Follicular tonsillitis is the most common form of inflammation of the lymphoid ring in the throat. The disease is accompanied by an increase and inflammation of the cervical regional lymph nodes, into which lymph flows from the foci of inflammation. The main risk group for the development of this pathology is children and young people, while follicular tonsillitis in adults after forty years is classified as a rare disease.
In adults, this ailment proceeds in the form of exacerbation of chronic tonsillitis, or as a result of complications of catarrhal processes. The lack of help with this disease leads to the development of many complications, so it is very important to know how to treat follicular tonsillitis correctly at home.
Features of follicular tonsillitis
Follicular tonsillitis is an acute inflammatory process of a purulent nature, localized in the follicles of the tonsils with the appearance of pinpoint purulent foci. Not only the mucous membrane of the lacunae is affected, but the follicles, of which the tonsil parenchyma (internal tissue) mainly consists, are inflamed. Several purulent follicles merge into an abscess called a tonsillar one.
The yellow spots of festering follicles are scattered across the entire surface of the tonsil. In the photo, ulcers with follicular tonsillitis resemble the starry sky.
According to the international classification of diseases, the disease has a name - follicular tonsillitis. The code ICD-10 corresponds to it - group J8.
According to the classification of diseases of the ICD 10, follicular and lacunar tonsillitis are classified as purulent tonsillitis.
Why does follicular tonsillitis appear, and what is it? It arises as a result of infection of the tonsils with bacteria that enter the body exogenously (externally) or endogenously (the degeneration of its opportunistic flora occurs). The main cause of this disease is an infection called staphylococcus.
The occurrence of follicular tonsillitis occurs in the case of the following situations:
- getting into the tonsils of streptococci and staphylococci,
- the presence of microbes that develop in the cold season,
- significant hypothermia of the throat, which led to a general decrease in the body's immune defense,
- viruses of diphtheria, syphilis, pneumonia and others, which lead to inflammatory processes in the tonsils.
A weakened immune system can no longer restrain opportunistic microorganisms, and they begin to multiply intensively in the oral cavity, causing inflammation of the tonsils.
Remember that follicular tonsillitis is acutely contagious, in severe cases the patient remains in the hospital. At home, the patient needs to be in a separate room, use exclusively personal items, limit contacts.
Causes of follicular tonsillitis
Angina is an infectious disease, so it is caused by pathogenic microorganisms. Moreover, according to the etiology, it can be primary, that is, that occurred during the infection of a healthy organism, and secondary, when it develops against the background of other infectious diseases.
Follicular tonsillitis has different causes, but the most common are bacteria, in particular beta-hemolytic streptococcus of group A. It will also be the main etiological factor of most possible complications. However, other bacteria can also cause a pathological process:
- Streptococcus group C and G.
- Haemophilus influenzae.
The following can act as pathogens viruses:
- Flu viruses.
In rare cases, with this disease, it is possible to identify mushrooms (the genus Candida is most often found), but they mainly act together with bacteria or viruses, and, as a rule, with reduced immunity.
However, a decrease in the body's resistance is a prerequisite for the occurrence of the disease with any pathogen. Such a condition can cause as usual hypothermia, and the presence of any concomitant diseases. When immunity decreases, the body is not able to fight with an infectious agent that penetrates through the respiratory tract. Once in the body, it causes inflammation in the lymphoid formations (follicles), which leads to suppuration, and in rare cases, to necrosis.
Symptoms of follicular tonsillitis
The course of follicular tonsillitis in the first days resembles acute respiratory viral infections and is characterized by hyperemia of the mucous membrane of the oropharynx, mild sore throat and low-grade body temperature.
The following clinical manifestations are observed within 2-3 days:
- A temperature increase to 39-40 ° C or more with chills (retained even while taking antipyretic drugs),
- Severe sore throat, especially when swallowing, eating (may give to the ear),
- Lump in throat, coughing,
- The phenomena of intoxication (pain in the muscles and joints, lethargy, headaches mainly in the frontal region),
- Hemodynamic and respiratory disorders (increased heart rate and respiratory rate),
- Sharp swelling and hyperemia of the tonsils, the formation of purulent follicles on their surface,
- Enlarged and tenderness of nearby lymph nodes (sublingual, anterior cervical, parotid),
On the sixth day of the disease, purulent follicles open into the oral cavity and the general condition of the patient is noticeably easier. In the absence of the effect of therapy, the follicular form of angina passes into the lacunar, that is, the inflammatory process extends to nearby tissues. Signs of intoxication increase, high body temperature is maintained, pain during swallowing and eating remains, lymph nodes increase and become sharply painful when pressed on them.
Symptoms and photos
In its pathogenesis, the symptoms of follicular tonsillitis go through several stages. Many of them resemble the clinical picture of influenza and acute respiratory viral infections, other types of tonsillitis, mononucleosis, candidiasis of the oral cavity. Incorrect treatment or its absence leads to the penetration of streptococcus in the blood and intoxication of the body.
Harbingers of follicular tonsillitis is inflammation of the mucous membrane of the soft palate, palatine arches, palatine tonsils:
- the surface of the tissues of the oral cavity is hyperemic, covered with mucus,
- the patient complains of mild sore throat
- during the examination, subfebrile temperature, moderate swelling, swelling of the mucous membrane, regional lymph nodes (cervical, submandibular) are enlarged, painful on palpation.
