Signs of herpangina in children and adults - routes of infection, symptoms and treatment. Features of symptoms and treatment of herpetic sore throat How long does quarantine last for herpes sore throat?

Sore throat is a term known to medicine since ancient times. Sore throat is a general disease caused by an infectious agent with local damage and inflammation of one or several elements of the pharyngeal lymphoid ring. Most often, the palatine tonsils become inflamed.

Of all tonsillitis, 90% are tonsillitis caused by viruses. Among viral tonsillitis in children, cases of herpetic tonsillitis occur at any age. It is useful for parents to know what this disease is and how it manifests itself, so that when faced with it, they do not get confused, but go to the doctor in time and begin the correct treatment.

You will be surprised, but it turns out that herpetic sore throat has practically nothing in common with the herpes simplex virus. Then why is it called that? The manifestations of herpangina were first described by Zagorsky in 1924, when the true culprits of the disease were not yet known to medicine. He called sore throat herpetic because its manifestations were very similar to herpes rashes: small, watery blisters covering the soft palate and anterior arches. Today, the true causative agent of herpetic sore throat has been identified, but the name remains the same.

Herpetic sore throat in children is a viral disease that is similar to a simple sore throat, and at the same time has signs of a herpetic infection. This type of sore throat is caused by the ECHO virus, which got its name after the city where it was first discovered. Both viruses belong to enterovirus species. The most common culprit of the disease is the Coxsackie A virus. Other groups of viruses cause the disease much less frequently.

Is it possible to get infected with herpetic sore throat?

Yes, it is possible and very easy. The susceptibility of children to these viruses is quite high. The virus enters the external environment with the patient’s secretions (saliva, mucus from the nasopharynx, feces). When a sick child enters a children's group, the disease quickly spreads among the children. The virus can get from a sick child to a healthy one in several ways.

3 ways to get infected with herpes sore throat

1. Airborne. When talking, coughing or sneezing, the virus from the patient with particles of saliva enters the air and circulates in it. When there is a large concentration of children in one room (in kindergartens, schools or at family holidays), the virus quickly spreads through the air and enters the body of healthy children through breathing. This is the most common method of infection.
2. Fecal-oral. Infection occurs less frequently this way. The virus enters the body along with toys, pacifiers or other objects with which the sick child has previously been in contact. You can also become infected through food, dishes and dirty hands. In other words, a healthy child ingests the virus remaining on things or objects that were previously used by someone with herpangina.
3. Contact. Infection occurs through direct contact of a healthy child with a sick child through mucus flowing from the nasopharynx. Young children can hug, kiss, bite or lick each other and easily contract an infection.

You can become infected from a sick person, from a carrier of the virus, who may not show any signs of illness, or from a recovering person, who can release the virus into the environment for another 3-4 weeks. Rarely, pets, with whom children love to play, can become a source of infection.

Herpangina can be caught at any time of the year, but a sharp increase in incidence is observed in the summer-autumn period. It is from mid-summer and throughout the fall that the number of cases increases, and the risk of infection also increases.

More often than others, children under 10 years of age get sick. Although herpangina occurs among all ages, cases of the disease are recorded much more often among children under 10 years of age. It is worst for children under three years of age; their disease is always more severe than others. In babies under six months of age, herpangina is extremely rare due to passive immunity (antibodies obtained from mother's milk), which protects them from infection.

Mechanism of development of herpangina

After viruses enter the body through the nose or mouth, they collect in the intestines, accumulating in the lymph nodes, where they multiply. Having multiplied, the viruses begin to penetrate the blood and spread throughout the body through the bloodstream. This is called viremia (presence of viruses in the blood). Where viruses settle and cause harm depends on the properties of the virus itself, as well as on the child’s body’s defenses.

The favorite places for the accumulation of Coxsackie and ECHO enteroviruses are mucous membranes, muscles, especially the heart, and nervous tissue. It is in these places that viruses settle more often, destroy healthy cells and cause inflammation, which is manifested by corresponding symptoms of the disease.

Quite often there are cases when herpetic sore throat occurs against the background of other viral infections, for example, together with an adenoviral infection or influenza.

Children who have had herpetic sore throat remain immune to this virus for life, but it will not protect the child from another type of virus. Thus, if the child encounters the same strain of the virus again, the child will not get sick, but if he encounters a new type of virus, he may get herpangina again.

Who is at risk of getting sick?

There is a risk of getting herpetic sore throat:

1. In children attending organized children's groups (kindergartens, schools, camps). Children in groups are more likely to catch an infection than unorganized children.
2. In frequently ill children. Often sick children have weakened immunity, and therefore the risk of getting sick increases.
3. In children with chronic diseases.
4. In children with systemic diseases being treated with drugs that suppress the immune system.

Manifestations of herpangina in children

The manifestations are varied. Herpetic sore throat can be one single sign of infection, or it can be combined with its other manifestations.

During the course of the disease, a latent period, a period of peak and a period of resolution or recovery are distinguished.

The latent period of the disease, when there are no symptoms yet, but the virus has already entered the body, can last up to two weeks, but more often the child becomes ill within 2 to 4 days after the virus enters.

The period at the height of herpetic sore throat is characterized by an acute onset, reminiscent of the flu. The temperature rises high, 39 ºС and above, the head hurts, the whole body aches and hurts, and weakness occurs. A sore throat bothers the child from the first days of the disease, it hurts him to swallow, his appetite decreases, and a runny nose and cough may also occur. A little later, other symptoms of enterovirus infection may appear - nausea, vomiting, loose stools, the child may complain that his stomach hurts. Other symptoms are not always present; the disease can only manifest itself as a sore throat. Sore throat caused by Coxsackie viruses has its own characteristics.

