Treatment of acute tonsillitis in a child

The powerful lymph nodes located around the pharynx cannot cope with the attack of the pathogen, so the body begins to produce antibodies that can find pathogenic bacteria, paralyzing their activity.

As a result, streptococci are defeated, but the child’s body produces so many antibodies that, in addition to foreign cells, the body’s own tissues, primarily the heart and joints, begin to suffer. Therefore, it is always better to entrust the treatment of sore throat in a child to a qualified doctor.

In 10% of cases, sore throat in children can be caused by Staphylococcus aureus, rarely pneumococcus, Haemophilus influenzae, chlamydia and fungal flora. Viral pathogens (adenoviruses, herpes virus) more often attack the body of children under 3 years of age.

How and why does infection occur?

Infection occurs by airborne droplets, from a sick person, by using shared utensils and eating contaminated food, as well as by a number of other factors:

• weakened immunity;
• hypothermia or consumption of cold foods and drinks;
• mouth breathing (for chronic adenoiditis, deviated nasal septum);
• irritation of the nasopharyngeal mucosa with a runny nose;
• recent viral diseases;
• inflammatory diseases of the ENT organs (sinusitis, sinusitis, otitis);
• caries and other oral infections.

Secondary tonsillitis in children can occur against the background of scarlet fever, diphtheria, mononucleosis, as well as blood diseases.

In any case, a sore throat develops rapidly, in a matter of hours, and is especially acute in children, accompanied by the main symptoms—a sore throat when swallowing and an increase in body temperature.

Causes of sore throat

Acute tonsillitis occurs due to invasion of the palatine tonsils by pathogenic microorganisms (viruses, bacteria, fungi, or a combination thereof).
Moreover, the infection in young children is more often of viral origin and develops as a result of herpes viruses, adenoviruses, cytomegaloviruses, Epstein-Barr viruses, etc. entering the child’s body. Children over 5 years of age are more susceptible to sore throats of a bacterial nature. The most common bacteria that cause the disease are streptococcus and staphylococcus, or a combination of both. In addition, acute tonsillitis can occur under the influence of pneumococci, spirochetes, and fungi.

The method of transmission of infection is airborne droplets or household contact. A child becomes infected from sick people around him or through contact with toys, dishes and other common items. Normally, a child’s body is able to independently cope with pathogenic microflora; infection occurs only in the presence of factors that reduce the body’s immune forces.

Factors that contribute to the weakening of a child’s immunity:

• hypothermia of the body;
• excessive mental and physical stress;
• unbalanced diet;
• deficiency of microelements necessary for growth and development;
• frequent colds;
• stress.

Sore throat in children: forms and clinical manifestations

Depending on the nature of the change and the degree of damage to the tonsils, several forms of angina are distinguished.

Catarrhal sore throat

A mild form, characterized by enlargement and redness of the tonsils, as well as the absence of purulent lesions. The child feels dry mouth, a whitish coating appears on the tongue, and the cervical lymph nodes are slightly enlarged. In addition to a sore throat that gets worse when swallowing, the child feels a sore and burning sensation. The temperature rises to 38 degrees, children complain of weakness and headache.

Follicular tonsillitis

A serious disease in which the tonsils become covered with purulent pinpoint follicles. On days 2-3, the ulcers open, leaving wounds that heal quickly. There is severe pain in the throat, radiating to the ear, making it difficult to swallow, children refuse to eat and drink. The lymph nodes are enlarged and painful when pressed lightly. Fever and chills are accompanied by a temperature of up to 40 degrees, vomiting, convulsions and fainting are possible.

Lacunar tonsillitis

In the lacunae, between the lobes of the tonsils, islands of yellow purulent plaque appear, which tend to unite into wide purulent foci. The symptoms are similar to those of purulent follicular tonsillitis, but are more pronounced and are accompanied by severe intoxication of the body. It hurts the child to turn his head, his mouth opens with difficulty, which makes speech slurred.

Viral (herpetic) sore throat

Most often, the development of the disease is facilitated by vitamin deficiency and weakened immunity. The tonsils become covered with red blisters, which burst, leaving small ulcers in their place. In addition to a sore throat, symptoms are acute respiratory in nature: cough, runny nose, abdominal pain, indigestion, as well as stomatitis and conjunctivitis. Lack of timely treatment of herpetic sore throat in children can lead to serous meningitis.

Fungal tonsillitis

A relatively mild form of sore throat that occurs in children under 3 years of age. It is distinguished by a coating of white, curdled flakes on the tonsils and, with proper treatment, goes away within a week.

Classification

Based on the nature of the lesion, the following types of this disease in children are distinguished:

• catarrhal tonsillitis;
• lacunar tonsillitis;
• follicular tonsillitis;
• ulcerative membranous tonsillitis.