Within 1-3 days, if untreated, the first signs appear:
- the temperature rises rapidly to 39-40, treatment with antipyretic drugs does not bring results,
- sore throat, dry cough, dry mouth,
- gradual increase in sore throat, especially when swallowing,
- swelling of the tonsils, redness,
- symptoms of intoxication (body aches, weakness, chills),
- pains in the head, joints, lower back that cannot be stopped with the help of analgesics,
- dyspeptic symptoms - nausea, vomiting, stool disorders,
- heart pain, tachycardia, arrhythmia,
- hoarseness or total loss of voice,
- severe sweating, insomnia.
The photo shows that they are small (1-3 mm), white or yellow.
Symptoms of follicular tonsillitis in adults are very bright and characteristic. But in some cases they can be confused with a very dangerous disease - diphtheria. It proceeds with similar symptoms, but it is treated completely differently.
In an acute process, characteristic changes in the blood composition occur: the number of leukocytes increases, the leukocyte formula shifts to the left (stab and segment leukocytosis, and sometimes eosinophilia, are noted). ESR increases, sometimes even very significantly.
On day 5-6, festering follicles are opened, the contents are poured into the oral cavity, the patient's condition is somewhat relieved. The aggravation of inflammation — the formation of a lacunar form, the release of pus into the peri-amindial tissue — is even accompanied by the treatment:
- increasing soreness
- outwardly noticeable swelling of the neck,
- stable hyperthermia,
- continued difficulty swallowing,
- increased soreness of the lymph nodes.
If the patient has the following symptoms 6 days after the start of treatment, this indicates a worsening of the condition and the inefficiency of the treatment:
- worse sore throat
- difficulty swallowing
- external tumor in the area of inflamed tonsils on the neck
- soreness of the lymph nodes.
It is especially important to differentiate infectious mononucleosis from follicular tonsillitis, since the treatment of these two pathologies differs radically. In the presence of mononucleosis, antibiotics are contraindicated, while the treatment of the purulent form of follicular tonsillitis is performed only with the help of antibiotics.
Complications of follicular tonsillitis
In the absence or delay of treatment, follicular tonsillitis can acquire a complicated course and proceed with the development of various complications, such as:
- Paratonsillar abscess - inflammation of the periopharyngeal tissue when a purulent follicle breaks into the palatine tonsil,
- Myocarditis, heart failure - arise as a result of the defeat by toxins of streptococcus of the heart muscle, heart valves,
- Glomerulonephritis - arise as a result of the pathogenic effect of streptococcus on organ tissues with the further formation of chronic kidney disease,
Acute rheumatic fever, arthritis - arise as a result of the influence of the body’s antibodies on its own tissues (cross-reaction) with the subsequent development of irreversible destructive changes in them.
Otitis - the inflammatory process spreads from the oropharynx to neighboring structures.
Infectious-toxic shock - as a result of a massive release of the toxin of the pathogen into the bloodstream.
Diagnostic measures for follicular tonsillitis include:
- Collection of patient complaints (typical symptoms of follicular tonsillitis are characterized by severe intoxication and sharp sore throat),
- History of the disease (finding out the reason, that is, with whom, when and how the patient contacted),
- Collection of an anamnesis of life (the patient has chronic diseases, his working and living conditions, the ecological situation of the place of residence),
- Objective research (exclusion of the pathology of other systems and organs),
- Pharyngoscopy (examination of the oropharynx) - attention is drawn to the presence of purulent follicles on the surface of the palatine tonsils,
- General blood test (allows you to detect leukocytosis with a shift of the leukoformula to the left, elevated ESR values),
- Blood biochemistry (allows you to determine the markers of the inflammatory reaction in the blood - C-reactive protein, gammaglobulins),
- Bacteriological examination of a smear from the mucous membrane of the oropharynx (for the purpose of differential diagnosis with other diseases of a bacterial or viral nature),
A differential diagnosis is mandatory with diseases such as diphtheria and infectious mononucleosis. Further tactics of treatment of the patient will depend on the nature of the pathogen, therefore, the attending physician should conduct a full range of examinations to exclude diagnostic errors.
Other forms of angina
Follicular tonsillitis is a form of inflammation that affects the tonsils and mucous membranes of the throat. The remaining types include:
- Catarrhal. Sore throat is accompanied by a slight fever, weakness and lethargy, slight inflammation of the lymph nodes
- Lacunar. Symptoms similar to follicular, but pus accumulates in the gaps (depressions) of the tonsils.
- Fungal. Yeast-like fungi cause. The course is similar to lacunar tonsillitis with the formation on the tonsils of a whitish plaque.
- Diphtheria. It develops due to the ingestion of diphtheria bacillus and represents the greatest danger. Accompanied by attacks of suffocation.
Follicular tonsillitis in children
In pediatric practice, follicular tonsillitis occupies a leading position among all found nosological forms, especially in the younger age group. In most situations, follicular tonsillitis in children is secondary and is seen as a complication of the course of a viral infection. Primary bacterial nature occurs only in 25% of cases.