Features of herpetic sore throat:

• fast development. Inflammatory changes in the oral cavity occur from the first days of the disease. The transformation of the rash from one element to another is characteristic. Therefore, the appearance of papules (rash protruding above the surface of the mucous membrane) may not be noticed. Most often, the rash is detected already at the stage of the appearance of vesicles;
• On the reddened and swollen mucous membrane of the soft palate, tonsils and posterior wall of the pharynx, single or grouped watery or purulent blisters form. Blisters are rare, but can appear even on the mucous membrane of the cheeks. Unlike those caused by the herpes virus, blisters never appear on the gums or on the surface of the tongue;
• blistering rashes are painful. The child may complain that his mouth hurts, and young children may even refuse to eat or drink;
• after a couple of days, the bubbles burst, and instead of the burst bubbles, erosions with a red rim along the edges remain. Erosions can be located singly, or they can merge, forming extensive wound surfaces with uneven edges;
• Erosion heals slowly. The healing process continues for 2 - 3 weeks. Children with weakened immune systems may experience repeated rashes; when they appear, the child feels unwell, his temperature rises again and everything starts all over again.

Closely located lymph nodes react to the appearance of rashes in the oral cavity. The chin lymph nodes are slightly enlarged. In children weakened after an illness, as well as with problems with immunity, in addition to the mental lymph nodes, the submandibular and cervical lymph nodes react. In such children, generalization of the infection is possible, the spread of a large number of viruses throughout the body, with the development of severe, life-threatening complications.

The recovery period begins with normalization of temperature. In the classic course of herpetic sore throat, the temperature lasts no more than three days, and then drops sharply. All rashes heal within a week. When a secondary infection occurs, as well as with severe manifestations of enterovirus infection, the recovery process is delayed, and complications from the nervous system (meningitis, encephalitis), heart (myocarditis) and kidneys (glomerulonephritis) may develop. This development of events usually occurs if the child has any disturbances in the functioning of the immune system.

In addition to the classic form of herpetic sore throat, there are also atypical erased forms. They proceed more easily, without characteristic rashes, and recovery occurs faster. Hidden forms often go unnoticed, since there are no characteristic manifestations, and patients are usually diagnosed with ARVI.

Diagnostics

The diagnosis of the standard course of herpangina, at the time of an epidemic outbreak, can be made during a routine examination. It is prescribed by a pediatrician or ENT doctor. During examination, characteristic rashes with typical localization are visible. Seasonality and contact with sick people are also taken into account.

However, in isolated cases of infection it is quite difficult to make a diagnosis. Of course, you can use laboratory research methods, but in most clinics the necessary methods are not available.

Therefore, the diagnosis is made only on the basis of examination in the presence of a clear picture of the disease and according to observation of the child during the illness.

A general blood test reveals changes characteristic of the inflammatory process - leukocytosis and accelerated ESR.

To accurately determine the pathogen, virological and serological diagnostic methods are used. To detect the virus using the PCR method, swabs and swabs obtained from the nasopharynx no later than 5 days from the onset of the disease are needed.

The serological method is based on the detection of antibodies to enteroviruses. This requires a double blood test, taken at the onset of the disease and again at intervals of 10 to 14 days. A fourfold increase in titer indicates the presence of enteroviruses in the body.

If there are complaints and any abnormalities are detected on the part of other organs and systems, the child is referred for consultation to a specialist of the appropriate profile or for additional examination methods.

Treatment of herpetic sore throat

Most children are treated at home to prevent the infection from spreading. Children under the age of one year, with severe illness, with the development of complications, disabled people and children with chronic diseases are required to be hospitalized. Below we will consider the main directions of herpangina therapy.

Regular events

For a speedy and complete recovery, you must follow a number of recommendations, including:

• Isolation is a fundamental principle in the treatment of contagious diseases. Moreover, the child must be isolated not only from the team, but also from other children living in the family, brothers and sisters. High-quality isolation implies the presence of a separate room where healthy children will not be allowed, individual use of utensils, and hygiene items. In most families this is not possible.

Therefore, during the period of illness, it is better to send one of the children healthy for a temporary stay with their grandmother or other relatives. This way you will reduce the time the infection stays in the family and the material costs of treating household members.

After recovery, carry out general cleaning using disinfectants.

• Bed rest is required for the entire acute period of the illness. It is extremely difficult to keep children in bed, even with a fever. But this is very important to avoid complications. Try to keep your child occupied with something, spend more time with him;
• Particular attention should be paid to the child’s nutrition. Since everything in the child's mouth hurts, it is necessary to exclude all foods that can cause irritation. These include sour, pickled and salty foods, as well as hard and hot foods. Give your child liquid or semi-liquid food that is warm, but not hot.

Particular problems may arise with feeding infants. Due to painful rashes, babies often refuse to eat or even drink, and this is very dangerous at this age, because dehydration can quickly develop. In such cases, you can feed and drink the child after pain relief. Gels with an anesthetic effect are suitable for this, or you can give an anesthetic syrup orally, for example, Nurofen.

Drug therapy

There is no specific treatment, so all treatment is aimed at eliminating the symptoms of the disease. Prescribe drugs that have antiviral activity (for example, Arbidol). Prescribing antibiotics for a viral infection is ineffective because they do not act on viruses. Antibiotics are used only in case of bacterial infection.

Despite the external similarity of the rashes with a herpetic rash and the general viral nature of the diseases, the treatment is still different. For example, Acyclovir, which is successfully used to treat herpes and does its job well, will not help with herpetic sore throat.

The thing is that it has a selective effect on herpes viruses of various types and is ineffective in the treatment of enterovirus infection. Therefore, it makes no sense to use Acyclovir to treat herpangina. For local treatment, it is better to use antiviral drugs in the form of gels (Viferon) or irrigate (spray) the affected mucosa with interferon.

