effective treatment of angina:

1. Antibacterial therapy is the most important part of the treatment, with which you need to start and finish the treatment of angina. The use of antibiotics for follicular angina eliminates the occurrence of deadly consequences.
2. Together with antibiotic therapy, procedures should be started.
3. Bed rest.
4. Frequent drinking of warm drinks (tea, fruit drink) contributes not only to the replenishment of fluid in the body, but also moisturizes the mucous membrane of the tonsils, easing pain.
5. Gargling with antiseptic solutions (furatsilin) ​​or saline solution (0.9% saline solution 1 teaspoon of salt per liter of warm water).
6. Symptomatic therapy (relief of the condition):

• pain-relieving sucking tablets or sprays (alcohol-free),
• antipyretic (at a long-term high temperature of more than 39 ° C),
• mucolytics (with viscous, hard-to-remove mucus on the tonsils).

Lacunar angina

Lacunar tonsillitis (ICD code 10 - J03) is the most severe form, characterized by widespread purulent inflammation and accumulation of pus in the lacunae (grooves between the structural elements of the tonsils).

Symptoms

To get a complete picture of a disease such as lacunar tonsillitis, the doctor collects an anamnesis and draws up a medical history, in which the following symptoms should be present:

1. 40 ° C - the temperature can be so high in this disease.
2. There is unbearable pain while eating.
3. In the throat and neck, pain can be even in a relaxed state.
4. The state of poisoning with toxins produced by streptococcus (intoxication):
   • feeling unwell,
   • pain in the head,
   • chills,
   • pain can appear in the lower back and joints.
5. The cervical lymph nodes are greatly enlarged.
6. When examining the throat:
   • redness of the tonsils and surrounding tissues;
   • enlargement and swelling of the tonsils (in severe cases, it can cover most of the pharynx);
   • islands of yellowish-white plaque, which can cover the entire tonsil;
   • there may be simultaneous manifestations of both follicular and lacunar tonsillitis;
   • plaque is easily removed with a spatula without damaging the mucous membrane.
7. General blood analysis:
   • leukocytosis (an increase in white blood cells),
   • increased ESR (erythrocyte sedimentation rate).

Treatment

With lacunar angina, it is very important to take antibiotics, given the severity of this form of angina, the refusal of antibacterial drugs can lead to very dangerous consequences, both general (heart problems, inflammation of the kidneys and joints) and local (peropharyngeal abscess, phlegmon, etc.) .

All other methods and procedures have a helper function, but this does not mean that they are not important and can be ignored:

• it is necessary to transfer the disease only in the supine state;
• repeated warm (not more than 40 ° C) drink;
• vibroacoustic therapy with;
• gargling with antiseptic solutions (furatsilin) ​​or saline (1 teaspoon of salt per 1 liter of water) will provide pain relief by moistening the surface of the tonsils;
• symptomatic therapy (relief of symptoms) only if necessary: ​​antipyretics (prolonged fever with a temperature of more than 39 °), anti-inflammatory, painkillers (with unbearable pain).

fibrinous

Fibrinous tonsillitis (pseudomembranous, diphtheroid) - inflammation of the upper layers of the tonsil, characterized by the formation of a grayish film (plaque), which is difficult to separate.

Causes

In some cases, follicular and lacunar tonsillitis can turn into a fibrinous form, the causative agents are pneumococcus, streptococcus, less often staphylococcus.

Symptoms

• Body temperature rises sharply and can reach 39 ° C.
• Signs of the presence of toxins in the blood (headache, weakness, chills).
• Characteristic pain during swallowing.
• The cervical lymph nodes are often enlarged.
• The tonsils are covered with a light film, which may extend beyond the tonsils, it is difficult to separate and, after removal, may leave ulcers, this symptom is identical to that of diphtheria.

No wonder this disease is called diphtheroid angina, the symptoms are very similar, so it is urgent to conduct a bacteriological study in order to exclude the presence of diphtheria bacillus, due to its high contagiousness (contagiousness).

Treatment

Fibrinous tonsillitis is treated in the same ways as ordinary bacterial tonsillitis:

• therapy with the help of taking antibacterial drugs;
• compliance with the regime of the day with a predominance of sleep (bed rest);
• it is necessary to drink a lot and often a warm liquid in the form of tea or raspberry juice;
• frequent gargling greatly relieves pain, to prepare a solution in 1 liter of warm water, dissolve 1 teaspoon of ordinary salt;
• if necessary, symptomatic treatment (antipyretic, painkillers);
• physiotherapy

However, if the causative agent is staphylococcus, then it is necessary to make an individual selection of antibiotics, due to its resistance to the penicillin series.

Phlegmonous

Phlegmonous tonsillitis or acute paratonsillitis is the most severe form, manifests itself as a complication 1-3 days after the onset of follicular or lacunar tonsillitis. It is characterized by inflammation of the peri-almond tissue.

There are three forms:

• edematous;
• infiltrative;
• abscessing.

They, in fact, are the stages of phlegmonous tonsillitis, which end with an abscess or extensive phlegmon.

Symptoms

• In most cases, the process is one-way.
• The body temperature is very high up to 40°C.
• Regional (cervical) lymph nodes are greatly enlarged and painful.
• Pain during swallowing is so severe that the patient is forced to refuse any food, even liquid.
• The patient takes a forced position with the head tilted forward and towards the affected part.
• The mouth opens with difficulty only a few millimeters due to contracture (restriction of movement) of the temporomandibular joint on the side of the lesion.
• There is an unpleasant smell from the mouth with hints of acetone.
• Severe redness of the affected tonsil,
• The tonsil protrudes strongly, and the surface is stretched in the area of ​​​​the abscess (accumulation of pus in a limited capsule).
• After opening the abscess, the patient's condition improves dramatically.

Treatment

• Surgical opening or puncture of the abscess, depending on the condition.
• Antibacterial therapy of a wide spectrum of action.
• Painkillers.
• Antipyretic drugs.
• At the stage of recovery, physiotherapy is indicated, it promotes rapid regeneration after surgery and enhances the effect of antibiotics.

Agree, you can get confused in this endless list of similar symptoms, for this in this table we present the most important distinguishing features of angina:

Purulent tonsillitis

What is purulent angina? This is a general descriptive term characterizing the totality of symptoms of a purulent-inflammatory process. Purulent can be called follicular, lacunar, fibrinous, staphylococcal and other tonsillitis, manifested by purulent dots or plaque. What purulent tonsillitis looks like can be seen in the figure below:

Causes

Purulent tonsillitis is most often caused by streptococcus, but general blood diseases or a decrease in immunity due to various types of viruses can serve as the cause.

Due to a sharp decrease in the local one in the throat area, the normal microflora of the oral cavity, in which streptococcus is constantly present, joins almost any infection.

Normally, the population of this bacterium is restrained by immune cells (lymphocytes and leukocytes), and with an infectious load, a deficiency of protective cells and immune proteins occurs, as a result, streptococcus begins to multiply uncontrollably.

Purulent tonsillitis in adults and children can also occur for additional indirect reasons that affect the overall weakening of the immune forces (decrease in the activity and number of lymphocytes):

• it can be systemic blood diseases (mononucleosis, leukemia),
• unhealthy lifestyle (smoking, alcohol, drugs),
• sharp seasonal fluctuations in environmental conditions (),
• tonsil injury,
• otorhinolaryngologist, doctor of medical sciences, professor Palchun V.T. notes that sore throats often occur as a result of a monotonous protein diet, which once again confirms the effectiveness without protein.
• existing for a long time bacterial foci in the mouth and nose (caries, chronic sinusitis, pulpitis, etc.).

Symptoms and signs

Signs of purulent tonsillitis that occur in adults depend on the causative agent of the infection. As a rule, they correspond to the symptoms of follicular or lacunar tonsillitis, the cause of which is in most cases streptococcus.

• The increase in body temperature varies from 38 to 40°C. At the same time, purulent tonsillitis is extremely rare without temperature. It is impossible to say exactly how many days the temperature lasts, approximately, it subsides 1-3 days after the start of antibiotics.
• Sore throat during meals is due to the cause and the form of the disease can be mild or unbearable.
• Almost always manifested by an increase in regional cervical nodes, which can be painful when palpated.
• Symptoms of general intoxication are characteristic: headache, fever, general weakness, lack of appetite.
• The tonsils are enlarged, covered with yellowish dots (purulent plugs), or may be partially or completely covered with pus, which should be easily removed with a wooden spatula.

How many days does purulent tonsillitis last?

Purulent tonsillitis is very diverse for its reasons, in addition, the state of the body strongly affects the duration of the disease, so it is difficult to answer this question exactly. One can only say that the duration of the disease should not be more than 20 days and less than 6, otherwise you are dealing with another pathology. With a follicular or lacunar form, recovery occurs in about 10 days.

Is purulent tonsillitis contagious?

Contagiousness (infectiousness) largely depends on the causative agent of the infection. Ordinary streptococcal tonsillitis, occurring in the form of follicular or lacunar, will not affect others, since exactly the same strains of streptococcus are present in the oral cavity of each person. But this does not relieve the patient and his loved ones from anxiety for the following reason.