Among the possible causative agents of follicular tonsillitis in children, the leading position is occupied by β-hemolytic streptococcus group A. Children of newborn age are not prone to the development of follicular tonsillitis, as acute nasopharyngitis predominates in this age group.
Follicular tonsillitis without temperature in children is an exception to the rule, since in most cases a child develops severe intoxication of the body. The appearance of clinical signs of follicular tonsillitis in a child of a newborn or infancy is the basis for immediate hospitalization in an infectious diseases hospital, since treatment of this group of patients should be carried out under the constant supervision of medical personnel.
Streptococcal genesis of follicular tonsillitis in children is a dangerous pathology due to the fulminant spread of the pathogen and the tendency to develop complications. Among the children's category of patients, local complicated forms of follicular tonsillitis prevail in the form of abscess and purulent lymphadenitis, which should be subject to immediate surgical correction. In relation to the generalized consequences of this disease in children, acute rheumatic fever, the debut of which occurs at the end of the second week of the disease, glomerulonephritis and bacterial endocarditis, should be noted.
When managing a patient suffering from follicular tonsillitis of streptococcal origin, it should be borne in mind that it poses an epidemiological danger to people around them from the first day of the disease. Antibiotics for follicular tonsillitis of streptococcal genesis should be prescribed from the beginning of the clinical picture, which can reduce the duration of symptoms and prevent the possibility of complications.
All etiopathogenetic forms of follicular tonsillitis in children are characterized by an acute onset of clinical symptoms in the form of hectic fever, severe chills, sore throat and back wall of the pharynx, aggravated by head movements and swallowing, swelling of the tonsils and the appearance of plaques on the tonsils.
To identify the causative agent of follicular tonsillitis in children, the fundamental diagnostic technique is to sow a throat smear. And at the same time, a clear analysis of the child’s clinical manifestations allows an experienced specialist to determine the viral or bacterial form of the disease. With the viral nature of follicular tonsillitis, manifestations such as cough, difficulty in nasal breathing, conjunctivitis prevail. With streptococcal genesis of follicular tonsillitis, catarrhal symptoms are usually absent.
After establishing the bacterial nature of follicular tonsillitis in a child, it is necessary to prescribe etiotropic antibacterial therapy as soon as possible.The drugs of choice in this situation are antibiotics of the penicillins, cephalosporins or macrolides. The main purpose of using antibacterial drugs for follicular tonsillitis is the complete eradication of streptococcus from the body to prevent a possible relapse of the disease, to prevent the appearance of antibiotic-resistant strains of the pathogen. With follicular tonsillitis in a child of viral origin, drug treatment consists of symptomatic drugs and compliance with dietary and dietary recommendations. With streptococcus virus carriage in a child, follicular tonsillitis does not develop and this situation does not require therapeutic measures.
With the follicular type of the disease, the following symptoms are observed:
- chills appear
- the temperature rises to 39-40 degrees,
- severe weakness, aching in the lower back and joints,
- loss of appetite
- the lymph nodes are enlarged and painful on palpation,
- palatine tonsils and the areas around them swell, become inflamed and redden,
- festering follicles are observed - white or yellow plaques on the tonsils,
- due to very strong and acute pain, it’s difficult for the patient to swallow,
- with severe rhinitis, it is difficult to breathe through the mouth and nose.
At the first stages of the development of the disease, it can be mistaken for oral candidiasis, herpetic sore throat, or mononucleosis.
Follicular tonsillitis treatment
How to treat follicular tonsillitis (especially a variant of its complicated course) is decided solely by a specialist in this profile. Treatment of follicular tonsillitis should include an integrated approach and take into account the symptoms. The treatment regimen necessarily includes antibacterial drugs, symptomatic drugs and topical medications. Self-medication is contraindicated in this form of pathology and often leads to the development of complications.
For the best result in the treatment of follicular tonsillitis, the following rules must be observed:
- Compliance with bed rest in the early days of the disease,
- Drink plenty of water (fruit drinks, warm compotes, tea, milk with honey can be used as drinks, drinks should not be cold or hot to avoid additional trauma to the mucous membrane of the oropharynx),
- Gentle nutrition (food should be warm and thoroughly wiped, salty, spicy, smoked foods are excluded from the diet),
The patient must be isolated in the acute period of the disease, provide him with individual dishes and items for care.
As a means of etiotropic therapy (aimed at eliminating the pathogen), broad-spectrum antibacterial drugs are used - Augmentin, Amoxicillin, Sumamed, Erythromycin, Clarithromycin, Ceftriaxone, Cefotaxime.
The form of application depends on the severity of the patient's condition and its morphofunctional characteristics of the patient. The course of treatment lasts an average of 7-10 days (can be extended with a complicated course of angina).
The use of antibiotics is not recommended without first consulting a doctor, since their unjustified use creates the prerequisites for the formation of resistant (resistant) strains of the pathogen.