Do not self-medicate; only a doctor can determine the true cause of the disease and prescribe appropriate treatment. Incorrect treatment is not only a waste of time and money, but also an additional threat to the child’s health.

• Hyposensitizing agents are prescribed to relieve swelling and redness. These include Suprastin, Loratadine, Tavegil. They are selected according to age dosage;
• To reduce the temperature, antipyretics (, ibuprofen) are prescribed, also in compliance with age-specific dosages;
• As a local treatment, treatment of the oral cavity with various antiseptic, analgesic and healing agents is used.

To prevent secondary infections, it is recommended to treat the oral cavity with antiseptic solutions. Older children who can rinse their mouths on their own need to do this procedure every hour. Furacilin solution, Miramistin, Chlorhexidine, and various herbal decoctions (calendula, chamomile, sage) are used as antiseptics. For children who do not know how to rinse their mouths, antiseptic solutions in the form of sprays are used. After rinsing with an antiseptic, it is recommended to treat the mucous membrane with antiviral drugs (Interferon, Viferon).

As part of complex therapy, Derinat is prescribed together with antiseptics, a drug that has proven itself in the treatment of diseases that cause inflammation and damage to the oral mucosa. Derinat stimulates the immune system, increasing the activity of cells that can recognize and neutralize cells affected by the virus.

Derinat also activates and accelerates healing processes, increases the resistance of cells and the body as a whole to the effects of viruses, bacteria and other infectious agents. In addition, it has an antiallergic effect, relieves swelling and reduces inflammation. The advantage is that Derinat can be used from birth and has good compatibility with other medications.

In the treatment of heprangina, Derinat solution is used for rinsing. The frequency of rinsing is 4 - 6 times during the day.

The only drawback is the small volume of the drug in one bottle. It only lasts once or twice. It is necessary to rinse for 5 - 10 days. Considering the cost of 250 and above in various pharmacies, it turns out that the treatment will not be cheap.

To speed up healing, use sea buckthorn oil, Dexpanthenol, and rosehip oil.

A good effect is achieved by using complex products: Ingalipt, Cholisal, Tantum Verde. They anesthetize, disinfect and envelop the affected mucosa, protecting it from irritation.

Physiotherapeutic procedures

Ultraviolet irradiation is also used to stimulate and accelerate healing. This method can only be used during the recovery period, after acute inflammation has subsided. In the acute period, ultraviolet radiation is contraindicated.

Modern mothers love to be treated with inhalations, using them from the first days of the disease. Inhalations are a good treatment method in certain situations. But in cases where the cough is associated with herpetic sore throat, inhalations are contraindicated, as are compresses. Any thermal procedures, which include inhalations and compresses, increase blood circulation and give viruses an excellent opportunity to spread throughout the body, affecting new organs.

• Vitamins C and group B are prescribed together with general treatment. If the child does not have allergies, you can take age-appropriate vitamin complexes;
• In case of disturbances in the functioning of the immune system, immunostimulating drugs are prescribed. A pediatrician can also prescribe them, but it is better to consult with an immunologist to choose the right drug.

The prognosis is favorable if treatment is started on time and all recommendations are followed. Full recovery ensues.

Complications of herpetic sore throat

The development of complications indicates disturbances in the functioning of the immune system or improper and delayed treatment of the disease.

1. Complications from the nervous system. These include viruses affecting the brain (encephalitis) and meninges (meningitis).
2. Heart complication. They occur when viruses penetrate the heart tissue, which causes inflammation of the heart muscle (myocarditis).
3. Kidney complication

Glomerulonephritis is a serious complication that occurs when viruses penetrate the kidney tissue.

All complications can lead to disability or death, so all sick children with complications are treated in a hospital.

Prevention

Vaccination against enterovirus infection has not yet been invented.

Therefore, the main method of prevention remains timely detection and isolation of sick people.

Quarantine for a period of two weeks is introduced for sick people and those in contact with them. Children's institutions where cases of infection have been reported are being disinfected. Contact children are given intramuscular gamma globulin depending on the child's weight. After the quarantine period expires, children can be in the group again.

During an outbreak of infection, the same means are used for prevention as for the prevention of ARVI. Antiviral drugs are prescribed. For example, Interferon intranasally (drip into the nose) in a prophylactic dosage.

A good preventive measure is the normal functioning of the child’s immune system. The formation of good immunity should be done from childhood: lead a healthy lifestyle, treat in a timely manner and prevent diseases from developing, get vaccinated and follow all the recommendations of the pediatrician.

Herpangina, like any contagious disease, requires timely diagnosis and treatment to prevent complications and the spread of infection. If you find any of the symptoms in your child, do not self-medicate, consult a doctor. This condition is usually treated by an ENT doctor. If such a doctor is not available, contact your pediatrician.

Herpetic sore throat is a throat disease caused by specific pathogens from the group of enteroviruses. Most often these are Coxsackie viruses type A and B, ECHO viruses. Sources of infection are a sick person, contaminated food. The carrier does not necessarily have a clinic for tonsillitis. This may be a skin, intestinal or latent form of the disease.

Like any viral disease, such a sore throat differs from bacterial infections in its symptoms and treatment regimen:

• sometimes the signs are nonspecific for tonsillitis;
• the main category of patients is children;
• dangerous due to viral complications on the membranes of the brain;
• does not respond to treatment with conventional antibacterial agents.

Herpetic sore throat in a child is highly contagious (infectious). This explains its widespread use. A variant of morbidity in the form of epidemic outbreaks is possible. It occurs more often in the age group of 3 - 10 years.

Dr. Evgeniy Komarovsky provides information about viral sore throat in children in a competent and accessible manner. We will sometimes refer to his authoritative opinion on questions of how to recognize and how to treat a sore throat in a child.

