Angina

May 21, 2011

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As the disease is angina known since the days of ancient medicine. The term comes from the Latin word angere   - Squeeze squeeze. With this disease, many associated lesions of the oropharynx. Although they differ in etiology, they share common symptoms and they fall under the term - a sore throat.

Angina   - Common infectious disease, which is characterized by an acute inflammation of the components lymphadenoid pharyngeal ring. The most common manifestation of the disease is local deals specifically with the tonsils. According to the standard classification of angina is divided into three types: primary . secondary   and specific . The primary Angina include ordinary, simple or banal angina, which are acute inflammatory diseases having signs of only lymphadenoid ring throat. Secondary is symptomatic angina. These include lesions in the tonsils scarlet fever . Diphtheria , Infectious mononucleosis and other acute infectious diseases. The secondary Angina also apply lesions in diseases of the blood - leukemia . agranulocytosis   and others. The third type includes diseases caused by specific infections - fungal angina . Vincent's angina .

Primary angina

Primary angina is one of the most frequent diseases of the upper respiratory tract. Most often, the disease affects children and young adults up to 35 years, mainly may have the character of seasonal epidemics. Epidemics are more common in urban areas, as the source of the disease is a positive person, a great population density contributes to the spread of the disease.

The virus that causes primary angina in most cases acts ß-hemolytic streptococcus group A . Also, agents can be aurococcus   or pneumococcus . But in 85% of the disease occurs when it is infected with streptococci. Carriers of these infections are released into the environment is quite a large number of pathogens that are transmitted by airborne droplets, as well as household, contact and alimentary paths. It is a group of people most susceptible streptococci, especially in childhood.

The course of the disease and diagnosis of angina

The primary focus of inflammation formed in the lymphoid tissue of the oropharynx. The causes predisposing to the disease may be local and general hypothermia, dusty and polluted the atmosphere, increased dryness of the premises, reduced immunity, etc. In most cases, angina develops after an SARS That reduce the protective function of the airway epithelium thereby opening the way infections.

The first damaged amygdala due srodnennoy lymphoid tissue with a number of antigenic structures of the streptococcus. Toxins that are waste products of microbes enter the bloodstream, thereby causing damage to the nervous and cardiovascular systems. Therefore angina is characterized not only by local tissue damage oropharynx, and a deterioration of the general condition of the patient.

The incubation period for the disease ranges from 10-12 hours to 2-3 days., Characterized by an acute onset of illness, fever, chills, and the occurrence of pain while swallowing. All this, together with the increase in regional lymph nodes and is the main symptoms of angina.

If you suspect Strep throat , An accurate diagnosis is established according to the clinical picture, pharyngoscope and laboratory studies. To clarify the pathogen carried additional diagnostics angina, namely bacteriological and serological laboratory tests of crops mucus from the oropharynx. All these data are needed to determine the class of the disease and the administration of an effective treatment.

Classification of angina

Depending on the extent of angina is divided into several types. Determination of disease also depends on the nature of injuries and so isolated bluetongue . follicular . lacunary   and purulent   or necrotic   sore throat. For general manifestations emit as light, moderate and severe forms of the disease. Faringoskopicheskaya pattern and severity of some of the symptoms depends on what classification of angina. In some cases, depending on the class and severity of the disease.

Catarrhal angina   It characterized by superficial lesions of the tonsils. If there is a bright pharyngoscope diffuse flushing, swelling of the tonsils. Patients have low-grade fever (37, 0-37, 5 "C), minor changes in the blood and signs of mild intoxication. Bluetongue disease angina lasts 1-2 days, after which the symptoms of a sore throat disappear, or the disease becomes another form.

Lacunar tonsillitis   characterized by lesions of the tonsils in the gaps. Pharyngoscope shows pronounced flushing, swelling of the tonsils and expansion gaps. In tonsils revealed purulent plaque. It is formed from fibrous pus gaps may be in the form of small pockets or films. This yellowish-white film can be easily removed without leaving a trace of bleeding and is localized exclusively on the tonsils are not spread beyond them. In this form of catarrhal angina passes more often than others.

Angina follicularis   It has a clear picture of the "starry sky" - raying the epithelial cover, festering follicles. It is typical for this form of the defeat of the follicular apparatus of the tonsils. The examination revealed a profound defeat of the tonsils, they are hypertrophied, swollen and covered with festering follicles that have a whitish-yellow appearance of small entities.

If the patient follicular and lacunar angina, the more strongly expressed intoxication , Body temperature rises to 39-40 "C. Therefore, the main symptoms of angina are complemented by general weakness, headache, pain in the heart, muscles and joints. In vitro studies revealed blood leukocytosis, and traces of protein in the urine, erythrocytes .

Necrotic angina   It differs from other forms of the disease more severe and more severe symptoms. In this form of the disease pharyngoscope it finds on the affected areas of the tonsils, covered extending deep into the mucous membrane coating. It has a rough surface pitted greenish yellow or gray. Such sites are solid, and after removal of surface bleeding. After the rejection of nekrotizirovanyh areas are deep flaws in the tissues of the tonsils. Often necrosis extended to the tongue, back of the throat and on.