Symptomatic therapy of follicular tonsillitis includes the use of:
Antipyretic drugs - Paracetamol (1 tablet 2 times a day), Nurofen (1-2 tablets 2-3 times a day) to normalize body temperature,
- Antiseptic solutions for rinsing the pharynx - “Chlorhexidine”, “Furacilin”, “Chlorophyllipt”, “Miramistin” (rinsing is carried out 2 times per hour in order to cleanse the surface of the tonsils from the pathogenic flora and prevent the spread of the pathogen),
- Oral oropharynx sprays - “Tantum Verde”, “Stopangin” (oropharynx is irrigated 2-3 times a day) - these drugs have anti-inflammatory and analgesic effects,
- Tablets and lozenges for resorption - "Faringosept", "Septolete" (1-2 lozenges or tablet 3 times a day) - have antiseptic and analgesic effects,
- Antihistamines - “Suprastin”, “Zyrtec”, “Zodak” (1 tablet 2 times a day in the morning and evening) - the drugs relieve inflammatory edema,
- Probiotics - Linex, Bifidumbacterin (2 tablets 3-4 times a day) - the drugs are used against the background of a course of antibiotic treatment to restore normal intestinal microflora,
As additional funds for the treatment of follicular tonsillitis, folk remedies can be used, such as:
- Gargling with soda or salt diluted in warm water several times a day,
- Chewing and resorption of pieces of propolis (has a powerful antiseptic effect),
- Gargling with a solution of aloe juice and warm water in a ratio of 1: 1,
- Beetroot juice
Before using symptomatic and alternative methods, it is also necessary to consult with your doctor, since the possibility of developing adverse reactions to the components of some drugs is not ruled out.
After removing the symptoms of inflammation, physiotherapy is recommended (UHF therapy, laser therapy, electrophoresis on the tonsil projection area).
It must be remembered that severe forms of the disease require constant dynamic monitoring and intensive treatment, so the patient needs mandatory hospitalization. Mild to moderate forms of follicular tonsillitis can be treated at home.
With the ineffectiveness of drug therapy, the torpid course of the disease, a significant increase in tonsils (swallowing and eating is not possible), the purulent process spreads to nearby tissues, the patient is shown surgical treatment in the amount of tonsillectomy.
Apply some physiotherapeutic techniques. But they are rather aimed at enhancing the effect of drugs, but do not act as the main treatment.
The following procedures may be prescribed:
- UV irradiation of tonsils,
- electrophoretic applications,
- Microwave, UHF,
- magnetic, laser therapy.
Physiotherapy can be carried out only when the activity of the disease subsides, because with a large amount of pus and a high temperature, such procedures will only harm the body.
Rinse and irrigation
Rinses can accelerate the treatment of follicular tonsillitis. They are made 6-10 times every day. Solutions can be prepared independently or purchased at a pharmacy.
Doctors usually prescribe the following antiseptic drugs:
- soda solution.
In addition, you can use sprays that are more convenient than rinsing. With follicular tonsillitis, you can use Hexoral, Ingalipt, etc.
The first days it is necessary to reduce the negative symptoms of the disease, so rinse is performed hourly. The procedure is almost harmless and can be used even by pregnant women.
Inhalation with follicular tonsillitis is also an auxiliary option. They are performed exclusively with the direct appointment of a doctor. So, you can prepare a solution of Chlorophyllipt, which has a selective effect on pathogenic staphylococcus. Inhalations are done with improvised means, and using ultramodern nebulizers. Instead of chlorophyllipt, you can also use Miramistin, Dioxidin, Tonsilgon, mixtures of medicinal herbs.
With follicular tonsillitis, if it was caused by pathogens of a bacterial nature, it is mandatory to take antibiotics in tablet form. Before this, a determination of the sensitivity of bacteria to selected drugs is carried out.
The following antibiotic groups are commonly used:
- Semi-synthetic and protected penicillins. The advantage of these drugs in their breadth of action, so that they can destroy most pathogens of follicular tonsillitis. Doctors may prescribe Amoxicillin, Augmentin, Amoxiclav, etc.
- Macrolides. These drugs more quickly saturate the body with the required shock dose to kill bacteria, so they are used in a much shorter course. The group includes Azithromycin, Josamycin, Clarithromycin. In the first 3 days, a pronounced effect of treatment occurs, but the administration of drugs continues until the end of the prescribed course.
It is also possible to use non-steroidal analgesics (Paracetamol, Nurofen) to reduce temperature and pain, as well as antihistamines (Loratadin, Tsetrin) to reduce swelling of the tonsils.
Such an intervention is used quite often, since many go to the doctor only at the chronic stage of the disease, when drug therapy does not always help. A tonsillectomy is performed with local or general anesthesia.
But there are contraindications to the operation, in particular:
- severe metabolic disorders,
- heart failure,
- severe kidney disease
- chronic diseases of an infectious nature during relapse.
Surgical treatment is absolutely necessary if the tonsils significantly impair breathing and swallowing, there is no effect from the treatment, the inflammatory process worsens and spreads to neighboring organs.
Tonsils can be removed using the following methods:
- excision (scissors, ultrasound, current),
- radiofrequency ablation,
- modern laser removal.
The nutritional rules for follicular tonsillitis, first of all, are the sufficient consumption of warm drinks. You can make tea with sage, chamomile, rose hips, drink warm milk or heated water.
Food is consumed in the most homogeneous form so that hard lumps do not irritate the sore throat. The diet should have as many soups, cereals, broths as possible.
Food is often taken - up to 6 times a day. Use all in boiled form. Exclude fried foods, pickles and very hot dishes. It is advisable to eat more dairy products. They should be in the diet every day. You can also eat soft bread, pasta, eggs, lean meat and fish, boiled soft vegetables and fruits.