Herpangina has a moderate or severe course due to severe intoxication syndrome with high fever, local inflammation of the tonsils and pharynx. Viral sore throat in children has special principles of medical care. Komarovsky voices its prevention and treatment in his publications and on forums.

Herpangina signs and symptoms

The clinical picture of herpangina is typical and does not cause any particular difficulty in diagnosis. Main symptoms:

1. Severe intoxication syndrome (headache, fever, refusal to eat, lethargy).
2. Sore throat that gets worse when swallowing.
3. Painful rashes on the surface of the soft palate. They look like blisters or ulcers (aphthae) that are white-gray in color with a red border. Element sizes are 1 - 5 mm.
4. There may be a small blistering rash on the skin of the extremities.
5. Enlargement and inflammation of the submandibular, parotid, cervical lymph nodes.
6. Abdominal pain, nausea, and vomiting may occur.

The development of herpangina is preceded by contact with a patient with enterovirus infection. The fact of infection must be mandatory. The incubation period lasts from 7 to 14 days. The acute phase with fever lasts four to five days. After the ulcers resolve, scars remain on the mucous membrane of the oropharynx. They dissolve completely within a week. Patients with immunosuppression may have an intermittent course. In this case, episodes of fever and rashes are repeated every 2 - 3 days.

Komarovsky always focuses the attention of parents on careful monitoring of the condition of a child with herpes sore throat. Such alertness is associated with a high risk of complications from the Coxsackie virus and the possibility of secondary infection.

Re-seeking medical help should be immediate if the patient develops alarming symptoms:

• rashes on the throat are accompanied by severe pain and suppurate;
• the child refuses to drink and does not open his mouth;
• sharp intense muscle pain in the back of the head, back;
• Strong headache.

Viral tonsillitis is especially difficult in infants. In infants, its development is complicated by neurological symptoms (depression, convulsions), clinical dehydration (crying without tears, lack of urination for more than 8 hours, dry mucous membrane of the lips, oral cavity, sunken fontanels).

Doctor Komarovsky about the disease

Dr. Komarovsky talks about enteroviruses and sore throat in a very interesting and accessible way. This information is available from his blogs, videos, printed media. He calls enteroviruses the second most common cause of all acute respiratory viral infections. In the clinic of herpetic sore throat, Komarovsky identifies several syndromes:

• flu-like syndrome;
• skin syndrome - blisters and ulcers on the pharyngeal mucosa;
• there may be a combination with hand-foot-mouth disease.

The complaints are varied, since these pathogens multiply in almost all human tissues and organs. Although sometimes there are no manifestations other than an unmotivated increase in body temperature. Komarovsky recommends that such a child be examined for enteroviruses.

Evgeniy Olegovich points out an uncharacteristic transmission route. This type of sore throat is transmitted to a child through the fecal-oral route, that is, through dirty hands. However, intestinal forms of the disease are quite rare. This is one of the main differences between Coxsackie and other pathogens of ARVI. The doctor explains their high prevalence by good stability in different conditions, even in acidic gastric juice.

About sore throat in children in the classic version, Komarovsky begins his explanations with the features of anatomy. Indeed, not every “red throat” is considered a sore throat. It is the infectious disease of the tonsils that is called tonsillitis. The palatine tonsils consist of lymphoid tissue, and therefore actively participate in the fight against antigens. This organ belongs to the peripheral immune system. The lymphopharyngeal ring is the first barrier to infection that penetrates through the nasopharynx and oral cavity.

If pathogens multiply uncontrollably in the tissue of the tonsils, on the mucous membrane of the oropharynx, this will cause frequent sore throats, which will lead to chronic tonsillitis. In this case, for the development of sore throat, what is needed is not reinfection, but a provocation in the form of a cold, physical or psycho-emotional stress.

There are dozens of causative agents of sore throat, but the most typical are streptococcus and staphylococcus. This pathogenic flora causes the development of ulcers in the lacunae of the tonsils. And bacterial toxins contribute to the formation of severe intoxication with fever. The treatment of sore throat in children depends on the type of pathogen.

How to recognize the symptoms of a sore throat according to Komarovsky:

• acute onset;
• general malaise (chills, fever, loss of appetite);
• inflammation of the palatine tonsils - they are swollen, enlarged, with purulent plaque or inclusions;
• peripheral lymphadenitis of the cervical and submandibular nodes.

In children with purulent sore throat, a severe general condition often comes to the fore without complaints of sore throat. The patient should be shown to a doctor at the first symptoms of the disease, even with a common cold. This is important for timely diagnosis of tonsillitis and proper treatment.

According to Komarovsky, tonsillitis is not a disease that can be treated with traditional medicine. In addition, any inflammation of the oropharynx requires differentiation from diphtheria. It is carried out only in a medical institution. Independent unqualified treatment is fraught with complications of angina.

Untreated bacterial tonsillitis leads to myocarditis, valvular heart disease, rheumatic fever, and glomerulonephritis. Herpangina can be complicated by viral encephalitis, meningitis, carditis. That is why, after recovery, the patient is registered with a temporary dispensary and periodically monitored with urine tests and an electrocardiogram.

Tips for treating sore throat from Dr. Komarovsky

Komarovsky’s advice on the treatment of tonsillitis is based on the principles of evidence-based world medicine. The doctor identifies two main features in the treatment of patients with bacterial tonsillitis:

1. The effect is achieved quickly and efficiently only when selecting the right antibacterial agent.
2. In the absence or incorrect regimen of antimicrobial treatment, it is sore throat that causes 100% of rheumatic complications and other pathologies of the kidneys, blood vessels, and heart.

Komarovsky always gives due place to security measures. For tonsillitis, he recommends bed rest, gentle nutrition, and drinking plenty of fluids. The diet involves pureed food, which protects a sore throat, and the exclusion of spicy, salty foods.

