Acute pharyngotonsillitis

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Diagnosis of pharyngotonsilitis what is it

Chronic pharyngitis is a disease in which constant inflammation appears in the mucous membrane of the pharynx. In adults, the disease occurs with constant exacerbations and periods of remission.

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Diagnosis of pharyngotonsilitis what is it
Treatment of viral OFT
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Acute pharyngotonsillitis:
Diagnostics
Treatment
Treatment of viral OFT
Treatment of bacterial OFT
conclusions
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Acute, chronic pharyngitis. Types, causes and symptoms
Causes of development of chronic pharyngitis
At-risk groups
Symptoms
Diagnostics
Treatment
Acute pharyngotonsillitis
Complications

The cause of the disease can be ARVI, mental and physical stress, and decreased immunity. How to protect yourself from chronic pharyngitis? And how to treat it?

Causes of development of chronic pharyngitis

The following factors for the occurrence of the disease have been identified:

persistent acute respiratory viral infections;
untreated disease;
regular exposure to external irritants on the lining of the larynx;
chronic inflammatory diseases;
any gastrointestinal disorders;
as a result of removal of tonsils;
frequent use of alcohol and tobacco;
eating spicy and hot dishes.

In the chronic form of the disease, there are 3 main types:

The first type of chronic pharyngitis is considered the simplest of all three. In this case, only the superficial layers of the laryngeal mucosa become inflamed, with moderate swelling. The granular appearance manifests itself in the form of lumps and nodules of the throat mucosa. The third type is considered the most complex in its manifestations with a severe course of the disease. The walls of the larynx become thinner and drier. The recovery process may take a long time.

Reasons that contribute to decreased immunity:

smoking;
allergies;
lack of vitamin A;
diabetes;
problems with the heart, kidneys, liver, lungs;
hard breath;
endocrine diseases.

When chronic pharyngitis appears in an adult, the following symptoms may occur:

frequent pain in the larynx;
soreness;
feeling of an extra object in the throat;
pain in the larynx when swallowing;
unpleasant odor;
dry cough.

During a lull in the disease, the patient experiences only general symptoms. With exacerbation of the disease, intoxication and increased general symptoms are observed. In the second form of acute pharyngitis, more severe manifestations of pain in the larynx are observed, which increase with blowing and overwork. During examination, the therapist may notice redness and swelling of the mucous membrane.

When the granulosa and atrophic form of chronic pharyngitis manifests itself, the patient feels a sensation of an extra object in the larynx. With this form, chaotic growths of mucus in the form of nodes and lumps are noticed in the throat. The appearance of thickening of the mucous wall without the formation of lumps is also noted. In extreme cases, the patient draws the doctor’s attention to symptoms such as:

dry mouth;
unproductive cough;
feeling of a coma.

Upon examination, the therapist notices a thinned wall of the pharynx, scabs, and hemorrhages. During an exacerbation, a number of health problems may arise:

ENT diseases in which inflammation of the trachea occurs;
inflammation of the mucous membranes of the throat;
measles;
scarlet fever;
angina.

The examination is carried out on the basis of interviewing the patient and taking samples from the patient. Initially, the doctor performs a pharyngoscopy. Upon examination, distinctive features of one of three types may be detected.

In the catarrhal form, modification of the posterior wall of the larynx can be detected. As a result, it is observed:

In the hypertrophic form, modification of the larynx is noticeable:

The atrophic form represents modifications on the laryngeal mucosa:

To determine the irritant of the disease, it is necessary to take a scraping from the mucous wall of the larynx, then a study will be carried out. When conducting a blood test during a decline in the disease, no changes may be observed, but when it intensifies, general symptoms are characteristic (increased leukocytes and erythrocyte sedimentation rate).

The patient usually undergoes therapy with an otolaryngologist. Treatment occurs on an outpatient basis; hospitalization is not necessary. Therapy for chronic pharyngitis is carried out under the supervision of a specialist, and you must also follow all medical prescriptions of the doctor. Firstly, it is necessary to isolate the patient from all harmful factors that damage the laryngeal mucosa:

exclude spicy, salty, hot foods;
quitting tobacco;
do not breathe harmful substances;
do not drink alcohol.

Secondly, during the treatment of acute pharyngitis, you need to drink plenty of fluids. Thirdly, humidify the air in the room. You can make the air more humid using specialized devices or by hanging damp fabrics in the room. A noticeable result can be achieved by gargling with medicinal drugs and herbs:

To reduce swelling in the laryngeal mucosa in chronic pharyngitis, antiallergic medications are used:

The oral cavity is also treated with Lugol's solution. For sore throat, use local antiseptics:

Antimicrobial drugs are used when the inflammatory process intensifies. Therefore, the following antibacterial drugs are used: Amoxicillin, Ampicillin, Pefloxacin.

