Viral sore throat: treatment in adults, symptoms, complications
The content of the article:
- What virus causes angina?
- Symptoms of viral sore throat
- Diagnostics of the sore throat
- How to treat viral sore throat in adults
- Possible complications
- Video
Viral tonsillitis accounts for up to 90% of cases of acute tonsillitis, so its treatment is an urgent problem in modern otorhinolaryngology. In this case, not only the palatine tonsils are affected, but also the mucous membrane of the nasal cavity and oropharynx.
Treatment of viral and bacterial sore throat is different, so it is important to ask an otolaryngologist to clarify the diagnosis
Symptoms and course of viral tonsillitis, in addition to the etiology of the pathogen, may depend on the state of the immune system, the patient's age and the presence of concomitant pathology, which doctors rely on when prescribing therapy.
What virus causes angina?
Currently, more than 200 types of viruses are known that cause ARVI (acute respiratory viral infection) and contribute to the occurrence of sore throat.
Rhinoviruses can cause inflammation of the tonsils
Inflammation of the tonsils, or acute tonsillitis, can cause rhinoviruses, coronaviruses, adenoviruses, parainfluenza viruses, herpes simplex, coxsackie viruses, cytomegaloviruses. They can themselves cause damage to the respiratory tract or act as additional pathogens. Thus, mixed forms of infection reach 70–85% of the total incidence and are characterized by a severe course.
The entrance gate, as a rule, is the epithelium of the mucous membrane of the upper respiratory tract, oropharynx and directly palatine tonsils.
Most often, the virus is transmitted by airborne droplets
Sick people or healthy virus carriers are the source of infections. Pathogens can be spread by airborne droplets - by coughing, sneezing, talking, or through contaminated personal items. Most viruses are stable in the environment and are active at room temperature for a few hours to 14 days.
Due to the wide circulation of various serotypes of viruses, especially respiratory, short-term immunity is formed. This underlies seasonal increases in morbidity and epidemic outbreaks with an interval of 2–3 years. The maximum rate for the year falls on the autumn-winter period.
Symptoms of viral sore throat
Symptoms appear in the early days or hours of the illness. A patient with a viral form of acute tonsillitis has the following complaints:
- sharp sore throat, aggravated by talking, swallowing;
- increased body temperature;
- headache, chills, general weakness;
- discharge from the nose and nasopharynx;
- Difficulty nasal breathing.
Cough, abdominal pain and dyspeptic symptoms (nausea, vomiting, stool disorders) are possible. Regional lymph nodes (chin, submandibular, cervical) increase in size and become painful.
Depending on the etiological agent, symptoms may have their own characteristics. For example, an adenovirus infection manifests itself in the form of conjunctivitis, often a purulent rhinitis and plaque in the pharynx. The disease proceeds in waves: after improvement of the general condition, on the 7-10th day, an increase in body temperature and a resumption of symptoms are again noted.
Enterovirus infection can be accompanied by muscle pain
Enterovirus infection can occur with dyspeptic, myalgic (muscle pain) or meningeal syndrome.
For cytomegalovirus infection, the entrance gates are the mucous membranes of the oropharynx and the salivary glands, where the primary reproduction of the virus occurs. Although the tonsils are rare, the likelihood of this virus must be taken into account.
Also, secondary angina can occur with infectious mononucleosis. The disease is caused by the Epstein-Barr virus and is characterized by a febrile condition, inflammation of the tonsils, swollen lymph nodes, liver and spleen. Infection occurs by airborne droplets.
Infectious mononucleosis is also characterized by a lesion of the nasopharyngeal tonsil, resulting in severe nasal congestion, nasal tone of voice, snoring. After the infection, the virus persists for life in the tonsils, lymph nodes and lymphocytes.
With herpes sore throat, vomiting and loose stools are often observed.
Diagnostics of the sore throat
It is very important at the stage of primary diagnosis to distinguish a viral infection of the tonsils from a bacterial one, since the tactics of managing patients differ.
To make a diagnosis, you should consult an ENT doctor
A thorough examination is performed, a clinical blood test, a general urine test is performed. Laboratory diagnostic methods also include polymerase chain reaction (PCR), which is based on the detection of RNA or DNA of viruses, immunofluorescence and enzyme immunoassay analysis of swabs from the nasal cavity, posterior pharyngeal wall and from the surface of the tonsils.
The etiological diagnosis of the virus is not always justified. Therefore, in everyday practice, the decision about etiotropic treatment of a patient is based on clinical data, history and results of pharyngoscopy.
But this does not exclude the need for bacteriological inoculation of the discharge from the mucous membrane of the palatine tonsils and the posterior pharyngeal wall with the determination of sensitivity to antibacterial drugs.
To exclude streptococcal infection, dangerous purulent and rheumatic complications, an express test is performed to determine the antigen of group A beta-hemolytic streptococcus.
To clarify the etiology of the disease, a clinical blood test is usually prescribed.
