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Angina (acute tonsillitis)

Angina - a common acute infectious and allergic inflammation of the tonsils, often palatine, other tonsils are involved in the inflammatory process much less often.

Forms of tonsillitis differ in etiology, mechanisms of disease development and clinical course.

Among the various microbial pathogens of tonsillitis, which include cocci, rods, viruses, spirochetes, fungi, Klebsiella, in the first place is the β-hemolytic streptococcus of group A. Staphylococcus may be a frequent causative agent.

The penetration of the pathogen into the mucous membrane of the tonsils occurs by airborne droplets or alimentary, but more often the infection occurs due to exposure to microbes and viruses that are on the mucous membrane of the pharynx. Sore throats can occur as a result of:

1) episodic infection, with environmental conditions worsening, often as a result of general cooling;

2) infection from a sick person;

3) as an exacerbation of chronic tonsillitis.

The most common classification includes the following forms of angina:

1) catarrhal;

2) follicular;

3) lacunar;

4) herpetic;

5) phlegmonous;

6) necrotic;

7) fungal;

8) mixed forms.

Sore throats can be primary and secondary in acute infectious diseases: scarlet fever, diphtheria, syphilis, infectious mononucleosis, as well as in blood diseases. Clinic

Catarrhal sore throat. The disease begins acutely. The main symptoms: burning sensation, dryness, perspiration, slight soreness when swallowing. Body temperature is low-grade. On examination, there is hyperemia of the tonsils and the edges of the palatine arches, an increase in the tonsils, they are covered with a thin layer of mucopurulent exudate. The tongue is usually dry, coated, there is an increase in lymph nodes. The duration of the disease is 3-5 days.

Follicular tonsillitis. The disease begins with a fever up to 38 ° C, but sometimes it can be subfebrile. There may be severe sore throat when swallowing, which radiates to the ear. Sometimes salivation is increased. On the part of the blood, neutrophilic leukocytosis occurs, a stab shift to the left, an increase in ESR, traces of protein in the urine may appear.

There is an increase in lymph nodes, they are painful on palpation. When examining the pharynx, diffuse hyperemia and infiltration of the soft palate and arches, hyperemia of the tonsils and their increase are noted. On the surface of the tonsils visible above the surface are yellowish or whitish dots up to 3 mm in size, which are festering follicles of the tonsils.

The disease lasts about a week.

Lacunar angina. The main symptoms: the onset of the disease is the same as with follicular tonsillitis. But the form has a more severe course. With lacunar angina with pharyngoscopy, against the background of enlarged hyperemic tonsils, yellowish-white deposits appear on the mouths of the gaps, and then on the surfaces of the tonsils. The disease lasts about a week.

Fibrinous tonsillitis. Its other names are pseudodiphtheria, pseudo-membranous, diphtheria angina. The name indicates that, despite the external similarity, this is not a diphtheria process. In some cases, fibrinous tonsillitis is formed from bursting follicles. The fibrinous film spreads over the area of ​​necrotization of the epithelium in the mouths of the gaps, connects to neighboring areas, forming a drain plaque that can extend beyond the tonsils. Sometimes a fibrinous film develops from the first hours of the disease. When the film is formed in the first hours of the disease, it is accompanied by high fever, chills, severe intoxication.

Phlegmonous tonsillitis is rare. The disease is associated with purulent fusion of the tonsil, usually a one-sided lesion. There are sharp pains when swallowing, nasal voices, spasm of the masticatory muscles.

With phlegmonous tonsillitis, the tonsil is hyperemic, enlarged, painful on palpation. Peripheral lymph nodes are usually enlarged. A matured abscess can break into the oral cavity or fiber near the tonsil.

A paratonsillar abscess is usually localized anteriorly and upward from the tonsil.
After opening it, spontaneously or as a result of surgery, the patient's condition improves.

Herpetic tonsillitis. Most commonly reported in young children. The incubation period lasts from two days to two weeks. An acute onset of the disease is noted: an increase in body temperature up to 40 ° C, pain when swallowing, headaches, muscle pains in the abdomen, vomiting and loose stools appear.

On the part of the blood, leukopenia is noted.

A complication may be serous meningitis. When examining the pharynx in the first hours of the disease, diffuse hyperemia of the mucous membrane is noted. On the soft palate, tongue, palatine arches, less often - on the tonsils and posterior pharyngeal wall, small reddish vesicular patches are visible. After 3-4 days, they resolve, the mucous membrane returns to normal.

