Lacunar tonsillitis: symptoms and treatment. Lacunar tonsillitis - main causes, symptoms and treatment tactics Lacunar tonsillitis in adults

It is called an acute infectious disease that affects the tonsils. The lacunar form of tonsillitis, as a rule, affects the palatine tonsils, namely, the crevices in these organs, which are called lacunae or crypts. The lacunae penetrate the entire tissue of the tonsils; they have many branches, in which pus accumulates during sore throat.

Lacunar tonsillitis is most often caused by pathogenic microorganisms. A high incidence of this disease occurs during the cold season. Along with the decrease in air temperature, the reactivity of the human body weakens. As a result of the lesion, the patient’s condition deteriorates greatly, and dangerous complications may develop.

It is more difficult than in adults, so treating them at home is not recommended. If you have signs similar to purulent inflammation, we recommend going to the hospital immediately. There you will be diagnosed and given adequate treatment.

Causes of the disease

The reason for the development of inflammation in the tonsils is an increase in the pathogenicity of such bacteria:

• beta-hemolytic streptococcus from group A;
• pneumococci;

Other microorganisms can also cause lacunar tonsillitis, but the 3 types listed are the most common.

Factors that provoke the occurrence of sore throat:

• hypothermia;
• viral disease (, etc.);
• abnormalities in the development of the tonsils;
• who have not been treated for a long time;
• lack of vitamins;
• not a healthy diet;
• smoking and frequent consumption of alcohol.

Interesting fact! People who are used to breathing through their mouths are more susceptible to infection by pathogenic microflora.

Is lacunar tonsillitis contagious and how is it transmitted?

Yes, lacunar tonsillitis is very contagious. Patients with this diagnosis should be isolated in infectious diseases departments.

Infection can occur through household means. Therefore, the patient must be provided with separate dishes and care items.

The incubation period for lacunar tonsillitis ranges from 12 hours to 2 days. During this period, the patient does not know about his illness, but can already infect others.

Lacunar tonsillitis: symptoms and clinical manifestations, temperature with lacunar tonsillitis

Symptoms of lacunar tonsillitis include:

• fever. The temperature rises almost immediately to 38-39C. This is a natural response of the immune system to infection in the human body. As the temperature rises, chills and muscle pain are also noted. A temperature within 38.5C is not so dangerous, but when it rises to a critical level, convulsions, delirium or respiratory arrest may begin. In this case, emergency medical care is required. In rare cases, lacunar tonsillitis without fever occurs;
• a sore throat. Occurs as a result of swelling of the glands;
• suffocation (consequence of severe swelling);
• the lymph nodes in the neck and jaw become swollen and painful;
• headache.

The tonsils look hyperemic, white-yellow or gray plaques appear on their surface. At first they are located in the lacunae, but then they spread to almost the entire surface of the organ. Plaques are easily removed without damaging the tonsil tissue or bleeding.

Also, a manifestation of lacunar tonsillitis is a complication of a person’s general condition, weakness, loss of appetite, fatigue. Children often feel even worse. They may experience abdominal pain, diarrhea, and vomiting.

Important! With severe tonsillitis, pain appears in the lower back and at the site of the heart, which may indicate cardiac or renal complications.

Diagnosis of lacunar tonsillitis

A therapist or otolaryngologist can diagnose a sore throat. Initially, he collects the patient’s medical history, conducts an external examination, checks the condition of the pharynx and larynx, and palpates the lymph nodes. Also, to diagnose lacunar tonsillitis, a clinical blood test and a general urine test are prescribed. Analysis for lacunar angina usually shows a highly elevated level of leukocytes and accelerated ESR, and protein is present in the urine.

It is good to make smears from the surface of the tonsils for bacteriological examination. This method allows you to identify the pathogen that caused the disease and, based on this data, prescribe an appropriate antibiotic.