It should be noted that in some sources catarrhal tonsillitis is considered as acute pharyngitis.

It is also customary to consider the classification of sore throat in children, based on the type of pathogen:

• bacterial;
• viral;
• fungal.

Catarrhal sore throat

Catarrhal tonsillitis is considered the mildest form of this type of pathology. Characterized by redness and swelling of the tonsils. If treatment is started in a timely manner, complete recovery occurs within a week. Otherwise, the disease progresses to a more complex stage.

Follicular tonsillitis

In this case, a pustular rash forms on the mucous membrane of the respiratory tract. The tonsils become enlarged and swollen. Just as in the case of catarrhal tonsillitis, with adequate treatment, complete recovery occurs in 1–1.5 weeks.

Ulcerative film form

The most complex form of sore throat. It is characterized by a severe clinical picture and is often accompanied by other diseases. The tonsils are enlarged and a loose film forms on them with the accumulation of pus.

With this form of development of the pathological process, general intoxication of the body almost always occurs. Often, the ulcerative film form of tonsillitis becomes the cause of the development of serious complications.

General symptoms

Regardless of the exact subtype of angina, the clinical picture almost always manifests itself the same way. The initial symptoms of sore throat in children are:

• a sharp increase in temperature to 39 degrees;
• a sore throat;
• congestion and pain when swallowing even liquids;
• pain in muscles and joints;
• headache for no apparent reason;
• fatigue, “broken” state;
• the lymph nodes, which are located in the submandibular region and on the neck, are enlarged;
• the tongue is covered with a white coating, sometimes with a gray tint;
• red throat, enlarged tonsils.

In addition, the general clinical picture may be supplemented by the following signs:

• almost complete lack of appetite;
• disorders of the gastrointestinal tract - unstable stool, nausea and vomiting;
• a child's hoarse voice;
• capricious state, the child’s sleep is restless.

At the first symptoms, you should immediately seek medical help. It is strongly not recommended to treat this disease on your own, at home, for children under one year of age. A sore throat in a child at this age can cause serious complications.

The danger of this disease also lies in the fact that complications may appear after some time. Therefore, it is better to carry out treatment under the supervision of a doctor in a hospital. It is not recommended to treat a sore throat at home also because you cannot independently diagnose the nature of the pathogen.

Symptoms of a sore throat

Diagnostics

As a rule, children under one year of age are rarely referred for additional diagnostic procedures, since the clinical picture is very clear. If such a need exists, the following additional studies may be carried out:

• general and biochemical blood tests;
• oral swab;
• general urine examination.

Treatment

Clinicians note that it is better to treat sore throat in children under one year of age in a hospital. This infectious disease can cause serious complications even in adults. Due to the fact that a child under one year of age has a weakened immune system, death is no exception.

The main treatment program consists of the following points:

• drinking plenty of warm liquids;
• taking prescribed medications;
• strict bed rest;
• gargling.

Drug therapy includes taking drugs with the following spectrum of action:

• antibiotics;
• antihistamines;
• antipyretics;
• antimicrobial substances.

Antibiotics for sore throat in children are prescribed necessarily. To prevent the immune system from becoming even more vulnerable, vitamin therapy is used at the same time. Please note that antibiotics for sore throat in children should only be prescribed by a doctor. You cannot use any medications on your own, as this may cause the situation to worsen.

In addition to taking medications, you should gargle. Rinsing should be carried out only with warm antiseptic solutions:

• chamomile decoction;
• furatsilin;
• a decoction of sage, calendula and chamomile.

Please note that you can reduce the temperature of a child over 3 years old only if it exceeds 38 degrees. As for infants, the temperature should be lowered already at 38.

Treatment of sore throat should be comprehensive, even if the disease is treated at home. Only in this case can serious complications be avoided. It is unacceptable to use folk remedies alone to treat such a complex infectious disease.

Possible complications

In the case of sore throat in children, complications can be either primary (which arise during the course of the disease itself) or delayed (develop some time after recovery).

The first group includes the following pathological processes:

• laryngitis;
• acute otitis;
• inflammation of the mediastinal organs;
• general body intoxication syndrome;
• meningitis;
• sepsis.

The last two points are only possible if the infection gets into the blood.

Delayed complications include the following ailments:

• damage to small and large joints;
• encephalitis;
• inflammation of the heart valve against the background of an infectious-inflammatory process;
• hemorrhagic vasculitis;
• acute renal failure;
• acute pyelonephritis.

Such serious complications can be avoided if you seek medical help in a timely manner and begin correct treatment. Sore throat should be treated only as prescribed by a doctor.

After completing the course of treatment, the child should be regularly examined by a specialized medical specialist. Also, within a month after the end of treatment, you should avoid vaccinations and Mantoux reactions.

