Every year, three million people die from tuberculosis, a dangerous infectious disease. This pathology usually affects the lungs of a person, but can affect other organs and tissues. One of the manifestations of the disease is throat tuberculosis - a laryngeal disease provoked by mycobacterium tuberculosis. As a rule, this pathology is secondary, it occurs when an infection enters the larynx in various ways: airborne, through blood, and lymph.
Description and description of the problem
Throat tuberculosis is an infectious disease that most often develops as a complication of a pulmonary disease. Sometimes pathology may indicate the presence of an unrecognized focus of infection in the lungs. In the affected organs, a so-called cold inflammation of a granulomatous nature develops, which leads to the appearance of a large number of tubercles, prone to decay. For ICD-10, the disease is assigned code A15.5.
With tuberculosis, the throat hurts due to the constant exposure to sputum and pathogenic bacteria, which irritates the walls of the larynx. This occurs especially when the pathology has an open form, including lung damage. The disease is quite contagious, especially in an open form. A person can become infected by airborne droplets. In most cases, the disease affects adults, especially men aged twenty to forty years, children suffer from the disease quite rarely.
Epidemiology
About a third of the world's population are carriers of Mycobacterium tuberculosis (Koch's bacillus). Tuberculosis of the throat, the symptoms of which will be described below, usually acts as a complication of the pulmonary form of the disease, it is diagnosed in 50% of people with lung infection. Over the past few years, the number of patients with this pathology has increased to 52%, and the number of deaths has increased by two and a half times. Women are less susceptible to the disease than men; children under ten years of age are very rarely affected.
Infection
The main source of infection is a sick person, as well as cattle, which release pathogenic bacteria into the external environment. You can get infected by airborne droplets, dust, hematogenous, lymphogenous, contact or alimentary routes.
The risk group includes:
- people who do not have a specific place of residence, including refugees and immigrants;
- people who were serving sentences in places of deprivation of liberty;
- persons who, due to their professional activities, are forced to contact with a large number of people;
- those who have diseases such as diabetes mellitus, stomach ulcer, HIV infection, AIDS;
- people being treated in drug and psychiatric clinics;
- patients who underwent radiation therapy took glucocorticosteroids for a long period of time;
- women in the postpartum period;
- children who are not vaccinated;
- people of advanced age;
- having a genetic predisposition.
Most often, an infection is diagnosed in people with a compromised immune system.
Causes of pathology
Before considering why throat hurts with tuberculosis, it is necessary to understand the causes of the development of pathology.
As you know, the causative agent of infection is Koch's bacillus. It penetrates the larynx from other foci of infection, such as the lungs or kidneys. Most often, pathogenic microorganisms enter the larynx when sputum discharge, which is secreted from the affected lungs. In this case, the disease affects not only the larynx, but also the trachea, bronchi.
If a person has a closed form of pulmonary tuberculosis, the infection can enter the throat with a blood or lymph flow. In this case, foci of inflammation appear in various parts of the mucous epithelium. In case of infection with lymph flow, the larynx will be one-sided.
The development of the disease is primarily associated with low body reactivity. It also depends on the anatomical features of the larynx. It is located so that the sputum that their bronchi enter into it lingers in the ventricles for a long time, contributing to loosening of the epithelium. Bacteria through the damaged mucosa enter the vocal cords and the intercarpal space, where the pathological process begins to develop. Chronic diseases of the throat only contribute to the rapid development of pathology.
Pathogenic microorganisms in the human body can be suppressed for a long time by human immunity. But with its violation, bacteria are activated and cause the development of the tuberculosis process. In this case, inflammatory diseases, such as laryngitis, as well as an improper lifestyle: smoking and drinking alcohol, regular inhalation of dirty air, constant dampness, and so on, can act as provoking factors.