Additionally, examination of the nose and ears, immunological examination, and ECG may be required. If surgery is planned, other necessary tests may be prescribed, including x-rays and CT scans.

Treatment of lacunar tonsillitis: antibiotics, sprays, tablets, etc.

When the diagnosis is confirmed, the question arises: should I go to the hospital? This decision depends on the severity of the patient's condition. If the patient's general condition is not severely impaired, the doctor may decide to treat him at home. The patient is given the necessary prescriptions and only then released. If it occurs in a severe form or is diagnosed in a child, treatment at home is out of the question.

For purulent tonsillitis, bed rest, plenty of fluids and diet are very important. The most important component of the treatment of lacunar tonsillitis is antibiotics, which are necessary to eliminate the cause of inflammation, that is, bacteria.

The following drugs are most often used:

• "Suprax"
• "Cephalexin"
• "Azithromycin"
• "Ceftriaxone".

In the hospital they are usually given intramuscularly or intravenously.

Can be taken at home, but only as prescribed by your doctor. The course, as a rule, lasts 5-10 days and must be completed to the end. If you see that one antibiotic does not help, then it should be changed. For this, bacteriological analysis data may be required.

The temperature in lacunar sore throat can be brought down with any antipyretic drug (“”, “Rapidol”, “”, “Antigrippin”, “Arofen for children”), but be prepared for the fact that it will last a couple of days until the antibiotics begin to act.

Interesting to know! The duration of the disease with proper treatment is 5-10 days, but in children and in severe cases this period can increase to 2 weeks.

In addition to antibiotic therapy, the following drugs are used to eliminate the symptoms of lacunar tonsillitis:

• antihistamines ("", "Dexamethasone", "Diazolin") to reduce swelling of the tonsils;
• anti-inflammatory drugs to eliminate inflammation and relieve symptoms in the throat. They may be prescribed in the form of tablets or throat sprays. Sprays ("", "Kameton", "Givalex", "Sore throat with calendula") are suitable for lacunar sore throat in adults and children at least 3 years old;
• antiseptics for the throat, which help destroy bacteria locally and cleanse the oral cavity of pus and germs. Some antiseptics can be used to gargle (solutions such as Miramistin, Orasept, Furacilin, Chlorophyllipt, alcohol tinctures of calendula or propolis are suitable for this), while others can be used to lubricate the tonsils (Lugol's or iodine). Among the most popular is soda-salt solution. It is accessible to everyone and has good cleansing properties. Chamomile decoction is also widely used. They gargle with it for sore throats and also drink it instead of tea. Please note that procedures need to be carried out as often as possible, preferably once every 1-2 hours;
• lozenges with an analgesic and antimicrobial effect (“Strepsils”, “Faringosept”, “Neo-angin”, “Rinza Lorsept Plus”, “Trachisan”, “Decatylene”). They are used in addition to the listed medications.

Since bacterial lacunar tonsillitis undermines the immune system, the following immunomodulatory drugs can be prescribed to increase it: “”, “Interferon”, “Ingavirin”, “Imudon”, “Immunal”.

Protracted purulent lacunar tonsillitis is treated by washing the lacunae of the tonsils. This procedure helps to wash out purulent plugs, disinfect lacunae and speed up recovery. Rinsing is carried out using a special syringe with a blunt needle, but the vacuum method is considered more effective, when the contents of the lacunae are sucked out using a vacuum suction. The number of procedures required for cure can be up to 10 times.

Extreme measures for lacunar tonsillitis involve surgical opening or removal of the tonsils. Lacunotomy is designed to remove purulent contents from the tonsils, along with the affected areas, while preserving the organ. This operation can be performed using a conventional scalpel or laser. Laser lacunotomy is safer and less traumatic.

Tonsillectomy is performed when there is a real threat of complications, as well as with constant relapses of the disease. After such an operation, a further course of rehabilitation is necessary.

Antibiotics for lacunar angina help avoid these complications, so do not delay taking them.

