Angina - a fairly common infectious disease caused by bacteria, viruses or fungi, a characteristic feature of which is the defeat of palatine tonsils. Also, the inflammatory process can develop in the nasopharyngeal, laryngeal and lingual tonsils; then angina, respectively, will be nasopharyngeal, laryngeal or lingual. Infection occurs both with its own microbes, and from outside and occurs in two ways: food and airborne. However, most often internal infection occurs from the pharynx or oral cavity (carious teeth, chronic inflammation of the tonsils, etc.)
In most cases, angina is caused by streptococci, staphylococci or pneumococci, which mostly fall into the pharynx from household items (dirty dishes, etc.), which were previously used by a person with a sore throat. Also, the emergence of this disease can contribute to all kinds of irritants that systematically fall into the throat (dust, smoke, etc.) and the presence of diseases of the nasopharynx (adenoids, etc.), in which the nasal breathing is disturbed. Purulent inflammatory processes that occur in the nasal cavity, its accessory sinuses (sinusitis, etc.) and the oral cavity (carious teeth) also often lead to the formation of angina.
Predisposing factors of the occurrence of angina are general or local hypothermia, mental overstrain, overwork, transferred infectious diseases, sensitization of the body, beriberi
- Acute sore throat when eating and swallowing
- Weakness and general malaise
- Enlargement of lymph nodes
- Arthritis in joints
- Increase in body temperature to 38 * - 39 * C
- Soft palate, tonsils, tongue and palatine arches in the first days of the disease development are painted in bright red color
- Directly on the tonsils may be pustules, or small areas of accumulation of pus
The duration of the incubation period is from ten hours to three days. The disease always begins sharply: there is a chill, the overall body temperature rises, characteristic pains appear when swallowing, become painful and regional lymph nodes increase.
The main symptoms of angina are quite similar to those of a common cold, but with sore throat the pain in the throat is much sharper, the flow is longer and it is much heavier
Types of sore throat
Angina can be primary, secondary and specific.
Primary. Acute inflammatory disease, in which only the lymphadenoid ring of the pharynx is affected.
Secondary. Tonsils are affected by acute infectious diseases (diphtheria mononucleosis, diphtheria, scarlet fever, etc.), as well as diseases of the blood system (leukemia, alimentary-toxic aleukia, agranulocytosis, etc.).
Specific. The provoking factor is a specific infection (fungal angina or angina of Simanovsky - Plaut - Vincent)
Types of sore throat
Depending on the depth and nature of the damage to the tonsils, angina is divided into: lacunar, follicular, catarrhal and necrotic
Tonsils are affected in the area of lacunae with the subsequent spread of purulent plaque to the surface of the tonsils. When carrying out pharyngoscopy, infiltration and edema of tonsils, marked hyperemia and expansion of lacunae are observed. Fibrinous - purulent yellowish - white contents of lacunas on the surface of the tonsils form a loose coating in the form of a film or small foci, which is easily removed without leaving a bleeding defect
Follicular sore throat
Primarily affects the follicular apparatus of the tonsils. In this case the tonsils are edematous and hypertrophied, the supine follicles (pale yellowish formations up to five millimeters in diameter) are seen through the epithelial cover. Suppurated follicles are opened, thereby forming a purulent coating that does not extend beyond the tonsils
It is characterized by superficial damage of the tonsils. Body temperature rises to 37 * -38 * C, blood changes are minor or completely absent. Tonsils increase due to infiltration and swelling. During pharyngoscopy, there is a bright diffuse hyperemia, which captures the hard and soft palate, as well as the posterior wall of the pharynx. The disease lasts from one to two days, after which the inflammatory manifestations in the pharynx abate, or the angina flows into another form (follicular or lacunar)
This form is characterized by more pronounced local and general manifestations than with other forms (persistent pronounced fever, confusion, repeated vomiting, etc.). In blood tests, there is a significant increase in ESR, neutrophilia, leukocytosis. Affected tissues of the tonsils cover a gray or greenish - yellow coating with a dull, uneven surface leaving deep into the mucous membrane. Due to impregnation with fibrin, often enough affected areas become densified, and when they are removed, the surface bleeds. Also sufficiently deep, irregularly shaped tissue defects (up to two centimeters in diameter) are formed due to the rejection of necrotic areas.
Necrosis can spread beyond the tonsils: the back of the pharynx, the tongue and the arches
Pharyngoscopy is the main diagnostic tool for suspected angina. In addition, the general symptomatic picture, the patient's complaints and the history of the disease are taken into account.
, скарлатиной, острым катаром верхних дыхательных путей и острыми заболеваниями крови. It is also necessary to differentiate angina with diphtheria, measles , scarlet fever, acute catarrh of the upper respiratory tract and acute blood diseases. To do this, in case of doubt, additional diagnostic procedures are performed: diagnostic puncture, bacteriological analysis of the plaque on the tonsils, additional blood tests, etc.
In most cases, treatment of sore throat is performed on an outpatient basis, however in the case of a severe course - the patient is hospitalized in the infectious department. Attributed sparing diet, enriched with vitamins B and C, be sure to drink abundantly. The basis of treatment of angina is antibacterial therapy, which includes the use of amoxicillin with clavulanic acid, phenoxymethylpenicillin, cephalosporins (zinate, cefaclor, etc.), macrolides (azithromycin, erythromycin) and sulfonamides (cotrimaxosol, etc.). For local treatment, apply bioparox (fuzafunzhin), pharyngosept, gramicidin C, rinse with broths of medicinal herbs (calendula, chamomile, etc.), irrigate the tonsils (inhalipt, kametone, sebidin, etc.), rinse with solutions of antiseptics (furacilin, nitrofural).
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