There are hardly any people who have never had a sore throat. To avoid this, some are afraid to eat ice cream, do not drink drinks directly from the refrigerator, but they are necessarily heated. But is it only from the cold that tonsillitis occurs? The causative agent of the disease, as scientists have definitely found out, is very diverse. And it “attacks” our throat for multiple reasons. Angina can begin as a complication of other serious diseases, such as flu, dangerous microbes can deliver it to us from without. But in most cases, the causative agent of tonsillitis is the genus of tiny bacteria that live in our mouth constantly and do no harm. What must happen to make these bacteria suddenly aggressive? What other pathogens cause inflammation in the throat? How do they affect the nature of the course of the disease? How to protect yourself and loved ones from them?
Angina, tonsillitis or pharyngitis?
How do we imagine a sore throat? This is a red throat, tickle, pain when swallowing, temperature, lethargy, an irresistible desire to lie down. Some call this condition tonsillitis, others tonsillitis. In principle, this is one and the same. The word "tonsillitis" is derived from the Latin tonsillae, translated as "tonsils", or, in popular terms, tonsils. These are formations of lymphoid tissue that protect us from dangerous microbes and help to develop immunity. The word "angina" is derived from the Latin ango, which means "squeeze, squeeze."
Tonsil inflammation, in which the throat is compressed, as it were, is tonsillitis, or tonsillitis. The causative agent that violates the normal condition of our tonsils may be:
- viruses;
- bacteria
- pathogenic mushrooms.
It turns out that angina is never from ice cream or a cold drink. A long stay in the cold has nothing to do with it either.
Pharyngitis is called inflammation of the pharyngeal mucosa (the tube connecting the oral cavity to the esophagus), as in Latin the pharynx sounds like pharynx. But in its upper part, this organ is a throat with tonsils. Thus, pharyngitis in the throat and larynx can also be considered a sore throat. The difference is that angina is only an infectious disease, and pharyngitis can be non-infectious, that is, caused by exposure to the throat of toxic fumes, hot air, the same ice cream and hypothermia. Symptoms are similar to a sore throat and include:
- sore throat;
- pain when swallowing;
- sometimes fever and cough.
Infectious pharyngitis also happens, and in addition, it can be a complication of influenza, scarlet fever and other ailments. In such cases, it is often mistakenly diagnosed as a sore throat. The causative agent in these two diseases is the same, the symptoms are almost identical. The difference that even experienced doctors do not always notice is that with tonsillitis, inflammation is localized on the tonsils. And with pharyngitis, it does not have clear boundaries, the redness in the throat is spilled, as it were, tonsils do not stand out against the general background of hyperemia.
Types of sore throat
With the names of ailments sorted out. Now we will consider what forms tonsillitis, or tonsillitis, can take. The causative agent here plays a major role, but not only he. In addition to the type of microbe that has invaded the throat, the degree of damage is also distinguished, which is very important when prescribing a course of therapy. Based on the foregoing, tonsillitis happens:
- catarrhal;
- lacunar;
- follicular;
- phlegmonous;
- fibrinous;
- herpetic;
- gonorrhea;
- ulcerative film.
Pathogenic viruses
These living structures reproduce only in the cells of living beings, therefore they constantly strive to penetrate there. When they enter our mouths, defense systems instantly begin to develop armies of antibodies to neutralize intruders. If everything is in order with health, and the immunity is strong, viruses can be contained or completely destroyed.
If the body is weak, parasites invade the cells of the tonsils - our protective barrier - and begin active reproduction. Cells die, tonsils become inflamed, viral tonsillitis begins. The causative agent of the disease can be influenza, Epstein-Bar, herpes, Coxsackie, adenovirus, picornavirus, enterovirus. In practice, the type of pathogen is rarely determined and gives them all one name - SARS. Most often, viral tonsillitis is sick:
- children;
- the elderly;
- having undergone any disease, operation;
- Pregnant
- patients with any chronic illness.
That is, people with weak immunity are at risk. Their body is not able to produce many antibodies, so the invading viruses easily reach the cells they need.
The peak of viral tonsillitis occurs in winter and off-season, especially the beginning of spring, when we eat less fresh vegetables and fruits.