As for antibiotics for angina, semisynthetic penicillins (Amoxil, Amoxiclav, Flemoxin) and macrolides (Erythromycin, Azithromycin) remain effective against staphylococcus and streptococcus. The prescription of an antimicrobial regimen is based on the patient’s weight and age. The course for tonsillitis requires at least 7 days of treatment.

Treatment with local remedies is also encouraged. Treatment and gargling of a sore throat is carried out with a solution of Chlorophyllipt, decoctions of medicinal herbs (sage, chamomile, calendula flowers). For rinsing, a regular homemade solution of baking soda and salt is suitable. To prepare it, you need to dissolve one teaspoon of salt or two teaspoons of soda in 0.5 liters of warm boiled water. Dissolving lozenges or irrigating the throat with aerosols is also possible.

Such techniques do not have an impact on the mechanism of disease development. Just like they don’t prevent the formation of complications. But their action should be aimed at reducing pain and swelling of the pharynx and tonsils. Symptomatic drugs include antipyretics and non-steroidal anti-inflammatory drugs.

Dr. Komarovsky recommends extending bed rest for the entire period of fever. And in no case should the use of antibiotics be interrupted after the condition improves; they must be taken for at least 7 days. He considers a short course of treatment dangerous for the development of post-infectious complications.

Herpes sore throat in children is subject to a different treatment regimen. General activities are similar to the previous ones. But there is no specific drug against enteroviruses. Evgeniy Olegovich repeatedly insisted on the lack of evidence base for the use of antiviral agents. And when treating herpes sore throat in children, pediatrician Komarovsky does not recommend giving such medications.

Help should be symptomatic and consist of lowering body temperature and relieving unpleasant local sensations. Paracetamol and Ibuprofen-based products (Nurofen, Bufen) are allowed in pediatrics as antipyretics. You can treat blisters and ulcers on the palate with antiseptic agents and rinsing. Gels with lidocaine have an analgesic effect. They act quickly and effectively, but they can be used no more than 3 times a day. When there is a proven layer of bacterial flora, broad-spectrum antibiotics are added to therapy.

Prevention

There are no specific measures to prevent bacterial and viral tonsillitis. But since the disease is highly contagious, epidemic prevention measures are taken.

Preventive measures at home:

• family members who have a herpangina patient must strictly observe the rules of personal hygiene and treat their hands with an antiseptic;
• the patient has his own set of dishes and personal belongings;
• wet cleaning and ventilation of the room at least once a day.

In a team where an episode of herpetic sore throat occurred, a particularly strict anti-epidemic regime is introduced:

• It is recommended that a child who has recovered from an illness stay at home for up to two weeks;
• employees of school and preschool institutions who have had an enteroviral disease are suspended from duty for 14 days;
• Children from closed groups (orphanages, boarding schools, summer camps) are treated in an infectious diseases hospital.

Referring to the recommendations of pediatricians, in particular Komarovsky, the general strengthening of the body’s defenses is also important. A healthy lifestyle with adequate physical activity, rational nutrition, hardening, and frequent walks contributes to the proper formation of immunity. In cases where the tonsils become a source of chronic infection and streptococcal complications develop, the use of radical measures is justified. Then ENT doctors recommend removing the diseased tonsils.

Herpes sore throat in children occurs both in adolescence and infancy. The disease is indicated by an inflamed and reddened throat, enlarged lymph nodes, rashes in the larynx, and general weakness.

Causes of herpes sore throat and routes of transmission

The following factors can provoke the development of an infectious disease:

• weakened resistance of the child’s body;
• frequent colds;
• reduced protective function of mucous membranes.

Routes of entry of the virus:

• household (through pacifiers, dishes, toys, with dirty fingers - the child puts them in his mouth);
• by direct contact (infection is transmitted through saliva, as well as discharge from the nasopharynx);
• airborne droplets (during communication, coughing or sneezing);

The main source of infection is the carrier of the virus.

International Classification of Diseases (ICD code 10): B08.5.

Symptoms of herpangina in a child and the course of the disease

After the incubation period, characteristic signs of the disease appear.

In some cases, nausea and diarrhea may occur due to high fever.

You can see what the external manifestations of the disease look like in the photo.

Which doctor should I contact?

If you suspect herpangina in a child, you can make an appointment with:

1. Pediatrician – specialist in childhood diseases.
2. An otolaryngologist is a doctor who deals with ear, nose and throat problems in young patients.
3. An infectious disease specialist is a doctor who is well versed in the treatment of infectious diseases.

You can obtain information about the appointment of specialized specialists at the clinic at the reception desk.

Diagnostic methods

The doctor makes a diagnosis based on the results of examinations:

• pharyngoscopy - visual examination of the pharynx in bright light with a spatula;
• palpation to detect enlarged lymph nodes;
• a clinical blood test demonstrating an increase in the level of leukocytes in the blood, which confirms the development of an inflammatory process in the body;
• PCR method that detects viral RNA in biomaterial from nasopharyngeal and oropharyngeal swabs or throat swabs;
• An enzyme-linked immunosorbent assay that determines the level of antibodies to the pathogen in the patient’s blood.

The blood test will be accurate if done on an empty stomach.

Treatment of herpetic sore throat in children

Therapy for herpangina is carried out on an outpatient basis. After a full examination of the little patient, the doctor makes individual prescriptions.