Prevention of lacunar tonsillitis

To prevent lacunar tonsillitis, you need to take care of your immunity. Strengthen it with healthy eating, exercise and exercise, and eliminate bad habits from your life.

Also remember that in cold weather it is important to dress warmly. This is especially true for children. To reduce the risk of a viral disease, which can subsequently trigger a sore throat, during an epidemic, avoid visiting crowded places or wear a protective mask, as viruses are transmitted by airborne droplets.

Informative video

– an acute inflammatory process of predominantly bacterial etiology, which is characterized by damage to the lacunae of the tonsils and is manifested by a pronounced disturbance in the general condition, pain in the throat, aggravated by swallowing. On physical examination, the tonsils are enlarged, hyperemic, and purulent exudate is visible at the mouth of the lacunae. When palpating the regional lymph nodes, pain is noted. To identify the pathogen, a bacteriological analysis of a throat smear is performed. Treatment involves maintaining bed rest during the acute period, prescribing antibiotics, anti-inflammatory drugs, gargling with antiseptics, and physical therapy.

General information

Causes of lacunar tonsillitis

This is an acute infectious disease, the main pathogens of which in children under 5 years of age are adenoviruses, Coxsackie viruses, measles and scarlet fever, in adolescents and adults (in 80% of cases) - streptococci, staphylococci, Haemophilus influenzae and other bacterial agents. Pathogens penetrate the upper respiratory tract with inhaled air, less often through contact and household contact, and are localized on the tonsils. With a decrease in immune defense, pathogenic microorganisms are activated, accumulate in the lacunae and develop a pathological process in the lymphoid formations of the pharyngeal ring. It is possible for streptococci and other bacteria to spread through the bloodstream to other organs and tissues (heart, kidneys, joints), which, against the background of a decrease in the body’s defenses and inadequate antibiotic therapy, leads to various complications: myocarditis, endocarditis, polyarthritis, glomerulonephritis.

Symptoms of lacunar tonsillitis

Clinical symptoms are characterized by a combination of local changes in the pharynx and lymphoid tissues with a disturbance in general well-being. The disease begins acutely with the appearance of symptoms of intoxication: hyperthermia with chills, body aches, and headache. On days 2-3, a sore throat occurs, which becomes more intense when swallowing food and saliva. Due to the enlargement of the maxillary and cervical lymph nodes, there is pain when opening the mouth and turning the head. There is an unpleasant odor from the mouth, and speech is slurred (“nasal tone”). Examining the oral cavity, you can notice redness and swelling of the tonsils, yellowish-white contents in the form of separate islands, which quickly connect, covering the surface with purulent films.

Sore throat in children is accompanied by more severe intoxication, which is manifested by fever, severe headaches, repeated vomiting, syncope with loss of consciousness, decreased appetite, restless sleep, weakness, and irritability. Often there are signs of disruption of the digestive tract with abdominal pain, nausea, and diarrhea. Complaints of discomfort in the throat when swallowing food and water may be absent in the first 1-3 days.

Complications

Purulent inflammation with inadequate treatment and decreased immunity can cause a paratonsillar or retropharyngeal abscess, and also spread to the paranasal sinuses and middle ear. In this case, hyperthermia persists, the pain in the throat becomes pulsating and can radiate to the ear, opening the mouth becomes difficult, as does eating. Repeated sore throats lead to the development of chronic inflammation in the lymphoid tissue of the pharynx and surrounding tissues - chronic tonsillitis, as well as damage to distant organs and tissues: heart muscle, kidneys, joints.

Diagnostics

To correctly interpret the clinical symptoms observed with lacunar angina and to distinguish primary from secondary inflammation, a thorough examination by doctors of various specialties is necessary: ​​pediatrician, internist, otolaryngologist, infectious disease specialist, rheumatologist and nephrologist. Examination of the pharynx reveals signs characteristic of lacunar tonsillitis: pronounced infiltration and swelling of the tonsils, accumulation in the lacunae of yellowish islands of purulent contents and films covering the surface of the tonsil. When removing the films with a spatula, they come off relatively easily without damaging the underlying tissue or causing bleeding.