It is possible to accurately identify the causative agent of the disease only after visiting a doctor and clinical studies, diphtheria can never be ruled out in advance, therefore, for any sore throat, a set of quarantine measures must be observed:

• providing the patient with separate utensils and food,
• when relatives come in contact with the patient, it is advisable to wear cotton-gauze bandages (do not forget to change the bandages every 2-3 hours),
• exclude the use of common household items,
• wash hands often (to the sick and loved ones),
• exclude contact of the patient with children, because they are especially susceptible to angina.

It is especially important that the cotton-gauze bandage fits snugly to the face without leaving gaps, since purulent tonsillitis is transmitted mainly through the air (airborne droplets) and, a little less often, through unwashed hands and dishes.

How and how to treat purulent tonsillitis in adults?

Purulent tonsillitis before treatment is studied for signs inherent in a particular pathogen. It is necessary to fully collect an anamnesis (a set of signs and complaints), conduct a full diagnosis and find out the cause of the disease, since there are pathogens that require highly targeted antibiotics.

Before treating purulent tonsillitis in an adult, it is important to accurately determine the form of the disease and identify the pathogen. Most purulent tonsillitis are vulgar forms (follicular, lacunar or fibrinous), and doctors prescribe treatment aimed at eliminating the most likely cause - streptococcus. To do this, use broad-spectrum antibacterial agents, as a rule, the penicillin series.

Medical treatment

Medications for purulent tonsillitis:

• antibacterial (more on that below),
• antiseptic mouthwash (furatsilin),
• antiseptics for mechanical cleaning of the tonsils from pus (Lugol),
• antipyretics (most often paracetamol),
• anti-inflammatory,
• painkillers (sprays, sucking tablets),
• antiviral drugs (for a viral infection).

Antibacterial therapy is perhaps the most important part of the treatment of most sore throats and is the exact answer to the question: "how to quickly cure purulent sore throat?". The most commonly used antibiotic for purulent sore throat is penicillin and its derivatives, since it accurately affects the common cause of the disease - streptococcal infection. But the uncontrolled use of antibiotics has led to the fact that penicillin-resistant strains of streptococcus are increasingly appearing (by the way, in Europe, antibiotics are not sold without a prescription).

With a reduced sensitivity of streptococcus to the entire penicillin series, or with allergic reactions to penicillin, antibacterial drugs from the group are selected:

• cephalosporins,
• macrolides,
• sulfonamides (very rarely, unless other groups of antibacterial agents cannot be used for one reason or another).

Only a doctor should decide which antibiotic to use and what to do with purulent sore throat. This is due to the very high toxicity of most drugs. Moreover, with an illiterate calculation of the dosage and duration of use, there is a risk of “educating” resistant strains of streptococcus or another microbe and, thereby, complicating treatment.

In order to enhance the effect of the antibiotic, the body needs to provide a more intense blood supply to the affected areas (throat) and good lymph flow. All this makes it possible to carry out, which, due to sound waves, provides a deep and directed increase in blood circulation in the throat area, as a result, the effectiveness of antibiotics and the body's resistance increases significantly.

What is the best way to gargle?

Before gargling with purulent sore throat, you should figure out why this procedure is necessary. Rinsing has two purposes:

1. Throat moisturizing. This provides softening and lubrication of the parched mucosa, which helps to relieve the pain of purulent sore throat.
2. Removal of pus and plaque from the mucous membrane of the tonsils.

In addition to these two goals, the task of suppressing the growth of bacteria (antiseptic) is usually added, but the main problem of angina is that all microorganisms are inside the tonsil, where the antiseptic cannot get, so rinsing with antiseptics will not give a serious effect.

Almost all possible solutions will fulfill these goals, for one simple reason: the basis of any solution is water, because it is it that allows you to remove pus and alleviate the course of purulent tonsillitis. Therefore, the best gargle is lightly salted water (1 teaspoon of salt per liter of water)

It happens that on the Internet it is suggested to use hydrogen peroxide for gargling with purulent sore throat, we do not recommend using this remedy for other purposes, you can study in more detail about the mechanisms of the effect of hydrogen peroxide on the human body

How to smear the throat with purulent sore throat?

In addition to rinsing, there are procedures for mechanical cleaning of the tonsils with Lugol. This antiseptic adjuvant kills microorganisms found only on the surface of the tonsils. Unfortunately, the antiseptic does not penetrate deep into the tissues, where the bulk of bacteria such as streptococcus is located, but, in general, lugol helps fight purulent tonsillitis.

It's important to know:

• Lugol should not be used more than twice a day, because in large quantities it can damage the mucosa of the esophagus and stomach;
• lugol is not desirable during pregnancy and lactation;
• Lugol is contraindicated in thyrotoxicosis and in case of allergy to it.

Inhalations

On the Internet, inhalations are actively promoted for any diseases of the upper respiratory tract, both steam and with the help of nebulizers. However, the effectiveness of inhalation with purulent sore throat is doubtful. From steam, you can get a burn of an already damaged mucous membrane, and through a nebulizer, inhalations are completely useless, since the bulk of the devices create too small particles that do not settle in the mouth and throat.

Consequences and complications

From a philistine point of view, angina is a mild disease that you should not pay special attention to. Unfortunately, this simple pathology can create very complex health problems that can result in both systemic pathologies and local complications.

Systemic complications:

Can be expressed in the form of diseases of the kidneys, joints and heart. It would seem, where is the throat and where are the kidneys? But the fact is that the proteins (structural elements) of the causative agent of angina are similar in structure to the proteins that make up our heart, kidneys and joints.

Immunity, in this case, is the main culprit of complications. Every time it enters the body of bacteria, it triggers the synthesis of protective proteins (antibodies), which selectively attach to foreign substances (streptococcus proteins) in such a way that they lose all their properties (destroy).

An antibody is a substance (protein) with a simple chemical program to attach to a specific sequence of amino acids. The antibody does not distinguish its own from the foreign, therefore, while performing its functions, it attaches both to streptococcus and to the tissues of the joints, heart and kidneys. As a result, the destruction of both streptococcus and our cells occurs. This is manifested by myocarditis, nephritis or rheumatism.

Local complications:

The purulent process can spread from the tonsils to the surrounding tissues, which causes the following complications:

• Paratonsillitis. Purulent inflammation penetrates into the tissue surrounding the tonsil. Long-term antibiotic treatment is required.
• Retropharyngeal, parapharyngeal and other abscesses. The most severe complications are characterized by a massive accumulation of pus in a limited space near the pharynx. Surgical treatment.
• Phlegmonous tonsillitis (see the relevant section in the article).
• Phlegmons of various locations. Phlegmon is an infiltration (impregnation) of tissues with pus. An extremely severe complication that requires immediate surgical intervention and aggressive antibiotic therapy.

If you let the treatment take its course or “profess” a fundamental rejection of antibiotics, then just 9 days are enough and a sore throat can become deadly!

infectious

There are many varieties of infectious sore throats. In some cases, the defeat of the tonsils can be a primary disease, and in some cases, tonsillitis occurs against the background of systemic pathologies or as a result of weakening. Let's look at specific examples.

Mononucleosis

It occurs in the information space as monocytic, mononuclear, mononuclear angina. All this manifestation of such an infectious disease as mononucleosis, which is transmitted by airborne droplets or household contact, is characterized by damage to the system of mononuclear phagocytes (cells responsible for the destruction of the bacterial agent).

Causes

The reasons are not clear to this day. There are two theories, one bacterial (the role of the pathogen is attributed to B. monocytogenes homines), the other is viral (the pathogen is considered to be a special lymphotropic Epstein-Barr virus).

In any case, this disease is common, affecting the entire body with a primary lesion of the blood system. With mononucleosis, tonsillitis almost always joins, since the disease weakens the protective cells of the immune system. As a result, immunity is sharply reduced at strategically important points - the oral and nasal cavities, and streptococcus begins to multiply uncontrollably on the surface of the tonsils, causing a sore throat.

Symptoms

Clinical signs of this pathology are divided into three groups:

1. Fever:
   • elevated body temperature 39-40 ° C,
   • headache,
   • weakness.
2. Angina-like changes:
   • inflammatory changes in the pharynx and palatine tonsils,
   • significant enlargement of the palatine tonsils,
   • plaque on the tonsils resembles diphtheria,
   • possible development of purulent tonsillitis.
3. Blood changes (hematological signs):
   • the appearance in the blood of monocytes with a modified structure (60-80%),
   • increase in ESR.

Treatment

Mononucleosis angina carries many problems for medical science: there are no drugs that affect the etiological (causal) factor, because there is no proven theory about the causative agents of the disease. All treatment is reduced to symptomatic (elimination of consequences):

• antibiotic therapy in the development of purulent tonsillitis, but if there is no pus - antibiotics are not needed;
• gargling with antiseptics;
• physiotherapy procedures, including vibroacoustic therapy using the apparatus "";
• hormone therapy, to relieve severe inflammation.