Medicines

Treatment is based on combating the pathogen, therefore the following are indicated:

1. Antiviral drugs and immunostimulants (tablets Groprinosin, Lizobakt, drops Proteflazid, Viferon, Immudon, Immunal) are aimed at combating viral infection and are basic in the fight against herpes sore throat. The second one improves immunity.
2. Antihistamines (Fenistil drops, Claritin syrup, Suprastin tablets) relieve swelling and prevent allergies.
3. Symptomatic drugs (Nurofen, Ibufen, Panadol) have an antipyretic and anti-inflammatory effect.
4. Local preparations (Miramistin, Hexoral sprays, Stomatofit rinse solution, Cholisal gel) have an antiseptic, analgesic, enveloping and anti-inflammatory effect.

Antibiotics are prescribed only in the presence of a purulent infection. Special suspensions are approved for use for children.

Antibacterial drugs for herpetic sore throat are prescribed when all kinds of bacterial infections occur. The group of macrolides most often used is because they are safe for the body. Sumamed suspension is highly effective for angina.

Nutritional Features

Particular attention should be paid to the child's nutrition. Since everything in the child's mouth hurts, it is necessary to exclude foods that can cause irritation. These include:

• sour, pickled and salty foods;
• solid and hot food.

The child should be given:

• liquid or semi-liquid food, warm but not hot;
• drink more (compotes, fruit drinks, herbal teas and plain warm water).

It is worth considering that juices and carbonated drinks can also be irritating.

How to treat with folk remedies?

Treatment of herpes viral sore throat with traditional methods can be used in case of intolerance to antiviral drugs, as well as as an addition to traditional therapy.

Alcohol tincture with propolis

30 g of propolis are placed in the freezer overnight. In the morning it is placed in a bag and crushed with a hammer. Then the resulting powder is placed in a glass container and 90 ml of alcohol is poured. The jar is kept in a dark place for 12-15 days. The tincture should be shaken daily. The finished product is used as a compress daily for 15 minutes. Duration of treatment is 10 days.

Beetroot water

Grate 1 medium-sized beetroot on a fine grater. Hot water (50-70 degrees) is added to the resulting slurry in a 1:1 ratio. The composition is kept for 6 hours, then filtered. Gargle with the resulting liquid 3 times a day. The course of treatment is 1 week.

Herbal decoction

Take 1 tsp. collect leaves of coltsfoot, eucalyptus and sage, pour in 0.5 liters of spring water and bring to a boil. Boil for a quarter of an hour, then remove from heat and cool. Add 1 tbsp to the broth. liquid natural honey and 1/3 tsp. citric acid. Gargle with the resulting product every 4-6 hours. Use for at least 5 days.

Possible complications

Complications from herpes sore throat are rare. They occur in children with weakened immune systems.

Herpangina can cause the following complications:

• heart muscle disease;
• liver diseases;
• serous meningitis;
• encephalitis;
• Kernig's sign;
• addition of a bacterial infection;
• rashes on the body.

If a child experiences seizures or nervous disorders during the period of illness, an urgent need to consult a doctor.

Disease prevention

By following a number of rules, the risk of herpes sore throat can be minimized:

1. After visiting public places, be sure to wash your child’s hands with soap.
2. Before eating in public catering establishments, use a damp antibacterial wipe.
3. If you suspect contact with a sick person, gargle with a weak solution of potassium permanganate.

Timely identification of a sick child and his isolation prevent the spread of infection. Sick children are admitted to the children's group after 14 days.

The appearance of vesicular rashes with ulcerations in the area of ​​the pharyngeal ring in a child causes a feeling of anxiety in parents.

This is not in vain, since such symptoms against a background of elevated temperature may indicate that the child has contracted herpetic sore throat.

This type of pathological process occurs due to the penetration of an enterovirus infection into the body, which poses a particular danger with its negative consequences if there is no adequate treatment.

Sore throat is one of a number of infectious diseases that occurs due to the penetration of various pathogenic agents into the body. This can be bacterial or viral microflora, protozoan fungi of the genus candida, in rare cases the disease is caused by a herpes virus.

Most often, the disease occurs in children aged 4 to 14 years. This is facilitated by the weakened immune status of the body.

The disease primarily begins in an acute form after inhaling atmospheric air that contains harmful microflora. Pathogenic pathogens settle on the mucous membrane of the oropharynx, which causes activation of the body's immune cells.

This condition leads to vasodilation and tissue swelling, causing pain when swallowing. The development of pathogens is accompanied by the release into the bloodstream of toxic substances that they produce during their life activities.

This is a consequence of intoxication of the body, and if appropriate methods of therapy are not applied, the disease can move to other organs, causing dangerous consequences.

Main types

Before starting treatment for angina, it is especially important to establish its type. This is necessary because each form of the disease requires an individual approach.

The following types of this pathology are distinguished:

Possible routes of infection and risk groups

Both in an adult patient and in a child, the ways of contracting tonsillitis are the same.

They are:

The occurrence of sore throat occurs more often in people who are at risk.

They are the following categories of the population:

The impetus for the development of sore throat, both in a child and an adult, can be the following situations:

• Wearing clothes that are not appropriate for the weather causes general hypothermia of the body.
• If colds, acute respiratory infections, acute respiratory viral infections or influenza occur more often than twice a year.
• When an adult or child, due to an unbalanced diet, experiences a constant lack of vitamins and beneficial microelements.
• Chronic diseases of the paranasal sinuses (sinusitis, sinusitis or sinusitis).
• Allergic manifestations and intestinal infections.
• Violation of the psycho-emotional state as a result of prolonged stressful situations and prolonged depression.

Why is herpetic sore throat not considered a manifestation of herpes?

In the pathogenesis of herpetic sore throat, the main role is played by the active reproduction of the Coxsackie virus within the velopharyngeal ring. It belongs to the group of enteroviruses, and has nothing to do with herpes infection.

Herpangina gets its name due to the similarity of clinical signs that resemble the blistering rashes of herpes. Their appearance causes a feeling of pain, which is also inherent in herpetic rashes.

