Angina - what are the symptoms? Angina is an inflammation of the tonsils and throat that can be caused by bacteria, viruses, or fungi. Initially, it gives symptoms similar to minor infections of the upper respiratory tract: sore throat, broken bones, runny nose, increased temperature. In no case can angina be underestimated, because its complications can be extremely dangerous. What are the causes of angina? How is angina treated? Are antibiotics always necessary?

Angina - general characteristics of the disease

Anginais an acute inflammation of the tonsils and the pharyngeal mucosa. The symptoms are quite characteristic and antibiotic treatment is often a necessity.

Angina is a contagious disease . Microbes that cause it can spread to other people by droplets (when the patient, for example, coughs or sneezes in our presence). We contract strep throat less often, using the same cutlery, glasses and mugs as he does. Angina is especially common in children. Children often "catch" angina by kissing an infected person, e.g. with a sick friend in the yard, in kindergarten.

Angina - types

Due to the location of the infection, it is distinguished by:

  • palatine tonsil angina
  • pharyngeal angina
  • lingual tonsil angina

There is also another division that takes into account the following types of angina:

  • aphthous angina
  • agranulocytic angina
  • membranous angina (diphtheria angina, Plaut-Vincent angina)
  • Ludwig's angina
  • monocytic angina
  • pseudomembranous angina
  • septic angina

Angina - reasons

Bacteria that causeanginacan live in the body "dormant" - this happens quite often. Fatigue, unfavorable weather conditions or chronic diseases or recent viral infections make the body weak. The bacteria that we naturally carry within us multiply faster then and are eager to attack, e.g. the palatine tonsils. And the angina is ready. This mechanism is professionally referred to by doctors as auto-infection.

It is this mechanism that makesangina more common in summer . When it is hot, the blood vessels in the throat dilate. Local cooling of tissues - and this is what we deal with, for example, in timeeating ice cream - causes small vessels to contract. As a result of ischemia, the mucosa lining the throat becomes more defenseless against the attack of pathogenic microorganisms, because then the defense mechanisms are weaker.

Angina is most often caused by streptococci , less often by other bacteria, such as :

  • staphylococci
  • diphtheria (pneumococcus)
  • (Haemofilus influenzae)
  • Escherichia coli

Apart from bacteria, the culprits of angina are usually viruses and sometimes fungi.

Angina - symptoms

The symptoms of anginacannot be mistaken for a cold, because in its course fever and sore throat are much more troublesome. If you recognize most of the symptoms below and a sore throat makes it difficult for you to eat or even swallow saliva, you are probably dealing with strep throat.

However, angina, depending on its location, may have a different course. Typical tonsil angina differs significantly from lingual tonsil and sideband tonsillitis and tonsil tonsillitis. Here are theangina symptoms !

Symptoms of palatine tonsil angina

  • the onset of the disease is sudden - it usually begins with a severe sore throat that makes it difficult to swallow and radiates towards the ears
  • usually has a high fever (over 38 °) and chills
  • the neck and submandibular lymph nodes are enlarged and painful
  • the only symptom similar to a cold is malaise, headache and general breakdown

Symptoms of tonsillitis

Angina of the pharyngeal tonsil in young children, especially infants, can give quite turbulent symptoms:

  • high fever, up to 40 degrees C
  • lack of appetite
  • mucus stools
  • meningeal symptoms
  • convulsions

In older children and adultsthe symptoms of anginaadenoids are milder:

  • pain and burning in the throat
  • obstruction and rhinitis
  • cough
  • body temperature is normal or slightly elevated
  • swelling and redness of the pharyngeal tonsil and the mucosa of the back of the pharynx, along which the mucus-purulent discharge flows
  • in more severe forms, there are also fibrin raids on the pharyngeal tonsil and enlargement and tenderness of the lymph nodes in the neck

Symptoms of lingual tonsil angina

Angina of the lingual tonsil and of the side bands occurs in people after tonsillectomy (removal - enucleation - of the palatine tonsils):

  • painthroat radiating to the ears, intensifying when swallowing
  • speech disorder
  • lockstitch sometimes appears
  • the inflammatory process of the lingual tonsil may move downwards towards the larynx and lead to shortness of breath

Symptoms of Plaut-Vincent's angina

  • throat tightening
  • slight pains when swallowing
  • bad breath
  • body temperature is usually not elevated, but sometimes low-grade fever occurs
  • locally found, most often on one tonsil, in its upper pole, round, crater-shaped ulceration, sharply limited, covered with white-gray, yellow-brown or green patches, quite easy to remove - ulceration bleeds easily when touched

Symptoms of pneumococcal angina

Pneumococcal anginamay be erythematous with reddening and swelling of the mucosa and serous exudate or with the presence of smooth, white-gray raids, quite strongly attached to the substrate and passing to the uvula and palate soft. With a yellowish tinge to blooms it can be difficult to distinguish them from diphtheria.