Viral angina

Viruses are a common cause of sore throats, including bacterial ones. Almost always, they strongly suppress local immunity in the throat and open the way for the attachment of a secondary infection in the form of streptococcus.

Viral tonsillitis can also be a consequence of a general disease of the body, for example, very often tonsillitis develops with Measles or HIV infection.

Measles

Measles is an acute contagious (contagious) infectious disease characterized by intoxication, skin rash, inflammation of the mucous membranes of the respiratory tract and the lymphoid pharyngeal ring (tonsils). It is transmitted by airborne droplets.

One of the frequent manifestations of measles is measles tonsillitis, which can proceed easily with a slight reddening of the tonsils, but sometimes streptococcus joins and the tonsillitis becomes purulent.

Causes

By airborne droplets through the mucous membranes of the respiratory tract and eyes, an infectious agent from the paramyxovirus family enters the body.

The measles virus causes T-cell immunodeficiency (decreased immunity) that persists for 30 days. Against this background, almost any infection (including streptococcus) can join, therefore measles is often accompanied by purulent tonsillitis, the incubation period of measles lasts 9-14 days (the time of virus reproduction without external manifestations of the disease).

Symptoms

At the onset of the disease are characteristic:

• lethargy, headache;
• swelling of the face, eyelids;
• tearing from the eyes;
• photophobia;
• nasal congestion;
• cough;
• increase in body temperature up to 39 ° C.

For 2-3 days:

• small red spots appear on the soft palate;
• small dot spots appear on the mucous membrane of the cheeks; resembling semolina (Filatov-Koplik symptom), they persist for 1-3 days and then disappear during the appearance of a rash on the skin.

For 4-5 days:

• a rash appears, first on the face and neck, and during the day spreads to the body;
• at this time may appear measles sore throat:
• enlargement and redness of the tonsils,
• the presence of purulent plugs or purulent easily removable plaque,
• pain when swallowing;

On the 8-10th day, the disease subsides, the rash turns pale, cough and tonsillitis (if any) disappear.

Treatment

Means acting directly on the measles virus does not yet exist, therefore, treatment is mainly symptomatic (relieving symptoms), aimed at preventing complications and the addition of secondary infections. Treatment with antibiotics before bacterial infection occurs is not required.

Many doctors, including Dr. E.O. Komarovsky advises to start treating such a disease as purulent tonsillitis with measles by creating the right microclimatic conditions: cool (18-20 ° C), humid (50-70%), clean (ventilation) air.

• antibiotic therapy aimed at eliminating a secondary infection (streptococcus),
• bed rest,
• plentiful warm drink,
• rinsing the mouth and throat with a solution of salt (1 teaspoon per liter of water) or furacilin.

With HIV infection

Frequent manifestations of HIV infection are pathologies of the upper respiratory tract and infections of the external mucous membranes (eyes, mouth and nose).

Due to damage to the immune system (human immunodeficiency virus), angina is most likely to be caused by a bacterium from the normal microflora of the oral cavity (streptococcus). And it will manifest itself in the form of symptoms characteristic of purulent tonsillitis in the form of follicular, lacunar, fibrinous, etc. (see the corresponding section).

Herpangina (herpangina)

With herpetic, herpes and herpangina, the situation is very confusing. In view of the similarity of symptoms (vesicles or papules), similar names have historically developed, but the causative agents can be completely different viruses. Many medical schools also vary in name, with the Internet adding fuel to the fire in the form of many incompetent articles on the topic of viral sore throats.

In order not to completely get confused, we will consider separately:

1. Herpangina (herpangina).
2. Herpes sore throat.
3. Infection of the pharynx with the herpes zoster virus.

Causes

The causative agent of herpetic sore throat (herpangina) is Coxsackie enterovirus (enteroviral sore throat). It is so named after the city of Coxsackie (USA), in which there was a hospital with examined children. The American virologists G. Doldorf and G. Sickles working there in 1948 described the properties of the new virus for the first time.

Symptoms

Since there are several types of the Coxsackie virus, the symptoms may differ in different cases. The main signs that cause suspicion of herpetic sore throat are:

• sudden onset with an increase in body temperature up to 39-40 ° C;
• after 2-3 days, the temperature also drops sharply;
• on the 1-2 day of illness in the area of ​​​​the tonsils, arches, uvula and palate, characteristic small papules (bulges) 1-2 mm in size appear, then turn into vesicles;
• on day 2-3, the bubbles burst, leaving behind erosion covered with a grayish-white coating;
• the appearance of bubbles is accompanied by pain when swallowing, and profuse salivation;
• enlarged cervical lymph nodes;
• for 5-7 days in most patients, all changes in the throat disappear.

The final diagnosis can be made only with a virological study, which in most cases is not done.

Treatment

If herpetic sore throat is not complicated, then treatment is practically not required, it all comes down to alleviating the condition and reducing the risk of complications:

• bed rest,
• physiotherapy » (acceleration of recovery and reduction of the risk of complications),
• plentiful drink,
• antipyretic (at a long-term high temperature of 39 ° C),
• vitamin therapy (effervescent vitamin C),
• providing cool (18-20°C), humid (50-70%), clean indoor air,
• antibiotics are not needed (if there are no complications).

Herpetic angina, says doctor E.O. Komarovsky, not such a terrible disease as mothers imagine, is described in more detail in the video:

herpes sore throat

In some textbooks on otorhinolaryngology, such a form as herpes sore throat is distinguished, the causative agent of which is the Herpes buccopharyndealis virus. A microorganism of the same class as Herpes simplex, however, is several times more toxic to living beings.

Symptoms

The salient features are:

• a sharp and stormy onset with an increase in body temperature even up to 41 ° C;
• severe pain when swallowing;
• violation of the swallowing process (the food bolus does not leave well);
• on the 3rd day of the disease: the entire mucous membrane of the pharynx is evenly hyperemic (red); an accumulation of small rounded white vesicles appears in the region of the tonsils and pharynx;
• over the next 3 weeks, the bubbles burst, ulcerate and suppurate, but this process may not be;
• herpetic eruptions appear on the mucous membrane of the cheeks, lips, and even on the skin of the face.

Treatment

Mostly symptomatic (relieving condition):

• gargling with saline solution (1 teaspoon of salt per 1 liter of water),
• plentiful drink,
• antiviral drugs (such as acyclovir),
• if a secondary infection joins, then broad-spectrum antibiotics are prescribed,
• antibiotics are not needed (if there are no complications),
• physiotherapy is used to improve local immunity and speed up the healing process.

Throat infection with herpes zoster virus

Usually the virus spreads along the course of the intercostal nerves, but the trigeminal nerve is also affected, which is in particular responsible for the functions of the oropharynx.

Symptoms:

The salient features are:

• the occurrence of pathology in adults and the elderly, in contrast to herpetic sore throat, which affects mainly children;
• vesicles (vesicles) appear on one side of the affected nerve;
• pain when swallowing gives to the eye from the side of the affected nerve.

Treatment:

As with most viral infections, it is mostly symptomatic:

• antiviral drugs,
• antibiotics are prescribed only if a secondary infection joins,
• rinsing with a solution of salt (1 teaspoon per 1 liter of water) or furacilin,
• symptomatic treatment (anti-inflammatory, painkillers, etc.),
• (locally enhances immune protection in the throat area and contributes to a general increase in immunity).

bacterial

Bacterial tonsillitis is an infectious lesion of the palatine tonsils by various kinds of bacteria, usually streptococcus. It manifests itself in the form of a follicular, lacunar or fibrinous form with all the symptoms and signs characteristic of them (see the relevant sections above).

Different infectious agents (bacteria) have some similar symptoms and complaints, but there are also characteristic differences, which we will consider further.

Streptococcal angina

The main part of bacterial tonsillitis is streptococcal tonsillitis, while such a term does not exist in official medicine. The fact is that the causative agent of most types of tonsillitis is streptococcus (various strains of group A beta-hemolytic streptococcus), so this name does not reflect the main characteristics of the disease.

Most often, streptococcal angina manifests itself in the form of the main forms of the disease (disassembled at the beginning of the article) is:

• catarrhal
• follicular,
• lacunar,
• fibrinous,
• phlegmonous.

And also a streptococcal infection can join any sore throat:

• viral,
• fungal,
• ulcerative necrotic,
• mononucleosis, etc.

Streptococcal angina is characterized by the following symptoms:

• body temperature may vary depending on the severity of the disease (38-40 ° C),
• tonsils enlarge and turn red, may be covered with a film, purulent plaque or purulent plugs,
• lymph nodes in the neck may be enlarged to varying degrees,
• sore throat during meals, and in severe cases even at rest.

scarlet fever

Many mothers know firsthand about such a disease as scarlet fever. Against the background of it, angina of various forms almost always occurs (catarrhal, follicular or lacunar)

Scarlet fever is an acute infectious disease characterized by angina, punctate rash and a tendency to purulent processes on the skin.

Causes

There are many different strains of streptococcus, and only a few of them are particularly toxic and produce erythrotoxin, which causes certain symptoms (more on them later).

The causative agent is transmitted by airborne droplets from patients. After an infection enters the body, it can take from 1 to 12 days before the first symptoms appear (incubation period).