Possibility of occurrence in newborns

The main feature of herpetic sore throat is that a child of the first year of life does not suffer from it.

This is due to the fact that some antibodies are transferred from mother to child during prenatal development.

The period when the baby is breastfed is also associated with the supply of antibodies that prevent the development of sore throat.

This is the main advantage of natural feeding over artificial feeding.

And that’s why babies don’t get herpetic sore throat.

Clinical picture of herpetic sore throat in a child

The resulting herpetic sore throat in a child with adequate therapy lasts no more than 8 days, but the child remains infectious for approximately 7 days after the disappearance of all clinical symptoms of the disease. This necessitates quarantine.

Clinical symptoms that occur in a child with sore throat:

Manifestations of herpetic sore throat in adult patients

Clinical symptoms in adults differ from those in children in that the disease is milder and complications occur in rare cases.

The main clinical signs and manifestations of angina in adult patients:

Diagnosis of herpetic sore throat in a child

For an experienced specialist practicing in the field of ENT pathologies, making a diagnosis usually does not cause difficulties.

This pathological process necessitates differentiation (difference) in the following pathologies:

• Thrush. A distinctive feature is the curd coating, which, when peeled off, leaves a hyperemic surface.
• Stomatitis in pathogenesis, which has a herpes infection. This disease is characterized by rashes on the tongue and gums, and the absence of blisters in the tonsil area.
• When a purulent sore throat appears, there is no symptom of a runny nose. Purulent contents are formed only in the follicular or lacunar form of tonsillitis.

To clarify the diagnosis, the following types of examination are used:

In some cases, additional consultation with related specialists is required.

Most often, to confirm or clarify the diagnosis, people turn to:

• Nephrologist.
• Cardiologist.
• Neurologist.

How is herpes sore throat treated in children?

When a child develops a sore throat, complex therapy is performed, the purpose of which is to prevent the development of complications.

The treatment process follows the following rules:

• Compliance with the regime.
• Therapy with medications.
• Use of hardware physiotherapy procedures.

Treatment regimen

There is a certain set of rules that must be followed in order to prevent negative consequences and for a sick child to quickly recover.

The use of pharmaceutical drugs for the treatment of herpetic sore throat in a child

The manifestation of this type of sore throat excludes the use of antibacterial agents, since they do not act on viral microflora.

They can be used only when the disease is complicated by the addition of bacterial pathogens. Also, it is impossible to eliminate the negative symptoms of herpetic sore throat by using anti-herpes drugs.

Approximate treatment regimen for angina in childhood:

• To relieve the symptoms of swelling in the tonsil area, drugs that block the production of histamine are used.
  For children the following will be effective:
  • Diazolina.
  • Claritina.
  • Tavegila or Suprastina.

• To stabilize the body temperature, it is necessary to take antipyretic drugs. It should be taken into account that the temperature must be lowered when it has passed the 38°C mark on the thermometer.
  For this purpose you can use:
  • Paracetamol.
  • Ibuprofen.

• To eliminate painful sensations in the throat, as well as for sore throat, the following is prescribed:
  • Inhalipt.
  • Hexoral.

• To prevent the spread of further rashes, it is recommended to use Acyclovir in the form of an ointment.
• To restore natural breathing through the nose, drops are prescribed, which are based on a vasoconstrictor effect.
  Recommended use for children:
  • Naphthyzin (in children's dosage).
  • Sanorin.
  • Aquamaris.
  • Otrivin.

• To relieve cough symptoms, the following medications are recommended:
  • Ambrobene in the form of syrup.
  • Gedelix.
  • Lazolvan.

• Antiseptics (Furacilin or Chlorhexidine) can be used for rinsing. You can also buy dry chamomile inflorescences, calendula or sage herb in the pharmacy chain. After brewing them, you can rinse even the smallest patients. To do this, use a syringe without a needle, which is filled with a warm medicinal composition and injected into the baby’s mouth.

• In order to increase the immune status of the body, vitamins or multivitamin complexes are prescribed in combination with immunomodulators. Allowed to use:
  • Anaferon.
  • Pikovit.
  • Multi-Tabs.

The use of hardware physiotherapeutic procedures

For herpetic sore throat, in order to speed up the child’s recovery process, the positive qualities of currents, magnetic fields, ultraviolet or infrared radiation are used.

The main methods prescribed in childhood:

• Application of electrophoresis and laser therapy.
• Use of ultrasound (increases local immune status).
• Application of ultraviolet light. You can act locally by inserting a tube into the mouth, or use general irradiation.

This type of sore throat does not allow the use of inhalations and compresses.

How is herpes sore throat treated in adult patients?

The only difference in the treatment of this pathology in adults, compared to children, is the possibility of expanded use of medications.

The treatment process occurs using the following medications:

• Dosage forms that block histamine receptors. With their help, the swelling of the palatopharyngeal ring is removed, and at the same time the redness of the throat is eliminated. Separately, it is worth emphasizing the use of Diphenhydramine in combination with analgin. This combination not only relieves swelling, but also reduces pain by lowering body temperature.
  The following drugs are especially popular:
  • Suprastin.
  • Claritin.
  • Loratadine.

• Liquids with a bactericidal effect are used as local anesthetics:
  • Hexoral.
  • Inhalipt.
  • Lugol's solution or Tantum Verde.

• Antiviral drugs may be prescribed if there is a risk of complications. This situation can occur when the body's protective barrier is reduced.
  In this case, the assignment occurs:
  • Genferon.
  • Cycloferon.

• For rinsing the following can be used:
  • Furacilin.
  • Miramistin or Chlorhexidine.
  • Diluted hydrogen peroxide solution.

• The resulting cough requires the use of:
  • Lazolvana.
  • Ambrobene.