Prevention

Preventing a disease is much easier than treating it. Unfortunately, it is impossible to completely eliminate the formation of sore throat in children. However, if you follow simple recommendations, you can significantly reduce the risk of its development.

The following rules are good for preventing sore throat in children:

• the child’s immune system should be strengthened;
• Hypothermia and eating too cold food are not allowed;
• all diseases must be treated completely and in a timely manner;
• the use of any medications should be carried out only as prescribed by a doctor;
• At the first symptoms you should seek medical help.

In this case, even if the child gets a sore throat, significant complications can be avoided.

Otorhinolaryngologist L.V. Ledova Literature:

"Practical otorhinolaryngology". Clinical recommendations. Kryukov A.I., Palchun V.T.

“Guide to practical otorhinolaryngology” Palchun V.T., Luchikhin L.A., Magomedov M.M., 2011.

Source: https://gorlonos.com/ushi/otit/opredelit-i-vylechit-naruzhnyj-u-rebenka.html

Why is a sore throat dangerous?

As practice shows, only in half of the cases are enlarged tonsils and sore throat caused by purulent sore throat. Many diseases, such as diphtheria or Epstein-Barr virus, have symptoms similar to sore throat. Therefore, only a qualified doctor with modern diagnostic equipment and a well-equipped laboratory can accurately determine the disease and prescribe the necessary treatment.

Each causative agent of sore throat is sensitive to a certain type of antibiotics prescribed by a doctor depending on the diagnosis.

Remember!

Incorrect or untimely treatment of sore throat in children, as well as relying on folk remedies for “red throat” can lead to serious complications and irreversible consequences.

Delay in diagnosis and prolonged treatment provoke the development of rheumatoid arthritis, vascular diseases, heart diseases (including rheumatic endocarditis), renal failure and many chronic diseases leading to disability.

Diagnostics

A consultation with an otorhinolaryngologist begins with collecting the patient’s medical history and complaints. The ENT doctor finds out how long the symptoms of inflammation have been appearing and whether any treatment has already been carried out. Direct examination includes palpation of the neck, parotid and occipital areas. Then the ENT doctor examines the oral cavity and pharynx. If necessary, an endoscopic examination of the pharynx is performed. He assesses the condition of the mucous membranes, palatine tonsils (their size, the presence of plaque on them or purulent plugs in them).

The patient may also be prescribed laboratory tests: a general blood test, a throat smear. If complications are suspected, serological blood tests, X-rays, electrocardiography, etc. are additionally performed.

After suffering a sore throat, a child may be diagnosed with myocarditis, arrhythmia, heart murmurs, pyelonephritis, renal failure, and rheumatism. If an infection from the tonsils enters the bloodstream and spreads throughout the body, sepsis may develop.

Complications of GABHS-pharyngitis

In most cases, GABHS pharyngitis resolves without complications. Non-purulent complications include acute rheumatic fever, post-streptococcal glomerulonephritis, childhood autoimmune neuropsychiatric disorders associated with streptococcal infection. Purulent complications of streptococcal pharyngitis include necrotizing fasciitis and bacteremia.

The differential diagnosis of GABHS pharyngitis includes both infectious and non-infectious causes of pharyngitis.

The main viral diseases manifested by acute pharyngitis:

• infectious mononucleosis - Epstein-Barr virus (EBV) and cytomegalovirus. More common in adolescents and characterized by fever, severe pharyngitis (which lasts longer than GABHS pharyngitis), anterior and posterior cervical or diffuse lymphadenopathy. Periorbital edema, mild hepatomegaly, and splenomegaly may be present. Patients prescribed ampicillin, amoxicillin (sometimes other antibiotics) may develop a characteristic rash;
• primary HIV infection —may cause an acute retroviral syndrome (similar to infectious mononucleosis) in sexually active adolescents or rarely in sexually abused children. Clinical signs of primary HIV infection include severe cervical or generalized lymphadenopathy and complaints of fever, weight loss;
• herpes simplex virus - pharyngitis caused by the herpes simplex virus, manifested by blistering rashes on the mucous membrane, lips;
• influenza - characterized by fever, cough, headache and myalgia, which occur during seasonal epidemics;
• other viral diseases - enteroviruses, adenoviruses, rhinoviruses, coronaviruses, respiratory syncytial virus, parainfluenza viruses.