Angina purulent symptoms. Check if you have them!

Angina - tests and diagnosis

Angina is not always accompanied by white coating on the tonsils . Most often it is not so. At the beginning, when the angina is just beginning to develop, the doctor during the examination notices swelling, congestion and loosening of the palatine tonsils and the mucous membranes surrounding them.

After some time in the so-called in the crypts of the tonsils, whitish patches may form, and sometimes pinpoint-like, yellowish lesions can appear through the mucosa. The yellow-white coating on the tonsils is a mixture of fibrin and leukocytes (immune cells) that have died in the fight against bacteria. The raid may be very little, but sometimes you cannot see it at all because it is rubbed off by food and saliva when swallowing. And withanginaviral does not arise at all.

However, the picture of the disease is so specific that the doctor usually has no problems diagnosing angina at first glance.

Of course, you can always order a test for the presence of streptococci in the throat (if the doctor does not have a tester in his office, you can ask at the nearest laboratory). Such a test allows the detection of anti-streptococcal antibodies in a few minutes, which confirms the presence of these bacteria in the body.

However, since most of us are streptococcal carriers, the value of this test is somewhat questionable. The sick person can only be the carrier of the detected onestreptococcus, and the angina itself could have been caused by a completely different bacteria or virus.

Another type of test (almost 100% reliable) is taking a tonsil swab and viewing the preparation directly under the microscope. Culture and taking an antibiogram take longer, about 2 days, but we are sure that the antibiotic selected in this way will work.

Angina - treatment

There is a common opinion thatwith angina should always be given antibiotic . However, in virus-induced angina, it will not work at all, as in the case of the rare fungal angina.

On the other hand,anginais most often caused by streptococci, and then taking an antibiotic (mainly penicillin) is fully justified. However, do not do it on your own, only on the doctor's recommendation and do not stop the treatment as soon as the throat stops hurting.

In addition, the patient with angina should be given painkillers, antipyretics and local disinfectants in the form of lozenges or gargle solutions. If the lymph nodes in your neck are enlarged and hurt, warm, dry compresses around the neck can help.

You don't always need to stay in bed during strep throat, but the usual weakness that accompanies the disease makes it seem like the only viable option.

You definitely need to isolate yourself from the environment so as not to infect others.

As you sweat and dehydrate in hot weather, be sure to drink as much warm fluids as possible.

The diet should be semi-fluid so that it is easier for you to swallow food. Better avoid hot and spicy foods.

After an illness, it is worth doing preventive examinations. It is about detecting possible complications after angina. The doctor sometimes orders, for example, morphology, ESR, general urine test or EKG.

Angina and tonsil removal

In some cases, more invasive treatments may be necessary. For example, recurrent adenoid tonsillitis in children is an indication for adenoidectomy. It is an ENT surgical procedure involving the removal (cutting) of an enlarged adenoid. The procedure is performed mainly in children over 3 years of age.

Especially if their effect is a permanent hypertrophy of the palatine tonsils. Such tonsils are made up mainly of connective tissue (fibrosis) and no longer protect against any infection. They are normally part of the immune system and protect us from bacteria, viruses and fungi. Overgrown - They are just a type of delay bomb because bacteria live between the fibers and do not respond to antibiotics that cannot get there. An indication for remov althe tonsils are oozing purulent contents when the doctor presses them with a spatula. Such purulent infection is dangerous for the entire body.

Read also: allergic angina or allergic pharyngitis

Angina - complications

Otitis media

The most common complication of untreated or untreated angina is otitis media. It is manifested by severe, stabbing pain in the ear, temporary loss of hearing, accumulation of fluid and a fever. The intervention of an ENT doctor is necessary to prevent the inflammation of the inner ear. Sometimes the eardrum must be cut to prevent uncontrolled rupture. Fortunately, the membrane regenerates.