Treatment with folk remedies at home
The most popular folk remedy for controlling follicular tonsillitis is rinsing with beet juice. To do this, rub the root crop finely (you need to get a glass of raw materials), add 1 tbsp. l apple cider vinegar and insist 4 hours in a dark place. Next, the juice is separated from the solid mass. Gargle the affected throat every 3-4 hours.
There are other recipes:
- Cabbage leaves are fixed on the neck. After 2 hours they are changed.
- 2 tbsp. l Onion peel is moistened with water (0.5 L) and boiled for 2 minutes. Leave the mixture for 4 hours. The solution is separated from the husk, preparing a means for the rinse procedure.
- Chew honey in honeycombs or a slice of lemon.
- Anise fruits in an amount of 1 tsp. placed in 250 ml of water, brewed, drink 0.25 cups 4 times a day.
Folk remedies have a weak supporting effect. They can be used only with the approval of a doctor, not excluding the main methods of treatment.
During the period of exacerbation, it is necessary to lie in bed. The patient suffers from high fever and weakness, so he needs to remain calm. Exclude contact with children, as they are more likely to contract sore throat.
Ventilate the patient permanently.
The patient should drink as much as possible, since toxins are removed with water. Stop smoking, otherwise tobacco smoke will dry the mucous surface of the tonsils, increasing pain, leveling the effect of sprays and rinses.
The air in the patient's room should be moist so that the mucous membranes of the tonsils do not dry out.
Hardening the body is the best way to avoid any type of sore throat. In addition, it is necessary to deal with chronic infectious pathologies. Exclude smoking, play sports.
If the patient already has chronic tonsillitis, it is recommended that at least once every six months wash the tonsils with a special apparatus. This will exclude the further development of purulent tonsillitis.
It is necessary to observe hygienic rules for the oral cavity and hands. Avoid any contact with a sick person; use individual dishes, a towel, and hygiene items.
Complications and consequences
Usually within a week all the main symptoms of the disease with proper treatment go away. But if the sore throat continues to intensify, the temperature rises, the tonsils swell, the lymph nodes are painful when touched, we are talking about the ineffectiveness of the treatment.
The following complications are possible:
- severe toxic shock,
- paratonsillar abscess,
- streptococcal meningitis,
- heart failure,
Most often, complications arise in the absence of antibiotic treatment, reluctance to conduct local therapy in parallel, and refusal of surgical intervention if necessary. Often the lack of treatment leads to rupture of abscesses and the ingress of their contents into the blood, which is why sepsis is rapidly developing.
Is it contagious and how is it transmitted
The disease has an infectious nature, so contact with the patient can lead to infection. The main transmission method is airborne. Infection can be transmitted through food, hygiene items, dishes. Adults, as a rule, better resist infection, therefore children are more susceptible to the disease.
Adults are especially prone to illness at the time of exacerbation of other chronic diseases or with a general weakening of immunity.
Features in children
First of all, the dose of antibiotic depends on body weight. It should be prescribed by a doctor, while prescribing probiotics. Children are more likely to suffer from dysbiosis due to a violation of the natural microflora, so this pathological phenomenon should be excluded.
If the temperature rises above 38º, it is recommended to start taking antipyretic drugs in the form of candles or syrups in order to avoid the development of a convulsive syndrome.
Treatment of angina in babies eliminates the use of sprays, rinses, as well as tablet forms, if the child is very young. The throat is lubricated with a solution of Lugol, Furacilin is also used.
The disease develops in children more rapidly than in adults, it is necessary to stop in time - to stabilize the temperature, relieve severe sore throat and soothe the child.
During pregnancy, this form is very dangerous. Often, the disease even leads to the death of the fetus. Circulating toxins in the blood, raising the temperature to exorbitant values, weakening immunity - all this provokes a miscarriage. If the pregnant woman has signs of a purulent form of sore throat, hospitalize her immediately and carefully examine it.
Preparations for treatment should be chosen by the doctor in order to select only those funds that will not harm the unborn baby. So, most antibiotics for pregnant women are contraindicated, especially in the early stages.
Strictly observed dietary restrictions, bed rest. As the basic treatment options, rinses with Furacilin, decoctions, salt solutions are used. The heat is brought down by Paracetamol. Other antipyretic drugs cannot be used. Fever is extremely dangerous because it can lead to congenital malformations in a child.
Despite the reluctance to eat during an exacerbation of the disease, pregnant women should not refuse to eat, since the body especially at this time needs protein food and vitamins. You should also drink plenty of water, excluding hot and sour drinks.
Self-medication during pregnancy is strictly contraindicated!
Upon learning of the presence of follicular tonsillitis, many fall into a panic and begin to worry too much. Yes, the disease is dangerous and has its consequences, but timely intervention is necessary to exclude its development. And then the forecast will be favorable.
At the first suspicion of follicular tonsillitis, it is necessary to consult doctors who will begin antibiotic therapy and other treatment methods. And even if you need to remove the tonsils - this is better than getting complications - severe pathologies of the heart, kidneys and other organs.
Drug treatment of follicular tonsillitis necessarily includes broad-spectrum antibiotics. Their main task is to destroy the causative agent of the disease.
