Viral angina in children: symptoms, treatment, complications, prevention
The content of the article:
- Symptoms of viral sore throat in children
-
Diagnostics of the viral sore throat
Diagnostic features
- How to treat a viral sore throat in a child
- Complications of viral sore throat in children
- Prevention
- Video
Viral sore throat in children most often means secondary acute inflammation of the palatine tonsils in viral diseases of various etiologies. Symptoms of the disease, depending on the pathogen, can manifest themselves with different intensities and are most often a sign of an acute respiratory viral infection.
The viruses that cause sore throat are most often transmitted by airborne droplets
Inflammation of the tonsils can occur under the influence of influenza and parainfluenza viruses, Coxsackie A and B, adenoviruses, rhinoviruses, respiratory syncytial virus, Epstein-Barr virus and others.
Coxsackie viruses of group A and less often of group B cause herpetic sore throat, Epstein-Barr virus - infectious mononucleosis.
Inflammatory process in the tonsils can cause influenza virus
The transmission of infection occurs mainly by airborne droplets, less often by contact and food. Viruses are characterized by low resistance in the external environment, they are very sensitive to the action of disinfectants, heating, ultraviolet radiation and drying. The source of infection is a sick person or a healthy carrier of bacteria. Symptoms may begin several hours after infection.
Viral diseases are widespread, but acute tonsillitis does not always develop against the background of infection. This is primarily due to the reactivity of the body, the presence of concomitant diseases, as well as mechanical, chemical or thermal damage to the mucous membrane of the tonsils. Also, predisposing factors can be:
- the presence of chronic foci in the ENT organs;
- immunodeficiency states or features of the immune response;
- passive smoking, in which tobacco smoke irritates the mucous membranes and leads to a violation of the barrier function;
- various anomalies in the development of the upper respiratory tract.
It should be remembered that frequent viral infections are not a sign of immunodeficiency, but only indicate a high level of contact between the child and the source of infection.
The peak of susceptibility to viral infections occurs at the age from 6 months to 3 years.
Symptoms of viral sore throat in children
Common signs of a viral lesion of the tonsils include the following symptoms:
- acute onset of the disease;
- an increase in body temperature to 39 ° C and above;
- chills, general weakness;
- headaches, dizziness;
- sharp sore throat, aggravated by talking, swallowing;
- hoarseness of voice, nasality;
- muscle and joint pain;
- runny nose, nasal breathing difficulties;
- enlargement and soreness of regional lymph nodes.
During illness, the child prefers mashed food that does not irritate the sore throat.
Because of sore throat, the child refuses to eat or prefers soft, non-irritating foods. Dyspeptic symptoms are possible: nausea, vomiting, loose stools.
Diagnostics of the viral sore throat
The primary examination and diagnosis can be carried out by a pediatrician, otorhinolaryngologist or infectious disease specialist.
Primary diagnosis includes examination and collection of anamnesis
When making a diagnosis, the data of anamnesis and clinical manifestations are taken into account. The doctor conducts an examination and pharyngoscopy. In the photo of the throat, taken during pharyngoscopy, you can see the main pathological changes in tonsillitis.
According to the indications, laboratory and instrumental research methods are prescribed. In difficult situations, the help of specialized specialists is required: a rheumatologist, cardiologist, immunologist.
The pharyngoscopic picture of acute inflammation of the tonsils against the background of a viral infection is characterized by the presence of bright hyperemia and edema of the mucous membrane of the oropharynx, mainly in the area of the palatine arches, tonsils and the posterior pharyngeal wall. An easily removable plaque is detected on their surface.
In a clinical blood test for a viral infection, a shift in the leukocyte formula to the right is observed due to an increase in the number of lymphocytes. Often the number of leukocytes is reduced. But depending on the reactivity of the body, leukocytosis is possible.
Virus isolation by serological testing is rarely used for practical purposes.
It should be remembered that bacterial tonsillitis can be hidden behind the clinical picture of a viral lesion.
In order to further confirm the preliminary diagnosis or possible correction of treatment (if a bacterial agent is detected), it is recommended to make a bacteriological culture of the discharge from the surface of the tonsils and the posterior pharyngeal wall.
To exclude pyogenic streptococcus, an express test is performed
To exclude the presence of beta-hemolytic streptococcus with sore throat, an express test is performed, which makes it possible to recognize classic streptococcal tonsillitis in time, in which it is very important to start antibacterial treatment from the first days of the disease. This is due to a number of complications from the heart, kidneys and other organs, which are caused by group A beta-hemolytic streptococcus.
Diagnostic features
Depending on the etiological agent, the disease can have its own characteristics in the clinical picture and in diagnosis.
Adenoviral sore throat is manifested by fever, pharyngitis, and conjunctivitis. The disease begins acutely with an increase in body temperature and muscle pain. Within a few hours there is a sore throat, inability to swallow, watery eyes, itching and photophobia.
With adenoviral angina, photophobia and lacrimation occur
On examination, there is redness and edema of the conjunctiva of the eyeball, eyelids, enlargement and tenderness on palpation of the parotid, cervical and submandibular lymph nodes.
With pharyngoscopy, pronounced manifestations of acute pharyngitis are determined. There is hyperemia and edema of the palatine arches, tonsils, uvula, posterior pharyngeal wall, on the mucous membranes - point or confluent whitish plaques.
With adenovirus infection, acute otitis media and tracheobronchitis may develop.
Herpetic sore throat is more common in children of the younger age group. The disease begins acutely with high body temperature and chills. Older children complain of sore throat, abdominal pain and headache. Vomiting and loose stools are common. The child becomes lethargic, apathetic.