• To restore natural breathing through the nasal cavity, use:
  • Naphthyzin.
  • Sanorin.
  • Galazolin.

Doctor Komarovsky's opinion on the treatment of herpetic sore throat

Popular TV presenter Dr. Komarovsky expresses his opinion about the danger of this pathological process. He notes that parents should be vigilant when the first symptoms of a sore throat occur in their child.

Complications

Poor quality treatment or its complete absence can cause serious consequences that cause serious harm to health.

A young patient may develop the following pathologies:

• Phlegmon (purulent melting of subcutaneous fatty tissue).
• Retropharyngeal abscess.
• The development of inflammation in any part of the ear canal.
• Swelling of the larynx, which can move to other parts of the respiratory tract.
• Development of bleeding from the tonsils.
• In severe cases, damage to the myocardium (the lining of the heart) may develop.
• Relatively rarely, a violation of the glomerular filtration of the kidneys occurs due to pyelonephritis.
• Development of an inflammatory process in the brain (encephalitis or meningitis).

Prevention

Since herpetic sore throat, in the vast majority of cases, is a consequence of a decrease in the body’s barrier forces, preventive measures should be aimed at increasing the quality of immunity.

To do this, it is necessary to take the following preventive measures:

Therapy for a child is always associated with certain difficulties. Since not all pharmaceutical drugs are suitable for the body of a small patient.

The first thing parents should do if they suspect a sore throat is to contact a medical clinic. Self-medication in this case can have dire consequences. This is due to the fact that this pathology tends to develop rapidly, and with the flow of blood it can cause new foci of inflammation in other organs.

] and tonsillitis are diseases with a high rate of spread and mass distribution. The diversity of species, the multitude of pathogens, and the similarity of symptoms do not allow us to determine the form without an idea of ​​the developmental pattern. We talk about herpes viral sore throat and its treatment.

Viral herpetic (herpetic) sore throat has a number of features due to which the disease can be classified as having dangerous consequences. External resemblance to herpes and a specific course in adults can cause misdiagnosis, and the disease suffered in childhood provides long-term immunity, but with the likelihood of recurrence in an atypical form.

This sore throat received the name herpetic or herpetic because of the external picture - rashes appear on the tonsils, reminiscent of herpes blisters, which can be seen with [herpetic stomatitis in children] on the oral mucosa.

Important! - herpetic sore throat is not herpes!

In contrast, the causative agent of the disease is a virus, and it is classified as a separate variety - the Coxsackie virus (types A and B) or the so-called ECHO virus. It penetrates the body, affects the pharynx, mucous membrane and lymph nodes [of the intestines], after which it rapidly spreads through the blood. The incubation period for herpes sore throat is 3–8 days, but the virus remains in the blood for a longer period.

Features of the development and spread of the disease

Among the most insidious features of this disease are:

• acute course with severe viral intoxication and deterioration of health;

• high speed of spread and ease of transmission by contact, airborne droplets and food;

• the ability of the virus to spread through the blood;

• the likelihood of a blurred form, typical of cases where the disease was suffered in childhood, but recurred in an adult.

Particular difficulty is created by the atypical form of herpetic tonsillitis, in which blisters on the tonsils and in the pharynx do not appear, but the disease can fade away and return with a period of one week. In this case, the patient remains a carrier and distributor of the virus for a long time. An adult who has been acutely ill receives lifelong immunity. The virus can be obtained from milk, fruits and vegetables; the disease has a pronounced seasonal pattern of distribution and is especially active during the spring and summer months.

Symptoms and diagnosis of herpes tonsillitis

Diagnosis of herpes sore throat is based on examination data, interviewing the patient and conducting tests - in cases of a blurred external picture, a tonsil flush study and [blood test] are prescribed. Often in adulthood, patients do not recognize the disease in the absence of blisters on the tonsils and mistake it for ARVI, which leads to complications and a long course. With proper diagnosis, treating herpes sore throat is easy.

Differential comprehensive diagnosis of herpangina

The doctor differentiates complexly. The picture of symptoms typical of herpetic sore throat is taken into account.

1. The disease develops quickly, the first to occur is a very severe pain in the throat, accompanied by a sore throat, a feeling of stuffiness, and severe difficulty swallowing.

2. The second stage of the disease can be misleading - a picture appears similar to ARVI or influenza, with aches throughout the body, nervousness, insomnia or drowsiness with a general deterioration in well-being.

3. On the second or third day, blisters appear in the throat and tonsils, which can be used to identify the classic form of herpetic sore throat.

4. Temperatures are rising rapidly, sometimes reaching critical values ​​above 39.5 C.

5. The sore throat becomes so severe that it becomes difficult to drink and swallow liquid food, and abdominal pain may occur as the virus attacks the mucous membranes and lymph nodes of the intestines.

The duration of the disease usually ranges from 10-14 days, treatment is prescribed conservative and symptomatic, outside the hospital, if there is no significant deterioration, swelling that interferes with breathing, or other complications.

When treating herpetic sore throat, it makes no sense to use antibiotics - the nature of the disease is viral. The name should not be misleading; typical antiherpes drugs do not help, although cases of the effect of using Zovirax and Acyclovir rinse solution have been described. The throat is gargled or treated with iodinol, furatsilin, miramistin. Rashes can be treated with Hexoral or Inhalipt. The doctor may prescribe antiviral, antipyretic and other supportive medications.

The patient must be well isolated, since the disease is transmitted aggressively. Rest is ensured, plenty of fluids are drunk at a fever, a diet is prescribed with a limit on hot, cold, and irritating foods. Rinsing with sage and chamomile, and calendula decoction are allowed.

The use of warm compresses for herpetic sore throat is not allowed! - they promote blood flow and rapid reproduction of viruses and other infectious agents in comfortable conditions for them.