The following antibiotics are widely used for follicular tonsillitis:
The appointment of a drug with follicular tonsillitis should be etiologically justified and pathogenetically directed.
The obligatory rule of all infectious disease specialists is the exclusion of the use of antibacterial drugs with the unknown bacterial nature of follicular tonsillitis, which is quite common in pediatric practice.
The unjustified prescription of antibacterial drugs inevitably leads to the formation of antibiotic-resistant strains of pathogens, which greatly complicates the further treatment of patients.
Follicular tonsillitis is characterized by an increase in body temperature, pain of varying intensity. If necessary, the doctor prescribes drugs that eliminate unpleasant symptoms.
- After taking antibiotics, it is advisable to prescribe probiotics to restore the intestinal flora - these can be Linex, Bififorma, or Bifidumbacterin preparations.
- Rinsing the oral cavity with antiseptic solutions (Chlorhexidine, Chlorophyllipt, Furacilin), rinsing should be frequent (2-3 times per hour), since the purpose of this procedure is not only the inhibition of microorganisms, but also the cleansing of the tonsils from purulent deposits, which means a warning of further spread of infection
- Antihistamines like Fenistil, Suprastin, Zirtek, or Zodaka relieve swelling in the throat and reduce the severity of the body’s allergic response to antibiotics.
- The disease is often accompanied by rhinitis, which involves the use of nasal drops. For example, the drug Derinat, in addition to affecting the focus of inflammation, also has an immunomodulatory effect, so it is often used in pediatric practice.
The main indications for this procedure are:
- ineffective antibacterial treatment,
- enlarged tonsils that make swallowing and breathing difficult
- the spread of the purulent process to closely located tissues.
The doctor recommends various methods of tonsillectomy:
- method of a wire loop and scissors,
- electrocoagulation or an ultrasonic scalpel,
- radiofrequency ablation,
- carbon dioxide or infrared laser.
In the absence of dangerous complications from the heart, kidneys, musculoskeletal system, the prognosis of follicular tonsillitis is favorable.
It should be remembered that folk prescriptions are not a substitute for medical treatment, and before using them you need to consult a doctor.
- Gargling with soda, salt and iodine. Put half a teaspoon of salt in a glass of boiled water, the same amount of soda and 3 drops of iodine. Stir well. Instead of table salt, you can use sea salt.
- Grate raw beets (1 cup finished mass), add 1 tbsp. a spoonful of apple cider vinegar, mix and put for 4 hours in a cool dark place. After that, the composition is filtered, used to gargle.
- You can fight with an infectious agent using propolis. Chew a small piece of the product until soft and place over the cheek for 30-40 minutes.
- Using aloe: take the lower leaves, rinse them with running water, then rinse with boiled water, dry them slightly, grind and squeeze the juice. The resulting juice must be diluted with water in a 1: 1 ratio and gargled every time after eating for several days.
Follicular tonsillitis: complications
Inflammation can spread to the inner ear, causing otitis media.
Already after 7-14 days, a pharyngeal abscess may develop. A serious difficulty swallowing will join the sore throat, the temperature rises. Drug therapy will not be enough: an abscess must be opened.
Late complications occur no earlier than a month later. They are caused by persistence in the body of streptococcus, which secretes toxins that damage other organs:
- Heart (rheumatism and myocarditis develop, which is accompanied by pain, arrhythmia and shortness of breath).
- Kidney (glomerulonephritis, which may ultimately lead to renal failure).
- Joints (mainly against the background of developed rheumatism).
With the disease, follicular tonsillitis complications can become chronic, which will be characterized by frequent exacerbations and lack of drug therapy effect. A radical solution to this problem is tonsillectomy, when the tonsils are completely or partially removed. This procedure may lead to not entirely favorable consequences, since tonsils are important for immunity, but more preferable than permanent ineffective treatment of recurring episodes of tonsillitis.
Complications of follicular tonsillitis are quite common if treatment is not started on time.
- When the sore throat is too strong and acute, and the patient cannot swallow, the dehydration of the body most often occurs, leading to problems with the kidneys.
- With untimely treatment on one of the tonsils, a peritonsillar abscess may occur - an accumulation of pus in the tissues of the throat. The pain becomes unbearable, taking a pulsating character. A spasm of the masticatory muscles may occur. It is difficult for a patient to swallow even liquid food; it spills out through the nose due to severe swelling. In this case, urgent hospitalization is needed.
- The infection can spread to the internal jugular vein (paired vein through which blood flows from the neck to the head). A purulent pocket forms near the amygdala, and septicemia, or in other words, blood poisoning, can occur.
People who have had tonsillitis can develop glomerulonephritis, which leads to edema, increased pressure, and the appearance of blood in the urine. Untreated tonsillitis in the future can lead to rheumatic heart damage: in the first stage, there can be muscle damage, which in the future can lead to the formation of heart disease.
What to treat?
Otolaryngologist - a specialist in the diagnosis, therapeutic or surgical treatment and prevention of diseases of the nasal cavity, larynx, pharynx, ears.
