Streptococcal pharyngitis is a pathology that can lead to dangerous complications. The disease usually proceeds in a mild form and lasts no more than a week. Often patients take pharyngitis for a common cold and do not always see a doctor. However, this disease carries a hidden threat to human health. Its effects on the body can be very serious. How is this disease manifested? Why is it dangerous? We will consider these issues in the article.
Pathogen and pathogenesis
Streptococcal pharyngitis is an inflammation of the posterior pharyngeal wall of an infectious origin. The causative agent of the pathology is a bacterium - beta-hemolytic streptococcus group A. These microorganisms in a small amount are in the throat, even in healthy people. Only under adverse conditions, streptococcus begins to multiply actively, shows its pathogenic qualities and causes inflammation in the pharyngeal mucosa.
Symptoms and treatment of streptococcal pharyngitis in adults and children depend on the stage of the pathology. In the development of the disease, the following stages can be distinguished:
- The incubation period. It lasts no more than 4 days. Streptococci actively multiply on the surface of the pharynx, but the person does not yet feel any signs of the disease.
- Prodrome. Bacteria invade the mucosa of the pharynx. Signs of general intoxication appear (fever, general malaise).
- The acute stage. There is a large number of streptococci in the throat. There is inflammation of the posterior pharyngeal wall, which spreads very quickly to the tonsils. A sick person releases bacteria and can infect others. Antibodies to infection are actively formed in the body.
- Recovery. Symptoms of inflammation gradually disappear. With proper treatment, the disease passes without a trace. If therapy was insufficient, then a person after the disappearance of obvious manifestations of pathology becomes a carrier of bacteria. The titer of anti-streptococcal antibodies in his blood remains high, which leads to complications.
On average, the disease lasts about 7 days. Carriage of bacteria after the disappearance of clinical manifestations can last up to 6 months.
Pharyngitis and tonsillitis: differences
It is important to distinguish between streptococcal pharyngitis and tonsillitis. Patients often confuse these diseases. With tonsillitis, the inflammatory process affects only the tonsil region. This disease can also be of streptococcal origin. The main symptom is gland pain. With tonsillitis, a person never has a sore throat and cough.
With pharyngitis, the inflammatory process initially occurs in the deeper parts of the throat. Therefore, the disease is accompanied by coughing and perspiration. In the future, inflammation passes from the posterior pharyngeal wall to the tonsils. There is pain when swallowing. With pharyngitis caused by streptococcus, tonsillitis is always secondary.
Infection pathways
Streptococcal pharyngitis is a contagious disease. The causative agent of the pathology can be transmitted in several ways:
- Airborne. In most cases, beta-hemolytic streptococcus is transmitted by this method. A sick person secretes a large number of microorganisms during coughing and breathing.
- Food. A person becomes infected by eating contaminated food or through dishes.
- Contact. You can get streptococcus through objects that the patient used.
- Intrauterine. The unborn child is infected from the mother. This disease is very dangerous for pregnant women, it often leads to fetal death. In newborns, sepsis or meningitis may occur.
- Medical. Infection occurs during an ENT examination if the instruments were poorly sterilized.
A sick person is dangerous to others in the acute period of the disease. In some cases, the patient can isolate bacteria for another six months after recovery.
Provocative factors
Far from all people, penetration of streptococcus into the body leads to inflammation of the pharynx. This microbe becomes dangerous only with a decrease in immunity. The following adverse factors contribute to the disease:
- hypothermia;
- smoking;
- physical and mental overwork;
- malnutrition;
- frequent stressful situations.
ICD code
The international classification of diseases classifies streptococcal pharyngitis as pathologies of the respiratory system. These diseases are indicated by codes J00 - J99. Inflammation of the pharynx caused by streptococcus is considered as a type of acute pharyngitis. The complete code for streptococcal pharyngitis according to ICD-10 is J02.0.
Symptomatology
The incubation period for this disease does not last very long: from 2 to 4 days. The first manifestations of the disease resemble the symptoms of a common cold or flu. Usually the patient is concerned about:
- general malaise;
- joint aches;
- headache;
- chills;
- temperature increase to 37.5 degrees.
The initial stage of the disease lasts 1-2 days. Then there are characteristic symptoms of streptococcal pharyngitis:
- The temperature rises to 38-39 degrees, poorly stray even after taking antipyretic drugs to patients.
- A sore throat is growing. First, it is felt deep in the throat, and then spreads to the glands.
- The patient is worried about sore throat and bouts of dry cough. Sputum does not stand out.
- It becomes painful for a person to swallow, he feels a lump in his throat.
- Lymph nodes on the neck swell.
- In some cases, a slight runny nose appears.
The patient's throat looks swollen and has a bright red tint. On the tonsils you can see a yellowish coating. It is easily removed with a spoon or cotton swab, but soon formed again. This is a specific sign of streptococcal pharyngitis. A photo of the throat of a sick person can often be found on specialized medical sites. These images look rather unpleasant, so we will refrain from publishing such illustrations.