Necrotic tonsillitis. This sore throat is extremely rare. There are complaints of a feeling of awkwardness and a foreign body when swallowing, putrid breath, profuse salivation at normal body temperature, swallowing is painless. The duration of the disease is from one to three weeks.

Fungal tonsillitis. Often found in young children. More often recorded in the fall and winter. It begins acutely, the temperature rises to 37.5-38 ° C, but more often it is subfebrile. On examination, an increase and a slight hyperemia of the tonsils, bright white, loose, curd-like plaque, which are easily removed, are revealed. The raids disappear on the 5-7th day. In smears, accumulations of yeast cells, mycelium of thrush and bacterial flora are detected.

Monocytic tonsillitis. Angina with infectious mononucleosis occurs after an increase in several groups of lymph nodes, the spleen. Changes in the throat are characterized by a picture resembling any of the tonsillitis. Characteristic features include the appearance in the patient's blood of a large number of altered monocytes.

Diagnostics

Diagnosis of tonsillitis is carried out on the basis of clinical symptoms, pharyngoscopic examination, as well as bacteriological, bacterioscopic and serological examinations, especially with secondary infectious tonsillitis. Changes from the general blood test are important.

Treatment

With angina, a sparing diet, local and general therapy are used, strict bed rest is mandatory in the early days of the disease, and then home without physical exertion. The patient is given separate dishes and care items. In severe cases of the disease, hospitalization is indicated. A milk-vegetable table is prescribed, the food should be non-irritating, soft. Locally prescribed warm rinses with a solution of 3% hydrogen peroxide, 0.1% solution of potassium permanganate, furacilin, tincture of calendula, a decoction of chamomile, calendula, infusion of sage.

The choice of antibacterial drugs depends on the severity of the disease and the threat of complications. For treatment, sulfonamide drugs such as trimethoprine in age doses are used.

With various forms of bacterial tonsillitis, antibiotics are used taking into account the sensitivity of the pathogen to antibiotics. In emergency cases, broad-spectrum antibiotics are prescribed.

Improvement usually occurs with a decrease in intoxication, an improvement in general condition. However, antibiotic treatment lasts from another three to five days. It is not recommended to prescribe drugs such as neomycin, monomycin, etc. due to the ototoxic effect.

In children during hyperthermia, convulsive syndrome may occur. Antipyretics are prescribed.

The treatment of paratonsillar abscess is surgical, while antibacterial therapy is carried out according to the generally accepted scheme.

With viral tonsillitis, interferon, UPC-19 spray, anti-influenza immunoglobulin are prescribed.

In mixed forms, antibacterial agents are combined with antiviral agents.

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Angina (acute tonsillitis)

  1. Acute tonsillitis (tonsillitis). U-03.
    {foto6} Treatment outcome: Clinical criteria for improving the patient's condition: 1. Normalization of temperature. 2. Normalization of laboratory parameters. 3. Improving the clinical symptoms of the disease (pain, difficulty swallowing, purulent discharge from
  2. Acute tonsillitis
    Inflammation of the tonsils is usually caused by viruses. From the age of 5 years, the bacterial process caused by the p-hemolytic streptococcus of group A is becoming more frequent. ¦ Streptococcal tonsillitis (unlike viral) is not accompanied by cough and catarrh. Complications characteristic of streptococcal tonsillitis: purulent lymphadenitis,
  3. Acute tonsillitis, unspecified. U-03.9
    {foto12} Treatment outcome: Clinical criteria for improving the patient's condition: 1. Normalization of temperature. 2. Normalization of laboratory parameters. 3. Improving the clinical symptoms of the disease (pain, difficulty swallowing, purulent
  4. Acute tonsillitis caused by other specified pathogens. U-03.8
    {foto11} Treatment outcome: Clinical criteria for improving the patient's condition: 1. Normalization of temperature. 2. Normalization of laboratory parameters. 3. Improving the clinical symptoms of the disease (pain, difficulty swallowing, purulent
  5. Differential diagnosis of angina Comparative signs of various forms of angina