This disease is considered one of the most common diseases in the work of first-line doctors. This disease accounts for more than 37% of all upper respiratory tract infections. Most often, pharyngotonsillitis occurs among young people between the ages of five and fifteen years. The peak incidence occurs from November to May. Acute pharyngotonsillitis is most often considered a viral disease. therefore, in many cases antimicrobial therapy is not required. Treatment is with antibiotics, the course is 10 days. Treatment of the disease includes:

diet;
treatment of the throat with sprays;
resorption of tablets;
taking vitamins;
taking antibiotics.

Substances of natural or semi-synthetic origin that inhibit the growth of living cells, usually prokaryotic or protozoan, are prescribed by a doctor. The therapist selects antibiotics so that the drug has a broad effect with slow absorption into the mucous membrane. Indications for choosing the most appropriate medication for treatment:

prolonged inflammatory process;
the appearance of purulent otitis media;
the appearance of pneumonia;
high temperature for more than two days;
angina;
fever.

Traditional medicine in the treatment of chronic pharyngitis

Some traditional methods of treatment are quite effective in the fight against pharyngitis. For example:

milk and honey;
propolis tinctures;
garlic and honey syrup;
inhalation over potato broth.

A good effect can be achieved with the maximum combination of folk and traditional medicine. These procedures should be carried out strictly according to a special schedule without getting carried away. Otherwise, you may end up doing more harm than good.

Improper treatment of pharyngitis can lead to inflammation moving to neighboring organs and develop the following diseases:

inflammation of the tonsils;
inflammation of the tracheal lining;
inflammation of the bronchi.

There is also the development of autoimmune disorders:

immunoinflammatory diseases;
damage to the heart muscle;
inflammation of connective tissue.

The most complex and severe complication of chronic pharyngitis may be the transition to a malignant tumor. Preventive actions:

completely give up tobacco;
do not inhale chemicals;
carry out therapy on time;
During a sore throat, do not eat: spicy, salty, cold foods.

Often, due to their inexperience, patients are not able to distinguish between pharyngitis and tonsillitis, the differences of which will seem obvious only to an experienced specialist. Both diseases are pathological processes in the throat of an inflammatory nature. Although the treatment is a little similar, it is still extremely important to know the difference between pharyngitis and tonsillitis. This will make it possible to conduct differential diagnostics, make the correct diagnosis and prescribe adequate therapy.

Pharyngitis and its causes
Causes of tonsillitis
Symptoms of acute forms of diseases
How to identify a chronic disease
Treatment of the disease
Which disease is more severe?

Differences between pharyngitis and tonsillitis (tonsillitis)

Knowing what pharyngitis is, a person can at least suspect it and consult a doctor in time.

Pharyngitis is an acute inflammatory process that affects the mucous membrane and lymphoid tissue of the posterior wall of the pharynx. The causes of the development of the disease can be infectious agents (adenoviruses, rhinoviruses, streptococci, staphylococci) or saprophytes, which are activated under the influence of unfavorable factors. These may be, for example, general or local hypothermia. It is also not uncommon for pharyngitis to occur against the background of acute respiratory infections, but it will be combined with laryngitis or rhinitis. The provoking factor may be the action of thermal or chemical irritants: cold air, spicy or hot food, cigarette smoke, dust, alcohol.

Photo of the throat with pharyngitis

There are also a number of factors that create favorable conditions for the development of inflammation in the pharynx:

nasal injuries resulting in a deviated septum;
the presence of foci of inflammation in the body (sinusitis, caries, rhinitis);
nasal polyps;
lack of vitamins;
hypothermia;
decreased immunity;
adenoids.

Tonsillitis is an inflammatory lesion of the lymphadenoid tissue of the pharyngeal ring. More often you can hear the name “angina” for this disease. If nothing is written before the diagnosis, then it means inflammation of the tonsils, otherwise its location will be indicated before the word “tonsillitis”.

Unlike pharyngitis, tonsillitis is caused only by germs or viruses. The most common pathogen is group A B-hemolytic streptococcus. In very rare cases, sore throat is caused by a fungal infection.

Provoking factors are somewhat similar to those that cause pharyngitis:

hypothermia;
intoxication of the body;
decreased resistance;
hypovitaminosis;
nasal obstruction;
overwork.