Symptoms

Scarlatinal tonsillitis begins abruptly, with an increase in body temperature to 39 ° C and a sore throat, then the following symptoms appear:

• after a few hours, a small-dotted rash occurs almost throughout the body (reaction to erythrotoxin);
• the general skin tone becomes reddish;
• the skin feels like sandpaper to the touch;
• the tongue becomes crimson with sharply enlarged papillae;
• bright hyperemia of the pharynx and tonsils;
• purulent plaque or plugs on the tonsils.

Treatment

It is extremely important to prescribe antibiotics of the penicillin series first of all, and in a day there will be a noticeable improvement.

The key point is that when treated with antibiotics, in 99% of cases, scarlet fever ends in recovery, and without them, complications almost always occur in the form of rheumatism, heart or kidney damage.

Complementary treatment is:

• bed rest,
• plentiful warm drink,
• gargling with salt water (1 teaspoon per liter of warm water),
• physiotherapy " » it is prescribed together with antibiotics, as it significantly enhances their effectiveness, as well as the body's immune response.

It is advisable to limit contact with the patient during treatment, do not use common utensils, wear cotton-gauze bandages when communicating. After recovery, in order to avoid re-infections, it is advisable to limit the child's social contact for 2 weeks.

diphtheria

Diphtheria is an acute infectious disease manifested by damage to the oropharynx with the formation of fibrinous plaque on the tonsils and possible damage to the cardiovascular and nervous systems. The cause is the causative agent - diphtheria bacillus (Leffler's bacillus). It is transmitted by airborne and household routes, the incubation period is from 2 to 10 days. There are diphtheria of the skin, eyes, genital organs, nasopharynx and oropharynx (diphtheritic angina).

Symptoms

In 70-80% of cases, the course of the disease is very similar to a common sore throat.

• It begins acutely with a rise in temperature, usually it is lower than with angina, but the patient's condition is felt as more severe.
• From the first hours, a sore throat begins to bother, and on the second day it becomes very pronounced.
• Enlargement of the cervical nodes.
• There are signs of intoxication (headache, weakness, chills).
• There is a sweetish bad breath.
• Despite the fever, the skin of the face is pale, which is not typical for ordinary sore throats, in which a slight blush appears on the cheeks.
• Swelling and redness of the tonsils are characteristic.
• Grayish-white plaques appear on the tonsils, which may look like islands or completely cover the tonsils and even spread beyond them to the oral mucosa.
• An important distinguishing feature is the characteristics of plaque. They are difficult to remove with a spatula and, after removal, are re-formed in the same place. The removed fibrinous film is thick and dense, does not rub and does not dissolve in water, sinks quickly.

Treatment

If diphtheria is suspected, urgent hospitalization in the infectious diseases department is necessary.

The clinic produces:

• treatment with anti-diphtheria antitoxic serum, which is especially effective in the early stages of the disease;
• antibiotics are prescribed to prevent complications
• apply, if necessary, symptomatic (relieving the condition) means: antipyretics, antihistamines, painkillers.

After the cure, it is necessary to conduct a three-fold analysis of the mucus from the nose and throat for the absence of the pathogen, and after that the patient can be considered non-infectious.

Staphylococcal

Staphylococcal tonsillitis is a purulent inflammation of the mucous membrane of the palatine tonsils as a result of their defeat by Staphylococcus aureus.

Symptoms

The manifestations of the disease are not specific, it is extremely difficult to see staphylococcal in the usual purulent tonsillitis:

• high body temperature 39°C;
• intoxication is strongly pronounced (headache, weakness, chills);
• unbearable pain when swallowing;
• purulent plaque on the tonsils, which is easily removed with a spatula;
• enlarged and painful when probing the cervical lymph nodes,
• the course of the disease is usually more severe than with streptococcal infection;
• weak effect of broad-spectrum antibacterial drugs.

Treatment

Bacterial staphylococcal angina is more difficult to treat than streptococcal. Basic treatment with broad-spectrum antibiotics may not work. Therefore, to select the most effective treatment, it is necessary to conduct a bacteriological study, as well as to study the sensitivity of the strain to specific drugs.

Along with the start of antibiotics, auxiliary treatment is prescribed:

• physiotherapy with help, enhance the effect of antibiotics and the functioning of the immune system,
• bed rest,
• plentiful drink,
• gargling with a solution of salt (1 teaspoon per 1 liter of water) or furatsilina.

Ulcerative membranous (necrotic)

Doctors call this pathology Simanovsky-Plaut-Vincent's angina.

Ulcerative necrotic angina is a characteristic lesion of one palatine tonsil in the form of the appearance of areas of necrosis (death) of the mucous membrane of the tonsil and the formation of ulcers. The causative agents are fusiform bacillus and oral spirochete. It is quite rare and occurs against the background of a decrease in general and local.

Symptoms

• It is characteristic that such a sore throat is one-sided, pathological processes occur only on one tonsil.
• On the side of the same name, the cervical lymph nodes are enlarged.
• The patient complains only about the sensation of a foreign body when swallowing.
• There is often a putrid odor from the mouth.
• Body temperature is normal in most cases.
• The duration of the disease is from 1 to 3 weeks (sometimes months).
• On the surface of the affected tonsil, grayish-yellow or greenish masses, after removal of which an ulcer is found.

To make a final diagnosis of Simanovsky-Plaut-Vincent's angina, it is necessary to conduct a histological examination of a biopsy from an ulcer (a piece of tissue).

Treatment

• Antibacterial therapy with penicillin drugs.
• Complete sanitation (cleansing) of all possible foci of infection in the oral cavity is necessary.
• Mechanical cleansing of ulcers on the tonsil from necrosis and treatment with an antiseptic.
• Professor Palchun V.T. notes that the fight against beriberi (complex vitamins) and the restoration of immunity () are urgently needed.

syphilitic

This disease develops against the background of the defeat of pale treponema. As a rule, the main pathological processes occur at the site of entry of the pathogen into the human body, if the mouth is the gate, then it is very likely that syphilis will manifest itself in an anginal form.

Symptoms

• Unilateral prolonged inflammation of the tonsils (more than 10 days).
• An increase in body temperature up to 38 ° C.
• Enlarged painless cervical lymph nodes.
• Moderate pain when swallowing.
• A primary chancre (painless ulceration) appears in the pharynx.

In general, the symptoms are not specific and it is difficult to clearly identify syphilitic tonsillitis from them, so such a diagnosis can only be made after a laboratory test.

Treatment

Syphilitic tonsillitis is treated only in the dermatovenerological department with antibacterial drugs and auxiliary procedures.

Fungal angina

Fungal angina is an inflammation of the mucous membrane of the palatine tonsils, caused by various kinds of infectious fungi. There are several types of pathology, the most common of them is candidal tonsillitis, the causative agent of which are fungi of the genus Candida.

Symptoms

Fungal tonsillitis, as a rule, proceeds without temperature or with a slight increase. The following signs are also characteristic:

• There are practically no signs of intoxication (headache, weakness, chills), or they are weakly expressed.
• Soreness and soreness in the throat when swallowing.
• Sensation of incomplete swallowing of food.
• Hyperemia (redness) of the mucous membrane of the tonsils.
• Islands (specks) of curdled masses on the surface of the tonsils, the back wall of the pharynx and the root of the tongue.
• In a smear under a microscope, yeast-like clusters of cells are visible.
• The course is long, often in the form of a chronic pathology.

Treatment

Often, fungal tonsillitis occurs against the background of the usual or after it. If a course of antibiotic treatment is prescribed, then it must be stopped and prescribed:

1. antimycotics:
   • ingestion of drugs with active ingredients: fluconazole, ketoconazole, etc.;
   • locally lubricate the affected areas with a solution or ointment with active ingredients: natamycin, terbinafine, etc.
2. physiotherapy, which will significantly enhance the effect of antimycotic drugs and natural human immunity.

laryngeal

Laryngeal angina is a disease of the pharynx, characterized by damage to the lymphoid tissue near the larynx (part of the respiratory tract, located below the pharynx). It differs from laryngitis in the depth of inflammation and the predominant lesion of lymphoid tissue. Laryngitis, unlike laryngeal tonsillitis, is characterized by inflammation of only the mucous membrane of the larynx.

Causes

The reasons why such angina occurs:

• reduced immunity after viral infections (flu, measles, etc.)
• as a complication of common angina,
• as a complication of peripharyngeal phlegmon,
• as a complication of laryngitis (inflammation of the mucous membrane of the larynx).

To understand the difference between ordinary angina and laryngeal, let's look at the illustration:

The figure shows that the larynx is located below and is the entrance to the respiratory system of the body, which immediately leads to concerns about the possibility of swelling of this department, with all the ensuing consequences - difficulty breathing. This arrangement creates another problem - the inability to see pathological changes during a normal examination of the throat (look at the location in the figure).