In a clinical blood test for a viral infection, a shift in the leukocyte formula to the right is determined due to an increase in the number of lymphocytes. In this case, leukopenia (a decrease in the number of leukocytes) can be observed.
From the photo taken during pharyngoscopy with viral angina, one can see the presence of bright hyperemia of the palatine tonsils, arches, and the posterior pharyngeal wall. But, depending on the etiological agent, there may be its own characteristics.
The symptoms of angina vary depending on the pathogen and the presence of comorbidities
The pharyngoscopic picture of angina with infectious mononucleosis is as follows:
- the mucous membrane of the palatine arches, tonsils and uvula is hyperemic, edematous;
- The palatine tonsils are enlarged and may touch each other;
- plaque on the surface of the tonsils can be in the form of purulent stripes, islets, or all over;
- plaque white-yellow, it can spread beyond the tonsils;
- the mucous membrane of the posterior pharyngeal wall is hyperemic, edematous, granular;
- a mucopurulent secret flows from the nasopharynx along the back of the pharynx.
Follicular tonsillitis is most often observed, less often necrotic.
During rhinoscopy, edematous, enlarged adenoids are determined, which can completely cover the choanae. In the nasopharynx, there is an accumulation of mucopurulent secretions.
In a clinical blood test for infectious mononucleosis, leukocytosis is determined, atypical mononuclear cells appear, ESR (erythrocyte sedimentation rate) is accelerated.
With enterovirus infection during pharyngoscopy, bubbles are visible on the mucous membrane of the oropharynx.
With herpetic sore throat during pharyngoscopy, against the background of diffuse hyperemia of the pharyngeal mucosa, small reddish bubbles are noted on the tonsils, arches and soft palate, which burst after a couple of days, and then healed tissue is visualized at the site of erosion. At the same time, new bubbles appear in other areas. Differential diagnosis is facilitated due to the fact that bubble eruptions also appear on the patient's lips with herpetic sore throat.
Unlike other viruses, with cytomegalovirus infection, there is no increase and soreness of regional lymph nodes.
How to treat viral sore throat in adults
For adequate therapy, you must immediately consult a doctor. The sooner treatment is prescribed, the faster you can achieve recovery and prevent many complications.
After excluding bacterial lesions, in particular after performing an express test for streptococcus, the patient is prescribed antiviral drugs. In an uncomplicated course of acute viral tonsillitis, antibiotic therapy is not required, since antibiotics do not work on viruses.
An important role is played by local therapy, which contributes to a more rapid relief of the inflammatory process.
As part of the treatment, gargle is prescribed.
For washing the lacunae of the palatine tonsils and rinsing the pharynx, a Betadine solution is often prescribed, which is diluted in boiled water or saline (20 drops per 200 ml of saline). Rinsing is recommended 2 times a day for 3 minutes for 3-5 days. Other antiseptic solutions for washing are prescribed: Chlorhexidine, Miramistin, Chlorfillipt.
The surface of the tonsils is lubricated with 1% Lugol's solution, 2% Collargol's solution, 40% propolis solution or interferon ointment. Alkaline rinses and inhalations are performed.
With herpetic sore throat, Acyclovir, Valacyclovir are prescribed. Irrigation of the pharynx with interferon, disinfecting rinsing (Furacillin), restorative therapy are recommended. Immunomodulators (Echinacea), vitamin complexes are prescribed.
Patients with infectious mononucleosis are shown bed rest
For infectious mononucleosis, bed rest, drinking plenty of fluids, rinsing the mouth with 2% soda solution, and herbal decoctions are recommended. Cycloferon is prescribed according to an individual scheme. In severe cases, it is advisable to prescribe antibiotics (cephalosporins of 2-3 generations).
Antiviral therapy for angina should be accompanied by the appointment of pathogenetic agents. In the fight against high fever and as pain relievers, non-steroidal anti-inflammatory drugs are prescribed. This is especially important for fever in children, since high temperature is a risk factor for the development of seizures, encephalopathy.
Most often assigned:
- Paracetamol;
- Ibuprofen;
- Celecoxib.
Possible complications
Are there complications in acute tonsillitis? With adequate treatment of viral sore throat in adults, the risk of developing consequences is minimal.
Symptoms of pathology are due to the development of a local inflammatory reaction in the tonsils. The severity of the clinical picture directly depends on the immunity and the rate of elimination of the virus from the body. Sometimes an excessive local inflammatory reaction occurs, which leads to massive death of surrounding tissues and viremia, as a result of which such a formidable complication as infectious-toxic shock develops.
Often, in the viral form of acute tonsillitis, bacterial flora joins, which can contribute to the severe course of the inflammatory process and the occurrence of various consequences, such as paratonsillar abscess, purulent cervical lymphadenitis, mediastinitis, acute sinusitis, acute otitis media and others.
Video
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Alina Ervasova Obstetrician-gynecologist, consultant About the author
Education: First Moscow State Medical University. THEM. Sechenov.
Work experience: 4 years of work in private practice.
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