Symptoms of angina necrotizing form worsen the overall condition of the patient is stable fever Often repeated vomiting, confusion, fever. Laboratory blood tests reveal marked leukocytosis, leukocyte sharp shift to the left, neyrofilez. This form of the disease are more likely to lead to complications.

Complications of tonsillitis may be early or late. In the first case of the disease that occur during the illness, they are caused by the inflammation spread to nearby organs. These complications are peritonzillit, sinusitis, otitis, peritonsillar abscess, etc. Late complications of tonsillitis is a disease caused in 3-4 weeks, they have an infectious-allergic origin - a joint rheumatism , Rheumatic heart disease, post-streptococcal glomerulonephritis .

Treatment of angina primary forms

Treatment of angina is performed on an outpatient basis in the light stages and uncomplicated forms of the disease. In severe cases, the patient is required to be hospitalized in the infectious disease clinic. Assigned to medical therapy, local treatment, light diet, drinking plenty of fluids. The main drugs used in the treatment is antibiotics, which prescribe a course of 5-7 days. Antibiotic therapy includes fenoksimetilpenitsilin or Amoxicillin   with clavulanic acid, may also be administered cephalosporins, macrolides, such as erythromycin, and sulfonamides.

Local treatment of angina held rinsing with an antiseptic solution, it can be furatsilin and decoctions of herbs with the same properties - chamomile, calendula, St. John's wort. Irrigation is also used drugs such as the tonsils kameton . ingalipt . sebidin . For topical use and fuzafunzhin, ambazone, gramicidin and others. Rinse effective removal of purulent plaque, which is different tonsillitis.

It is important to comply with the treatment of prevention, isolation of patients is required in order that would prevent infection spread among people in contact with the patient. To prevent the disease recommended hardening of the body, eliminating irritants such as dust, smoke, excessive dryness of the air. It is time to eliminate pockets of chronic infection, for example, caries Sinusitis.

As for the prognosis of treatment in catarrhal angina prognosis is favorable in all cases. Especially quickly the disease is when time begun treatment. The favorable prognosis and the treatment of follicular and lacunar angina. Still, they can lead to the development of chronic tonsillitis . Severe complications is transferred necrotic angina any form of complexity. The most common complications such stayut rheumatism glomerulonephritis .

Secondary and specific angina

Secondary angina develop as a concomitant disease in other infectious lesions. As primary angina, an acute inflammation of the lymphatic throat ring, or separate elements, often tonsils.

Angina occur in such diseases as measles . scarlet fever . diphtheria . adenoviral   and herpes infection . syphilis   and others. The secondary also include a group of angina occur when agranulocytosis   and leukemia . Symptoms of angina in the secondary form and its course is not very different from primary angina, but against other diseases are more severe form of the symptoms and severity.

Specific sore throats not caused by streptococcus and other pathogens. Depending on the clinical picture of the changes and treatment of disease. Such diseases arise due to a decrease of protective functions of the organism, frequent use of antibiotics, exhaustion.

Fungal angina   It occurs against a background of other diseases, especially after long-term treatment with antibacterial drugs in chronic tonsillitis. Pathogens angina yeast fungi Candida albicans In many cases, they are joined by pathological cocci. Most often the disease occurs in young children.

Symptoms of angina fungal origin expressed little. The general condition of the patient does not suffer nearly as very weak toxicity. In rare cases, it may present low-grade fever and mild headache, sometimes felt overwhelmed. Local symptoms are limited to minor throat hyperemia and moderate pain in the throat. But the pain can not be at all. Slightly increased lymph nodes, on palpation they are almost painful. This disease is characterized by the presence of white or yellowish-white plaque on the tonsils, mucosa of the cheeks and tongue. Plaque is distributed in the form of dots or islands, it can be easily removed.

Pseudomembranous angina   or Vincent's angina   also relates to specific angina. Pathogens are fusiform stick Plaut-Vincent Vincent pallidum. Most often affects immunocompromised patients, hypovitaminosis, chronic intoxication, weakening and exhaustion of the body which does not have sufficient protective functions. This disease is characterized by one-sided defeat of the tonsils.

On the first day agnina Simanovskiy Plaut-Vincent-manifests itself by the fact that the affected tonsil formed, curdled or filmy plaque, grayish white or greenish dirty color. After his removal remains a bleeding surface, which is covered with bloom again. After 4-5 days on the affected places there is an ulcer crater, which is alive, leaves no defects. Ulcers can affect the palatal arch and the soft palate.

The main symptoms of angina are virtually absent. No signs of intoxication, fever, except for the local manifestations, there is only an increase in regional lymph nodes . Laboratory blood tests reveal only a slight leukocytosis.

Treatment of angina specific form

Fungal angina, first of all, requires the abolition of antibacterial drugs, who were appointed earlier. Spend treatments Nystatin , Levorin combined with washing the tonsils are the same drugs. Appointed restorative therapy and vitamins B and C, K. The disease is characterized by a prolonged course, relapses are frequent, it is recommended surgical removal of the tonsils.

Treatment of Vincent's angina is performed locally. Assigned rinsing 0, 1% ethacridine lactate solution and potassium permanganate, sometimes with a weak solution of hydrogen peroxide. Mucous affected ulcers smeared 2% methylene blue solution or 1% - of boric acid. When protracted course of prescribed antibiotics, mainly penicillins .