Remember: viral sore throat is very contagious. The causative agent has high virulence, that is, it easily infects new victims by sneezing, coughing, emotional conversation, kissing. Also, viruses can settle on various objects and get into the mouth (especially for children) in the absence of hygiene.
Symptoms of viral sore throat:
- sore throat;
- redness of the tonsils (sometimes there is a whitish coating);
- temperature;
- an increase in lymph nodes in the neck, submandibular zone.
Common symptoms of many viral infections are often observed:
- violation of the stool;
- nausea;
- cough;
- conjunctivitis;
- runny nose.
Treatment is with antiviral drugs, such as Ergoferon. Antibiotics are contraindicated. At high temperatures, antipyretic Aspirin and Paracetamol are prescribed. The patient will benefit from a plentiful warm drink, gargling with "Chlorhexidine", a solution of furatsilina or decoctions of chamomile, calendula, and a solution of baking soda. Compresses help well. Children can do them with plain warm water; for adults it is advisable to add any alcohol to the water (1: 1). Bed rest is a prerequisite for a quick recovery.
Pathogenic bacteria, the causative agent of strep throat
About 4 kg of bacteria live in each person. Fortunately, only 1% of them are pathogenic. Among the remaining 99%, there are so-called opportunistic pathogens that become pathogenic when circumstances coincide, for example, when immunity is weakened. “Alien” bacteria can be added to our own bad microbes from the environment. The causative agents of angina among them are:
- streptococci;
- staphylococci;
- spirochetes;
- diplococci;
- bacillus of Loeffner;
- gonococcus.
Most of these parasites have their own broad classification. Representatives of each strain differ from each other not only in appearance, but also in behavior. They are addicted to the invasion of strictly defined cells, secrete different endo- and exotoxins, respectively, cause various types of inflammation and ailments. Therefore, it is impossible to treat them all with the same antibiotics. To determine what you need to fight with and what medicines, doctors take smears of pus and mucus from the tonsils and throat.
The causative agent of angina streptococcus is an anaerobic that does not need oxygen, does not move, located in pairs or in chains. The classification of streptococci is impressive. All of them, depending on how they destroy red blood cells (carry out hemolysis), are divided into three groups - alpha, beta and gamma. Alpha streptococci are called green because their hemolysis is incomplete, and a greenish color appears in the destruction zone.
Gamma streptococci do not destroy red blood cells at all. Now they are isolated in a separate group of enterococci.
Beta streptococci completely destroy red blood cells. They are divided into groups from A to U. Representatives of group A, or pyogenic bacteria, are considered conditionally pathogenic. They can get into the mouth from the environment and immediately provoke the disease, and can not cause trouble for a long time. But as soon as a person's immunity weakens, these streptococci begin destructive activities, causing tonsillitis, pharyngitis, bronchitis, scarlet fever, abscesses and even toxic shock.
Bacterial tonsillitis, the causative agent of staphylococcus
This is the second type of microbe that can become very dangerous from an opportunistic pathogen. It received its name from the Greek word "staphili", which means "grape", because staphylococci are always located in groups resembling grapes. They are also motionless and do not require oxygen. In the oral cavity they contain up to 40% of the remaining microorganisms. While a person has high immunity, they are harmless, but in weakened people, these microbes are extremely activated. Pathogenic streptococci, with which staphylococci often work together, also help them. This couple is found in a throat smear for tonsillitis and other infectious diseases. Staphylococcus happens:
- golden;
- epidermal;
- saprophytic;
- hemolytic.
All of them cause purulent inflammatory processes and produce multiple toxins that can even lead to death. To protect themselves, staphylococci produce specific proteins and penicillinase that kill antibodies and render many antibiotics useless.
Staphylococci live not only in the mouth, but also in the environment. They have fantastic stability. For example, in dry substrates left from pus and sputum, they remain active for six months, in dust for 3 months, do not die in the sun, in the freezer, in hot water, can withstand disinfectants. Only boiling can kill them immediately.
The remaining bacterial species, although no less pathogenic, are much less common.