Symptoms

Laryngeal angina is a diagnosis that only a doctor can make. Symptoms can only indirectly indicate the possibility of this pathology:

• Hoarseness (or any change in the sound of the voice). The larynx is the organ that allows us to produce sounds, so damage to the larynx is almost always accompanied by problems with the voice, up to the inability to pronounce any sound (aphonia).
• Dryness, itching and sensation of a foreign body in the throat.
• Pain when swallowing.
• Elevated body temperature up to 39°C.
• Enlarged cervical lymph nodes.
• History of laryngitis (in the history of a person's disease).
• In severe cases, respiratory failure, shortness of breath.

These symptoms direct the doctor's thoughts towards laryngeal angina, while all of them can be with ordinary follicular angina (see details in the corresponding section above). Therefore, additional instrumental studies in the ENT room are needed. Usually, for this, the doctor performs manipulations with a mirror (indirect laryngoscopy) or with a laryngoscope (a special tube for examining the larynx).

Treatment

The decision to treat laryngeal tonsillitis can be difficult to make in favor of home conditions. The main problem is the potential risk of laryngeal edema (direct entry into the respiratory tract), the consequences of such edema can even be fatal. Therefore, with such a sore throat, it would be quite reasonable to protect yourself and decide on hospitalization for several days.

The main methods of treatment of laryngeal angina:

• antibacterial therapy (penicillin series, cephalosporins, macrolides);
• antihistamines to reduce the risk of swelling;
• with edema diuretics;
• hormone therapy, to reduce the risk of severe swelling;
• antipyretic, at a high temperature of more than 39 ° C,
• bed rest,
• sparing mode of communication (once again do not talk),

Recovery from laryngeal angina can last from 14 to 20 days. The disease is serious and with untimely and unprofessional treatment can turn into the following consequences:

• the transition of inflammation to the deep layers of tissue (muscles, fiber, and even to the epiglottic cartilage);
• purulent complications in the form of abscesses (accumulations of pus limited to the capsule) or phlegmon (impregnation of tissues with pus);
• narrowing of the entrance to the respiratory system (stenosis of the larynx), with the risk of complete obstruction of the airways and death from suffocation.

Stomatitis

Stomatitis is an inflammation of the oral mucosa. Probably, various microorganisms (bacteria, viruses, fungi) can serve as the reasons, and in some cases it is a manifestation of an allergic reaction to a product. Until now, this pathology has not been fully studied, especially, difficulties arise in identifying the causes.

Stomatitis sore throat occurs as a consequence or complication of prolonged stomatitis, which greatly weakens local immunity, as a result, control over the reproduction of streptococcus in the oral cavity is lost and tonsils are damaged.

Symptoms

Stomatitis angina is characterized by all the symptoms inherent in bacterial angina (follicular, lacunar, fibrinous):

• elevated body temperature,
• intoxication (headache, weakness, chills)
• pain when swallowing
• enlarged cervical lymph nodes
• redness of the mucous membrane of the tonsils,
• purulent plugs or plaque on the surface of the tonsils.

Treatment

Stomatitis angina, first of all, requires antibiotic therapy to suppress and contain the growth of all pathogenic and opportunistic microorganisms that enter the oral cavity.

But this is a treatment for the consequences of stomatitis, antibiotics may not have an effect on the root cause.

With stomatitis, local immunity in the oral cavity is significantly reduced, therefore, together with antibiotic therapy, it is necessary to prescribe, which will strengthen immunity and increase the effectiveness of drugs.

For full treatment, a complete examination in a medical institution is necessary.

allergic

Allergic angina is not an independent disease, it is a manifestation of the general pathology of the body - allergies.

As a result of exposure to an allergen (food or pollen), an allergic reaction occurs in the form of:

• hyperemia (redness) of the tonsils and pharynx,
• swelling of the tonsils and pharynx,
• may be accompanied
• there is no fever and signs of intoxication.

Treatment

• Allergen detection.
• Exclusion of contact with the allergen.
• If necessary, antiallergic drugs (antihistamines).
• helps to reduce allergic reactivity.

Chronic

All of the above types of angina mainly occur in an acute form, that is, they quickly arise, last no more than one month and eventually end in recovery.

Chronic tonsillitis is a long-term (more than 1 month) inflammation of the mucous membrane of the tonsils, which does not end in complete recovery and is accompanied by periodic exacerbations.

Treatment of chronic angina, depending on the causes, severity and variety, is:

1. Medication (most often antibacterial),
2. Surgical:
   • tonsil removal,
   • sanitation of foci of infection in the tonsils (partial removal),
3. Physiotherapy:
   • laser therapy,
   • quartzization,
   • (actually produced in conjunction with antibiotic therapy and after surgical treatment).

Conclusion

Summing up all the sore throats, we can draw several important conclusions:

1. Angina is not a mild cold that can be carried on the feet.
2. With plaque on the tonsils, severe pain when swallowing and high body temperature (38-39 ° C), it is vital to visit a doctor.
3. Angina can give severe complications to the heart, kidneys or joints that occur when ignoring the doctor's instructions about antibiotic therapy.
4. Angina in most cases is very well treated with broad-spectrum antibiotics. Relief occurs on the second day.
5. Together with antibiotic therapy, physiotherapy is performed to improve lymphatic drainage and blood circulation. In addition to the obvious physical effect of vibroacoustic therapy, there is also a hidden biochemical effect that cannot be felt immediately. It consists in saturating our body. It is present in our body continuously, and is necessary for the implementation of immune processes, protein biosynthesis (metabolism - metabolism), cleaning and tissue regeneration. During an illness in the body, the need for microvibrations of tissues increases, which can be filled by the only medical one that currently exists.
6. For bacterial sore throats, no amount of rinsing, lubrication, inhalation or sucking of tablets will replace antibiotics.
7. Not all sore throats require antibiotics for treatment, be careful and do not take them unnecessarily.

Bibliography:

1. Babiyak V.I. Clinical otorhinolaryngology: A guide for physicians. - St. Petersburg: Hippocrates, 2005
2. Ovchinnikov Yu.M., Gamov V.P. Diseases of the nose, pharynx, larynx and ear. Textbook. - M.: Medicine, 2003
3. Palchun V.T., Magomedov M.M., Luchikhin L.A. Otorhinolaryngology. - M.: GEOTAR-Media, 2011
4. Berezov T.T., Korovkin B.F. Biological chemistry: Textbook. - M.: Medicine, 1998
5. Novitsky V.V., Goldberg E.D., Urazova O.I. Pathophysiology: textbook. - M.: GEOTAR-Media, 2009
6. Fedorov V.A., Kovelenov F.Yu., Kovlen D.V., Ryabchuk F.N., Vasiliev A.E. body resources. Immunity, health and longevity. - St. Petersburg: Vita Nova, 2004
7. Semenov V.M. Guide to infectious diseases - M.: MIA, 2008

You can ask questions (below) on the topic of the article and we will try to answer them competently!

Angina is a very insidious disease that attacks mainly in the cold season. The causative agents of angina or acute tonsillitis are most often pathogenic bacteria: staphylococcus aureus and streptococcus. Less commonly, tonsillitis may be caused by viruses, in which case the treatment process does not take much time and effort, but such diseases are at most one case out of ten.

All other sore throats are severe and are treated exclusively with antimicrobial drugs. However, acute tonsillitis itself has not been considered dangerous for a long time, and the patient's complete cure usually takes no more than a week. Another thing is unilateral or atypical angina - this is a completely different case.

Unilateral tonsillitis is even now considered a very dangerous disease. Their causative agents are bacteria modified at the gene level, which are not affected by the usual antibiotics.

In general, it is almost impossible to get an atypical sore throat in the classical way from another carrier of the disease, everything is much more complicated. Similarly, with treatment, the treatment of complex unilateral tonsillitis, according to doctors in special cases, may take up to a month.

However, before discussing the methods of therapy, let's try to figure out where bilateral tonsillitis comes from and how to distinguish them from ordinary tonsillitis.

Article plan

Causes of bilateral angina

There are a huge number of factors that can cause the development of unilateral tonsillitis. Sometimes this has nothing to do with pathological bacteria that enter our body, as they say, from the outside.

For example, a disease can be provoked by: purulent and tonsils, infectious lesions of the lymph nodes, problems in the dental part, or just loud talking, screaming or singing.