To identify the pathogen, it is necessary to examine the contents of a smear from the throat and tonsils by performing a bacteriological or virological analysis. General clinical tests of blood and urine are prescribed, with the help of which the activity of the process is determined (leukocytosis and increased erythrocyte sedimentation rate in a blood test) and the presence of complications from the urinary system (leukocytes, red blood cells, protein in a general urine test for nephritis). It is necessary to exclude complications (in particular, rheumatism) when performing a biochemical blood test (changes in the level of C-reactive protein, antistreptolysin-O, rheumatoid factor). Differential diagnosis of lacunar tonsillitis is carried out with other diseases of the ENT organs, secondary processes of an infectious nature (diphtheria of the pharynx, scarlet fever, mononucleosis, etc.).

Treatment of lacunar tonsillitis

During the acute period of the disease, it is necessary to observe bed rest; in severe cases and the presence of complications, hospitalization is required.

• Etiotropic therapy. The basis of therapeutic measures for bacterial etiology is antibacterial therapy for 8-15 days in sufficient dosage, taking into account the sensitivity of the pathogen. Antibiotics from the penicillin group (benzylpenicillin, amoxicillin), as well as cephalosporins and macrolides are usually used. For secondary sore throats of viral and fungal etiology, appropriate medications are used (acyclovir, fluconazole, etc.).
• Symptomatic remedies. Nonsteroidal anti-inflammatory drugs (aspirin, ibuprofen, diclofenac), vitamins, immunomodulators, as well as medications that normalize impaired functions of the cardiovascular system, digestive tract, urinary tract, and nervous system are prescribed.
• Local treatment. Antiseptic solutions and decoctions of medicinal herbs are used locally. After the acute manifestations subside, the patient is given a referral for physical treatment.

With the development of local complications (peritonsillar abscess), surgical intervention with opening of the purulent focus is necessary. Treatment for rheumatic carditis and glomerulonephritis is carried out in a specialized hospital using antibacterial agents, glucocorticosteroids and other drugs.

Prognosis and prevention

The average duration of treatment is 8-15 days. This is enough for a complete recovery, subject to adequate timely therapy. The addition of early and late complications worsens the prognosis and can lead to long-term disability. The main preventive measures are limiting contact with people with colds and sore throats, using personal protective equipment, ventilating the premises, proper work and rest schedule, hardening the body, and regular exercise and sports.

A sore throat is the first symptom of colds. Most often it is caused by a virus that affects the pharyngeal ring. The tonsils take the entire blow, preventing infection from entering the respiratory tract. Often with this development of events, lacunar tonsillitis begins. Symptoms, treatment and features of this pathology will be presented to your attention in the article.

General information about the disease

First of all, you need to find out what lacunar tonsillitis is. Treatment in adults can only be carried out after a complete understanding of the pathology. Sore throat, which doctors often call tonsillitis, can occur in two forms: acute and chronic. The first type most often occurs in childhood and adolescence. If the disease is detected in an adult, then it is likely to have a chronic course in the acute stage. Sore throat often becomes a complication resulting from a common ARVI.

Human tonsils are covered with lacunae and pits. With tonsillitis, plaque forms in them. More often it is of bacterial origin. Despite this, pathology can also be fungal and viral. To avoid complications from lacunar tonsillitis, treatment in adults and children should be carried out after examining scrapings taken from the lacunae.

Symptoms of pathology

A sore throat in a person develops when an infection enters the body. This happens during communication with the patient, when inhaling polluted air. Less commonly, the cause is another disease: caries, inflammation in the oropharynx, hypothermia.

