Herpetic sore throat in children as transmitted. Herpetic sore throat: symptoms, causes and treatment

When the baby is sick, you need to urgently go to the clinic, especially if herpes sore throat is found in children, because it is the children who endure it very hard. Here the main thing is to correctly diagnose the disease, because herpangina can be confused with both stomatitis and purulent tonsillitis. You also need to know that the treatment of herpes sore throat in children can differ significantly from treatment in adults. Therefore, do not self-medicate and urgently show the baby to a specialist.

Herpangina in children occurs on the basis of the Coxsackie virus and ECHO infection. This is a whole group of pathogens of acute childhood diseases. The infection is transmitted by already infected with clinically formed signs of the disease and virus carriers.

The causes of transmission of herpes sore throat in children are many factors. Consider the main mechanisms of transmission of the virus.

1. The contact path is the communication of a child with a sick person or a virus carrier. Thus, the risk of infection through discharge from the nasopharynx increases.
2. airborne way- during the conversation of children with patients, the presence next to a sneezing or coughing child.
3. fecal-oral route- infection occurs during common use household items, through toys, food, unwashed hands.
4. Close contact with convalescents(patients in recovery). They serve as sources of infection, because the virus continues to be shed for about four weeks.

The virus enters the child's body through the nasal mucosa and oral mucosa. pathogens penetrate into The lymph nodes intestines and briskly multiply. After reproduction, they make their way into the blood, where the viruses cause rapid development. Due to this, viral pathogens spread throughout the child's body. They are fixed in various tissues, where the processes of inflammation and dystrophy are formed.

The highest point of infection with herpangina in children is from the beginning of summer to mid-autumn. During this period, the disease is highly contagious. Reduced immunity can also cause infection, especially if the child has a cold and there are people with herpangina around him.

Symptoms

General signs

Herpetic sore throat manifests itself in children almost as well as SARS and acute respiratory infections. There are signs characteristic of a respiratory disease:

• general intoxication, weakness, malaise;
• strong headache and dizziness;
• nausea, vomiting, abdominal pain and diarrhea;
• a sharp increase in temperature;
• cough and runny nose;
• a small rash of bright red color in the area of ​​​​the tonsils and on the mucous membrane of the palate;
• sometimes a small rash may form on the face and body;
• babies often have seizures.

Herpetic sore throat in a child still has some differences from other infections so that:

• no swelling in the nasopharynx;
• no abundance of nasal mucus;
• there is no frequent bleeding;
• in the summer, herpetic sore throat in children is much more common than any other viral disease.

Timeline of symptoms

1. The latency of infection is from a week to two. Herpangina in a child begins with a high fever. Weakness, malaise, inability to eat. The head, the muscles of the limbs begin to hurt very strongly, the whole body begins to ache with pain.
2. These symptoms are followed by a sore throat. In herpes sore throat in children, local changes progress rapidly. In the initial stage of the disease, against the background of hyperemia of the mucous membrane of the tonsils, palate, tongue - against the background of the entire oral cavity, small papules appear, with incredible speed they begin to form into vesicles filled with serous content.
3. Two days later, the blisters break open, forming grayish-white ulcers, corolla-coated hyperemia. Or the combined sores turn into confluent defects. The resulting erosion in the mucosal area is very painful. As a result, children cannot take food and even any liquid.
4. In children with a weak immune system, the rash may flare up every three to four days. In this connection, the resumption of fever and signs of intoxication are accompanied. After five days, the fever subsides, and the defects formed on the mucous membranes oral cavity and pharynx epithelialized in a week.

What does herpangina look like and how does it differ from other diseases

1 2

Diagnostics

In the early stages of herpes sore throat in children, in order for the symptoms to confirm this disease, it is necessary to contact the local pediatrician. First of all, a pharyngoscopy is performed by a pediatrician - clinical method visual examination of the condition of the pharynx.