Photo of a throat with a sore throat

Therapy and patient care can vary greatly for different diseases, which is why it is very important to know how pharyngitis differs from tonsillitis.

A person without special education and work experience can easily confuse tonsillitis and pharyngitis with each other. And this will lead to unpleasant consequences. That is why it is important to know what differences there are between diseases.

Acute tonsillitis is a disease with pronounced local changes in the throat and distant complications (heart, kidneys, joints). There are several forms of sore throat:

catarrhal – the mildest form. It is most easily confused with acute pharyngitis. A distinctive feature is the absence of redness on the oropharynx;
follicular – characterized by a more severe course. Yellow or yellowish-white patches form on the tonsils - festering follicles;
lacunar - the clinical picture is similar to the previous one, but upon examination plaques are visible that can be easily removed. The surface will not bleed;
ulcerative-membranous – the most severe form of the disease. With it, yellow-white films are formed on the surface of the tonsils, which, after removal, leave a bleeding wound. The danger of the disease is that it can lead to necrosis of the tonsils.

The disease begins acutely. Patients complain of dryness and tolerable pain in the throat, which may worsen when swallowing. Fatigue and mild headache are also noted. Occasionally, body aches and discomfort in the joints may occur. At first the temperature is low - up to 38 degrees.

If treatment for sore throat is not started in time, the symptoms worsen. Body temperature can reach high values - more than 40 degrees. The sore throat intensifies significantly and may radiate to the ear. Painful sensations appear that limit movement in the lower back and joints.

Using a blood test, leukocytosis, acceleration of ESR and a shift in the leukocyte formula to the left are determined. An oral swab helps identify the causative agent of the disease.

The picture of acute pharyngitis is quite similar to the initial symptoms of tonsillitis (catarrhal form) - there is a feeling of dryness and soreness in the throat, pain that becomes stronger during swallowing. Cough and ear congestion may bother you. There is a sensation of a foreign object in the throat. But pharyngitis differs from tonsillitis in that it does not cause an increase in temperature and disturbances in the general condition of the body. And upon examination, the redness is localized not only on the tonsils, but spreads throughout almost the entire pharynx.

It often happens that two neighboring organs are involved in the process. Then pharyngitis and tonsillitis occur simultaneously. In this case, the disease will be called pharyngotonsillitis. Clinically, it will manifest itself as symptoms of inflammation in both the pharynx and tonsils.

The acute form can develop into chronic tonsillitis or pharyngitis. This occurs due to incorrect or untimely treatment, reduced body resistance, aggressiveness of the disease, and specific climatic conditions. Chronic disease proceeds sluggishly, with periods of exacerbation. It is almost impossible to cure it, but there are methods that prevent the process from escalating.

A major role in the development of chronic pharyngitis is attributed to the influence of occupational factors - temperature fluctuations, too dry air, the presence of gases, vapors or dust in the inhaled air. Diseases are divided into three types:

Catarrhal - patients complain of tickling, dry throat, frequent coughing. Symptoms are intermittent, sometimes disappearing, sometimes appearing. During pharyngoscopy, swelling and redness are visible. The mucous membrane is thickened, the vessels are dilated, and mucous deposits are noticeable here and there.
Hypertrophic – the above complaints are accompanied by stuffy ears after taking several sips in a row. Upon examination, growths of lymphadenoid tissue are determined, which look like humps protruding above the surface.
Atrophic - symptoms are more pronounced in the morning, ears do not become blocked. There is an unpleasant odor from the mouth. The mucous membrane is thinned, it is pale, and may have a varnished appearance. In some places it may be covered with green or gray crusts.

The difference between tonsillitis and pharyngitis is that it requires the action of a virus or bacteria to occur. Inflammation can be specific - damage by infectious agents (tuberculosis, syphilis) or nonspecific - is infectious-allergic in nature.

Chronic tonsillitis is associated with the occurrence or worsening of a huge number of diseases. First of all, these are kidney and heart diseases. Rheumatism and thyrotoxicosis occur most often.

The clinical picture is characterized by frequent exacerbations, especially in the autumn-winter period. During remission, the disease practically does not bother the patient. In case of exacerbation, the symptoms are the same as in the acute form.

During the examination, a roller-like thickening of the palatine arches, cicatricial changes in the tonsils, pus in the lacunae, and enlarged regional lymph nodes are visible.

As with any other illness, the most important thing is to see a doctor as soon as possible and not self-medicate. The symptoms are quite similar, but the treatment of tonsillitis and pharyngitis can be radically different. Only a specialist can tell you how to treat and care for a patient.