Forms of the disease
Throat tuberculosis may manifest itself in different ways. A photo of the pathology is presented in the article. In medicine, it is customary to distinguish several forms of the disease, depending on the degree of changes in the tissues of the larynx:
- Miliary acute form is rare. In this case, the symptoms and first signs of throat tuberculosis appear immediately. Pathology is caused by the appearance of small nodular formations, redness and swelling of the mucous epithelium of the larynx. Nodes appear, forming ulcers.
- The chronic infiltration form is characterized by the formation of foci of infection under the mucous epithelium. Gradually, they develop into ulcers with a gray coating. At the same time, the tissue that surrounds them becomes dense and swollen, nodules are observed on it. In this case, inflammation develops slowly, a person’s well-being usually does not worsen, an increase in the temperature of the rear at night is possible. As the pathology progresses, the symptoms will appear brighter.
- Lupus is a form of throat tuberculosis, the symptoms of which are similar to the initial manifestation of the disease. Lupus formations appear in the throat of a person, which are located symmetrically. They gradually transform into ulcers, on the surface of which scarring occurs. Such formations are usually located on the edge of the epiglottis, its contour can be completely destroyed.
Symptoms and signs of pathology
Does larynx sore throat? This question worries many. With the progression of the disease, a person will feel severe pain at the time of conversation. Pain in the presence of ulcers in the larynx will appear when eating food, in which case it will give to the ear. Hoarseness and dry cough will also be observed. This is due to the fact that tuberculosis causes a sore throat. As a result of difficulties in swallowing food, the patient's body weight decreases, the body is depleted.
Progressing further, the disease causes fistula formation due to tissue decay as a result of a purulent infection of the cartilage skeleton of the larynx. Often, pathology provokes the development of pneumonia or stenosis of the larynx, accompanied at night by a sore throat. Tuberculosis provokes the appearance of such a strong pain syndrome that cannot be eliminated even with narcotic drugs.
The disease also manifests itself in the form of expectoration of sputum with an admixture of blood, which indicates the development of complications of pathology. In this case, the lymph nodes will be greatly enlarged and have a solid consistency. The patient has cachexia, shortness of breath, tachycardia.
In elderly people, all signs of throat tuberculosis are manifested against the background of symptoms of age-related changes in the internal organs and systems of the body, as well as existing diseases. Symptoms of pathology are especially pronounced during pregnancy and after childbirth. But according to statistics, infected women give birth to healthy children who receive BCG vaccine.
With lupus, dry ulcers occur, surrounded by a blue mucous epithelium. The disease is slow, scars appear over time, and the patient is not disturbed. Lupus often provokes the development of a cold abscess of the pharyngeal space, which manifests itself in a disorder of neck mobility. Does the throat hurt with tuberculosis in this case? A person with this form of ailment experiences pain when swallowing saliva and eating food.
Acute miliary form of pathology
Acute miliary tuberculosis of the throat has several types: acute, subacute, and super-acute.
Super acute pathology is progressing rapidly. On the third day after the appearance of hoarseness, the body temperature rises greatly, the swallowing process is disturbed, tuberculosis causes a sore throat, excruciating cough, salivation, respiratory failure. Abscesses, phlegmon appear on the mucous membrane of the larynx, the tissue begins to decay rapidly, provoking intoxication of the body and bleeding. After a few weeks, death occurs. Treatment in this case is ineffective.
Subacute disease develops slowly, over several months, the formation of nodules that may be at different stages of development occurs.
Stages of the development of the disease
In medicine, there are several stages of the progression of pathology:
- Infiltration. An inflammatory change in the exudative nature occurs in the throat. In the center of the inflammatory process, a site of necrosis appears, in which the tissue becomes a protein mass, tubercles appear.
- Formation of an ulcer with subsequent manifestation.
- The process of tissue breakdown, damage to cartilage.
- Seals and scarring.
To the question of whether the throat persists with tuberculosis, doctors give an affirmative answer. The formation of seals that degenerate into ulcers and then scarring is accompanied by unpleasant sensations in the throat. The first symptoms of throat tuberculosis should immediately alert a person, you must immediately visit a medical facility.