If necessary, the doctor gives a referral for examinations to the ENT. Directions are also given for the delivery of various kinds of analyzes - general analysis blood test, serological blood test, analysis of fluid from vesicles for virus verification, swabs and swabs from the nasopharynx. Only after complete passage medical examination, the decision of the attending physician will be made - how to treat herpes sore throat in children.

Treatment

In children, the treatment of herpes sore throat is not accompanied by characteristic antiviral therapy. The disease usually appears once, after which the baby's body acquires indefinite (eternal) immunity. A single transferred herpangina can mean like a hard-tolerated vaccination. However symptomatic treatment herpetic sore throat in children is necessary.

Therapy Methods

In children, treatment is usually carried out in this way:

• at high temperatures, antipyretics are used. For this, soft preparations for children are prescribed, such as Panadol, Efferalgan;
• with severe inflammation, drugs such as Ibuprofen and Nimesulide are usually enough;
• most used to reduce pain safe means- this is a decoction of sage for gargling, mouth cavity and Castellani liquid;
• antiseptic agents are used to treat open erosions;
• the rest of the therapeutic measures should be used as with ordinary angina.

Care and nutrition during treatment

Also, a sign of a speedy recovery is formed with fairly proper care for a sick child:

• the baby needs to provide complete rest;
• provide all the conditions for a good, restful sleep;
• in without fail ventilate the room;
• wet cleaning is required.

Form a proper diet, which consists of:

• warm, thin porridges;
• warm teas, not very sweet compotes, medicinal decoctions;
• broths and soups, which should not be very salty and hot.

However, with what to treat herpes sore throat in children, it is necessary for the entire period of the disease to provide the baby's body with a complete vitamin complex.

Herpes sore throat in a child should in no case be carried out by warming the throat with various warming agents. These measures can only lead to the activation of the virus and a great risk of the duration of the disease.

Complications

With a low reactivity of the organism or a high level of viremia, generalization of an enteroviral infection with the formation of:

• meningitis is an inflammation of the lining of the brain and spinal cord;
• encephalitis is a group of diseases characterized by inflammation of the brain;
• myocarditis is an inflammatory lesion of the heart muscle;
• pyelonephritis is an inflammation of the kidneys;
• hemorrhagic conjunctivitis is a dangerous acute eye disease.

The appearance of such extremely severe complications after herpes sore throat in children can lead to permanent nervous and heart diseases. There may also be deaths. Since children with a weak immune system suffer from herpangina, they should therefore be under the supervision of the attending physician. As a result, diagnostics are early stage and undergoing surgical treatment.

So, summing up, it must be said that it is better to treat herpangina as soon as possible, this is not tonsillitis or a cold, herpangina can give serious complications. And you need to monitor the child, if you notice a decrease in immunity, then be on your guard, because low immunity can give a lot serious problems baby's body. But now that you know what herpangina is and how dangerous it is for children, you must urgently show the baby to a specialist.

Herpes sore throat (herpetic sore throat or herpangina) in children is an infectious disease associated with the defeat of the tonsils by viruses. The peak incidence of this disease, as a rule, falls on children's age - 3-12 years. Newborn children are not susceptible to the disease, because, despite the immaturity of their own immune system, their body does not allow the disease to develop due to the antibodies that come with mother's milk.

In addition, it is worth noting that you can get sick with herpes sore throat only once - after the child has suffered this ailment, lifelong immunity is formed in him.

Ways of transmission of infection

Ways of transmission of pathogens - contact-household and fecal-oral. In most cases, the disease is transmitted from one child to another, which explains the susceptibility of children in the age group from 3 to 12 years (kindergarten and schoolchildren). AT educational institutions Outbreaks of the disease are not uncommon, as kindergarteners and school students are in close contact with each other and often in enclosed spaces.

Considering the foregoing and the high degree of contagiousness of herpes sore throat pathogens, the contact-household route of transmission of viruses is the most common. In addition, a sick child becomes contagious while the disease is still in the incubation period, which reduces the effectiveness of quarantine measures in children's educational institutions.

