Purulent sore throat in children
The content of the article:
- Causes and risk factors
- Forms of the disease
- Symptoms of purulent sore throat in children
- Diagnostics
- Treatment of purulent sore throat in children
- Nutrition for purulent sore throat
- Potential consequences and complications
- Prevention
Purulent tonsillitis in children is an infectious and inflammatory process that affects the palatine tonsils and is accompanied by the appearance of purulent plaque on their surface. The disease is widespread among people of both sexes and all ages. In children, it is more common and more severe, often accompanied by the development of complications. In the autumn-winter period, the incidence of purulent sore throat increases.
Yellow dots (suppurating follicles) on the surface of the tonsils - a characteristic symptom of purulent tonsillitis
Causes and risk factors
The causative agent of purulent sore throat in children can be various microbial agents, both viral and bacterial, but more often the disease is caused by group A β-hemolytic streptococcus (85% of all cases). The main route of transmission of infection is airborne, but contact-household is also possible, for example, through common dishes, toys.
Factors that increase the risk of developing purulent sore throat in children are a decrease in general and / or local immunity, which occurs for the following reasons:
- acute respiratory illness;
- hypothermia;
- injury to the tonsils;
- second hand smoke;
- the presence of a focus of chronic infection in the oral cavity (stomatitis, caries);
- living in an area with an unfavorable ecological situation.
In 85% of cases, purulent tonsillitis in children is caused by group A β-hemolytic streptococcus
Forms of the disease
Depending on the cause, purulent sore throats in children are classified into several types:
- primary (common, or banal) - caused by pathogenic bacteria, manifested by purulent lesions of the lymphoid tissue of the pharyngeal ring, intoxication syndrome;
- secondary (symptomatic) - is a symptom of any other disease (leukemia, agranulocytosis, alimentary toxic aleukia); manifestations of the underlying disease are primary, tonsillitis joins later and may be atypical;
- specific - purulent inflammation of the tonsils is caused by a specific microflora (gonococci, spirochetes). This form of purulent sore throat in children practically does not occur.
Depending on the nature and depth of the defeat of the tonsils:
- lacunar;
- follicular;
- necrotizing purulent tonsillitis.
Symptoms of purulent sore throat in children
The incubation period for purulent angina in children lasts from several hours to several days. The disease begins suddenly, without a pronounced prodromal period. The child develops severe chills, against the background of which the body temperature rises to 39-40 ° C. Symptoms of intoxication rapidly increase, regional lymph nodes increase. Children complain of intense sore throat, which is worse when swallowing, and therefore refuse to eat and drink.
During pharyngoscopy, the following symptoms of purulent sore throat in children are revealed:
- severe hyperemia of the pharynx;
- infiltration and swelling of the tonsils;
- expansion of gaps;
- the presence of purulent discharge on the surface of the tonsils.
With purulent sore throat in a child, regional lymph nodes increase
With follicular angina, yellow dots are clearly visible on the bright red surface of the tonsils - suppurating follicles. This picture is called a symptom of the "starry sky".
With a lacunar form of purulent sore throat, a loose purulent plaque forms on the surface of the tonsils in the lacunae. This plaque extends beyond the lacunae, but does not spread beyond the tonsils. Purulent plaque is easily removed with a cotton swab, the surface after its removal does not bleed (one of the diagnostic signs that distinguish the lacunar form from the necrotic).
The necrotic form of purulent tonsillitis in children is especially difficult. It is characterized by a pronounced intoxication syndrome:
- confusion of consciousness;
- persistent fever;
- repeated vomiting.
On the tonsils there is a dull, dense bloom of greenish-yellow or gray with uneven, pitted edges. After removal, bleeding lymphoid tissue is found under it. The pathological process can spread to the arches, uvula, posterior pharyngeal wall. At the site of rejection of necrotic tissues, irregularly shaped defects with a diameter of 1–2 cm are subsequently formed.
Diagnostics
Diagnosis of the disease in most cases does not present any difficulties. It is carried out on the basis of the characteristic clinical symptoms of purulent tonsillitis in children and data from pharyngoscopy.
The diagnosis of "purulent tonsillitis" is based on clinical symptoms and pharyngoscopy data
To identify the causative agent of the disease and determine its sensitivity to antibiotics, if necessary, a bacteriological examination of a smear from the tonsils is carried out.