Signs of the disease can disappear on their own after about 7 days. However, this does not mean that treatment can be dispensed with. In the absence of therapy, this pathology leads to very dangerous consequences for the body.
Features of pathology in children
This disease most often occurs between the ages of 5-15 years. Pharyngitis is especially prone to children suffering from frequent colds, as well as inflammation of the middle ear.
Streptococcal pharyngitis in children occurs with the same symptoms as in adults. However, a small child may experience not only signs of sore throat, but also dyspeptic symptoms. Often, against the background of infection, diarrhea, abdominal pain, and nausea appear.
In some cases, a rash appears on the baby’s body. It is similar to the spots that form with scarlet fever. This is a characteristic sign of streptococcal pharyngitis in children. A photo of a sick child can be seen below.
Complications
As already mentioned, streptococcal inflammation of the pharynx and tonsils can cause dangerous complications. This is usually noted if untreated or if the medication is stopped prematurely.
Untreated streptococcal infection can lead to purulent inflammation in other organs: sinuses, middle ear, lymph nodes. Often there is a pharyngeal abscess - a large abscess in the deep sections of the throat.
The most dangerous consequences of streptococcal infection include:
- Rheumatism. This disease affects the joints and heart. Rheumatic complications occur 2 to 4 weeks after streptococcal sore throat.
- Post-streptococcal glomerulonephritis. This is an inflammation of the kidneys that can develop 1 to 3 weeks after recovery. Pathology is more common in children. Glomerulonephritis is accompanied by swelling of the face and limbs, as well as the appearance of blood in the urine.
Diagnostics
Signs of streptococcal pharyngitis are often similar to symptoms of other respiratory diseases. Only a doctor can carry out differential diagnostics. First of all, the otolaryngologist examines the patient's throat and studies the localization and nature of the inflammation.
To clarify the diagnosis, the following examinations are prescribed:
- Clinical blood test. Helps identify signs of inflammation - increased ESR and leukocytosis.
- Throat swab for back sowing. The biomaterial is sent to a laboratory where the causative agent of pharyngitis and its sensitivity to antibacterial drugs are determined. This helps to choose the most effective antibiotic for treatment.
7 days after the onset of the first signs of the disease, doctors prescribe a blood test for antibodies to streptococcus (antistreptolysin O) and an electrocardiogram. This helps to identify the carriage of bacteria and the risk of rheumatism. If the treatment was effective, then the titer of antibodies in the blood returns to normal one week after the onset of the disease.
Antibiotic therapy
Treatment of streptococcal pharyngitis is primarily aimed at combating infection. Therefore, the use of antibiotics is indispensable. It is impossible to cure such inflammation by local means alone.
Antibacterial drugs are prescribed on the basis of smear data for bacterial inoculation. If the test results are not yet ready, then penicillin antibiotics are prescribed that affect a wide range of bacteria:
- Amoxiclav;
- Amoxicillin;
- "Augmentin."
If the patient does not tolerate drugs based on penicillin, then drugs of the macrolide and cephalosporin group are used:
- Clarithromycin;
- "Azithromycin";
- Cefixim.
The course of treatment should last at least 10 days. If after 3 to 4 days the patient's condition has not improved, then it is necessary to replace the antibiotic. It is impossible to interrupt therapy ahead of schedule, this can lead to complications and prolonged bacterial carriage.
In order for the treatment to be effective, you need to adhere to bed rest in the first 5 days of the disease. A sore throat may make it difficult for a patient to swallow. Therefore, it is recommended to feed it only with chopped or liquid food.
Local funds
Patients are shown gargling with the following means:
- "Furacilin";
- Miramistin;
- Chlorhexidine.
This will help disinfect the lesion and reduce inflammation. Rinses should be done every hour. In the first 3 days of the disease, it is also recommended to treat the throat with Streptocide in the form of a powder.
It is important to remember that rinsing cannot be used as the only treatment. Local remedies can only serve as a complement to antibiotic therapy.
Other drugs
For the prevention of rheumatism, patients are prescribed Aspirin. The drug is taken three times a day for a week.
In order to prevent allergies to antibiotics and to relieve swelling in the throat, antihistamines are used:
- Claritin
- "Suprastin";
- Tavegil
- "Diazolin".
The method of dry cough syrups is shown: "Bronchicum", "Herbion", "Doctor Mom". To increase the body's resistance, immunomodulators and multivitamin complexes will be prescribed.
Prevention
How to prevent infection with streptococci? To do this, observe the following measures:
- exclude contact with infectious patients;
- Do not use the same dishes with infected people;
- wash hands thoroughly after the street;
- strengthen your immunity;
- to disinfect objects with which the patient was in contact;
- after suffering pharyngitis, replace the toothbrush (bacteria may remain on it).
A patient who has had a streptococcal infection needs to be under the supervision of a cardiologist and a rheumatologist within six months after recovery. This will help prevent heart and joint complications.