The causative agents of herpes sore throat are quite stable during external environment, therefore, the fecal-oral route of transmission of the disease also takes place. This is primarily due to non-compliance with hygiene rules.

Main reasons

herpes sore throat in childhood calls . These microorganisms are of two types - group A and group B, however, regardless of which species caused the disease, it proceeds with similar symptoms. causes herpes sore throat in children in the vast majority of cases. In addition, the following pathogens can cause the disease:

• herpes virus type 6;
• enterovirus.

In addition, it has been noticed that the occurrence of herpes sore throat is associated with a combination of adverse factors: children who have weakened immunity, have chronic foci of infection (tonsillitis,) are more at risk of getting sick.

Symptoms of herpes sore throat in children

Herpes sore throat is characterized by a rather long incubation period - from the moment of infection until the first signs of the disease appear, it can take up to 2 weeks.

The main symptoms of herpes sore throat in a child are:

• High body temperature. Body temperature with herpes sore throat in children can reach high levels - up to 39-40 degrees, which indicates a high degree of intoxication of the body. Important: significant numbers on the thermometer indicate an unfavorable course of the disease. In young children, high fever can cause seizures, which indicates damage to the central nervous system. When it rises above 39-40 degrees, parents of a small child need to call an ambulance.
• General weakness. General intoxication of the body, in addition to fever, also manifests itself in the form of general weakness, lethargy, and drowsiness.
• muscle pain. Myalgia or muscle pain is a common symptom accompanying most viral infections upper respiratory tract.
• Pain and redness in the throat. In addition, in rare cases, a sick child with herpes sore throat may be disturbed by: abdominal pain, nausea, vomiting and diarrhea.

What does the throat look like with herpes sore throat

Acute phase the disease begins with the fact that the child may experience a slight redness in the throat, outwardly resembling signs of pharyngitis. As the inflammatory process develops, so-called vesicles appear on the tonsils, which are essentially a rash (see photo). These formations in the process of their development can express themselves, burst and merge, forming larger lesions.

On the 5th - 6th day from the onset of the disease, the rash begins to turn pale and gradually disappears.

These manifestations of herpes sore throat are accompanied in children acute pain throat and difficulty swallowing.

Incubation period

From the moment the virus enters the body and before the first symptoms of the disease develop, some time passes when the presence of the disease cannot be judged by external signs. In medicine, this is referred to as incubation period. For various diseases it makes up different time periods, which can vary from a few hours to several years and even decades.

In the case of herpetic sore throat, caused in most cases by the Korsaki virus, it ranges from 6 to 20 days. It depends on the concentration of the virus in the blood, the state of immunity, the sick person and other individual characteristics.

Important! The child becomes a transmitter of infection long before the first symptoms appear - 3-4 days after infection.

Possible Complications

In some cases, when treatment was started late or therapy for herpetic sore throat was incorrect, the child may develop complications. Herpangina itself is not dangerous disease, but its consequences may be real threat life and health.

• Complications from the CNS. Often the virus that caused herpes sore throat causes damage to the central nervous system. It can be both (inflammation of the meninges) and encephalitis (damage to the deep structures of the brain). These pathologies manifest themselves in the form of frequent excruciating headaches, visual impairment, coordination, general lethargy and weakness. These conditions require immediate hospitalization in a specialized hospital.
• Complications of the cardiovascular system. In the case when the virus affects the heart muscle, development is possible, which is accompanied by pain in the sternum, and other disorders of cardiac activity. This condition also requires immediate medical attention.
• Complications from the urinary system. As a result of damage to the kidney virus, acute can develop, which is dangerous for development and death. Complications of herpes sore throat develop, although infrequently, but the nature of their severity requires mandatory medical supervision and treatment.

Diagnostics

Herpes sore throat is treated only as prescribed by a pediatrician on the basis of a simple external examination without additional examinations, since when examining the throat, it is easy to notice specific rashes on the tonsils. In case of problems with establishing a diagnosis or in case of a complicated course of the disease, additional consultation with an otorhinolaryngologist may be required. Herpangina by clinical symptoms similar to a sore throat caused by a bacterial infection, stomatitis and.