All these factors cause an increase in the number of opportunistic bacteria in the body, and some of them, if the patient is not lucky, can cause unilateral tonsillitis. More specifically, experts classify the causes of atypical tonsillitis as follows:

• medical reasons. At the moment when the body is fighting any infection, in most cases, the lymph nodes are also involved in this process. Most often, the lymph nodes in the neck swell and become sensitive, but from there the infection can go to the tonsils. Most often, both tonsils are affected, but it also happens that bacteria develop on only one, such a sore throat is called one-sided.
• Abscess. This is more likely not a sore throat, but a serious complication after suffering severe bacterial diseases of the nasopharynx. It is called a similar disease, according to experts -. It is perhaps the most dangerous among all existing types of atypical tonsillitis. Treatment is exclusively with antimicrobial drugs, but most often, the disease leads to the removal of the tonsils.
• Nodular laryngitis. First of all, this reason concerns those who use their vocal cords for all 100 and even more. Singing or talking loudly for several hours can lead to the appearance of small nodules on or near the tonsils, which later, in the absence of effective therapy, turn into unilateral tonsillitis. To help in this case, maybe complete rest for the vocal cords. However, this only works at the initial stage of the disease, if you ignore unpleasant symptoms, everything will certainly end with long-term treatment.
• dental reasons. Sometimes provoke a unilateral sore throat, maybe an unsatisfactory condition of the oral cavity. Millions of pathogenic bacteria live in carious teeth, which are just waiting for the owner's immunity to weaken in order to launch a massive attack on the body. Such a sore throat is treated, only at the dentist, and unpleasant symptoms disappear only after the main problem is eliminated. By the way, after visiting the doctor, if the treatment was very difficult, then in the patient's throat, and for some time something similar to a unilateral sore throat may occur. You should not be afraid of this - unpleasant symptoms will pass on their own within a few hours.
• Adverse environmental factors. Modern air, clean, can only be called a stretch. In the atmosphere, there are always many small, but very unsafe particles for the body. Very often they lead to irritation of the mucous membrane, allergies, and in some cases can even provoke atypical sore throat. Also, a similar sore throat may occur due to smoking or if you work in adverse conditions of polluted air.

Symptoms and Diagnosis

One-sided or atypical tonsillitis appears, in general, as the most common tonsillitis. The disease begins abruptly with a rise in temperature and severe pain in the throat. More specifically, experts also call the following symptoms:

• Severe sore throat, sometimes the patient cannot even eat or drink water normally.
• Hyperemia and swelling of the tonsils with unilateral angina is also observed exclusively, on the one hand. On the affected tonsil, depending on the type of disease, there may be a yellowish-white dense plaque or small abscesses and ulcers.
• General intoxication of the body. The patient feels severe weakness, apathy, lack of appetite, sometimes even nausea and vomiting are possible.

Another very important symptom of atypical tonsillitis is that this sore throat occurs without high fever. On the thermometer, as a rule, normal indicators in rare cases, the temperature may be subfebrile.

In fact, even despite the obvious symptoms, only an experienced specialist can distinguish an atypical angina in a patient or whatever is common. Two main diagnostic methods are usually used:

• visual inspection. The initial diagnosis is usually made at the moment when the doctor looks into the patient's mouth. If an experienced specialist one glance will be enough to figure out what kind of sore throat is tormenting the patient and how to treat it.
• Laboratory diagnostics. Usually used to refine the initial analysis. For example, if the antibiotic chosen by the doctor does not help, with the help of tests it is certainly possible to find out what kind of bacterium caused the disease and what drugs it is sensitive to.

Remember, atypical tonsillitis is not a disease in which it is worth self-diagnosis and self-treatment, even a small mistake by an inexperienced therapist can be fatal.

Treatment

In most cases, the development of unilateral tonsillitis is caused by pathogenic bacteria; as everyone knows, it is possible to get rid of them only with the help of antimicrobials. The main thing for the therapy to be successful is to strictly follow all the recommendations of the doctor, do not stop taking antibiotics until the end of the course and do not use drugs that are not combined with them.

However, not everything depends on the action of antibiotics. If some methods of conservative therapy are not used, immunity after a course of antimicrobial drugs will remain depressed and the disease can return at any time. So, as an adjunct therapy in the treatment of unilateral angina, use the following methods:

• Complete bed rest. It is necessary to minimize all movements around the apartment, to give up TV and the Internet during illness in order to give rest to the brain. Such measures will help to avoid many complications that can result in atypical tonsillitis.
• Irrigation and gargling. To relieve inflammation and pain, it is necessary to gargle the sore throat every hour with herbal decoctions and irrigate it several times a day with pharmacy aerosols.
• Rational nutrition, namely diet No. 13, is a very important step in the treatment of unilateral tonsillitis.
• Already during illness and within a few weeks after recovery, vitamins and mineral complexes should be taken. Perhaps the disease is caused just by the lack of any elements.

And be prepared that you will have to be treated, most likely, in a hospital. Refuse hospitalization. If you do not have atypical angina - the disease is very dangerous and health, as they say, is more expensive.

Video

The video talks about how to quickly cure a cold, flu or SARS. The opinion of an experienced doctor.

Attention, only TODAY!

Acute general infectious disease with a primary lesion of the palatine tonsils. The inflammatory process can also be localized in other accumulations of lymphadenoid tissue of the pharynx and larynx - in the lingual, laryngeal, nasopharyngeal tonsils. Then, respectively, one speaks of lingual, laryngeal, or retronasal angina.

Infection can be exo- (more often) or endogenous (autoinfection). There are two ways of transmission of infectious agents: airborne and alimentary.

Endogenous infection occurs from the oral cavity or pharynx (chronic inflammation of the palatine tonsils, carious teeth, etc.). The source of infection can also be purulent diseases of the nose and paranasal sinuses.

Etiology of angina (acute tonsillitis)

The most common causative agents of infection are staphylococcus aureus, streptococcus (especially hemolytic), pneumococcus. There is information about the possibility of angina of viral etiology. Predisposing factors: local and general cooling, decreased body reactivity. Angina often affects children of preschool and school age and adults under 35-40 years old, especially in the autumn and spring periods of the year.

Symptoms and coursengina (acute tonsillitis)

Pain when swallowing, malaise, fever. Frequent complaints of joint pain, headache, periodic chills.

The duration of the disease and local changes in the palatine tonsils depend on the form of angina. With rational treatment and compliance with the regimen, angina lasts an average of 5-7 days.

Types of angina (acute tonsillitis)

Distinguish catarrhal, follicular And lacunar form of angina. In essence, these are different manifestations of the same inflammatory process in the palatine tonsils.

Angina catarrhal. Usually begins suddenly and is accompanied by perspiration, mild sore throat, general malaise, low-grade fever. Changes in the blood are mild or absent. When examining the pharynx (pharyngoscopy), moderate swelling, hyperemia of the palatine tonsils and adjacent areas of the palatine arches are noted; soft palate and posterior pharyngeal wall are not changed. Regional lymph nodes may be enlarged and tender to palpation.

Catarrhal angina may be the initial stage of another form of angina, and sometimes a manifestation of a particular infectious disease.

Angina lacunar and follicular characterized by a more pronounced clinical picture. Headache, sore throat, malaise, general weakness. Changes in the blood are more significant than with catarrhal angina. Often the disease begins with chills, fever up to 38-39 ° C and above, especially in children. There is a high leukocytosis - 20-109 / l or more with a shift in the blood formula to the left and a high ESR (40-50 mm / h). Regional lymph nodes are enlarged and painful on palpation. With pharyngoscopy, pronounced hyperemia and swelling of the palatine tonsils and adjacent areas of the soft palate and palatine arches are noted.

At follicular angina festering follicles are visible, translucent through the mucous membrane in the form of small yellow-white vesicles.

At lacunar angina yellowish-white plaques are also formed, but they are localized at the mouths of lacunae. These raids can later merge with each other, covering all or almost the entire free surface of the tonsils, and are easily removed with a spatula.

Division of angina into follicular And lacunar conditionally, since the same patient can have both follicular and lacunar angina.

Angina phlegmonous. Acute purulent inflammation of the peri-almond tissue. More often it is a complication of one of the forms of angina described above and develops 1-2 days after the angina has ended. The process is often unilateral, characterized by a sharp sore throat when swallowing, headache, chills, feeling of weakness, weakness, nasality, trismus of masticatory muscles, fever up to 38-39 ° C, bad breath, profuse saliva. Changes in the blood correspond to an acute inflammatory process.

Regional lymph nodes are significantly enlarged and painful on palpation. With pharyngoscopy, a sharp hyperemia and swelling of the tissues of the soft palate on one side are noted. The palatine tonsil on this side is shifted to the midline and downward. Due to the swelling of the soft palate, it is often not possible to examine the tonsil. The mobility of the affected half of the soft palate is significantly limited, which can lead to leakage of liquid food from the nose.

If vigorous treatment of phlegmonous tonsillitis is not started in the first 2 days, then on the 5-6th day a limited abscess may form in the peritonsillar tissue - a peritonsillar (peritonsillar) abscess. With a high virulence of the microflora and a reduced reactivity of the organism, an abscess may form, despite active treatment, earlier than usual (on the 3-4th day from the onset of the disease).

With a formed peritonsillar abscess, one can see a thinned area of ​​the mucous membrane of a white-yellow color - a translucent abscess. After an independent or surgical opening of the abscess, a rapid regression of the disease occurs.

In recent years, prolonged up to 1-2 months have been observed. forms of phlegmonous tonsillitis with periodic abscess formation, which is associated with the irrational use of antibiotics.

Inflammatory changes in the lymphadenoid pharyngeal ring do not always indicate angina.

Differential diagnosis of angina (acute tonsillitis)

It should be carried out with scarlet fever, diphtheria, measles, influenza, acute catarrh of the upper respiratory tract, including acute pharyngitis, with acute blood diseases - infectious mononucleosis, etc.