  6. Chronic tonsillitis
    Chronic tonsillitis is a chronic inflammation of the tonsils, with damage to other tonsils, localization is indicated - chronic adenoiditis, tonsillitis of the lingual tonsil. There are many classifications of chronic tonsillitis. At present, the classification of IB Soldatov, approved by the VII All-Union Congress of Otolaryngologists, is the most recognized. According to this classification, two forms are distinguished
  7. Streptococcal Tonsillitis and Pharyngitis
    Classification Pharyngitis is an acute inflammation of the mucous membrane of the pharynx, usually of viral, less often bacterial origin. Tonsillitis is an acute inflammation of the tonsils, usually as a result of streptococcal, rarely viral, infection. Streptococcal tonsillitis (tonsillitis) - tonsillitis or pharyngitis caused by HBSA (S.pyogenes). Recurrent streptococcal tonsillitis should be
  8. Angina
    Acute inflammation of the tonsils and pharyngeal mucosa. the term "acute tonsillitis" narrows the concept of "tonsillitis" and we do not recommend it. IN AND. Voyachek emphasized that it is necessary to pay particular attention to the defeat of the entire pharynx with angina. According to clinical data and pharyngoscopic picture, sore throats are divided into catarrhal, follicular, lacunar, ulcerative-membranous and necrotic.
  9. Complications of tonsillitis
    C onclusion of General and Complicated ana ng. The most severe and formidable are common complications, since they cause persistent damage to vital organs and systems of the body. Among them, in the first place (in frequency, but not in severity) rheumatism with its attacks and lesions of the heart and joints, often no less serious complications of tonsillitis in the kidneys,
  10. Chronic tonsillitis
    The clinical picture Chronic tonsillitis (chronic inflammation of the tonsils). Frequent disease in adults and children. It develops as a result of repeated sore throats or acute infections. There are unpleasant sensations, pain in the throat, radiating to the ears, sometimes a bad breath. Often prolonged low-grade fever in the evenings, weakness, headache, decreased ability to work. In most patients -
  11. Angina
    Training target: using diagnostic algorithms, be able to diagnose angina and its complications (paratonsillitis, paratonsillar abscess), determine the clinical form of the disease and prescribe adequate treatment; be able to conduct dispensary observation. Assignment for independent study of the topic. Using the textbook, guidelines and lecture material for the acquisition
  12. Angina
    Angina is a common acute infectious disease in which local acute inflammation affects the lymphadenoid tissue of various tonsils of the pharynx. In the vast majority of cases, tonsillitis is tonsillitis, other tonsils are involved in the inflammatory process much less frequently. Therefore, in medical practice it is customary to mean the tonsillitis under the term “tonsillitis"
  13. Sore throats
    The clinical picture of Sore throat is infectious - diseases with the most pronounced local inflammatory process in the area of ​​lymphoid tissue of the pharynx. Palatine tonsils are more often affected. Overcooling and other unfavorable factors leading to weakening of the body contribute to the disease. With catarrhal sore throat, the patient has malaise, fever, chills, headache
  14. differential diagnosis of angina
    Differential diagnosis of angina should be carried out with diseases that occur with tonsillitis syndrome: a) localized forms of diphtheria (islet and membranous) - differ from angina by the gradual onset of the disease, specific manifestations of general intoxication in the form of pallor of the face, moderate adynamia and lethargy ( chills, body aches, muscle and joint pains, characteristic
  15. Laryngeal tonsillitis
    Laryngeal tonsillitis (angina laryngis) is an acute inflammation of the lymphadenoid tissue of the larynx (in the area of ​​the scooped palatine folds, the intercarpal space, in the organoid ventricles, in the piriform sinuses and individual follicles). As an independent disease, it is rare, it can occur as a result of hypothermia, after the flu, with TjfeBMe larynx by a foreign body, etc. K l
  16. Angina
    Since tonsillitis is an acute inflammation of the tonsils, see the article ALMOND
  17. Classification of angina. Treatment principles
    Classification of angina I. According to B.S. Preobrazhensky. It is based on pharyngoscopic signs, supplemented by data obtained in a laboratory study, sometimes with information of an etiological or pathogenetic nature. The following forms of angina are distinguished: catarrhal; follicular; III - lacuna; IV - fibrinous; V - herpetic; VI - phlegmonous
  18. Prevention of tonsillitis and chronic tonsillitis
    Prevention of chronic tonsillitis is largely a prophylaxis of tonsillitis and is carried out in two aspects - individual and social. Individual prevention consists in strengthening the body, increasing its resistance to infectious influences and adverse environmental conditions, especially to cold. Very often, angina develops after local or
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