Treatment of purulent sore throat in children
Treatment of purulent sore throat in children is carried out in most cases on an outpatient basis. Only with a severe course of the disease, hospitalization is indicated in the infectious diseases or ENT department of the hospital.
Antibiotics for purulent angina in children are the main means of therapy. Macrolides, penicillins, cephalosporins are used. The duration of the course and the dosage are selected by the attending physician individually. The general treatment is complemented by local therapy. Gargling with antiseptic solutions (Chlorhexidine, Furacilin) or decoctions of medicinal plants (pharmacy chamomile, eucalyptus leaf, calendula flowers) is prescribed. In addition, antiseptic and anti-inflammatory drugs can be used in the form of a spray for irrigating the tonsils (Faringospray, Bioparox, Novosept). The duration and frequency of their use are also determined by the attending physician.
Along with antibiotic therapy for purulent sore throat, children are shown gargling with antiseptic agents
Nutrition for purulent sore throat
One of the main symptoms of purulent sore throat in children is a severe sore throat, which makes it difficult to swallow, therefore, disrupting normal food intake. In addition, severe intoxication syndrome leads to a sharp decrease in appetite. Therefore, on the first day of the disease, if the child refuses to eat, it should not be insisted, however, it is necessary to provide an abundant drink (still water, tea, rosehip broth, jelly, compote, fruit drink). Drinks should be warm, not irritating the inflamed mucous membrane (it is better to refuse juices from citrus fruits, compotes and fruit drinks from sour berries). When the intensity of the symptoms subsides somewhat (usually after 1-2 days), the child's diet is expanded.
A diet for children with purulent sore throat is developed taking into account the following principles:
- eat often, but in small portions;
- food should be crushed (porridge, mashed potatoes, soups, mashed potatoes, soufflé);
- food and drinks should be at room temperature or slightly warmed up, as excessively hot or cold food increases the intensity of pain;
- meals should be nutritious but easily digestible. Dishes from lean meat (preferably in the form of minced meat), cereals, thermally processed vegetables and fruits, dairy and sour milk products are welcome.
Food for purulent sore throat should be gentle, with a predominance of cereals, soups, mashed potatoes
Pickled, fatty, fried foods, spicy, spicy, heavy foods, solid foods, carbonated drinks, confectionery should be excluded from the diet.
Potential consequences and complications
Complications of purulent tonsillitis in children are early and late. The early ones develop as a result of the spread of infection to neighboring tissues and organs. These include:
- peritonsillitis;
- paratonsillar abscess;
- sinusitis;
- inflammation of the regional lymph nodes (lymphadenitis);
- otitis.
Late complications of purulent tonsillitis in children caused by β-hemolytic streptococcus are:
- rheumatism;
- myocarditis;
- glomerulonephritis.
These complications can occur 3-4 weeks after the onset of the underlying disease and their development is associated with autoimmune processes.
Rational antibiotic therapy significantly reduces the risk of both early and late complications.
Prevention
Prevention of the occurrence of purulent tonsillitis in children includes the following areas:
- Avoiding hypothermia. Hypothermia, both general and local, leads to a deterioration in the blood supply to the tissue of the tonsils. In addition, a special mucous layer forms on their surface. These factors create favorable conditions for the vital activity of pathogenic and opportunistic microflora and can cause purulent sore throat in children.
- Hardening. Allows you to increase the resistance of the child's body to the effects of infectious factors.
- Dental control. At least twice a year, preventive examinations by the dentist should be carried out, and, if necessary, timely sanitation. It is also important to maintain good oral hygiene.
- Control of an ENT doctor. With difficulty in nasal breathing (rhinitis, adenoiditis, curvature of the nasal septum), the child instead of the nasal one switches to oral breathing, which creates the prerequisites for the development of purulent tonsillitis. Therefore, these pathological conditions require timely treatment.
If a child falls ill with purulent sore throat, it is necessary to take a number of preventive measures aimed at preventing infection of others:
- isolate the patient by placing in a separate room;
- caregivers wear a gauze mask during contact with the patient;
- regularly ventilate the room in which the sick child is, 1-2 times a day to carry out wet cleaning in it;
- allocate a separate dish for the patient, after use wash it separately from the general one, at the end of washing, pour boiling water over it.
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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!