In addition to the clinical manifestations of angina, the nature of local changes detected during examination of the pharynx and larynx (pharyngoscopy and laryngoscopy, posterior rhinoscopy) is of great importance. An important role is played by the data of laboratory research methods (the study of plaque in the tonsils in order to detect the causative agent of diphtheria, a general blood test).

In clinical practice, it is often necessary to differentiate lacunar tonsillitis with localized pharyngeal diphtheria. Angina with diphtheria is the most dangerous epidemiologically and because of possible complications. Suspicion of diphtheria should already arise during a general examination of the patient. Angina with diphtheria causes severe intoxication: the patient is lethargic, pale, adynamic, but at the same time, the temperature reaction can be mild (within subfebrile).

On palpation of the cervical lymph nodes, their increase is noted, as well as a pronounced edema of the tissue of the neck. Pharyngoscopy with lacunar angina they find plaques of a yellowish-white color, localized within the tonsils, with diphtheria they go beyond the tonsils and have a dirty gray color. At lacunar angina the plaque is removed easily, the surface of the tonsil under the plaque is not changed; with diphtheria, the plaques are removed with difficulty, when the plaque is removed, an eroded area of ​​the mucous membrane is found.

At lacunar angina- always bilateral symptoms; with diphtheria - often the localization of changes can be one-sided (especially in mild and moderate forms of the course).

If you suspect diphtheria, you should urgently take a smear from the raids of the tonsils for bacteriological examination for the presence of pathogenic corynebacteria of diphtheria. The patient must be urgently hospitalized in the boxed department of the infectious diseases hospital.

Diagnosis of peritonsillar abscess is not difficult.

A typical clinical picture that developed after a seemingly ended angina, unilateral hyperemia and a sharp swelling of the tissues of the soft palate, protrusion of the tonsil to the midline, a significant increase in body temperature indicate inflammation of the peri-almond tissue.

Complications angina (acute tonsillitis)

Of the local complications, in addition to the phlegmonous tonsillitis described above, the most common are acute otitis media, acute laryngitis, laryngeal edema, parapharyngeal abscess, acute cervical lymphadenitis, neck phlegmon.

Treatment angina (acute tonsillitis)

In the first days of the disease, until the temperature normalizes, bed rest is prescribed. Food should be rich in vitamins, spicy, hot and cold foods are excluded. Plentiful drinking is useful: freshly prepared fruit juices, tea with lemon, milk, alkaline mineral water. It is necessary to monitor bowel function.

Medications should be used strictly individually, depending on the nature of the sore throat, the state of other organs and systems. At mild angina without severe intoxication, according to indications, sulfanilamide preparations are prescribed orally, for adults, 1 g 4 times a day. IN severe cases, with significant intoxication, antibiotics are prescribed. More often, penicillin is used intramuscularly, 200,000 IU 4-6 times a day. If the patient does not tolerate penicillin, give erythromycin 200,000 IU orally with meals 4 times a day for 10 days, or oletethrin 250,000 IU orally 4 times a day for 10 days, or tetracycline 250,000 IU orally 4 times per day for 10 days.

Patients with rheumatism and persons with pathological changes in the kidneys are prescribed antibiotics to prevent exacerbation of the disease, regardless of the form of angina. Inside, acetylsalicylic acid is also prescribed, 0.5 g 3-4 times a day, ascorbic acid, 0.1 g 4 times a day.

For rinsing, use warm solutions of potassium permanganate, boric acid, furacilin, bicarbonate and sodium chloride, antibiotics, as well as decoctions of sage, chamomile (1 tablespoon per glass of water). Children who do not know how to gargle are often given (every 0.5-1 hour) to drink non-hot tea with lemon or fruit juices.

Lubrication of the pharynx is contraindicated, as it can exacerbate angina.

At regional lymphadenitis prescribe warming compresses at night (V3 of alcohol and 2/3 of water) and a warm bandage on the neck during the day, steam inhalations. With prolonged lymphadenitis, local application of solux, UHF currents is indicated. In the process of treatment, it is necessary to monitor the state of the cardiovascular system, repeat urine and blood tests, which will allow timely treatment of complications.

At phlegmonous angina, if the process progresses and a paratonsillar abscess has formed, its opening is indicated. Sometimes, instead of opening the abscess, an operation is performed - abscessotonsillectomy (removal of the tonsils, during which the abscess is emptied).

Prevention angina (acute tonsillitis)

The patient should be placed in a separate room, often ventilate it and make wet cleaning. Allocate special dishes, which after each use are boiled or scalded with boiling water. A vessel with a disinfectant solution is placed near the patient's bed for spitting saliva. Limit the contact of the patient with others, especially with children who are most susceptible to angina.

To prevent angina, it is important to timely sanitize local foci of infection (carious teeth, chronically inflamed palatine tonsils, purulent lesions of the paranasal sinuses, etc.), eliminate the causes that impede free breathing through the nose (in children, these are most often adenoids). Of great importance are the hardening of the body, the correct mode of work and rest, the elimination of various hazards - dust, smoke (including tobacco), excessively dry air, alcohol, etc.

Constant inflammation of the palatine tonsils, which ends with a complex form of angina, is called chronic tonsillitis. This disease carries a number of complications. It disrupts the normal way of life and causes significant discomfort. Chronic tonsillitis in adults can develop in various forms. Therefore, it is important to be able to recognize the signs of infection and understand why the disease appears. And it is better to contact a professional therapist who will prescribe a comprehensive treatment.

The course of chronic tonsillitis: the causes of the disease

The disease is caused by bacteria: streptococcus, staphylococcus, enterococcus or pneumococcus. They actively multiply on the damaged mucous membrane of the tonsils, causing pain and the formation of abscesses. Viruses can also cause chronic tonsillitis, even fungi and chlamydia are not left without suspicion when a patient comes to the doctor with this disease. Adults do not always understand how they became carriers of microorganisms that cause severe sore throats.

Only an experienced doctor will tell you what chronic tonsillitis is and what form is typical for a particular patient.

Further therapy and the choice of drugs depend on this. Here are the main reasons that contribute to the transition of angina into a chronic form:

• frequent inflammatory processes occurring in the area of ​​the tonsils and on the mucous membrane of the throat. Ideally, a person suffers from tonsillitis 1-2 times a year. If the number of sick days for this reason has increased up to 3-5 times, then you should immediately visit a doctor;
• curvature of the nasal septum, which creates ideal conditions for the reproduction of all kinds of bacteria;
• advanced caries, sinusitis or adenoid;
• destroyed immune barrier;
• frequent allergic reactions.

A severe cold can provoke a sore throat, which will definitely develop into a chronic disease if no action is taken. Tonsillitis is not just an inflamed tonsil and pain syndrome. This is a general decrease in the immune system. It is important to be able to recognize the symptoms in the early stages, but not to self-medicate. Only a doctor will tell you the name of the medicine for getting rid of a sore throat.

Symptoms of chronic tonsillitis

The recurrent course of a sore throat can be a serious reason for contacting a doctor. If a person knows the causes of chronic tonsillitis, then he will take all necessary measures to avoid complications. Unfortunately, most patients turn to a therapist when it is already difficult to help with antibiotics. As a result, an operation to remove the tonsils is needed.

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Discomfort in the tonsils can form in connection with a viral infection of the oral cavity. Tonsillitis often affects one tonsil, but occasionally the patient has an inflammatory process of two parts of the lymphoid tissue at once. Atypical angina without hyperthermia is often observed in childhood (over 10 years). The disease is mainly found in people with weakened immune systems and chronic phenomena in the nasopharynx. Exacerbation of tonsillitis is observed in the winter period, when there is a lack of vitamins and useful elements. It is optimal to exclude the formation of the disease, therefore it is required to treat rhinitis and colds in a timely manner.

Depending on the defeat of the tonsils in the throat, unilateral and bilateral tonsillitis is distinguished. There are a large number of causes that can provoke a disease such as unilateral tonsillitis. In some cases, this is in no way associated with pathogenic microflora that penetrates the body from the outside.

For example, they can cause a pathological process: a purulent abscess in the throat and tonsils, viral lesions of the lymph nodes, dental complications, or talking in raised tones, singing.

The above factors provoke an increase in the number of harmful microorganisms, some of which cause atypical tonsillitis. In addition, such provoking factors of unilateral angina are distinguished:

• Medical. During the fight against the viral agent inside the body, in many situations the lymph nodes are involved in this process. They often begin to swell. Lymph nodes in the neck will be particularly susceptible, from where infection can spread to the tonsils. Often two tonsils are affected, but there are situations when the harmful flora develops only on one side.
• Abscess. It is a complex consequence after severe viral diseases of the nasopharynx. It is considered the most dangerous of all known types of unilateral tonsillitis. The therapy is carried out directly with antibacterial agents, however, often, the pathology leads to the prompt removal of the tonsils.
• Nodular laryngitis. First of all, this factor refers to those who strain the ligaments too much. Singing or talking in raised tones for 3-4 hours can provoke the appearance of small nodes on the tonsils or next to them, which then, if there is no appropriate treatment, are converted into atypical tonsillitis.
• dental factors. In some situations, unilateral tonsillitis without fever is caused by an unsatisfactory condition of the oral cavity. A large number of pathogenic microflora lives in carious teeth. To get rid of such a disease is possible only at the dentist. Unpleasant symptoms disappear only after the elimination of the main pathology.
• negative environmental conditions. In the atmosphere all the time there are many small, dangerous elements for the body. Often they lead to irritation of the mucous membrane, allergic reactions, and in certain situations can cause unilateral tonsillitis. This disease can manifest itself due to smoking.