If herpes sore throat is suspected, a general blood test can be performed, which, in the presence of the disease, is characterized by a slight increase in the level of leukocytes.

After past illness or according to direct indications, with the possibility of complications, a urine test is required to detect pathologies from the kidneys, as well as an ECG to assess the state of the heart muscle.

Treatment

Treatment of herpes sore throat is primarily symptomatic - aimed at eliminating the main manifestations of the disease and strengthening the body's defenses. This means both taking medications and using other medical techniques(physiotherapy, compliance with the medical and protective regimen, diet, means traditional medicine).

Self-medication for herpes sore throat is unacceptable - therapy must be prescribed by a doctor, since it is possible not to recover, but, on the contrary, to worsen the child's condition and add complications.

It is worth remembering that many procedures indicated for colds of infectious diseases (compresses, inhalations) are unacceptable for herpangina in order to avoid aggravating the pathological process.

Treatment of herpes sore throat in children should be carried out in a complex manner, which contributes to a speedy recovery and minimizes the risk of possible complications.

Used drugs: names, instructions for use

One of the leading symptoms of herpes sore throat, which causes the greatest discomfort to the child, is fever. If the numbers on the thermometer do not exceed 37.5 degrees, then no medical correction of this condition is required. If the indicator is higher, then antipyretic drugs are used.

It is unacceptable to use as an antipyretic for children preschool age aspirin, as it can provoke a severe complication of the liver and central nervous system.

- Paracetamol.

Paracetamol is the most common and affordable drug. Available in the following forms: tablets, suppositories and syrups. Paracetamol, produced in suppositories, is convenient to use for the treatment of even the smallest patients, since the features of its administration minimize the possibility of negative side reactions.

It is inconvenient for a child to take paracetamol in tablet form - the tablets are too large and have an unpleasant bitter taste. It is preferable to use a syrup produced specifically for children.

The dosage depends directly on the body weight and age of the child, however, the frequency of administration should not exceed four times a day.

- Ibuprofen.

To eliminate the phenomena of desensitization (general weakness, swelling, malaise), antihistamines are widely used. For children, it is most preferable to use ibuprofen in the form of drops.

Like paracetamol, ibuprofen is available in various dosage forms. The popular syrup Nurofen also contains ibuprofen as the active ingredient. The dosage depends on the age of the child, the frequency of administration should also not exceed 4 times a day.

- Fenistil.

Fenistil is available in the form of drops and has a minimum of contraindications and side effects. Widely used antihistamine, which can be taken even by newborn children. The drug should be taken at the rate of 2 drops per 1 kg of the child's weight per day. daily dose divided into 2-3 doses.

- Suprastin.

Suprastin is available in tablet form and can be used in children older than three years. It is taken in half a tablet 2-3 times a day. As an impact on the causative agent of infection in children, antiviral drugs are prescribed.

- Viferon.

Possesses a wide range antiviral activity, acting directly on the causative agent of the disease. Produced in the form of candles. Take the drug should be 1 suppository containing 150,000 IU of the active substance 3 times a day.

Despite the fact that herpes sore throat is similar in its manifestations to antibiotic treatment in this case is not required.

Herpes sore throat is caused by viruses, causing unpleasant symptoms in children who are resistant to antibiotics. Therefore, their treatment does not make any sense except in situations where a secondary bacterial infection occurs against the background of the underlying disease. In this case, are used drugs from the group of penicillins and macrolides with a wide spectrum of antibacterial activity. Only the attending physician can prescribe antibiotics, determine the dosage and frequency of administration, if there are appropriate grounds.

In addition to the above drugs, the doctor may additionally prescribe immunostimulating drugs(immune) and vitamin complexes to strengthen the body's resistance.

Rinse solutions: names and recipes of products

Rinses are widely used in the treatment of diseases of the oral cavity and pharynx. Herpes sore throat in children is no exception. Rinsing reduces swelling, tonsils, helps relieve pain and speedy recovery of the baby.