For consultation with an otolaryngologist, if you suspect a sore throat, you must contact if you feel:
- sore throat
- swelling of the throat and shortness of breath,
- increase in local (in the throat) and general temperature,
The diagnosis is made on the basis of a survey, examination of the pharynx (pharyngoscopy) and larynx (laryngoscopy). The clinical picture of tonsillitis is characteristic, the percentage of diagnostic errors is not large. To determine the causative agent of tonsillitis (tonsillitis), laboratory research methods are often used (bacteriological culture, PCR method, test for beta hemolytic streptococcus of group A - BHSA, express method and others).
Differential laboratory diagnosis of bacterial and viral tonsillitis is necessary to determine the treatment strategy. With the viral etiology of the disease, antibacterial treatment is not effective. One of the laboratory criteria for the diagnosis of bacterial and viral tonsillitis is the evaluation of the therapeutic effect on the use of antibiotics in the first 48 hours, antibiotics do not act on viruses.
The next step preceding the treatment of bacterial tonsillitis is to determine the sensitivity of microflora to antibiotics and the choice of an effective drug. There is no fundamental difference in the treatment of various types of tonsillitis.
In the treatment of tonsillitis, there are two main methods of treatment:
Medications are used in the vast majority of clinical cases of treatment of angina.
The patient should observe the rest regimen, weakened patients are forbidden to go out, as deterioration may occur.
To avoid severe dehydration of the body from fever and severe intoxication, for the speedy removal of toxins, an abundant warm drink is shown, it is best to use warm milk with soda or mineral water without gases, and herbal teas — with chamomile, sage, and rosehips — also work well. The temperature of the liquid should be optimally comfortable, not hot and not cold, so as not to cause unnecessary injury to the inflamed mucosa.
- Antihistamines and antipyretics.
In order to reduce the manifestations of angina, non-steroidal anti-inflammatory drugs are used that reduce temperature and pain (ibuclin, paracetamol, nurofen). Also, antihistamines (Cetrin, Clarisens, Loratadin) are used to reduce the symptoms of the allergic component of inflammation.
Nutrition should be uniform, since when swallowing solid food significantly enhances pain, the diet should be formed from liquid broths, soups, cereals. It is also important to frequently ventilate the room and regularly clean the room (daily).
In addition to the antibiotic, treatment should be supplemented with local procedures. The process of development of this disease consists first in the formation of a purulent follicle, then its maturation, growth in size, and finally, the process of opening the follicle. It is because of the constant presence of purulent discharge in the oral cavity that the most important condition for the correct treatment of follicular tonsillitis is considered to be a frequent gargling.
Gargle with angina should be as often as possible up to 6-10 times a day. You can use special antiseptic agents during the procedure, such as Iodinol, Dolphin, Lugol, Chlorophyllipt, Miramistin, furatsilin (2 tablets per glass of water), herbal infusions, a solution of soda and salt. The pharmaceutical industry also offers a great many different aerosols that are convenient to use - Ingalipt, Tantum Verde, Hexoral. It is also possible to alleviate sore throats and swelling with the help of absorbable tablets and lozenges - Faringosept, Hexoral tabs, etc. In addition to the disinfecting effect, gargling helps to wash off the purulent secretions that form after opening the follicles.
There is one widely available method of folk treatment for follicular tonsillitis - gargling with the following solution: grate 1 beet on a fine grater, at the rate of 1 tablespoon 6% apple cider vinegar per 1 cup beetroot mass, combine the beetroot mass with vinegar and put the mixture in a dark place for 4 hours, then squeeze the juice using a dense tissue and gargle every 3 hours with the resulting juice. Beetroot juice in combination with apple cider vinegar has unique antibacterial properties.
What happens to tonsils?
With follicular tonsillitis, inflammation is localized in the follicles of the tonsils, in which pus forms, which is visible through the mucous membrane with foci of yellow-white color. As the famous doctor Simanovsky said, the picture of tonsils with follicular tonsillitis is very similar to the starry sky.
Over time, these purulent foci can merge with each other, forming one continuous purulent plaque of yellow-white color on the tonsils. Abscesses can melt tissue and burst into the throat.
Follicular tonsillitis (follicular tonsillitis) is a form of acute purulent inflammation of the follicles of the tonsils in the throat. In adults, it proceeds as an exacerbation of chronic inflammatory processes in the tonsils, or as a continuation of catarrhal inflammation.
Various forms of tonsillitis, including follicular, are often affected by people aged about 7 to 40 years. Much less common tonsillitis in people from 41 to 60 years. People of the older age group are practically not susceptible to tonsillitis.
In some cases, the pathogenesis can be localized in:
nasopharynx - the nasopharyngeal tonsil is affected,
larynx - lymphoid tissue of the larynx is affected.
Follicular tonsillitis is a common disease. The reason is because tonsils are vulnerable to various pathogens. Palatine tonsils, other formations of the pharyngeal lymphadenoid ring, in contrast to the subcutaneous regional lymph nodes protected from the environment:
located on the surface of the mucous membrane, and are not protected from the surrounding space like the rest of the lymph nodes,
they come into contact with microbial or viral agents directly, when they exhale air or when chewing and swallowing food, and not through the lymphatic and circulatory system of the body.
Palatine tonsils - paired lymph nodes located on the border of the palatine-larynx and palatine-lingual folds in the oral cavity. They are well accessible for inspection. The free surface of the tonsils, under magnification, consists of folds (crypts). The gaps between the crypts form gaps (invaginations). Between the crypts are follicles, through which lymphocytes freely move to the surface and participate in the phagocytosis (capture and destruction) of microorganisms, viruses, and tumor cells.