The symptoms of tonsillitis in the lacunar form are usually very pronounced, so the disease is difficult to confuse with another pathology. The clinical picture develops within 24 hours. First, the temperature rises to 39-40 degrees, the person feels a sore throat when swallowing. There is usually no runny nose. The patient is weak and often has a headache, and the lymph nodes become inflamed. If you examine the oropharynx, you will notice swelling of the mucous membranes and hyperemia. In the lacunae there is a purulent coating of white or grayish color.

Is it possible to cure lacunar tonsillitis on your own?

If lacunar disease has begun (in adults), a doctor should prescribe it. The specialist will prescribe the appropriate medications for you after a series of studies. The average duration of therapy is 7-14 days. With the right approach and following all the recommendations, you will feel better within a few days. But often people put off visiting a doctor, trying to cope with the problem on their own.

It is quite possible to cure tonsillitis at home. But such therapy can be compared to playing Russian roulette. If you correctly find out what causes lacunar tonsillitis (treatment in adults will be carried out correctly), then the outcome will be favorable. If the drugs are used incorrectly, tonsillitis can cause complications. The kidneys and cardiovascular system are especially affected.

Use of antibiotics, antifungals and immunomodulators

Treatment of lacunar is almost always justified. In 70% of cases, tonsillitis is caused by a bacterial infection. Today, preference is given to penicillin antibiotics. The drug “Augmentin” stands out especially. It contains an antibacterial substance (amoxicillin) and a component that eliminates the resistance of microorganisms (clavulanic acid). Macrolides, cephalosporins and sulfonamides are less commonly prescribed.

If fungal infection of the tonsils is confirmed, then lacunar tonsillitis treatment in adult patients involves antifungal therapy. Drugs based on nystatin and fluconazole are prescribed. There are also cases where fungal infection is caused by long-term use of antibiotics. Therefore, when treating a sore throat, it is advisable to take antifungal compounds for the purpose of prevention.

Antiviral agents (Kagocel, Rimantadine, Cycloferon) are prescribed if the viral origin of tonsillitis is confirmed. With this course of the disease, a runny nose is often associated. The use of immunomodulators is justified for all types of pathology. Doctors recommend Lykopid, Polyoxidonium and other medications.

Symptomatic therapy

Depending on the symptoms of lacunar tonsillitis, treatment in adults should be appropriate. When body temperature rises, it must be lowered. It is advisable to take antipyretics when the thermometer level shows more than 38-39 degrees. If you feel very unwell and at 37.5 degrees, you can also use antipyretics.

Nonsteroidal anti-inflammatory drugs are more suitable for self-administration. These are medications such as Nurofen, Ibuprofen, Nimesulide, Nise. They will not only reduce the temperature and eliminate pain, but also have an anti-inflammatory effect. The popular “Paracetamol” or “Panadol” is used less frequently for tonsillitis. The fact is that this medication is toxic to the liver, and in addition to it, you also have to take antibiotics, which also do not have the best effect on the functioning of the hematopoietic organ.

Treatment of the larynx and tonsils

If lacunar tonsillitis has begun, treatment in adults (you already know which antibiotics to take) can be carried out using local remedies. Most of these drugs are not absorbed into the bloodstream, but act on the surface of the tissue. It is advisable to treat the throat with tonsillitis with regenerating, anti-inflammatory, antibacterial agents and antiseptics. Doctors prescribe Lugol, Miramistin, and Chlorophyllipt for self-use. These drugs can be used to lubricate and irrigate inflamed tonsils. Particular attention should be paid to lacunae and, if possible, remove plaque from them with a sterile cloth soaked in the specified solutions.

Doctors also do not prohibit dissolving lozenges. “Gramidin” or “Gramicidin” is more often recommended. These are antibacterial formulations for topical use. They can also be used for children from 4 years old. You can give preference to such drugs as Strepsils, Septoleta and Hexoral. They not only act on the cause of the pathology, but also eliminate sore throat. Irrigating medications (“Tantum Verde”, “Ingalipt”, “Bioporox”, “Kameton”) can be used at home, but you should not use them all at once. Be sure to read the information about the possibility of combining some medications with others.