Sinusitis

Sinusitis is also a common complication of strep throat. Its beginning is easy to overlook, but when typical symptoms appear - a headache that intensifies in the morning or when bending down, discharge running down the back of the throat or a feeling of distension around the nose, you should see a doctor without delay. It is not always necessary to administer an antibiotic, sometimes popular allergy and painkillers are enough, and steroids applied directly to the mucosa are also increasingly used.

Peritonsillar abscess

A very serious complication of untreated angina is a peritonsillar abscess. It is manifested by severe pain on one side of the face which spreads into the ear. It is accompanied by a lockjaw. In the case of an abscess, you must immediately go to the ENT, because if left untreated, it can lead to inflammation of the meninges or the brain, which is life-threatening.

Pharyngeal abscess

A post-throat abscess is a complication of angina that occurs only in children. The symptoms of angina include the characteristic position of the head - it is tilted back, the side wall of the throat and neck are bulged, and the condition of the sick child deteriorates significantly. Patients require hospitalization in the ENT department. In addition to intensive parenteral antibiotic therapy, surgical emptying of the abscess is performed.

Pneumonia

Pneumonia after angina most often occurs in people with significantly reduced immunity, smokers, children and the elderly. the factor contributing to the disease is incorrect treatment with antibiotics (e.g. their discontinuation too early).

Myocarditis

Myocarditis is a very serious complication of untreated or untreated angina. We should be concerned about: fatigue, weakness, shortness of breath, unusual chest pain and arrhythmias - too slowpulse or palpitations or arrhythmia. In such a situation, consult a cardiologist. In more difficult cases, you may need to stay in hospital.

Arthritis

Neglecting angina or a frequently recurring disease can damage joints, which become painful, warm, and may develop swelling and redness. In this case, an ASO test should be performed, i.e. antistreptolysin test - an increased result will confirm arthritis.

Rheumatic fever

Angina can cause not only arthritis, but also rheumatic fever, especially in children. It is caused by an abnormal immune response to the presence of antigens from contact with streptococci that caused angina. Rheumatic fever damages the joints and the heart. The treatment uses antibiotics and corticosteroids.

Acute nephritis

Complication of angina may also be acute nephritis. Symptoms of the disease include fever, pain in the lumbar region, decreased urine output, thickening and cloudy urine, headache, nausea, and vomiting. Such symptoms require immediate contact with a urologist.

Sydenham's Pląsawica

Chorea, which appears as a complication of a streptococcal infection, is called Sydenham's Chorea (Lesser Chorea). The onset of this disease, considered to be autoimmune, is sudden. There are neurological symptoms: chorea, emotional disorders, compulsion, compulsion to be active and hyperactivity. The disease resolves itself within a few months, although it may recur.

Iritis

Iritis is an eye disease that affects the iris, the disc-shaped colored part of the eyeball membrane, and the ciliary body that supports it. Symptoms include sharp eye pain, tearing, photophobia, redness of the eye, change in the color of the iris to a greenish or brownish color, distortion of the pupil, and visual disturbances. As a rule, the doctor prescribes drugs for topical use. In the event of an exacerbation of the disease, corticosteroids are additionally administered into the eyeball and orally.

Dermatitis (erythema nodosum)

Erythema nodosum is an inflammation of the skin and subcutaneous tissue that presents with characteristic large, painful and red bumps on the skin. Hard, painful, well-warmed, vivid red bumps appear primarily on the thighs, and as the disease develops, they change their color to brown, then green, and resolve spontaneously without leaving ulcerations or scars. Erythema nodosum requires treatment of the underlying disease that is the cause of its development.

Ropowica of spaceparachute

Phlegmonous phlegmon is a rare, but still dangerous, complication of angina. The symptoms are similar to the primary disease, but the patient's general condition is usually very severe. Parapharyngeal phlegmon may be constrained to form an abscess of the parapharyngeal space, and may spread towards the base of the skull, into the cranial cavity or to the posterior mediastinum, as well as to the sub-parietal fossa, pterygo-palatal fossa, floor of the mouth, the mandibular fossa and the soft tissues of the neck. It can also cause sepsis.

Meningitis

Meningitis as a complication of angina is rare. The first characteristic symptom is a stiff neck that prevents the chin from touching the chest, accompanied by: increasing headache, vomiting, photophobia.

