Herpetic sore throat
The content of the article:
- Causes and risk factors
- Stages
- Symptoms
- Diagnostics
- Treatment
- Potential consequences and complications
- Forecast
- Prevention
Herpetic sore throat (vesicular pharyngitis, aphthous pharyngitis, ulcerous sore throat) is an acute infectious disease of a viral nature, occurring with a significant increase in body temperature, pharyngitis, dysphagia. A characteristic feature is the presence on the mucous membrane of the soft palate and the posterior wall of the pharynx of small fluid-filled vesicles (vesicles), prone to ulceration with the formation of erosion.
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Causes and risk factors
The causative agents of herpetic sore throat are Coxsackie viruses or ECHO. The infection is transmitted from person to person by airborne droplets or fecal-oral routes. The literature describes cases of human infection from sick animals (for example, pigs). The disease is highly contagious.
Herpetic sore throat is characterized by the seasonality of the incidence (the peak occurs in the summer-autumn period); it often develops against the background of acute respiratory infections. After the transferred sore throat, stable immunity is formed, but only to the specific strain of the virus that caused it. When infected with another strain of herpetic sore throat, you can get sick again.
Stages
During herpetic sore throat, several stages (periods) are distinguished:
- Latent (incubation) period. Lasts 7-14 days from the moment of infection. During this period, the virus multiplies in the body, but there are no clinical manifestations of infection.
- Prodromal period. The development of the clinical picture of influenza-like syndrome is characteristic.
- The peak period. The general condition of the patient worsens, characteristic herpetic eruptions appear on the back of the pharynx.
- The period of convalescence (recovery). There is a gradual epithelialization of ulcerations on the mucous membrane of the pharynx, the condition improves.
Symptoms
Herpetic sore throat occurs acutely. First symptoms:
- severe general weakness;
- lack of appetite;
- headache, muscle pain;
- irritability;
- increased body temperature;
- salivation;
- sore throat;
- runny nose.
Local changes are accelerating. Already in the first day from the onset of the disease, slightly rising small dense papules (nodules) appear on the hyperemic mucous membrane of the uvula, soft palate, tonsils and palatine arches. Gradually they increase in diameter, a cavity filled with serous fluid is formed inside - vesicles are formed. After 24-48 hours, the vesicles open up with the formation of small grayish-white ulcers surrounded by a red crown. Individual sores can merge with each other, forming a significant superficial drainage defect. The erosive surface at the site of the opened vesicles is very painful - for this reason, patients refuse not only to eat, but also to drink.
The main symptoms characteristic of herpetic sore throat
There is an increase in the submandibular, cervical and parotid lymph nodes (lymphadenopathy). Patients often complain of abdominal pain, the occurrence of which is associated with muscle soreness (myalgia) of the diaphragm.
Fever and intoxication with an uncomplicated course of the disease persist from 3 to 5 days. The processes of epithelialization of erosions of the oral mucosa begin in 6-7 days.
In patients with weakened immunity, the disease can take an undulating course. It is characterized by repeated herpetic eruptions that recur every 2-3 days.
With severe herpetic sore throat, a vesicular rash appears on the trunk, hands and feet.
Diagnostics
The presumptive diagnosis of herpetic sore throat is based on the characteristic clinical picture. For an accurate diagnosis, laboratory tests are required:
- serological. It is based on the detection of an increase in the antibody titer in the blood serum. For this, blood is taken from the patient in the first days of the disease and after 2-3 weeks;
- virological. Its object is pharyngeal swabs, which must be obtained in the first 5 days of the disease.
- method of immunofluorescence. This is the most informative study in this case.
Serological examination reveals an increase in antibody titer in serum
Treatment
Treatment is symptomatic. Antipyretic and antihistamines are prescribed. Local therapy is mandatory: irrigation of the oral mucosa with drugs with antiseptic, keratoplastic, analgesic, antiviral, proteolytic, enveloping action.
To accelerate the process of epithelialization of erosive surfaces, their irradiation with a helium-neon laser or ultraviolet is shown. Local application of bactericidal agents is justified in order to prevent secondary bacterial infection. To increase the general resistance of the body and prevent the development of complications, immunomodulators can be prescribed.
Sparing nutrition for angina can reduce inflammation and accelerate the healing of ulcerative lesions
Proper nutrition is of no small importance in the treatment of herpetic sore throat. The goal of diet therapy is to provide thermal, mechanical and chemical sparing of the damaged mucous membrane with a complete and balanced diet. Correctly organized nutrition should create conditions for reducing inflammation and accelerating the epithelialization of ulcerative lesions.
Potential consequences and complications
In patients with reduced immunity against the background of herpetic sore throat, viremia can develop, which leads to the generalization of the infection and can cause the following complications:
- hemorrhagic conjunctivitis;
- myocarditis;
- pyelonephritis;
- meningitis;
- encephalitis.
Forecast
The prognosis for herpes sore throat is favorable, the disease ends with recovery. With the addition of complications, the prognosis worsens.
Prevention
Specific vaccine prophylaxis of herpes sore throat is not carried out due to the large number of serotypes of the ECHO and Coxsackie viruses that cause the disease.
In the focus of the disease, preventive measures, standard for all types of respiratory infections, are carried out: frequent wet cleaning with the use of disinfectants, frequent ventilation and periodic quartzing of the room.
For children who have been in contact with patients, in order to prevent possible infection, the administration of gamma globulin is shown. In children's groups, quarantine is assigned to prevent the further spread of the infection.
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Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