Additional medications

You already know that lacunar tonsillitis greatly undermines a person’s immunity. Treatment at home involves the use of vitamin complexes. These could be drugs “Alphabet”, “Complivit” or some others. They will make up for the deficiency of missing substances, which is always observed with tonsillitis due to a malnutrition.

Patients often use Tonzilgon for self-medication. It is available in the form of alcohol drops and tablets. The medication helps strengthen the body and increase resistance. It also has an anti-inflammatory, cleansing effect. Instructions for use advise using the drug for acute and chronic sore throat of various origins.

If you experience additional unpleasant symptoms during tonsillitis, you can eliminate them using appropriate means. Medicines “Nazivin”, “Snoop”, “Vibrocil” will save you from nasal congestion. It is also advisable to use salt formulations for irrigation of the nasopharynx. If you have additional ear pain, you can use Otipax. The drops will relieve inflammation and numb the ear canals. For dry, obsessive cough, take Sinekod and Codelac. Productive cough is supported with mucolytic medications “Lazolvan”, “ACC”.

Diet and regimen

For purulent tonsillitis with the formation of white lacunae, it is necessary to follow the regimen. It is prohibited to lead a normal lifestyle. You need to limit physical activity and stay calm. Otherwise, there is a high probability of pathological complications. The body needs a lot of strength to fight infection. If you always want to sleep, sleep. If you have no appetite, don’t force yourself to eat. It is important to drink more liquid: water, juices, fruit drinks, teas. Food should not be hot or cold. Avoid anything that can irritate your throat: salty, sour, sweet, spices. Give preference to soups, pureed foods and cereals.

The room where the patient is located should be cool and humid. Don't dry out the air. Hot inhalations are strictly prohibited. Remember that by doing this you are creating all the conditions for further proliferation of microorganisms. Lacunar tonsillitis in adults can be highly contagious. Therefore, minimize contact with healthy people and family members.

Lacunar angina: treatment in adults with folk remedies

Many patients try to make do with their grandmother’s recipes. It is worth saying right away that such actions can be quite dangerous. If the wrong tactics are chosen, the result may be negative. For example, if treated incorrectly, lacunar tonsillitis goes from the acute phase to the chronic phase. The patient thinks he is recovering, but this is a big delusion. Chronic tonsillitis will recur with terrifying frequency. With the slightest decrease in immunity or hypothermia, you will again experience all the delights of the disease. But this does not mean that folk recipes are powerless. They can be a good addition to traditional treatment.

• Gargle with decoctions of sage, calendula, and chamomile. Such compositions will wash away pathogenic flora and have a regenerating and anti-inflammatory effect.
• Consume more vitamin C. It is found in large quantities in greens, especially parsley and cabbage. You should not eat lemon and other citrus fruits.
• Drink it. It will strengthen the immune system and soothe a sore throat.
• Milk and honey will have an analgesic effect on the oropharynx and eliminate an obsessive dry cough.
• Rub the throat area with badger or goat fat. It will warm up the inflamed areas. Remember that this can only be done if there is no fever.

Summarize

From the article you could find out how lacunar tonsillitis is corrected. Photos in adults, treatment and drugs are presented to your review. Think twice before refusing a doctor's appointment. Remember that angina is very dangerous. If treated incorrectly, it may require surgery and removal of the tonsils. Be healthy!

The oropharynx constantly encounters many microbes and bacteria, which, when penetrating through the mucosa, can cause inflammatory diseases. The body's protective functions are provided by lymphocytes and lymphoid tissue. Its accumulation in the pharynx provides local barrier properties. The accumulation of pathogenic bacteria and various provoking factors contribute to the active reproduction of pathogens. Tonsillitis often becomes chronic, has a protracted course, and exacerbations occur 2 or more times a year. To prevent such a condition, it is necessary to promptly, comprehensively and completely treat acute, first-time inflammation of the tonsils of the oropharynx.

