When the tonsils (or simply the tonsils) become infected with various pathogens, they speak of angina (acute tonsillitis ). Its purulent form is most difficult.
Purulent tonsillitis can affect both children and adults. The peak incidence occurs in the autumn-winter period.
By the nature of the structural changes and the involvement of the tonsils in the process, there are the following types of angina:
- catarrhal – without pus, the easiest form;
- follicular – with the formation of pus;
- lacunar – also purulent form of tonsillitis;
Depending on the pathogen that caused the infection in the glands, angina can be streptococcal, staphylococcal, mixed etiology.
According to the course of the disease, a sore throat can be mild, moderate or severe.
The causes of the disease are:
- B-hemolytic streptococcus group A (usually);
- penetration into the tonsils of staphylococci (single or in combination with streptococci);
- viruses ( Coxsackie virus, herpes virus);
- pale spirochete (causative agent of syphilis).
Predisposing factors for the development of the disease include:
- weakening the body’s defenses;
- gas pollution, dustiness of the environment;
- harmful working conditions (contact with dust, temperature changes);
- lack of vitamins;
- life in megacities;
- use common with diseased dishes.
Purulent tonsillitis is quite a serious disease and is difficult.
The incubation period for angina ranges from several hours to two days. The disease begins acutely, and the signs of intoxication of the organism come to the fore. These include:
- increase in body temperature (up to 38-40 ° C);
- body aches;
- head aching pain without a certain localization;
- weakness and lethargy;
- decrease or lack of appetite.
In addition, there is an increase in regional lymph nodes or lymphadenitis (swelling of the submandibular, ear, occipital lymph nodes).
On examination of the throat, bright red enlarged tonsils are visible, on which there are dilated follicles or lacunae with yellow (purulent) contents. Pus that expires from bursting follicles or lacunae forms a fibrous plaque on the tonsils, which is easily removed with a swab.
Also, patients may be disturbed by:
- pains in the joints and muscles, in the stomach;
- runny nose
Depending on the degree of swelling and enlarged tonsils, there is pain in the throat when swallowing. In severe cases, the tonsils are so hypertrophied that they almost overlap the throat, the patient not only cannot swallow, it is even difficult for him to open his mouth.
It is necessary to differentiate purulent quinsy and diphtheria , purulent tonsillitis and infectious mononucleosis . The diagnosis of the disease is determined by a combination of characteristic complaints and examination of the patient.
Obligatory palpable regional lymph nodes and pharyngoscopy.
Pharyngoscopy is a visual examination by the doctor of the oral cavity and pharynx with the help of a medical spatula; in the process of such examination, enlarged lacunae and / or follicles with purulent discharge and a deposit on the tonsils are detected.
In addition, a general blood test is prescribed, in which signs of inflammation are determined (accelerated ESR, an increase in the number of white blood cells).
To exclude diphtheria a swab is taken from the mucous membrane of the pharynx and nose, and a discharge is taken from the tonsils for planting and sensitivity to antibiotics.
An otolaryngologist is engaged in treating a sore throat, and in the case of his absence – a general practitioner.
As a rule, patients with mild and moderate severity of the disease are treated on an outpatient basis, but hospitalization is also possible with severe intoxication or the appearance of complications.
The patient is assigned bed rest, limited contact and, especially, conversations with loved ones.
Abundant warm drink shown:
- fruit and berry fruit drinks;
- still mineral water;
- Loose tea with lemon.
Since the body is weakened, and the patient himself is difficult to eat because of unpleasant sensations when swallowing, the food should be rich in vitamins, easily digestible, warm and soft in consistency.
Mandatory rinsing throat warm, but not hot solutions with antiseptics and decoction of herbs. To do this, you can use:
- a solution of soda, salt and iodine;
- furatsilina and chlorhexidine solution;
- weak potassium permanganate solution;
- decoctions of sage, chamomile, calendula and other herbs.
Gargles not only act as a disinfectant, but also relieve swelling of the tonsils, relieve sore throat.
Undoubtedly, in the treatment of purulent tonsillitis can not do it alone rinses, therefore, antibiotics must be prescribed. Preference is given to:
- antibiotics penicillin (amoxiclav, Augmentin);
- cephalosporins 2 and 3 generations ( ceftriaxone , cefuroxime , cefix );
- macrolides (azithromycin, sumamed ).
The course of antibiotic therapy is at least 7 days. It is important to take drugs within three days after the temperature normalizes.
Nonsteroidal anti-inflammatory drugs (paracetamol, nurofen ) and antihistamines (suprastin, claritin) are prescribed to relieve swelling and relieve pain in the throat.
Purulent tonsillitis is dangerous for its complications, which can be both late and early.
- otitis media;
- laryngitis ;
- purulent lymphadenitis;
- soft tissue abscesses.
Later may develop:
The prognosis for timely and high-quality treatment of the disease is favorable.