The physiological significance of lacunae and follicles of the tonsils:
capture and absorb foreign microorganisms when ingested through the mouth,
participate in the process of lymphopoiesis (the formation of lymphocytes) and the specialization of T and B - lymphocytes (immune defense cells),
A massive microbial attack, against the background of a weakened body, is accompanied by a decrease in the termination of the protective functions of the tonsils. As a result of pathogenesis in the tonsils, acute purulent processes develop in the follicles (follicular tonsillitis) and / or lacunae (lacunar tonsillitis). Damaged tonsils become a source of pathogenesis, distributing decay products through the lymphatic system throughout the body.
1. Methods of etiotropic therapy
drugs are used to suppress the cause of the disease, in this case microbes (staphylococci, streptococci).
Antibiotics for follicular tonsillitis. In the case of tonsillitis BHCA, it is advisable to use penicillin-type antibiotics (benzylpenicillin, amoxicillin, phenoxymethylpenicillin and similar drugs) tablets inside. With intolerance to antibiotics of the penicillin series, antibiotics are prescribed - macrolides (summed, chemomycin and others).
As a rule, usually prescribed:
The effect of antibiotic therapy should be expected in the first 48 hours. Lack of treatment is the reason for the correction of the treatment strategy. When using antibiotics, you should pay attention to:
Individual sensitivity to them of the patient,
The possibility of using antibiotics in certain periods (pregnancy, concomitant diseases and others),
Compatibility with other drugs.
The etiotropic methods for angina also include therapeutic methods (washing, rinsing, throat, suction of pus from the follicles, lubrication of the tonsils, the introduction of drugs into the follicles).Methods are considered etiotropic when used to treat tonsils with antimicrobial agents.
Tonsil follicle lavage. Washed with a syringe, antiseptic solutions. Reduces swelling of the tonsils, inflammation,
Suction of the purulent contents of the follicles. Use vacuum suction, while washing the follicles.
Injection of drugs into the tonsils.
Lubrication of the tonsils with a solution of wound healing oil solutions.
Rinse the oropharynx with decoctions of herbs, ready-made solutions for rinsing.
Video: how to quickly cure a sore throat at home? 5 simple steps:
2. Methods of pathogenetic therapy
They use drugs aimed at correcting the mechanism of pathogenesis (immunocorrection, vitamin therapy, antihistamines, procaine blockades, physiotherapeutic manipulations).
Immunocorrection. It is widely used in the case of tonsillitis of viral etiology.
Vitamin Therapy. It is used in combination with a diet, the correct regimen of the day, and is often prescribed for follicular tonsillitis.
Antihistamines. Sore throats cause sensitization of the body, the use of antiallergic drugs is justified in case of complications of allergies.
Novocainic blockade. In some cases, used as a means of pathogenetic therapy.
Physiotherapeutic manipulations. When follicular tonsillitis is prescribed (irradiation of the tonsils of the Ural Federal District, microwave, UHF, application of drugs using electrophoresis, magnetotherapy, inhalation)
3. Methods of symptomatic therapy
Follicular tonsillitis is characterized by an increase in body temperature, pain of varying intensity. If necessary, the doctor prescribes drugs that eliminate unpleasant symptoms.
Surgical treatments. Surgical removal of tonsils is a widely used manipulation. A tonsillectomy (removal of the tonsils) is performed under local, sometimes under general anesthesia. Manipulation is not shown to everyone. There are absolute and relative contraindications. Absolute contraindications: hemophilia, renal and heart failure, severe metabolic disorders and so on. Relative contraindications: pregnancy, exacerbation of infectious diseases and others.
The operation is shown with:
enlarged tonsils making it difficult to swallow, breathing (apnea), especially at night,
unpromising drug treatment of chronic forms of tonsillitis,
involvement of surrounding tissues in the purulent process.
In modern ENT surgery, the following methods are used:
excisions (with scissors, electrically, an ultrasonic scalpel, infrared scalpel, shaver technology, controlled removal technology)
radiofrequency ablation (controlled reduction of the size of the tonsils), carbon dioxide (carbon) laser (`` evaporation '' of the tonsils)
Methods of surgical removal of tonsils depends on the equipment of the clinic and the qualifications of doctors.
Education: In 2009, a diploma was obtained in the specialty “General Medicine”, at Petrozavodsk State University. After completing an internship in the Murmansk Regional Clinical Hospital, a diploma in the specialty "Otorhinolaryngology" (2010)
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Angina in children is an acute infectious inflammation of the tonsils. Sometimes it is accompanied by a serious complication of some internal organs (lungs, heart, joints). The cause of such a dangerous disease are various pathogenic microbes. They include them.
The cause of purulent tonsillitis is infection of the tonsils with streptococcus from the group of hemolytic series. The primary lesion of the tonsils is due to the tropism (susceptibility) of these tissues with antigens of this microorganism. Moreover.
Lacunar angina in adults manifests itself in the acute phase of inflammation. Pathogenesis develops rapidly. The clinic, in full, manifests itself during the day, accompanied by a sharp rise in temperature to febrile (38-390 C) or pyrethic (39-410 C) values.