There are hardly many people who have never had a sore throat. To prevent this from happening, some people are afraid to eat ice cream, do not drink drinks directly from the refrigerator, but always warm them up. But is a sore throat only from the cold? The causative agent of the disease, as scientists have accurately found out, is very diverse. And "attacks" our throat for multiple reasons. Angina can begin as a complication of other serious diseases, such as influenza, it can be delivered to us from outside by dangerous microbes. But in most cases, the causative agent of angina is a genus of tiny bacteria that live in our mouth all the time and do no harm. What must happen for these bacteria to suddenly become aggressive? What other pathogenic organisms cause inflammation in the throat? How do they influence the nature of the course of the disease? How can you protect yourself and your loved ones from them?
Angina, tonsillitis or pharyngitis?
How do we imagine a sore throat? This is a red throat, perspiration, pain when swallowing, fever, lethargy, an irresistible desire to lie down. Some call this condition tonsillitis, others angina. Basically, it's the same thing. The word "tonsillitis" is derived fromLatin tonsillae, translated as "tonsils", or, in a popular way, tonsils. These are such formations from lymphoid tissue that protect us from dangerous microbes and help develop immunity. The word "angina" is derived from the Latin ango, which means "to squeeze, squeeze."
Inflammation of the tonsils, in which the throat seems to be compressed, and there is tonsillitis, or tonsillitis. The pathogen that disrupts the normal state of our tonsils may be:
- viruses;
- bacteria;
- pathogenic fungi.
It turns out that a sore throat never comes 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 that connects the oral cavity with the esophagus), since in Latin the pharynx sounds like pharynx. But in its upper part, this organ is a throat with tonsils. Thus, pharyngitis in the pharynx and larynx can also be considered angina. The difference is that tonsillitis 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. His 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 misdiagnosed as angina. The causative agent in thesethe two diseases are the same, the symptoms are almost identical. The difference, which even experienced doctors do not always notice, is that with angina, inflammation is localized on the tonsils. And with pharyngitis, it does not have clear boundaries, the redness in the throat is as if spilled, the tonsils do not stand out against the general background of hyperemia.
Types of sore throats
The names of ailments are sorted out. Now consider what forms tonsillitis, or tonsillitis, can take. The causative agent plays the main role here, but not only it. 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, angina happens:
- catarrhal;
- lacunary;
- follicular;
- phlegmonous;
- fibrinous;
- herpetic;
- gonorrhea;
- ulcer-film.
Pathogenic viruses
These living structures reproduce only in the cells of living beings, so they constantly strive to penetrate there. When they enter our mouths, the defense systems instantly begin to produce armies of antibodies to neutralize intruders. If everything is in order with he alth, and the immune system 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 to actively reproduce. Cells die, tonsils become inflamed, viral tonsillitis begins. The causative agent of the disease can be influenza virus, Epstein-Bar, herpes, Coxsackie, adenovirus,picornavirus, enterovirus. In practice, the type of pathogen is rarely determined and they are all given the same name - SARS. Most often, viral sore throat is sick:
- children;
- elderly;
- who have undergone any disease, surgery;
- pregnant;
- sick with some chronic disease.
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 sore throats occurs in the 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 pathogen has a 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.
Viral sore throat symptoms:
- sore throat;
- reddening of the tonsils (sometimes there is a whitish coating);
- temperature;
- increased lymph nodes in the neck, submandibular area.
Common symptoms of many viral infections are common:
- breaking stool;
- nausea;
- cough;
- conjunctivitis;
- runny nose.
Treatment is carried out with antiviral drugs, such as Ergoferon. Antibiotics are contraindicated. At high temperatures, antipyretics "Aspirin", "Paracetamol" are prescribed. The patient is useful for a plentiful warm drink,gargling with "Chlorhexidine", a solution of furacilin or decoctions of chamomile, calendula, a solution of baking soda. Compresses help a lot. For children, they can be done with plain warm water; for adults, it is advisable to add any alcohol (1: 1) to the water. Bed rest is a prerequisite for a quick recovery.
Pathogenic bacteria, the causative agent of angina streptococcus
Every person has about 4 kg of bacteria. Fortunately, only 1% of them are pathogenic. Among the remaining 99% there are so-called conditionally pathogenic, which become pathogenic under a combination of circumstances, for example, when the immune system is weakened. In addition to our own bad microbes, "foreign" bacteria from the environment can be added. The causative agents of angina among them are:
- streptococci;
- staphylococci;
- spirochetes;
- diplococci;
- Bacillus Löffner;
- gonococcus.