• Salt or sea salt solution. To prepare the solution, use half a teaspoon of salt, which is diluted in a glass warm water. It is recommended to rinse the throat with the resulting remedy every 2 hours with a break for a night's rest.
• Furacilin solution. Furacilin has antiseptic and anti-inflammatory properties. To obtain a solution, 2 tablets of the drug are dissolved in a glass of boiled water. The tool is used for rinsing up to 4 times a day.

Furacilin solution should not be allowed to get inside, as the drug has moderate toxicity, which can lead to nausea and vomiting in a child.

In addition to the above, good healing effect with herpetic sore throat have infusions medicinal herbs(chamomile, sage).

Physiotherapy procedures: a list of effective techniques

The treatment of herpes sore throat with the help of physiotherapeutic procedures has the peculiarities that the appropriate therapy should take place only after they have been eliminated. acute symptoms diseases in the form of fever and fever.

Most effective methods are:

• UFO. Irradiation of the oral cavity and tonsils with ultraviolet light effectively destroys pathogenic microflora, has anti-inflammatory and regenerating properties.
• laser therapy. laser beams perfectly relieve inflammation and pain in herpangina, have a moderate bactericidal effect, which reduces the risk of secondary bacterial infection. The method is completely painless and has no significant contraindications and side effects.
• Ultrasound Therapy. Under the influence of ultrasound vibrations, tonsil lacunae are cleansed of pathogenic microorganisms, local immune processes are activated, which positively affects the course of the disease and minimizes the risk of complications.

Folk remedies for oral administration: recipes, regimen

Folk remedies cannot replace medicines and procedures prescribed by a doctor, however, as adjuvant therapy with herpetic sore throat, they are very effective.

• Propolis. Propolis - unique remedy that can relieve pain and inflammation of a sore throat. It can be used neat by chewing about 2 grams of the substance like gum for 10 minutes about 6 times a day.
• Garlic and honey. Chopped or crushed garlic in the amount of 0.5 cups is poured to the top with honey. The resulting mass should be put on fire and boil for 20 minutes after boiling. After that, the tool should be cooled. For medicinal purposes, give the drug to the child one teaspoon 3 times a day until the symptoms are completely eliminated.
• beetroot juice. By means of an extraction it is necessary to receive juice from a beet. The vegetable itself should be medium in size. Add a teaspoon to the resulting liquid apple cider vinegar. This means it is necessary to make rinsings not less than three times a day.

Parents whose child is ill with herpes sore throat should provide the latter with peace and good rest. In the acute phase of the disease, bed rest is mandatory - it is impossible to carry the disease "on the legs".

The food of the child should be sparing - spicy, fried, too hot or cold dishes are excluded. Food should be puree-like in consistency.

Also, don't forget to drink plenty of water. It should be at room temperature. Ideal as a drink pure water, fruit drinks and compotes from natural berries and fruits. The use of herbal decoctions also has a good therapeutic effect.

The causative agents of herpangina have a high degree of contagiousness, so it is important for parents to ensure that the child uses individual dishes and hygiene items.

After the illness, vaccination should not be carried out for at least two weeks. Also, the child for the same period is suspended from physical education at school and institutions of additional education.

Prevention

There is no specific prevention of herpes sore throat, however, it is important for a child to strengthen immunity through hardening, physical education and sports, proper and balanced nutrition.

Higher education (Cardiology). Cardiologist, therapist, physician functional diagnostics. Well versed in the diagnosis and treatment of diseases respiratory system, gastrointestinal tract and the cardiovascular system. She graduated from the academy (full-time), she has a lot of experience behind her. Specialty: Cardiologist, Therapist, Doctor of functional diagnostics. .

About 50% of the world's population experience angina in their lifetime. Such an international opinion is expressed by the respected Dr. Komarovsky. Among different types diseases of the throat, herpetic sore throat stands apart. Its active spread in childhood over the past decade has determined the relevance of this issue among doctors and parents. Let's figure out what are the main differences and features of the course of herpangina in children.