Angina without tonsils appears as a result of surgical intervention and the elimination of the organs in question. The tonsils directly help to contain the occurrence of any infection, and after their removal, angina, its chronic forms and more complex pathologies of the broncho-pulmonary system will be regular. Therefore, it is necessary to keep the tonsils in a healthy state, as well as strengthen the immune system.

negative environmental conditions.

Symptoms of angina

Often patients wonder if angina can occur without symptoms. Acute unilateral angina in each individual situation will manifest itself individually, but there are common laboratory signs. When therapy has not been started in a timely manner, the patient will experience a bacterial infection of the tonsils. For atypical tonsillitis, the following symptoms are characteristic:

• headache;
• muscle discomfort;
• chills;
• high fatigue;
• hyperthermia (sometimes more than 40 degrees);
• hyperemia of the tonsils;
• high sweating;
• loss of appetite;
• dryness in the mucous membrane of the sinuses;
• intense unilateral sore throat;
• enlargement of the tonsils;
• swollen lymph nodes;
• in the process of touching the lymph nodes, discomfort increases;
• while swallowing food products or water, extraneous sounds are noted in the ears;
• swelling in the tonsils;
• nausea and gag reflex;
• convulsive conditions;
• sore throat.

With bacterial tonsillitis, on the one hand, the symptoms are pronounced. At this stage, the temperature indicators are critical, and the general well-being of the patient has deteriorated too much. After getting rid of purulent follicles, the patient's condition returns to normal, and the symptoms of poisoning decrease. Basically, it will take about 10 days to eliminate the signs of such a disease. If there is no proper therapy, chronic inflammation of the tonsils can form. In this regard, it is easier to get rid of the disease at the initial stage than to fight chronic tonsillitis for a long time.

Headache.

Treatment of angina

When developing symptoms of the inflammatory process of unilateral tonsillitis, you need to contact a specialist or go to the medical center yourself. To know if a sore throat can turn into a chronic stage and cause complications, you should consult with a therapist or an otolaryngologist. During the diagnosis, the specialist determines the type of viral agent that provoked unilateral inflammation of the tonsil, specifies irritants on the mucosal cavity.

In certain situations, they differ, because the patient needs more complex treatment. In the process of diagnosis, the doctor finds out not only the type of viral agent, but also its susceptibility to antimicrobial agents. Only then will the otolaryngologist tell you how to treat unilateral tonsillitis. To prevent chronic inflammation of the tonsils, it is necessary to carry out timely diagnosis and treatment of the disease at an early stage.

Antibiotics

Antibiotics.

The choice of the most effective antibiotic in each case will be a difficult task for the ENT doctor. There is no generic drug available. The most popular antibacterial agents used to treat atypical tonsillitis are:

• Penicillins. Used in the form of injections. The most effective means: Amoxicillin, Ampicillin, Phenoxylmethylpenicillin.
• Cephalosporins. Preparations Cedrox, Biodroxil are an alternative to penicillin antibiotics, and therefore they are used by adult patients with an allergic reaction to penicillins.
• Macrolides. Contribute to the elimination of streptococci and staphylococci, often causing inflammation in the respiratory tract. Their effect is so effective that 7 days of treatment are usually enough to get rid of the pathogen. The most effective: Azithromycin, Clarithromycin, Midecamycin.
• Lincosamides. Assign in the absence of the possibility of using the above antibiotics. The main disadvantage is the addiction of pathogenic flora to medicines. Most used: Lincomycin, Clindamycin.

Antiseptics

Antiseptics.

In addition to antibacterial drugs for unilateral tonsillitis, external agents are used, which are designed to eliminate unpleasant symptoms. They have antimicrobial, anti-inflammatory and anesthetic effects. They have a small number of contraindications for use, so they can be used for therapeutic purposes in children, during pregnancy and breastfeeding. The most popular means:

• Medications for rinsing the larynx. The safest: herbal infusions and solutions with salt. Of the medicinal plants, decoctions of chamomile, sage and calendula are often used. Effective is the use of Furacilin, which is available for purchase in the form of tablets or solution. In addition, Chlorhexidine, Hexoral, Chlorophyllipt are used.
• Sprays. Gargling of the throat is not always permissible, because most of the drugs that are used to treat the pathological process are produced in various forms. Sprays are more often used in the treatment of children who do not know how to rinse the larynx. There are many sprays: Miramistin, Strepsils, Tantum Verde.
• Tablets, lozenges and lozenges. The most popular drugs used in the treatment of unilateral tonsillitis are Pharyngosept, Septolete, Lyzobakt. The main part of the medicines applied to the tonsils inflamed with atypical angina, in fact, have no contraindications for use.

Gargling

Gargling.

To rinse the larynx, various solutions have been created for the treatment of atypical tonsillitis. The most effective in the disease are considered:

• A solution of potassium permanganate.
• Infusion of garlic.
• A solution of iodine, soda and salt.
• Malic and acetic acids.
• Beet juice.
• Blueberries.
• Lemon juice.
• Herbal collection.
• Pharmaceutical preparations (Chlorfillipt, Furacilin, Miramistin).
• Probiotics (Narine, Trilakt, Normoflorin).

Inhalations

Inhalations.

In order for inhalation treatment to have the maximum effect, it is necessary to follow the basic instructions. The main condition is the proper choice of the drug and its dosage. It is advisable to consult on this matter with the doctor, as he will give the necessary recommendations.

Drugs used for manipulation:

• Tonsilgon N. Homeopathic remedy containing natural ingredients. The main component is the extract of medicinal plants (chamomile, dandelion, marshmallow root). It is used in acute and chronic form of unilateral tonsillitis.
• Chlorophyllipt. A natural preparation that is made from chlorophyll. It is used for infection with staphylococcus aureus.
• Miramistin. Such a tool gives an antiseptic effect on damaged areas. In view of this, taking the medication will be optimal for the bacterial form of atypical tonsillitis.
• Dioxidine. It is considered a disinfectant with an extensive effect. Manipulations with Dioxidin are done 4 times during the day.
• Furacilin. The medicine is characterized by a strong antiseptic effect and fights pathogenic flora on the affected tonsils.
• Kromoheksal. Therapy with this agent is recommended if the patient has severe swelling in the larynx or a tendency to spasm of the larynx.
• Saline, mineral water. With any kind of pathological process, inhalation through a nebulizer with such means helps to eliminate puffiness, soften the throat, and reduce pain.

Complications

A disease such as unilateral tonsillitis is fraught with dangerous complications for the patient, regardless of age. The provoking factors for the occurrence of pathology are diverse:

• Abscess. Painful purulent phenomenon in the tissues. Accompanied by hyperthermia. Get rid of with the help of surgery.
• Phlegmon. Looks like an abscess. Purulent phenomena are able to move from the tonsils to the tendons, under the skin, muscles. Eliminated through drug treatment.
• Otitis. It happens on one or both sides. Treatment is carried out in combination with throat therapy. Strong antimicrobials are used.
• Bleeding from the tonsils. It is stopped by ligation of vessels or cold treatment. Home treatment is prohibited.
• Swelling of the throat. If treatment is not carried out on time, a fatal outcome is likely. Eliminated with the help of conservative therapy.
• cardiac complications. Prevention is the comprehensive and appropriate treatment of a disease.
• Renal complications after tonsillitis. The main danger lies in the transition of the pathological process to the chronic stage. Immediate hospitalization and the entire complex of therapeutic measures are required.
• Sepsis. An extremely dangerous complication during atypical tonsillitis. Sepsis is eliminated in stationary conditions, often in the intensive care unit.

Otitis.

There are no special measures to prevent atypical angina. It is important to limit the contact of an infected person with others. The room needs to be constantly ventilated. Daily cleaning with disinfectants should be carried out. The patient must have their own dishes and hygiene items. To prevent the occurrence of a pathological process, you need:

• temper the body during the year;
• conduct systematic sports;
• use personal respiratory protection equipment (masks, respirators) while working in a smoky room;
• monitor the condition of the oral cavity;
• dress according to climatic conditions in winter;
• exclude hypothermia;
• get rid of adenoids, curvature of the septum and other factors that prevent nasal breathing;
• balance the diet, drink vitamin complexes, eliminate bad habits;
• constantly wash hands, wash with water, change into everyday clothes after being in a team.

Unilateral angina is considered a provoking factor in dangerous complications. Often, painful discomfort and poisoning lead to otitis media, sinusitis, and lymphadenitis. In the presence of swelling in the larynx, sleep disorders are formed, which leads to excessive fatigue and impaired breathing through the nose. To get rid of such a pathological process is permissible only by contacting an otolaryngologist, who will conduct a comprehensive examination and prescribe an effective treatment.