Most of these parasites have their own extensive 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 various endo- and exotoxins, respectively, cause various types of inflammation and ailments. Therefore, they cannot be treated with the same antibiotics. To determine what needs to be fought and what medicines, doctors take smears of pus and mucus from the tonsils and throat.
The causative agent of angina streptococcus is an anaerobe that does not need oxygen, does not move, is located in pairs or in chains. The classification of streptococci is impressive. All of them, independing on how they destroy red blood cells (carry out hemolysis), they 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 destroy red blood cells completely. They are divided into groups from A to U. Representatives of group A, or pyogenic bacteria, are considered opportunistic pathogens. They can get into the mouth from the environment and immediately provoke a disease, or they can not cause trouble for a long time. But as soon as a person's immune system is weakened, these streptococci begin destructive activity, causing tonsillitis, pharyngitis, bronchitis, scarlet fever, abscesses, and even toxic shock.
Bacterial tonsillitis, causative agent of staphylococcus aureus
This is the second type of microbe, capable of becoming very dangerous from being opportunistic. It got its name from the Greek word "staphyli", which means "grapes", because staphylococci are always arranged in clusters that resemble bunches of grapes. They are also immobile and do not require oxygen. In the oral cavity they contain up to 40% of the rest of the microorganisms. As long as 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 swab with tonsillitis and other infectious diseases. Staphylococcus happens:
- gold;
- epidermal;
- saprophytic;
- hemolytic.
All of them cause purulent inflammation 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 durability. 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 a freezer, in hot water, and withstand disinfection. Only boiling can kill them immediately.
Other types of bacteria, although no less pathogenic, are much less common.
Catarrhal angina
The term "catarrhal" is derived from catarrhus, that is, the flow of fluids. 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. Reasons for the onset of the disease:
- activation of pathogenic microbes present in the mouth;
- invasion from the outside (through contact with the sick and poor hygiene).
Symptoms:
- a sharp deterioration in he alth, weakness throughout the body;
- headache;
- temperature (in some patients, it can stay between 37.2-37.5 °C, but mostly rises above 38°C);
- increased lymph nodes in the submandibular area;
- feeling as if the throat "pulls";
- painful swallowing;
- redness and swelling of the palatine tonsils, as well as mucous arches in the throat;
- the appearance of a whitish coating on the tonsils, but without abscesses;
- increased protein in urine (at high temperature);
- in the blood, an increase in ESR and leukocytes is possible, but this sign is not characteristic.
Catarrhal angina without fever is often diagnosed as acute respiratory infections.
The causative agents of sore throats 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 aureus, streptococcus and viruses.
Symptoms are the same as in adults, but additionally may be:
- capriciousness;
- reluctance to eat;
- drowsiness or, conversely, anxiety;
- increased salivation;
- high fever convulsions, diarrhea and regurgitation.
Treatment methods:
- bed rest;
- gargles, compresses;
- drink plenty;
- sulfa drugs ("Biseptol", "Streptocid", "Bactrim");
- antihistamines;
- antipyretic (according to indications);
- vitamins.
Antibiotics are prescribed only by a doctor 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 onlybring down the high temperature (if it is above 38 ° C) in a folk proven way, consisting in wiping the child's body or only his forehead with a weak solution of vinegar. Neither antipyretics nor antibiotics can be given on their own. Babies older than a year before the arrival of the doctor can be given children's antipyretics "Paracetamol" or "Nurofen", as well as often give the child warm tea.
Follicular tonsillitis
Throat follicles are collections of lymphatic cells on the tonsils. In the normal state, they look like barely visible tubercles. When they become inflamed, follicular tonsillitis begins. The causes of the disease are the same as those of catarrhal tonsillitis, which often develops into follicular without treatment. It occurs equally in adults and children. The causative agent of follicular tonsillitis is streptococcus, staphylococcus, some viruses.
Symptoms:
- a sharp sudden onset, expressed in a jump in temperature above 39 ° C, fever, general weakness;
- sore throat radiating to ears;
- enlarged spleen;
- pain in the head, in the lower back;
- sometimes signs of intoxication, and in children they are more pronounced;
- tonsils are hyperemic, with clearly visible white or slightly yellowish small abscesses;
- sometimes signs of heart failure (tachycardia, pain in the heart area);
- increasing pain when turning head;
- Eosinophils, ESR, leukocytes are increased in the blood.