Herpetic sore throat is a sore throat caused by specific pathogens from the group of enteroviruses. Most often, these are Coxsackie viruses type A and B, ECHO viruses. Sources of infection - a sick person, contaminated food. Not necessarily the carrier has a clinic of angina. It can be skin, intestinal or hidden form illness.

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

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

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

About viral sore throat in children, Dr. Evgeny Komarovsky competently and clearly presents information. We will sometimes refer to his authoritative opinion in matters of how to recognize and how to treat a sore throat in a child.

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

Herpetic sore throat signs and symptoms

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

1. Severe intoxication syndrome (headache, fever, refusal to eat, lethargy).
2. Sore throat, aggravated by swallowing.
3. Painful eruptions on the surface of the soft palate. They look like bubbles or sores (aphtha) white - gray color with red border. The dimensions of the elements are 1 - 5 mm.
4. On the skin of the extremities there may be a small blistering rash in a small amount.
5. Enlargement and inflammation of the submandibular, parotid, cervical lymph nodes.
6. Abdominal pain, nausea, vomiting may occur.

The development of herpangina precedes contact with a patient with an enterovirus infection. The fact of infection must be mandatory. The incubation period runs from 7 to 14 days. The acute phase with fever lasts four to five days. After the resolution of ulcers, scars remain on the mucous membrane of the oropharynx. They dissolve completely within a week. Patients with immunosuppression may have an undulating course. At the same time, episodes of fever, 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. This concern is associated with high risk complications with the Coxsackie virus and the possibility of layering a secondary infection.

Re-application for medical care should be immediate if the patient develops alarming symptoms:

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

Viral tonsillitis in infants is especially difficult. In infants, its development is complicated neurological symptoms(oppression, convulsions), dehydration clinic (crying without tears, lack of urination for more than 8 hours, dryness of the mucous membrane of the lips, mouth, sunken fontanelles).

Dr. Komarovsky about the disease

Dr. Komarovsky talks about enteroviruses and tonsillitis in a very interesting and accessible way. This information is available from his blogs, videos, print 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 - vesicles and sores on the pharyngeal mucosa;
• there may be a combination with the hand-foot-mouth disease.

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

Yevgeny Olegovich points to an uncharacteristic way of transmission. Such a sore throat is transmitted in a child by the fecal-oral route, that is, through dirty hands. At the same time, intestinal forms of the disease are quite rare. This is one of the main differences between Coxsackie and other SARS pathogens. The doctor explains their high prevalence by good resistance to different conditions even in acidic gastric juice.

About angina in children in the classic version, Komarovsky begins explanations with the features of anatomy. Indeed, not any "red throat" is considered a sore throat. Exactly infection palatine tonsils called tonsillitis. The palatine tonsils consist of lymphoid tissue, therefore they are actively involved in the fight against antigens. This organ belongs to the peripheral immune system. The lymphopharyngeal ring is the first barrier to infection penetrating through the nasopharynx and oral cavity.

If pathogens multiply uncontrollably in the tissue of the tonsils, on the mucous membrane of the oropharynx, then this will cause frequent tonsillitis, which will lead to chronic tonsillitis. In this case, the development of a sore throat does not require infection again, but a provocation in the form of a cold, physical or psycho-emotional stress.

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

How to recognize the symptoms of angina according to Komarovsky:

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

In children with purulent tonsillitis, severe general state no complaints of sore throat. The patient should be shown to the doctor at the first symptoms of the disease, even if common cold. This is important for the timely diagnosis of the form of tonsillitis and competent treatment.

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

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

Tips for the treatment of angina from Dr. Komarovsky

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

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

Komarovsky always gives due place to security measures. With tonsillitis, he recommends bed rest, sparing nutrition, plentiful drink. The diet involves mashed foods that save sore throat, exclusion of spicy, salty dishes.