Catarrhal sore throat
The term "catarrhal" is derived from catarrhus, that is, the draining of liquids. Now this type of inflammation of the mucous membranes is often called SARS. The causative agents of angina in adults and children can be both viral and bacterial. The causes of the onset of the disease:
- activation of pathogens present in the mouth;
- invasion from the outside (in contact with patients and poor hygiene).
Symptoms
- a sharp deterioration in well-being, weakness throughout the body;
- headache;
- temperature (in individual patients, it can stay between 37.2-37.5 ° C, but generally rises above 38 ° C);
- an increase in lymph nodes in the submandibular zone;
- sensation as if throat were “tearing”;
- painful swallowing;
- redness and swelling of the palatine tonsils, as well as the mucous membrane of the arches in the throat;
- the appearance on the tonsils of a whitish plaque, but without ulcers;
- increased protein in the urine (at high temperature);
- in the blood, an increase in ESR and leukocytes is possible, but this symptom is not characteristic.
Catarrhal tonsillitis without fever is often diagnosed as ARI.
The causative agents of angina in infants are transferred from a sick mother or other family members. Since immunity in newborns has not yet been formed, the disease can begin from hypothermia and after other viral infections. Most often, babies suffer from staphylococcus, streptococcus and viruses.
Symptoms are the same as in adults, but can additionally be:
- moodiness;
- unwillingness to eat;
- drowsiness or, conversely, anxiety;
- increased salivation;
- at high temperature cramps, diarrhea, and regurgitation.
Treatment methods:
- bed rest;
- gargling, compresses;
- heavy drinking;
- sulfonamide drugs ("Biseptol", "Streptocide", "Bactrim");
- antihistamines;
- antipyretic (according to indications);
- vitamins.
Only a doctor prescribes antibiotics based on the tests performed.
The algorithm for the treatment of angina in infants is determined only by a doctor. Before his arrival, parents can only bring down the heat (if it is above 38 ° C) in a folk proven method consisting in wiping the child's body or only its forehead with a weak solution of vinegar. Neither antipyretic nor antibiotics can be given on their own. For children older than a year before the doctor arrives, you can give antipyretic for children "Paracetamol" or "Nurofen", as well as more often give the child a warm tea.
Follicular tonsillitis
The follicles in the throat are accumulations of lymph cells on the tonsils. In normal condition, they look like subtle tubercles. When they become inflamed, follicular tonsillitis begins. The causes of the disease are the same as that of a catarrhal sore throat, which without treatment often develops into a follicular one. In adults and children, it occurs with an equal degree. The causative agent of follicular tonsillitis is streptococcus, staphylococcus, some viruses.
Symptoms
- a sudden sudden debut, expressed in a jump in temperature above 39 ° C, fever, general weakness;
- sore throat, extending to the ears;
- enlarged spleen;
- pain in the head, lower back;
- sometimes signs of intoxication, and in children they are more pronounced;
- tonsils hyperemic, with clearly visible white or slightly yellowish small abscesses;
- sometimes signs of heart failure (tachycardia, pain in the heart);
- worse pain when turning the head;
- eosinophils, ESR, white blood cells are elevated in the blood.
Since the causative agents of angina are more often streptococci and staphylococci, that is, bacteria, treatment is mandatory with antibiotics. Their spectrum is large - “Ampicillin”, “Erythromycin”, “Cefamezin” and others.
Children and adults can also use sprays to relieve sore throats "Orasept", "Faringosprey." The rest of the algorithm is similar to that used for catarrhal sore throat.
Rough, spicy, salty, pepper food should be excluded from the menu. Children should be given mashed potatoes and light cereals, and forced feeding is contraindicated.
Lacunar angina
Gaps are the formations on the tonsils in the form of pockets and grooves. They are ideal for the accumulation of purulent-mucous exudate in them. The causative agents of lacunar angina are only bacteria, most often cocci, but viruses can significantly aggravate the already serious condition of the diseased. Symptoms with lacunar angina are similar to follicular, but all manifestations in this case are much more pronounced. So, the temperature in patients often jumps to 40 ° C, headaches can be up to vomiting, signs of intoxication are present in both children and adults, weakness and weakness throughout the body is such that a person does not want to move. On the tonsils of the patient, even a layman sees white or yellow abscesses. They are much larger than with follicular tonsillitis, but not as large as with fungal infections of the throat. This is the main principle of visual differentiation of these three diseases.
