Every year, three million people die from tuberculosis, a dangerous infectious disease. This pathology usually affects the lungs of a person, but can also affect other organs and tissues. One of the manifestations of the disease is tuberculosis of the throat - a disease of the larynx, provoked by Mycobacterium tuberculosis. As a rule, this pathology is secondary, it occurs when an infection enters the larynx in various ways: airborne, through the blood, lymph.
Characteristics and description of the problem
Tuberculosis of the throat 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, the so-called cold inflammation of a granulomatous nature develops, which leads to the appearance of a large number of tubercles prone to decay. According to ICD-10, the disease was assigned the code A15.5.
Tuberculosis has a sore throat due to constant exposure to sputum and pathogenicbacteria, which irritates the walls of the larynx. This occurs especially when the pathology has an open form, including lung involvement. 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 between the ages of twenty and forty, children are rarely affected.
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, is usually a complication of the pulmonary form of the disease, it is diagnosed in 50% of people with a 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 two and a half times. Women are less susceptible to the disease compared to men, children under the age of ten get sick very rarely.
Infection
The main source of infection is a sick person, as well as cattle, which release pathogenic bacteria into the environment. You can get infected by airborne, dusty, hematogenous, lymphogenous, contact or alimentary routes.
The risk group includes:
- people who do not have a fixed place of residence, including refugees and immigrants;
- people who served their sentences in prisons;
- persons who, due to their professional activities, are forced to contact a large number of people;
- those who havediseases such as diabetes mellitus, stomach ulcers, HIV infection, AIDS;
- people undergoing treatment in drug and mental clinics;
- patients who underwent radiation therapy took glucocorticosteroids for a long period of time;
- postpartum women;
- unvaccinated children;
- older people;
- having a genetic predisposition.
Most often, the infection is diagnosed in people with compromised immune systems.
Causes of pathology
Before considering why tuberculosis has a sore throat, it is necessary to understand the causes of the development of the pathology.
As you know, the causative agent of infection is Koch's wand. It enters the larynx from other foci of infection, such as the lungs or kidneys. Most often, pathogenic microorganisms enter the larynx when sputum is discharged 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 the blood or lymph flow. In this case, foci of inflammation appear in various parts of the mucous epithelium. If an infection enters with a lymph flow, the damage to the larynx will be one-sided.
The development of the disease is primarily associated with an underestimated reactivity of the body. It also depends on the anatomical features of the larynx. It is located in such a way that the sputum that enters it from the bronchi lingers for a long time inventricles, contributing to the loosening of the epithelium. Bacteria through the damaged mucosa enter the vocal cords and the interarytenoid 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 by human immunity for a long time. But when it is violated, the bacteria are activated and cause the development of the tuberculosis process. Provoking factors in this case can be inflammatory diseases, such as laryngitis, as well as an unhe althy lifestyle: smoking and drinking alcohol, regular inhalation of dirty air, constant dampness, and so on.
Disease forms
Tuberculosis of the throat can 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 tuberculosis of the throat appear immediately. Pathology is caused by the appearance of small nodular formations, redness and swelling of the mucous epithelium of the larynx. The nodes are expressed, forming ulcers.
- 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 edematous, nodules are observed on it. In this case, inflammation develops slowly, a person’s well-being is usuallydoes not worsen, it is possible to increase the temperature of the rear at night. 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 along the edge of the epiglottis, its contour can be completely destroyed.
Symptoms and signs of pathology
Does the throat hurt with tuberculosis of the larynx? This is a question that worries many. With the progression of the disease, a person will feel severe pain at the time of the conversation. Pain syndrome in the presence of ulcers in the larynx will also appear when eating food, in which case it will give to the ear. There will also be hoarseness and a dry cough. 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 the formation of fistulas due to tissue breakdown as a result of a purulent infection of the cartilaginous skeleton of the larynx. Often, pathology provokes the development of pneumonia or stenosis of the larynx, accompanied by a sore throat at night. Tuberculosis provokes the appearance of such a strong pain syndrome that it is impossible to eliminate even narcotic medications.
The disease also manifests itselfin the form of expectoration of sputum with an admixture of blood, which indicates the development of complications of the pathology. In this case, the lymph nodes will be greatly enlarged and have a hard consistency. The patient has cachexia, shortness of breath, tachycardia.