Herpetic sore throat is characterized by a pronounced intoxication syndrome. Fever can lead to seizures. Muscle, joint and headaches cause painful perception of external stimuli (sound, light, touch). Regional lymph nodes are enlarged and painful.
Herpetic sore throat is characterized by the appearance of bubbles on the mucous membrane of the pharynx
Pharyngoscopy reveals diffuse hyperemia of the mucous membrane of the pharynx, tonsils, palatine arches, uvula and soft palate, small reddish vesicles. The largest number of bubbles is located on the tonsils. Rashes do not appear at the same time: in some places they are formed, in others they are scarred. After 1–2 days after the appearance of the bubble, its contents become cloudy, burst and surface erosion of an irregular shape, covered with fibrinous plaque, is formed. Within 3-4 days, ulceration is scarred. By this time, the body temperature decreases, and the severity of the clinical manifestations of the disease decreases.
In the clinical analysis of blood, leukopenia and a shift in the leukocyte formula to the right are noted.
Infectious mononucleosis is characterized by an acute onset - with chills and a sharp increase in body temperature. Rapidly growing symptoms of intoxication and sore throat appear. Angina with mononucleosis is also a symptom of the disease, not the cause.
With pharyngoscopy, the tonsils are sharply enlarged, uneven, bumpy with a yellowish or gray coating on the surface. The lingual tonsil is often affected. There is marked edema of the anterior arch. All this leads to difficulty breathing, especially in young children with lesions of the pharyngeal tonsil. Putrid odor from the mouth is noted. In rare cases, there may be necrotic ulcerative changes in the tonsils.
With infectious mononucleosis, there is a systemic generalized enlargement of the lymph nodes
A hallmark of infectious mononucleosis is systemic generalized enlargement of the lymph nodes. The cervical, submandibular, axillary, inguinal, mesenteric and abdominal lymph nodes are affected. They increase in size, but at the same time they are slightly painful and do not suppurate.
On examination, the doctor can detect an increase in the liver and spleen, which are observed on the 2nd-4th day of the disease and disappear a few weeks after recovery. Less often, edema of the cervical tissue is found.
Pharyngoscopy reveals significant edema and hyperemia of the tonsils, the posterior pharyngeal wall, on which a significant number of enlarged follicles are visualized.
With infectious mononucleosis, a lymphocytic reaction is clearly visible in a clinical blood test. An increase in the number of monocytes, the appearance of atypical mononuclear cells is determined.
How to treat a viral sore throat in a child
With viral angina, antiviral, symptomatic, restorative and local treatment is used. Most often, therapy is carried out on an outpatient basis.
It is important to establish nutrition. Salty, spicy and sour foods are excluded. Food should be rich in vitamins, but not irritating or harsh.
Frequent drinking is recommended. In case of fever, the drug Regidron is prescribed to restore the water-salt balance.
Local treatment includes frequent gargling with disinfectant and antiseptic solutions:
- Chlorhexidine or Miramistin solution;
- sodium bicarbonate solution;
- hydrogen peroxide solution;
- warm broth of sage, calendula, chamomile.
Antiseptics can be administered as sprays
Antiseptics are also prescribed in the form of a spray or lozenges: Tantum Verde, Hexoral, Grammidin.
Medical treatment of viral sore throat in children takes the leading place. It must be remembered that the use of antibiotics for respiratory viral infections is unreasonable. They do not act on the virus and do not prevent bacterial complications.
The range of antiviral drugs approved for use in pediatric practice is rather narrow.
There are few drugs that activate the nonspecific resistance of the child's body: interferons and their inducers, as well as adaptogens of various origins.
The drug Isoprinosine, which increases the production of interleukins, has an immunomodulatory and antiviral effect.
Symptomatic therapy is aimed at relieving concomitant symptoms: headache, runny nose, fever.
When the body temperature rises above 38 ° C, non-steroidal anti-inflammatory drugs are recommended: Paracetamol, Ibuprofen. With subfebrile condition, antipyretic drugs are inappropriate to use.
To reduce tissue edema, antihistamines are prescribed (Zodak, Suprastin).
In the event of bacterial complications, the specialist selects an antibiotic depending on the allergic history, the age and weight of the child, the suspected or proven bacterial agent.
Side effects of drugs develop more often in children than in adults, therefore, when symptoms of sore throat appear, it is important to seek treatment from a specialist.
Complications of viral sore throat in children
The treatment of acute tonsillitis must be taken very seriously and comprehensively, as otherwise the risk of complications increases.
One of the possible complications of angina is otitis media
Most often in children, inflammation of the tonsils against the background of viral infections is complicated by otitis media, tracheobronchitis, pneumonia and other diseases as a result of the attachment of a bacterial pathogen.
In this case, the state of the general and local immunity of the baby plays an important role. With inflammation of the tonsils, the biocenosis of the oropharynx changes, which often leads to the transition of the saprophytic flora of the tonsils lacunae to the pathogenic one.
The following complications are also possible:
- regional lymphadenitis;
- abscesses and phlegmon of the neck;
- mediastinitis;
- meningitis;
- encephalitis;
- myocarditis;
- glomerulonephritis.
Prevention
Many doctors, including pediatrician Komarovsky E. O., believe that it is better to prevent the disease than to cure and, moreover, to deal with various consequences. Therefore, specific and non-specific prophylaxis is recommended.
Specific prophylaxis involves the administration of vaccines. It is not used for all diseases.
Compliance with the rules of personal hygiene reduces the likelihood of pathology
Non-specific measures include various methods of hardening the body, vitamin therapy in the autumn-winter period, full-fledged balanced nutrition, moderate physical activity. It is also important to teach your child the rules of personal hygiene.
Video
We offer for viewing a video on the topic of the article.
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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