Lacunar angina is a form of acute tonsillitis, which is characterized by purulent inflammation in lacunas, that is, folds of the tonsils. This form of the disease is more severe than follicular angina.In its pure form, it is rare. Most often it develops on the background of follicular.
The main risk group for this type of angina is children aged 5 to 12 years. In adults, this type of angina is most common in combination with another variant of the disease, that is, there is a mixed type. Treatment of lacunar sore throat in adults, as in children, is conducted by a course of antibiotics that eliminate the unpleasant symptoms of angina.
Adults tend to tolerate an illness more easily than children, but in the absence of correct and timely treatment, even adults can develop undesirable complications, including myocarditis, acute inflammation of the middle ear, pyelonephritis, rheumatism, pneumonia, etc.
Causes
Why does lacunar angina occur, and what is it? The main pathogens are streptococci, but it can also be caused by adenoviruses and staphylococci. That is why this disease is considered infectious. Transmitted by airborne droplets during sneezing, coughing sick person or by contact in children - through toys and other contaminated objects.
Also, sore throat can cause a variety of surgical interventions in the oral cavity and dental disease. External factors can also cause disease. These include - hypothermia, drafts, sudden changes in air temperature, dampness, air pollution.
Features of this form of the disease
The clinical name of this sore throat is called its name because it is localized in the lacuna of the palatine tonsils with its purulent-inflammatory process. In the thickness of the tonsils, these lacunae are many, so when the products of vital activity of pathogenic streptococci along with necrotic masses and slanted epithelium rise to the top, on the lymphatic formations appear extensive areas covered with plaque.
This distinguishes lacunar angina from follicular (another clinical form of angina), in which only a few are inflamed follicles located in the tonsils, which looks like small pustules on the surface of the lymphatic formations.
Symptoms of lacunar angina
The incubation period of lacunar angina lasts 1-2 days, and its symptoms develop rapidly and can manifest themselves within a couple of hours.
TOthe main signs of lacunar anginaadults and children are:
- a sharp increase in body temperature to high figures (38.5-40) s
- general manifestations of the infectious process in the form of weakness, malaise, rapid fatigue and headache;
- periodic chills, which is more common in children;
- pain in the joints;
- local manifestations in the form of severe pain in the throat and enlargement of the submandibular lymph nodes.
Upon examination, the doctor will detect the typical manifestations of the inflammatory process in the throat:
- redness in the larynx;
- swelling of the tissues in the throat;
- yellowish-whitish plaque, occupying most of the surface of both palatine tonsils, which is easily removed with a spatula.
The inflammatory process can affect both one and both tonsils. The average duration of the disease is 5-9 days, and the full capacity for work is restored by 14-17 days. In children lacunar angina has a more severe course, accompanied by cramps, attacks of suffocation, abdominal pain, nausea, vomiting, diarrhea, pain in the stomach.
Effects
Further spread of the infection along the respiratory tract often causes the attachment of bronchitis and even pneumonia. Inadequate treatment can provoke the appearance of a chronic form of the disease, often with complication of other types of tonsillitis, pharyngitis.
The presence of a foci of infection and ongoing purulent processes cause the spread of bacteria throughout the body, settling on the heart, lungs, bones. The consequences of this phenomenon are very dangerous - inflammation of the kidneys (pyelonephritis, glomerulonephritis), rheumatism, arthritis, myocarditis, staphylococcal meningitis, generalized defeat of lymph nodes, abscesses, sepsis.
Lacunar sore throat: photos
As this form of sore throat looks, we offer detailed photos to view.
Treatment of lacunar angina
In most cases, conservative treatment is indicated, and in the absence of effect, in the case of an acute increase in the tonsils, with difficulty in breathing, surgical removal of the tonsils is indicated.
When the first symptoms of lacunar angina appear, the patient should be isolated from others and provide him with a bed rest (the sore throat can not be carried on his feet, this often leads to complications). The question of hospitalization depends on the severity of pathogenesis.
The course of treatment should appoint a specialist. He will interview the patient, examine his throat, analyze the causative agent of the disease and sensitivity to antibiotics, and then appoints the necessary drugs in this case.
To cure angina at home, the following are recommended:
- Reception of the doctor appointed antibacterial drugs.
- To alleviate the general condition, you can take antipyretic or non-steroidal anti-inflammatory drugs. This is all known aspirin, Ibuprofen, Paracetamol. The essence of this appointment is the alleviation of the patient's condition due to a decrease in temperature, a decrease in the laryngeal edema.
- It is very important, especially in the first 2 days of the disease, hourly rinsing of the throat with antiseptic solutions - Miramistin, Chlorophyllitis, Iodinol, furacilin (2 tablets). a glass of water), a weak solution of potassium permanganate. At the stage of recovery, you can change them for infusions and broths of medicinal herbs - chamomile, calendula, oak bark, sage. For local treatment, you can use various sprays - Ingalipt, Geksoral, Tantum Verde.
- During treatment, it is important to pay great attention to drinking so that there is no dehydration.
It is also important after the end of the acute period of the disease to undergo a course of vitamin therapy and probiotics, since purulent processes, prolonged intoxication weaken the immune system, and antibiotic treatment disrupts the natural intestinal microflora.
Antibiotics
Antibacterial therapy is indicated for the microbial etiology of lacunar angina. As medicines use antibiotics, much less often sulfonamide preparations. The purpose of prescribing drugs is eradication (destruction of the pathogen).
Correct selection of antibioticprovides:
- complete destruction of the pathogen;
- Exclusion of side effects with various concomitant angina diseases;
- balance of the effect and safety of the antibiotic.
First-line drugs with purulent angina are modern penicillins, combined with their enhancing components, as they are best able to cope with streptococci. Such medicines include Augmentin, Flemoclav, Ecoclave and many others. It is also possible to take penicillins in a monoform (Ampicillin, Amoxicillin).
When allergic to penicillins are treated with antibacterial drugs from the group of macrolides (Sumamed, Azithromycin, Zitrolide, Clacid). Antibiotics of cephalosporins are prescribed for recurrent angina or severe disease. These include Cephalexin, Ceftriaxone, Cefazolin, which are often injected in the hospital.
It is necessary to drink a full course of antibiotics, appointed by a doctor, in order to avoid relapse of the disease and the development of complications. The course of taking antibiotics for lacunar angina is usually 7-10 days. If you become better after 2-3 days, and you decide that you are cured, do not abolish the prescribed drug in any case.
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