Treatment of lacunar angina is identical to follicular. Abscesses in the throat can not be removed with anything, and wounds should not be lubricated with antiseptics. Plaque is removed only by rinsing.
Sometimes follicular and lacunar tonsillitis develops to the fibrinous stage, when purulent plaque spreads from the tonsils to neighboring sections of the pharynx.
Herpetic sore throat
This ailment has several equivalent names - herpangina, aphthous or vesicular enteroviral pharyngitis. The causative agent of herpetic sore throat is the virus, more precisely several serovars of the Coxsackie virus, and not bacteria, therefore antibiotic treatment in this case is inappropriate. The disease often affects children, including infants, and is rarely diagnosed in adults. It is very easy to catch a herpangin since Koksaki viruses are fantastically virulent and quickly transmitted from their human carriers by airborne droplets, less often by fecal-oral routes (dirty hands - toys, nipples - mouth). Even more rarely, the disease can be obtained from contact with some animals, such as pigs. Once in the body of their victim, viruses invade the lymph nodes, then into the bloodstream, and from there into the lymphatic system of the throat.
Symptoms
- sharp debut (temperature jump over 40 ° C, weakness, up to instability on the legs, cramps are often observed in babies);
- increased sore throat;
- runny nose;
- sometimes coughing;
- rash in the throat in the form of reddish vesicles filled with transparent exudate (they resemble those that are poured on the lips with herpes); after a couple of days, the bubbles burst, and erosion appears in their place.
For infants, herpes sore throat is most dangerous . The causative agent in their weak body is able to provoke meningitis, pyelonephritis, encephalitis, and vesicles can appear not only in the mouth, but also on the body.
A visual diagnosis is made after examination of the mucous membranes, and the final one is based on serological and virological tests.
Treatment includes a complex of antiviral drugs, according to indications, antipyretic drugs, antihistamines, immunomodulatory. The throat is treated with special sprays, and adult children are prescribed rinses. Compresses and inhalations with herpetic sore throat are prohibited. Antibiotics are prescribed in the complex only if complications associated with bactericidal infection have begun.
Purulent tonsillitis
This term is sometimes called other diseases in which inflammatory processes are observed in the throat with the formation of purulent exudate. This is lacunar and follicular tonsillitis, an important sign of which is that abscesses are always located on the tonsils and do not spread to neighboring areas. The causative agent of purulent tonsillitis is only bacteria, and in 80% it is streptococcus, in 10% - staphylococcus and another 10% - a tandem of these two pathogens. Sometimes purulent tonsillitis is called a fungal or gonorrheal form, but there are visual differences. So, fungal tonsillitis is caused by mycoses, most often Candida. Its main symptom is a white curdled plaque throughout the pharynx, even in the tongue. That is why fungal tonsillitis is confused with thrush. Fungal plaque is easily removed, revealing reddish sores. The causes of the appearance are weakened immunity, prolonged or uncontrolled use of antibiotics. If the causative agent of angina is gonococcus, it is called gonorrhea, or rather throat gonorrhea. It happens, with the rarest exception, only in adults. The reason is oral sex with a carrier. Symptoms of gonorrhea and purulent tonsillitis are extremely similar, so accurate differentiation is possible only by taking a smear from the oral cavity. Visually, ulcers with gonorrhea of ​​the throat are denser than with angina, plus, they can spread to the palate and tongue.
It is important to understand that purulent tonsillitis is an acute disease, lasts no more than 10 days and does not recur. If in 10 days it was not possible to get rid of the disease, it means that the wrong diagnosis was initially made. Without proper treatment, angina causes complications:
- abscesses in the throat;
- otitis media of moderate severity with possible hearing impairment;
- sepsis;
- rheumatic fever;
- heartache;
- renal failure;
- chronic tonsillitis.
And the last: tonsillitis is a contagious disease. Therefore, in order not to infect their relatives, the sick person must strictly observe hygiene.