To properly treat pharyngitis, you must first remove the provoking factors. The following drugs are prescribed:

lozenges – Falimint, Strepsils;
throat sprays – Ingalipt, Yox;
gargling – Furacilin, tinctures of medicinal plants.

It is important that the patient consumes only warm food and drink. It should not irritate the pharyngeal mucosa. Medicines should also be taken warm if possible.

For tonsillitis, the use of such tablets and procedures will be ineffective. Antibacterial therapy should be added to them - Erythromycin, Oxacillin. Antihistamines are also prescribed - Diazolin, Diphenhydramine. If regional lymphadenitis develops, then thermal procedures are performed - Solux, compress.

We can immediately say unequivocally that tonsillitis is much more severe than pharyngitis. And it entails much more dire consequences.

Antibiotics are rarely used for pharyngitis, so you should not swallow them immediately as soon as your throat hurts. But if a diagnosis of “angina” is made, then taking antibacterial drugs is mandatory, and the sooner the better.

It is important to remember that if you have tonsillitis, it is not recommended to lubricate your tonsils, as this can lead to the spread of infection.

Chronic tonsillitis, like pharyngitis or other throat diseases, can lead to cancer of the upper respiratory tract. Therefore, patients need to undergo regular examinations.

Lviv Regional Children's Clinical Hospital “OHMATDET”

Acute pharyngotonsillitis (APT) is a very common disease in the practice of primary care physicians. It accounts for 37% of all acute upper respiratory tract infections.

Most often this is a disease of young people; up to 50% of children aged 5–15 years are affected. The peak incidence occurs in the first years of school and in the months of the year from November to May.

Viruses are a common cause of OPT (60–70% of cases). The most common bacterial cause of OPT is group A beta-hemolytic streptococcus (GABHS, Streptococcus pyogenes) . Other bacterial causes include Neisseria (1–2% in adults), Arcanobacterium haemolyticum , diphtheroids, anaerobes, spirochetes, Staphylococus aureus, Haemophilus influenzae .

Chlamydia pneumoniae and Mycoplasma pneumoniae is discussed , but their participation in the occurrence of OPT is not yet known. The clinical significance of beta-hemolytic streptococci of groups C and G is also controversial. The cause of acute bacterial pharyngotonsillitis in children under 3 years of age is very rarely GABHS.

Clinically, it is difficult to distinguish bacterial OFT from viral OFT. Clinical signs and symptoms are nonspecific. Accurate diagnosis should be based on bacteriological examination of throat swabs. It is best to perform microbiological rapid diagnostics, but such methods are virtually unavailable in our daily practice. Therefore, the differential diagnosis between viral and bacterial OFT must be carried out clinically. The following accompanying symptoms indicate a viral etiology: nasal discharge (rhinorrhea), hoarseness, cough, conjunctivitis. If any of these symptoms are present, the likelihood of viral OFT is higher.

The presence of a bacterial process is indicated by the following symptoms: swelling of the tonsils, fibrinous plaque on the tonsils, severe hyperemia, enlarged submandibular and/or anterior cervical lymph nodes, fever above 38? C and absence of cough.

Additional diagnostic methods. The diagnostic standard for OFT caused by GABHS is culture of a pharyngeal smear for flora. An important prerequisite for correct diagnosis is culture from the tonsil, since smears from the mucous membrane of the mouth or tongue are often negative. Culture testing has a sensitivity of 90–95%.

Antigen rapid tests for GABHS have now been developed and are commercially available in developed European countries and the USA. Most of these tests are very specific, but their sensitivity in clinical practice is low. Therefore, a negative result of rapid tests does not exclude the presence of GABHS during OFT. Therefore, such tests cannot be recommended for routine use.

Treatment of viral OFT

Antibiotic therapy is not indicated. Throat discomfort can be relieved with oral paracetamol or ibuprofen. In recent years, there have been reports that topical antibacterial/antiseptic medications (lozenges, sprays and gargles) may lead to the development of bacterial resistance. Therefore, their use is also not recommended.

The persistence of symptoms of viral OFT for 3–4 days indicates the addition of a bacterial infection and the need for antibiotic therapy.

There are several treatment tactics for OFT accepted in the world. In some countries, a wait-and-see approach with the prescription of an antibiotic has been approved - waiting for the results of a throat culture for 48–72 hours. If GABHS is present, an antibiotic is prescribed; if not, symptomatic treatment is prescribed. However, waiting in cases where an antibiotic is needed can lead to complications and worsen the patient's quality of life.