Mastoiditis

Mastoiditis may appear as a complication of the angina complication of otitis. It manifests itself with earache radiating towards the back of the head, swelling and redness in the behind-the-ear area. Mastoiditis with bone destruction and the created subperiosteal abscess is an absolute indication for surgical treatment. In addition, of course, antibiotic therapy is used as a standard.

Cavernous sinus thrombosis

Cavernous sinus thrombosis is a severe intracranial complication that progresses rapidly. There is a high fever alternating with a significant drop in temperature (hectatic fever), numerous neurological symptoms (including meningeal) and septic enlargement of the spleen. Even if the appropriate treatment is implemented in time, there is no certainty that it will prevent the patient from dying from meningitis or sepsis.

Learn about home remedies for angina!

Can angina be confused with other diseases?

It turns out that many diseases may begin with angina, and their main symptoms may only appear after a few days:

  • scarlet fever or scarlet fever - the tonsils and the throat mucosa are very red, there is pain when swallowing, and feeling very unwell. After 24 hours you have a typical rash that first appears on the upper body. At this time, there is also a marked reddening of the tip and edges of the tongue, then covering the entire tongue (the so-called raspberry tongue).
  • diphtheria - initially there are mild heraldic symptoms, i.e. slight pain when swallowing, fever up to 39 degrees C. The tonsils are slightly red and swollen, covered with white or gray,velvety membranes, firmly attached to the ground, confluent and extending beyond the tonsil into the tonsil arch and soft palate. After their separation, a bleeding surface remains. The cervico-bipolar lymph nodes are very swollen, tender and hard.
  • infectious mononucleosis - apart from enlarged, red, covered with fibrinous palatine tonsils, generalized enlargement of the lymph nodes and the liver and spleen are found.
  • tuberculosis - can cause flat ulceration on the mucosa of the pharynx, palate or palatine tonsil.
  • syphilis - in the secondary period (about 9 weeks after infection), white-white lumps (plaques muqueuses) appear on the palatine tonsils and the oral mucosa. They are painless and very infectious.
  • leukemia - acute lymphocytic leukemia causes hyperplasia of the entire lymphatic ring of the throat, especially of the palatine tonsils. Occasionally, a necrotic ulcer may form. Lumpy lymphocytic infiltrates can also form within the pharyngeal mucosa, breaking up to form easily bleeding erosions.
  • agranulocytosis - characterized by a poor general condition, fever, chills, ulceration and necrosis of the tonsils and pharynx with a black coating. Patients complain of very severe sore throat and neck, especially when swallowing, drooling and bad breath. There is no evidence of enlargement of the regional lymph nodes.
  • cancer of the palatine tonsil and pharyngeal cancer - most often manifest as ulcers spreading to adjacent anatomical structures.

Angina - prophylaxis

Unfortunately,there is no angina vaccine . The number of streptococcal strains themselves is enormous, and the vaccine can only work against one of them. It is hard to imagine us adopting a hundred vaccines without the certainty that the disease would not be caused by a strain … one hundred and one.

You can reduce your risk of developing strep throat by following these rules:

  • treat teeth and any inflammation of the sinuses or ears, because these are the foci of infection located close to the tonsils - hence the bacteria can quickly move to them;
  • avoid people already infected; if someone in the household has caught angina - pay attention not to use, for example, the same cutlery or cups as the sick person; wash your hands thoroughly after contact with a person suffering from strep throat;
  • take care of your immunity - eat lots of vegetables and fruits rich in vitamins, get enough sleep, rest, do some sports, dress appropriately for the weather, give up stimulants;
  • after consulting your doctor, you can use medicationsincreasing the body's resistance;
  • avoid the so-called thermal shocks - do not set the air conditioning to strong cooling in the car, do not jump from a sun-hot beach into the cold water; in hot weather, do not drink very cold drinks, e.g. with ice cubes, or eat heavily frozen ice cream.
About the authorMonika Majewska A journalist specializing in he alth issues, especially in the areas of medicine, he alth protection and he althy eating. Author of news, guides, interviews with experts and reports. Participant of the largest Polish National Medical Conference "Polish woman in Europe", organized by the "Journalists for He alth" Association, as well as specialist workshops and seminars for journalists organized by the Association.Probe

Category:

ENT