The main bacterial causes of pharyngitis:

• streptococci of groups C and G - there is still a debate about the role of these bacteria in the etiology of acute pharyngitis;
• n eisseria gonorrhoeae (gonorrhea) is a relatively rare cause of pharyngitis. Most cases are asymptomatic or symptoms are nonspecific (eg, pharyngeal congestion, swelling or exudate in the tonsil lacunae);
• f usobacterium necrophorum (Lemierre's syndrome) is the cause of most cases of purulent thrombophlebitis of the jugular vein. Clinical signs include strep throat, high fever (39°C), respiratory symptoms, unilateral neck swelling or pain;
• diphtheria - rare in developed countries, but important to consider in patients from endemic areas. Unlike GABHS pharyngitis, which has an acute onset, the onset of diphtheria symptoms usually occurs gradually. A distinctive feature of diphtheria is the formation of a gray filmy coating that adheres tightly to the mucous membrane of the nose and throat, the removal of which leads to bleeding;
• others - tularemia (Francisella tularensis), Arcanobacterium haemolyticum, Mycoplasma pneumoniae.

Non-infectious causes of pharyngitis are diagnosed based on medical history. This may be irritation or dryness of the pharynx, a foreign body (for example, a fish bone), chemical exposure, radiating pain due to dental abscess, acute otitis media.

Treatment of sore throat

Parents need to understand that seeing a doctor is an integral part of successful therapy. Self-medication can cause irreparable harm to children's health.

General recommendations

Sore throat is a highly contagious disease that requires temporary isolation from the sick child.
Young children are especially susceptible to infection. Transmission of infection through close contact is possible from the first day of illness. Acute tonsillitis is almost always accompanied by high fever; parents need to ensure that the child remains in bed. To speed up the removal of infection from the body and prevent dehydration, the baby must be given large amounts of clean water, compotes, fruit drinks and other liquids.

In addition, parents should know the recommendations for baby nutrition: if you have a sore throat, you should exclude hot, rough, spicy, fried and highly salty foods (to prevent pharyngeal irritation). The children's diet should contain boiled, baked or steamed dishes, pureed non-acidic fruits and vegetables, and low-fat broths.

Elimination of the pathogen

The treatment tactics for the inflammation itself depend on the type of infection that caused damage to the tonsils.
So, with a bacterial form of sore throat, the child is prescribed antibiotics (selected taking into account the sensitivity of a particular pathogen). For viral tonsillitis, the doctor selects antiviral drugs, for fungal tonsillitis - antifungal agents. Often, antibacterial and antiviral agents negatively affect the functioning of the baby’s gastrointestinal tract. To prevent diarrhea, bloating and other unpleasant symptoms, your doctor may prescribe a course of prebiotics and probiotics.

Relieving symptoms of sore throat

In addition to eliminating the causative agent of the disease, it is necessary to direct efforts to relieve the unpleasant symptoms of the disease and improve the overall well-being of the baby.
If the body temperature is high, the child is given antipyretics. At the pharmacy you can buy products that reduce body temperature in various forms of use. For infants, it is recommended to give preference to rectal suppositories; at older ages, oral medications are usually prescribed. Topical sprays, syrups, or lozenges may be used to relieve inflammation and sore throat. Such drugs act directly on the microorganisms that cause the disease.

Often a sore throat is accompanied by severe swelling of the tissues of the pharynx, which causes breathing problems in the baby. In such cases, the doctor may prescribe antihistamines. The remedies not only help to cope with swelling in the throat, but also enhance the effectiveness of antipyretic and painkillers.

The choice of agents and their dosage is determined taking into account the age characteristics of the patient and the severity of the manifestations of the disease.

Rinse

Rinsing with antiseptic and anesthetic solutions helps relieve inflammation and eliminate pain. However, this method of treatment is suitable only for those children who know how to gargle without the help of adults without swallowing the solution. For young children, it is recommended to replace rinsing with mouth irrigation. This treatment method allows you to moisturize the oral cavity, wash away purulent and mucous formations from the surface of the tonsils along with pathogenic microorganisms.

Physiotherapy

In addition to medicinal methods of treating sore throat in children, physiotherapeutic methods have proven themselves to be effective:

• inhalation;
• UHF;
• electrophoresis;
• phonophoresis;
• magnetic therapy;
• laser therapy;
• phototherapy.

General recommendations

Rest, adequate fluid intake, gentle nutrition, it is advisable to avoid irritation of the respiratory tract. Most patients can return to work or school after completing one full day of treatment, provided their general health allows it.

The recommendation is based on a small cohort study in children that showed that about 80% of patients with culture-proven streptococcal pharyngitis were no longer infectious within 24 hours of starting therapy.

A follow-up rapid test for streptococcus after treatment is usually not required and is indicated only in the following cases:

• patients with a history of acute rheumatic fever;
• patients who became ill during an outbreak of acute rheumatic fever or post-streptococcal glomerulonephritis;
• patients who became infected from close relatives (in the family).

If the control test is positive, it is recommended to repeat the 10-day course of antibiotic therapy. For the second course of treatment, an antibiotic is selected that is more stable against beta-lactamase degradation.