In recent years, there has been increasing evidence that the primary goal of antibiotic therapy should be the eradication of pathogenic bacteria from the site of infection. Eradication brings maximum clinical benefit to patients and minimizes the risk of the emergence and spread of resistant strains. Therefore, the use of the so-called “suboptimal” antibiotics (that is, those with which it is not possible to achieve complete eradication of bacteria) contributes to the relapse of the disease and the development of resistance. The goal of antibacterial therapy is also to prevent complications (including rheumatic fever).

The main goal of antibacterial treatment is eradication of the pathogen

In most cases of bacterial OFT, an antibiotic is prescribed empirically, since waiting for culture results delays antibiotic therapy and can lead to complications (see table).

Table. Complications of acute pharyngotonsillitis

Acute pharyngotonsillitis caused by GABHS requires the prescription of an antibiotic. Penicillin V 40 mg/kg/day, which is characterized by a narrow spectrum of action in vitro against GABHS, was considered the antibiotic of choice. However, over the past 10 years, clinically, penicillin V has become less effective. What's the matter? Penicillin V has universal and virtually unchanged in vitro high efficacy against GABHS. But it is known that due to the development of resistance, anaerobes of the oral cavity and pharynx destroy penicillin with their beta-lactamases and “protect” GABHS from the effects of penicillin. Therefore, while penicillin V is 100% effective in vitro, the in vivo is reduced to 50–60%.

For penicillin allergy, oral erythromycin is recommended for bacterial OFT. The disadvantages of its use are gastrointestinal side effects and the frequency of use 4 times a day. Compared to erythromycin, new macrolides do not have microbiological advantages; they are much more expensive, although they are easier to tolerate by patients. The Alberta Medical Association (Canada) recommends clindamycin for penicillin allergies and macrolide intolerance.

In bacterial OFT, the following antibacterial drugs are not recommended for empirical use: fluoroquinolones (extremely broad-spectrum, not approved for use in children), injectable cephalosporins (very broad-spectrum, requires injections), trimethoprim-sulfamethoxazole or biseptol (not active in against GABHS, does not prevent rheumatism), tetracyclines (high GABHS resistance, contraindicated in children under 8 years of age), chloramphenicol (severe toxic effects on the bone marrow) and aminoglycosides (ototoxicity).

Not recommended for acute bacterial pharyngotonsillitis

fluoroquinolones
injectable cephalosporins
trimethoprim-sulfamethoxazole
tetracyclines
aminoglycosides
chloramphenicol

Penicillins are inexpensive, effective antibiotics. However, their effectiveness decreases as bacterial resistance increases. This problem was overcome with the help of beta-lactamase inhibitors - in 1981, a combination drug of amoxicillin with clavulanic acid was first introduced for clinical use. With the advent of beta-lactamase inhibitors, penicillins entered a period of renaissance in their effectiveness.

Several studies from the 1990s showed that in 30% of cases, treatment with penicillin, amoxicillin, erythromycin or clindamycin was not effective, and the effectiveness of oral cephalosporins was slightly higher. Treatment with protected penicillins was highly effective - the use of amoxicillin/clavulanate led to positive results in 91–96% of cases. Moreover, amoxicillin/clavulanate (Augmentin) leads to 100% eradication of pathogenic microbes from the pharynx, and this correlates with a further absence of relapses.

A comparative study of the susceptibility of bacterial isolates to 5 antimicrobial drugs (amoxicillin/clavulanate, ampicillin, azithromycin, cefuroxime, trimethoprim-sulfamethoxazole) in Europe showed that only amoxicillin/clavulanate still retains initial activity against gram-positive, some gram-negative and major respiratory tract pathogens.

Duration of treatment. The standard duration of treatment is a course of antibiotics for 10 days. In some countries, shorter courses are also approved (3 days, 5 days, 7 days), but with such courses, while achieving clinical recovery, eradication of GABHS from the pharynx is often not achieved. And complete eradication is a prerequisite for preventing relapses of OFT and preventing chronic pharyngotonsillitis. The need for a 10-day course has been demonstrated in several studies to prevent rheumatic fever and improve clinical and bacteriological effectiveness.

Acute pharyngotonsillitis is often a viral disease. Therefore, in most cases, antimicrobial treatment is not necessary. If there is clinical and/or bacteriological evidence of the bacterial nature of OFT, a 10-day course of antibiotic therapy is required. To do this, it is necessary to select an oral antibiotic with convenient dosing, a low probability of developing resistance and maximum achievement of clinical (recovery) and bacteriological (eradication) effect.