As for antibiotics for angina, semi-synthetic penicillins (Amoxil, Amoxiclav, Flemoxin), macrolides (Erythromycin, Azithromycin) remain effective against staphylococcus and streptococcus. Purpose of the scheme antimicrobial agents based on the weight and age of the patient. The course for tonsillitis involves at least 7 days of admission.

Treatment local funds also welcome. Treatment and rinsing of the 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 liter of warm boiled water. Resorption of lozenges or irrigation of the throat with aerosols is also possible.

Such methods have no impact on the mechanism of the development of the disease. Exactly as they do not prevent the formation of complications. But their action should be aimed at reducing pain and swelling of the pharynx, tonsils. Of the symptomatic agents, antipyretic, non-steroidal anti-inflammatory drugs are used.

Dr. Komarovsky recommends extending bed rest for the entire period of fever. And the use of antibiotics should in no case be interrupted after the condition improves, they must be drunk 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. Evgeny Olegovich repeatedly insisted on the absence evidence base for the use of antivirals. And in the treatment of herpes sore throat in children, pediatrician Komarovsky does not recommend giving such medicines.

Help should be symptomatic and come down to lowering body temperature, removing unpleasant local sensations. Of the antipyretics in pediatrics, Paracetamol and Ibuprofen-based drugs (Nurofen, Bufen) are allowed. You can treat vesicles and ulcers in the sky with antiseptic agents, rinsing. The anesthetic effect is brought by gels with lidocaine. They act quickly and effectively, but they can be used no more than 3 times a day. With a proven layering of the bacterial flora, broad-spectrum antibiotics are added to the therapy.

Prevention

There are no specific measures for the prevention of bacterial and viral angina. But since the disease is highly contagious, measures are taken to prevent epidemics.

Preventive measures at home:

• family members where there is a patient with herpangina must strictly observe the rules of personal hygiene, treat their hands with an antiseptic;
• the patient has his own set of dishes, personal belongings;
• wet cleaning and airing 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:

• for a period of up to two weeks, a home stay is recommended for an ill child;
• school staff and preschool institutions, with a past enterovirus disease, are suspended from duty for 14 days;
• children from closed groups (orphanages, boarding schools, summer camps) are being 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. healthy image life with adequate physical activity, rational proper nutrition, hardening, frequent walks contributes to the proper formation of immunity. When the tonsils become the source chronic infection, streptococcal complications develop, the use of radical measures is justified. Then ENT doctors recommend the removal of diseased tonsils.

Herpetic sore throat (herpes, herpangina) refers to atypical inflammation of the palatine tonsils. It is caused by pathogens of a viral nature. You can also find the name herpes sore throat, it refers to the same disease, but is more colloquial. Most often, this type affects young children. The disease is acute. The main danger lies in the complication in the form.

causative agents of herpetic sore throat

Microorganisms of the following groups can cause inflammation:

What is the difference between the flu and? These names of diseases belong to different classes of concepts. Influenza is an etiological term, they refer to diseases caused by the virus of the same name. - anatomical concepts, i.e. associated with the localization of the infectious process, in this case with the tonsils. Thus, if the influenza virus infects the above organs, the disease can rightly be called both angina and influenza.

Disease pathogenesis

The following factors contribute to the development of herpetic or (herpes) sore throat:

1. Reduced immunity.
2. Prolonged hypothermia, temperature fluctuations, typical for the spring and autumn periods.
3. Injuries of the tonsils, mucous membrane of the pharynx.
4. The presence of dust and toxic substances in the air.

Once on the surface of the tonsils, the virus must penetrate into the intracellular environment. Otherwise, it will die, since these organisms do not have their own synthesis systems. To do this, it binds to receptors on epithelial cells and causes membrane invagination and entrapment. Inside, the virus actively multiplies, after which it causes their death, enters the extracellular space and infects new cells. In parallel, the decay products of cellular structures are released into the blood and cause intoxication of the body.

The virus itself can also enter the blood vessels. This phenomenon is called viremia. Inside the capillaries, the virus is able to infect endothelial cells, violating their integrity.