Description

Lacunar tonsillitis is an acute inflammatory disease primarily affecting the tonsils. Most often, the palatine are affected. In their structure, they have narrow passages between accumulations of lymphoid tissue, called crypts. The crypts open on the surface of the tonsils with small depressions - lacunae. Mucus, exfoliated epithelium, and food particles can accumulate in them - all this is a breeding ground for microbes.

Under certain conditions (ingress of virulent microorganisms, decreased immunity), a pathological process may develop, manifested by symptoms of intoxication and damage to the palatine tonsils.

Along with the chronicity of the process, complications such as:

• abscess formation;
• phlegmon of the palatal region;
• pneumonia;
• bronchitis and others.

Age features

The disease can develop at any age, regardless of gender, in people with intact tonsils (if surgery has not been performed to remove them).

Some time ago, almost all children with chronic tonsillitis had their tonsils removed, but today they are trying to preserve these anatomical structures whenever possible, since their significant contribution to the formation of immunity has been proven.

Lacunar tonsillitis is always an acquired disease and can affect even babies. For the appearance of a clinical picture, the mucous membrane of the baby must be populated by pathogenic bacteria. Even a small amount of them is enough to activate the inflammatory process, since newborns have practically no immunity.

In children, the disease is much more severe than in adults.

Lacunar tonsillitis has a certain seasonality - more often it occurs in autumn and winter, when the body's immune response decreases due to low temperatures, lack of vitamins and the sun.

Adults after 30-35 years of age suffer from lacunar tonsillitis several times less often, which is explained by a decrease in the reactivity of lymphoid tissue and age-related features of the structure of the upper respiratory tract. Older patients tolerate intoxication syndrome more easily, but the disease itself can last quite a long time. Pain when swallowing and swelling of almost the entire cervical region persist in adults for a long time.

Types and forms

Lacunar tonsillitis is one of the most severe and aggravated types of tonsillitis. Rarely occurs spontaneously and is usually chronic. The increase in clinical symptoms indicates another exacerbation or develops secondary, against the background of another inflammatory disease of the oropharynx.

We can talk about the occurrence of chronic tonsillitis if a repeated case of tonsillitis occurs within a year. It is usually more severe and more difficult to treat.

With constantly reduced immunity, tonsillitis bothers a person up to 4-6 times a year, accompanied by a pronounced and aggressive clinical picture.

The classification of the disease is presented in the table:

Fungal form of tonsillitis

The severity of a sore throat can be determined by the spread of the pathological process or the presence of symptoms of intoxication. All severe clinical cases require immediate hospitalization in a hospital, where specialized specialists decide on further therapeutic tactics. In some situations, purulent formations spread down into the mediastinum and chest area, so emergency surgery is necessary.

Bilateral lacunar tonsillitis

Depending on the type of pathogen, the degree of exposure, course of treatment and groups of drugs used differ. Even broad-spectrum antibioticsare not able to provide a therapeutic effect for tonsillitis of a fungal nature.

Causes

The most common cause of lacunar tonsillitis in adults is bacteria. The main pathogens include:

• staphylococci;
• streptococci;
• pneumococci;
• Haemophilus influenzae and Pseudomonas aeruginosa.

In children, the causative agents are often measles viruses, adenoviruses and others. But this does not exclude the possibility of developing viral tonsillitis in adults and bacterial tonsillitis in children.

Provoking factors:

• inflammatory diseases of nearby organs;
• chronic foci of infection in the body (caries, helminthic infestations);
• hypothermia, prolonged exposure to wind and low air temperatures;
• chronic stress and overwork;
• decreased immune response;
• frequent contacts with a person who has a chronic form with exacerbations.