Since the causative agents of angina are more often streptococciand staphylococci, that is, bacteria, treatment is mandatory with antibiotics. Their range is large - "Ampicillin", "Erythromycin", "Cefamesin" and others.
Children and adults can also use sprays to relieve sore throat "Oracept", "Pharingospray". Otherwise, the algorithm is similar to that used for catarrhal angina.
Rough, spicy, s alty, peppery foods should be excluded from the menu. Children should be given mashed potatoes and light cereals, and force-feeding is contraindicated.
Lacunar angina
Lacunas are 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 tonsillitis are only bacteria, most often cocci, but viruses can significantly aggravate the already serious condition of the patient. Symptoms in lacunar angina are similar to follicular ones, but all manifestations in this case are much more pronounced. So, the temperature in patients often jumps up 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 such that a person does not want to move. On the patient's tonsils, even a non-specialist sees white or yellowish abscesses. They are much larger than with follicular sore throat, 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 tonsillitis is identical to follicular. Ulcers in the throat cannot be removed with anything, and wounds should be lubricated with antiseptics. Plaqueremoves only by rinsing.
Sometimes follicular and lacunar tonsillitis develop to the fibrinous stage, when purulent plaque spreads from the tonsils to neighboring areas of the pharynx.
Herpetic sore throat
This disease has several equivalent names - herpangina, aphthous or vesicular enteroviral pharyngitis. The causative agent of herpetic sore throat is a virus, more precisely, several serovars of the Coxsackie virus, and not bacteria, so antibiotic treatment in this case is not advisable. The disease often affects children, including infants, and is rarely diagnosed in adults. It is very easy to catch herpangina, since Coxsackie viruses are fantastically virulent and are quickly transmitted from their human carriers by airborne droplets, less often by fecal-oral (dirty hands - toys, pacifier - mouth). Even more rarely, the disease can be obtained from contact with certain animals, such as pigs. Once in the body of their victim, the viruses are introduced into the lymph nodes, then into the blood, and from there into the lymphatic system of the throat.
Symptoms:
- abrupt debut (temperature jump over 40 ° C, weakness, up to being unable to stand, babies often have convulsions);
- increased sore throat;
- runny nose;
- sometimes cough;
- rash in the throat in the form of reddish vesicles filled with transparent exudate (they resemble those that are poured out 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 the most dangerous. Pathogen intheir weak body can provoke meningitis, pyelonephritis, encephalitis, and vesicles can appear not only in the mouth, but also on the body.
Visual diagnosis is made after examination of the mucous membranes, and the final diagnosis is based on serological and virological tests.
Treatment includes a complex of antiviral drugs, according to indications, antipyretics, antihistamines, immunomodulators. The throat is treated with special sprays, and gargles are prescribed for adult children. Compresses and inhalations for herpetic sore throat are prohibited. Antibiotics in the complex are prescribed only if complications associated with bactericidal infection have begun.
Purulent tonsillitis
This term is sometimes used to refer to other diseases in which inflammatory processes are observed in the throat with the formation of purulent exudate. These are lacunar and follicular tonsillitis, an important feature 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 in another 10% - a tandem of these two pathogens. Sometimes purulent tonsillitis is called fungal or gonorrheal forms, but there are visual differences. So, fungal tonsillitis is caused by mycoses, most often Candida. Its main symptom is a white cheesy coating over the entire throat area, even on the tongue. That is why fungal tonsillitis is confused with thrush. Fungal plaque is easily removed, revealing reddish sores. Causes of appearance - weakeningimmunity, prolonged or uncontrolled use of antibiotics. If the causative agent of angina is gonococcus, it is called gonorrhea, or more correctly gonorrhea of the throat. It happens, with rare exceptions, only in adults. The reason is oral sex with a carrier. The symptoms of gonorrheal and purulent tonsillitis are extremely similar, so accurate differentiation is possible only by taking a swab from the oral cavity. Visually, ulcers with gonorrhea of the throat are denser than with sore throat, plus, they can spread to the palate and tongue.
It is important to understand that purulent tonsillitis is only 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 gives complications:
- abscesses in the throat;
- moderate otitis media with possible hearing loss;
- sepsis;
- rheumatic fever;
- pain in the heart;
- kidney failure;
- chronic tonsillitis.
And the last thing: angina is a contagious disease. Therefore, in order not to infect their relatives, the sick person must strictly observe hygiene.