In elderly people, all signs of tuberculosis of the throat appear 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 he althy children who are given the BCG vaccine.
When lupus develops dry ulcers surrounded by blue mucous epithelium. The disease proceeds slowly, scars appear over time, the patient's well-being 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 the disease 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 superacute.
Superacute pathology is progressing rapidly. On the third day after the onset of hoarseness, the body temperature greatly increases, the swallowing process is disturbed, tuberculosis causes sore throat, painful cough, salivation, and respiratory failure. Abscesses, phlegmons appear on the mucous epithelium of the larynx, the tissue begins to rapidly disintegrate,causing intoxication of the body and bleeding. A few weeks later, death occurs. Treatment in this case is ineffective.
Subacute disease develops slowly, over several months there is the formation of nodules, which may be at different stages of development.
Stages of disease progression
In medicine, there are several stages of progression of pathology:
- Infiltration. In the throat, an inflammatory change of an exudative nature occurs. In the center of the inflammatory process, an area of necrosis appears, in which the tissue takes the form of a protein mass, tubercles appear.
- Formation of an ulcer followed by expression.
- The process of tissue breakdown, cartilage damage.
- Induration and scarring.
To the question of whether the throat tickles with tuberculosis, doctors give an affirmative answer. The formation of seals, which degenerate into ulcers and then scar, is accompanied by unpleasant sensations in the throat. The first symptoms of tuberculosis of the throat should immediately alert a person, you must immediately visit a medical facility.
Diagnostic measures
Diagnosis of tuberculosis of the throat begins with an examination of the patient and a study of the anamnesis of the pathology. Be sure the doctor conducts a test for tuberculin, radiography.
When interviewing a patient, the doctor pays attention to the following points:
- Time of onset of hoarseness that does not respond to standard therapy.
- Possibility of contact with a carrier of infection or people at risk.
- Was the patient vaccinated with BCG.
- Having bad habits.
- Past past respiratory illnesses.
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.
- Biopsy followed by throat biopsy.
- Bone marrow and lymph node analysis.
- Research 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.
- Phonetic and electroglotography, stroboscopy.
Differential Diagnosis
The doctor differentiates pathology from such diseases 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. X-rays, a pathological examination of biological material taken from the affected area of the throat, can also be used.
Therapy of disease
Treatment for throat tuberculosis aims to eliminatesymptoms of pathology, stopping the progression of the disease, restoring the functionality of organs and the ability to work. The disease is subjected to local and general therapy. In general treatment, all measures are aimed at eliminating the infection, as well as eliminating the primary focus through surgical intervention (lung resection).
Be sure to carry out drug therapy using:
- Strong antibacterial drugs like Rifabutin, Cycloserine, or Pyrazinamide.
- Anti-inflammatory drugs, glucocorticosteroids, such as Dexamethasone.
- Immunomodulators.
- Vitamins.
- Mucolytics and respiratory motility stimulants.
Symptomatic treatment includes primarily high-calorie nutrition, inhalations, painkillers, intralaryngeal surgery. For the treatment of ulcers, applications with ointments are used, which include an anesthetic, cauterization of ulcers is also performed. Lupus is treated with vitamin D2 and calcium.
When stenosis of the larynx develops, doctors perform a tracheostomy. Sometimes a resection of the larynx 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 are issued a disability.
Forecast
In this case, the forecast depends onthe 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 good if the person's immunity is not compromised. In the presence of scars resort to surgical interventions. If a patient has HIV infection, the pathology can spread to other organs and tissues, the prognosis in this case will be unfavorable.
Prevention
Prophylactic measures in this case should be those that prevent the development of pulmonary tuberculosis. Medical prevention is reduced 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 maintaining a he althy lifestyle, eliminating bad habits, timely treatment of respiratory pathologies, regular examinations (fluorography). People suffering from this disease should be hospitalized in a timely manner. The room in the clinic must be constantly ventilated, the person must comply with all prescriptions and prescriptions of the doctor, take medication on time. It is not recommended to overcool and overstrain the voice. It is necessary to monitor your he alth, follow preventive measures, lead a he althy lifestyle. Then tuberculosis of the throat will not be terrible.