Eradication - eradication (literally), complete disappearance of GABHS during microbiological examination of pharyngeal smears. (Translator's note.)

The original amoxicillin/clavulanate is registered in Ukraine by GSK under the name AUGMENTIN.

Tonsillitis, like pharyngitis, are the most common diseases of the upper respiratory tract, which are characterized by inflammation and pain in the throat. Both diseases are usually caused by a viral or bacterial infection, so they manifest themselves in the same way and without proper diagnosis they are difficult to distinguish from other diseases. Sometimes pharyngitis appears as a complication of tonsillitis.

The main difference between tonsillitis and pharyngitis is the location of the lesion. With tonsillitis, inflammation is observed in the palatine and pharyngeal tonsils, with pharyngitis - in the pharyngeal cavity. The main causes of diseases are viruses or bacteria that enter the respiratory system from the outside or are located in other parts of the respiratory system. The main causative agents of tonsillitis are streptococcus and staphylococcus, less often this occurs due to chlamydia, mycoplasma, viruses or fungi.

In the depths of the throat, at the base of the arch, there are 2 tonsils. What are tonsils? This is a collection of lymphocytes that take part in protecting the body. It is in the tonsils that sore throat or tonsillitis occurs. The moment a microorganism (usually streptococcus) enters and infects the throat, inflammation occurs. The tonsils, trying to fight the infection, increase in size and fight the microbe, as a result of which a purulent coating appears on their surface.

With tonsillitis, the tonsils become inflamed and pustules appear on them.

This disease is extremely dangerous and can cause serious complications. Acute tonsillitis lasts about 1 – 2 weeks, after which the disease can become chronic. To prevent the transition of acute tonsillitis into a chronic form of the disease (this happens quite often), the disease should be treated at an early stage. Tonsillitis should be treated only with medications that the doctor will select individually.

If pharyngitis differs from tonsillitis in cause and location, then their symptoms are often very similar. Initially, with tonsillitis, the body temperature rises to 38.5 and above. Afterwards, during the day, the symptoms worsen. A person begins to experience a feeling of soreness, constriction, and dryness in the throat. As a result of enlarged tonsils, there will be difficulty swallowing foods, liquids, and sometimes saliva.

Characteristic signs of tonsillitis or tonsillitis are the coating of the tongue with a gray coating, and the tonsils with white or yellow bubbles. The patient experiences symptoms such as pain and aches in the limbs, and a deterioration in overall health. There is an increase in the submandibular lymph nodes.

In the acute form of tonsillitis, when the temperature drops, all symptoms worsen. Improper treatment of the disease will invariably lead to the appearance of chronic tonsillitis, in which the surface of the palate becomes thicker, the lymph nodes become enlarged and begin to hurt, and the structure of the tonsils changes (their surface becomes loose, and adhesions may appear).

Chronic tonsillitis can occur with normal body temperature, but with a deterioration in the general condition of the patient. An exacerbation will occur with the slightest decrease in immunity and, as a result, conservative treatment will simply be powerless. In this case, adults and children can be treated through surgery.

You can learn more about tonsillitis, its causes and treatment from the article: Tonsillitis: symptoms, treatment and causes.

Pharyngitis differs from tonsillitis in that it is caused by viruses. Most often it occurs against the background of:

Pharyngitis occurs most often in autumn or winter, during the seasons when colds worsen. Against the background of chronic pharyngitis, when correct treatment was not carried out in the acute period, a bacterial infection develops, which complicates the course of the disease and aggravates unpleasant symptoms.

Chronic pharyngitis is often detected together with pathology of the digestive organs, in which food from the stomach returns back to the esophagus and enters the pharynx. This form of pharyngitis can be provoked by gastroreflux disease and hiatal hernia. Treatment of the disease in this case will take place in parallel with the main cause, which provokes the appearance of constant relapses. The cause of chronic pharyngitis may be pathology of the nasopharynx.

Symptoms of pharyngitis, in the acute period of the disease, are manifested by soreness, dryness and discomfort in the throat during swallowing. This main symptom of pharyngitis will accompany the disease throughout the entire period.

Depending on the cause of inflammation, symptoms such as:

localization of pain in the throat and ears;
enlargement and tenderness of the cervical lymph nodes;
the back of the pharynx, palatine ridges, and lymphoid granules become inflamed. If tonsillitis is manifested by damage to the tonsils, then with pharyngitis they remain absolutely clean.