Viruses and bacteria are transmitted by airborne droplets - this means that sore throat is contagious, and you can get it through contact with a sick person. With a significant decrease in immunity, the disease can also be caused by opportunistic microflora of the oral cavity (streptococci, Haemophilus influenzae, etc.). Microorganisms can also remain on dishes used by the patient and infect other people when eating food.

It is believed that lacunar tonsillitis is quickly transmitted and is one of the highly contagious diseases.

Symptoms

The disease begins acutely. The incubation period is short - from several hours to 2-3 days. The temperature rises sharply to febrile levels - 38-39 degrees. Fever is accompanied by a feeling of weakness, chills, headache and aches throughout the body.

Simultaneously with the rise in temperature, characteristic changes appear in the throat:

• the palatine tonsils increase in size and become red;
• there is soreness in the throat, which intensifies with swallowing movements;
• difficulty swallowing leads to a decrease in appetite, even to the point of refusing to eat;
• In addition to the tonsils, regional lymph nodes - cervical, submandibular - enlarge.

Associated symptoms of sore throat:

• weakness, headache, malaise, muscle fatigue;
• purulent contents that separate from the tonsils;
• pale skin (redness of the cheek area is clearly visible);
• bright red tint of the throat mucosa;
• chills;
• increased heart rate.

When examining the oral cavity, enlarged red palatine tonsils with purulent plaque are visible. At first, it can cover only the lacunae, and then grow and merge - in this case, the palatine tonsil will be completely covered with it. The plaque is easily removed, revealing enlarged hyperemic lacunae.

Treatment

With comprehensive treatment, the disease lasts 7-10 days, but the period can reach up to two weeks. To relieve severe symptoms and prevent complications (the development of an abscess, sinusitis, long-term cardiac consequences), competent therapy is extremely important.

First of all, it is necessary to observe bed rest. Considering that the disease is transmitted by airborne droplets, it is important to limit the patient’s contact with children, who are extremely susceptible to the pathogen. The room where the patient is located must be ventilated several times a day. The patient must use separate utensils during the therapy period.

Etiotropic treatment for bacterial tonsillitis includes antibacterial drugs, most often penicillins (amoxicillin, amoxiclav). If bacteria are resistant or allergic to these substances, macrolides (clarithromycin, azithromycin) are used. The course of antibiotic therapy is usually 7 days. For viral sore throats, antiviral agents are used - Acyclovir, Interferon, Viferon. For the fungal form, Fluconazole is prescribed.

In severe cases, drugs are prescribed in injections - Ceftriaxone or Cefazolin.

Sprays are prescribed locally, rinsing the pharyngeal cavity with antiseptic solutions (Miramistin, Nitrofural), and herbal decoctions (chamomile, sage). You can use absorbable tablets - Faringosept, Strepsils. To relieve symptoms of intoxication, non-steroidal anti-inflammatory drugs with analgesic and antipyretic effects (paracetamol, acetylsalicylic acid) are prescribed.

Physiotherapy is indicated during the rehabilitation process. The following have a pronounced therapeutic effect:

• inhalation;
• laser therapy.

Alternative medicine

Treatment with folk remedies is not used as the main one, but gives a proven effect as an auxiliary one.

During the day, it is recommended to drink fruit drinks and compotes based on cranberries, sea buckthorn and lemon. All these berries contain many vitamins, strengthen the body and relieve inflammation and swelling. Drinking large amounts of fluid reduces intoxication, improving the patient's condition.

Iodine has a negative effect on the purulent contents of the tonsils. It is sold in pharmacy form in the form of Lugol's solution, which is used to lubricate the affected tonsils at home. You can also use a regular alcohol solution. To do this, 10 drops of iodine are mixed with 1 tsp. soda and diluted in 150-200 ml of warm boiled water. The resulting mixture is gargled every 3-4 hours.

Decoctions of linden and chamomile have a beneficial effect on the mucous membrane, reducing inflammation and swelling. Milk with honey and butter softens the soft tissues of the oropharynx and facilitates the act of swallowing.