Diagnostic measures
Diagnosis of throat tuberculosis begins with an examination of the patient and a history of pathology. Be sure the doctor conducts a test for tuberculin, radiography.
When interviewing a patient, the doctor draws attention to the following points:
- The time of hoarseness, which is not amenable to standard therapy.
- The possibility of contact with the carrier of infection or people at risk.
- Whether the patient was vaccinated with BCG.
- The presence of bad habits.
- Transfer of respiratory diseases in the past.
The doctor also prescribes the following diagnostic methods:
- Bacteriological culture of sputum. This method has one drawback - the analysis is carried out for a long time (up to four weeks). But the analysis is quite reliable. Sometimes only he is able to identify pathogenic microorganisms.
- A biopsy followed by a throat biopsy.
- Analysis of bone marrow and lymph nodes.
- The study with a button probe makes it possible to detect changes in the cartilage tissue of the larynx.
- PCR, RPR test.
- CT of the larynx, bronchoscopy, ultrasound.
- Laryngoscopy, spirography.
- Phoneto and electrography, stroboscopy.
Differential diagnosis
The doctor differentiates the pathology with diseases such as diphtheria, syphilis, mycosis, cancer, Wegener's granulomatosis, contact ulcer, scleroma, SLE, as well as benign neoplasms, chronic laryngitis. For differential diagnosis, the CT technique is used, which makes it possible to identify signs of the disease. Radiography, a pathomorphological study of biological material taken from the affected area of the throat can also be used.
Disease therapy
Treatment of throat tuberculosis is aimed at eliminating the symptoms of pathology, stopping the progression of the disease, restoring the functionality of organs and the person’s ability to work. The disease is subjected to local and general therapy. With general treatment, all measures are aimed at eliminating the infection, as well as eliminating the primary focus through surgical intervention (lung resection).
Necessarily conducted drug therapy using:
- Strong antibacterial drugs such as Rifabutin, Cycloserine, or Pyrazinamide.
- Anti-inflammatory drugs, glucocorticosteroids, for example, "Dexamethasone".
- Immunomodulators.
- Vitamins.
- Mucolytics and stimulators of respiratory motility.
Symptomatic treatment primarily includes high-calorie nutrition, inhalation, pain medication, intrahlottal surgery. For the treatment of ulcers, applications with ointments, which include an anesthetic, are used, and cauterization of ulcers is also carried out. Lupus therapy is performed using vitamin D 2 and calcium.
With the development of stenosis of the larynx, doctors conduct a tracheostomy. Sometimes laryngeal resection with plastic surgery may be required to restore it. The course of treatment is developed individually in each case. Therapy is carried out in special medical institutions (dispensaries). After treatment, in most cases, patients receive disability.
Forecast
In this case, the prognosis depends on the stage of the disease, the degree of its manifestation, the presence of concomitant pathologies and addictions, as well as the age of the patient and the duration of the disease, the effectiveness of therapy. Usually, the prognosis is favorable, but in severe cases, disability and even death can occur. With lupus, the prognosis is usually favorable if the person’s immunity is not compromised. In the presence of scars, they resort to surgical interventions. If the patient has HIV infection, the pathology can spread to other organs and tissues, the prognosis in this case will be unfavorable.
Prevention
Preventive measures in this case should be those that prevent the development of pulmonary tuberculosis. Medical prevention comes down to the use of BCG vaccination. It is carried out on the seventh day of the baby's life, then at the age of seven to fourteen years, if the Mantoux test was negative.
Social prevention consists in observing a healthy lifestyle, eliminating bad habits, timely treatment of pathologies of the respiratory system, regular examination (fluorography). People with this disease should be hospitalized in a timely manner. The room in the clinic should be constantly aired, a person must comply with all the appointments and prescriptions of the doctor, take medicines on time. It is not recommended to supercool and overexert the voice. It is necessary to monitor your health, observe preventive measures, maintain a healthy lifestyle. Then throat tuberculosis will not be scary.