Chronic pharyngitis occurs due to lack of proper treatment during the acute period or when frequent colds occur. Against the background of chronic pharyngitis, adults experience a feeling of dryness and a lump in the throat. The patient constantly coughs, trying to get rid of the obstruction in the throat.

Chronic pharyngitis is also characterized by a deterioration in a person’s general well-being. This especially affects the emotional state, since he cannot get a good night's sleep due to discomfort in the throat. As a result, this leads to irritability and nervousness in adults.

Treatment of chronic pharyngitis should be carried out only after the underlying cause of the disease has been identified. It makes no sense to treat the manifestations of infection alone, since this will only bring short-term relief.

Before treating a disease that has caused unpleasant symptoms, it is necessary to conduct a correct diagnosis. To do this, they take blood for analysis, a smear from the tonsils in case of inflammation, an ECG, and radiography. To confirm tonsillitis, a visual examination of the throat is sufficient, which will be red, with a loose layer of tonsils and the appearance of a characteristic coating on them. If it is chronic, then adhesions will be observed on the surface of the tonsils, coloring them a rich scarlet color. In children, unlike adults, all signs will be more pronounced. If pharyngitis is suspected, a visual examination of the throat and pharyngoscopy will be performed.

Treatment of the disease is carried out only after the cause of inflammation has been identified and differential diagnostics have been carried out, helping to exclude diseases of the respiratory system with similar clinical signs.

Acute tonsillitis should be treated with antibacterial agents, gargling with Furacilin or Miramistin, using antiseptics and painkillers that act directly in the throat (Lizak, Doctor Mom, etc.). Additionally, sprays are prescribed that irrigate the tonsils, such as Orasept, Tantum Verde, etc. Treatment with antipyretics is indicated during the acute period of the disease, which is accompanied by an increase in temperature. To do this, use Panadol, Nurofen or combination drugs that are administered intramuscularly.

Treatment of the chronic type of the disease consists of using an inhaler, rinsing and gargling, strengthening the immune system with the help of immunomodulators, and using physiotherapeutic procedures. Do daily nasal rinsing and gargling using medications or folk remedies. A good remedy that is prescribed to adults and children is sea salt, which is used to rinse and wash the mucous membranes of the nose and throat.

Source: http://first-doctor.ru/diagnoz-faringotonzilit-chto-eto/

Acute pharyngotonsillitis:

when and how to prescribe antibiotics

Lviv Regional Children's Clinical Hospital “OHMATDET”

Acute pharyngotonsillitis (APT) is a very common disease in the practice of primary care physicians. It accounts for 37% of all acute upper respiratory tract infections.

Diagnostics

Clinically, it is difficult to distinguish bacterial OFT from viral OFT. Clinical signs and symptoms are nonspecific. Accurate diagnosis should be based on bacteriological examination of throat swabs. It is best to perform microbiological rapid diagnostics, but such methods are virtually unavailable in our daily practice. Therefore, the differential diagnosis between viral and bacterial OFT must be carried out clinically. The following accompanying symptoms indicate a viral etiology: nasal discharge (rhinorrhea), hoarseness, cough, conjunctivitis. If any of these symptoms are present, the likelihood of viral OFT is higher.

Treatment

Treatment of viral OFT

The persistence of symptoms of viral OFT for 3–4 days indicates the addition of a bacterial infection and the need for antibiotic therapy.

Treatment of bacterial OFT

In recent years, there has been increasing evidence that the primary goal of antibiotic therapy should be eradication [1] of pathogenic bacteria from the site of infection. Eradication brings maximum clinical benefit to patients and minimizes the risk of the emergence and spread of resistant strains. Therefore, the use of the so-called “suboptimal” antibiotics (that is, those with which it is not possible to achieve complete eradication of bacteria) contributes to the relapse of the disease and the development of resistance. The goal of antibacterial therapy is also to prevent complications (including rheumatic fever).

The main goal of antibacterial treatment is eradication of the pathogen

In most cases of bacterial OFT, an antibiotic is prescribed empirically, since waiting for culture results delays antibiotic therapy and can lead to complications (see table).

Table. Complications of acute pharyngotonsillitis

Not recommended for acute bacterial pharyngotonsillitis

fluoroquinolones
injectable cephalosporins
trimethoprim-sulfamethoxazole
tetracyclines
aminoglycosides
chloramphenicol

Penicillins are inexpensive, effective antibiotics. However, their effectiveness decreases as bacterial resistance increases. This problem was overcome with the help of beta-lactamase inhibitors; in 1981, a combination drug of amoxicillin with clavulanic acid was first introduced for clinical use [2]. With the advent of beta-lactamase inhibitors, penicillins entered a period of renaissance in their effectiveness.

conclusions

[1] Eradication - eradication (literally), complete disappearance of GABHS during microbiological examination of pharyngeal smears. (Translator's note.)

[2] The original amoxicillin/clavulanate is registered in Ukraine by GSK under the name AUGMENTIN.

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Source: http://msvitu.com/archive/2004/april/article-11.php?lang=ru

Acute, chronic pharyngitis. Types, causes and symptoms

Chronic pharyngitis is a disease in which constant inflammation appears in the mucous membrane of the pharynx. In adults, the disease occurs with constant exacerbations and periods of remission. The cause of the disease can be ARVI, mental and physical stress, and decreased immunity. How to protect yourself from chronic pharyngitis? And how to treat it?

Causes of development of chronic pharyngitis

The following factors for the occurrence of the disease have been identified:

persistent acute respiratory viral infections;
untreated disease;
regular exposure to external irritants on the lining of the larynx;
chronic inflammatory diseases;
any gastrointestinal disorders;
as a result of removal of tonsils;
frequent use of alcohol and tobacco;
eating spicy and hot dishes.

In the chronic form of the disease, there are 3 main types:

At-risk groups

Reasons that contribute to decreased immunity:

smoking;
allergies;
lack of vitamin A;
diabetes;
problems with the heart, kidneys, liver, lungs;
hard breath;
endocrine diseases.

Symptoms

When chronic pharyngitis appears in an adult, the following symptoms may occur:

frequent pain in the larynx;
soreness;
feeling of an extra object in the throat;
pain in the larynx when swallowing;
unpleasant odor;
dry cough.

dry mouth;
unproductive cough;
feeling of a coma.

Upon examination, the therapist notices a thinned wall of the pharynx, scabs, and hemorrhages. During an exacerbation, a number of health problems may arise:

ENT diseases in which inflammation of the trachea occurs;
inflammation of the mucous membranes of the throat;
measles;
scarlet fever;
angina.

Diagnostics

In the catarrhal form, modification of the posterior wall of the larynx can be detected. As a result, it is observed:

In the hypertrophic form, modification of the larynx is noticeable:

The atrophic form represents modifications on the laryngeal mucosa:

Treatment

exclude spicy, salty, hot foods;
quitting tobacco;
do not breathe harmful substances;
do not drink alcohol.

To reduce swelling in the laryngeal mucosa in chronic pharyngitis, antiallergic medications are used:

The oral cavity is also treated with Lugol's solution. For sore throat, use local antiseptics:

Antimicrobial drugs are used when the inflammatory process intensifies. Therefore, the following antibacterial drugs are used: Amoxicillin, Ampicillin, Pefloxacin.

diet;
treatment of the throat with sprays;
resorption of tablets;
taking vitamins;
taking antibiotics.

prolonged inflammatory process;
the appearance of purulent otitis media;
the appearance of pneumonia;
high temperature for more than two days;
angina;
fever.

Traditional medicine in the treatment of chronic pharyngitis

Some traditional methods of treatment are quite effective in the fight against pharyngitis. For example:

milk and honey;
propolis tinctures;
garlic and honey syrup;
inhalation over potato broth.

Complications

Improper treatment of pharyngitis can lead to inflammation moving to neighboring organs and develop the following diseases:

inflammation of the tonsils;
inflammation of the tracheal lining;
inflammation of the bronchi.

There is also the development of autoimmune disorders:

immunoinflammatory diseases;
damage to the heart muscle;
inflammation of connective tissue.

The most complex and severe complication of chronic pharyngitis may be the transition to a malignant tumor. Preventive actions:

completely give up tobacco;
do not inhale chemicals;
carry out therapy on time;
During a sore throat, do not eat: spicy, salty, cold foods.

Source: http://lor.guru/zabolevaniya/faringit/ostryy-hronicheskiy-faringit-vidy-prichiny-poyavleniya-i-simptomy.html

First Doctor

Diagnosis of pharyngotonsilitis what is it

Table of contents:

Treatment of viral OFT

Archive

Acute pharyngotonsillitis:

Diagnostics

Treatment

Treatment of viral OFT

Treatment of bacterial OFT

conclusions

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Acute, chronic pharyngitis. Types, causes and symptoms

Causes of development of chronic pharyngitis

At-risk groups

Symptoms

Diagnostics

Treatment

Acute pharyngotonsillitis

Complications