Symptoms and course of herpes sore throat

The disease begins with a high temperature, sometimes reaching up to 40 °. Patients report severe headache, muscle aches. Also present in the throat pain, difficulty in swallowing. Sometimes symptoms from the gastrointestinal tract are possible: diarrhea, vomiting, lack of appetite. The pain has an atypical localization: behind the sternum, in the abdomen.

The tonsils themselves and the mucous membrane surrounding them are covered with a red rash. It consists of vesicles that usually burst 3-4 days after the onset of the disease. In rare cases, blisters persist for up to 30 days after recovery. With herpes sore throat, the lymph nodes increase. Moreover, their swelling is possible both locally and throughout the body.

Herpetic (herpes) sore throat

A runny nose is possible with the spread of inflammation to neighboring mucous membranes. With influenza sore throat, lesions of the nervous system are observed, expressed in pain in the eyes, especially when exposed to bright light.

Establishing diagnosis

The doctor diagnoses the disease according to the following signs:

• Diffuse hyperemia of the mucous membrane of the pharynx. It is expressed in heterogeneous redness and swelling of tissues and organs (tonsils, palatine arches, soft palate, tongue). The presence of bubbles on the mucous membrane of the throat.
• When analyzing blood, an increase in the number of leukocytes, a shift leukocyte formula to the left (the predominance of neutrophils).
• The presence of the virus in the separated liquid contents (sputum), it is possible to conduct an ELISA ( enzyme immunoassay) to determine antibodies to a specific pathogen.

Treatment of herpetic sore throat

For the treatment of the disease, the following methods are used:

1. Taking medicines.
2. Inhalations.
3. Compliance with the regime of the day - drinking plenty of fluids, liquid food, exclusion motor activity, surge.

Used to maintain the body's resistance pharmacological preparations- immunomodulators, herbal medicines. Antiviral medications are also prescribed. It is possible to use anti-inflammatory drugs, analgesics, mucolytics that promote sputum discharge.

Immunomodulators with antiviral activity

With viral respiratory diseases The following have been proven to be effective:

• Rimantadine. The drug prevents the penetration of the virus into the cells. Important! In persons with kidney failure may accumulate in toxic concentrations. Rimantadine is also used as a prophylactic during the peak of an infection.
• Amantadine. It is an analogue of the above means, American-made. Important! The drug has a wide range of contraindications and side effects, so it is better to take it under the supervision of your doctor.
• Oseltamivir. Another name for the drug is Tamiflu. It inhibits the action of viral enzymes responsible for the exit of microorganisms from the affected cells and the infection of new ones. The drug is suitable for the treatment of herpes sore throat and other respiratory viral diseases in persons older than 1 year.
• Zanamivir. You can meet the name of the release. The drug accumulates in the intercellular space of the epithelium and prevents the spread of the virus. Side effects of the drug are rare due to its inhalation form, allowing topical application. He is allowed to receive from the age of five.

Herbal preparations

a special role in antiviral therapy plays a plant shrub cinquefoil. This representative of the flora in recent years has been subjected to diverse studies. His aqueous extract has a beneficial effect on the immune system of patients, enhancing antiviral activity. It can also prevent the development of the disease. So at work Burovoy L.G., performed in 2004, indicated “ inone extract of cinquefoil had a preventive effect in experimental Coxsackie VZ-virus infection“.

Ural plant elecampane high used to improve sputum separation. It contains natural antibacterial substances - phytoncides. They fight locally infectious agent and speed up recovery. PhD in Biology Khabaltusv Evgeny Yurievich describes elecampane “ how valuable medicinal plant, which has a wide range of therapeutic effects. With angina, its rhizome is used. It retains its properties not only fresh, but also dried. Dried rhizome is crushed and added to tea, tincture is widely used.

Has a similar effect wild rosemary. It is recommended for use in viral sore throats, as it has a mild effect, low toxicity and allergenicity. For therapeutic purposes, decoctions are used, alcohol tinctures and essential oils wild rosemary. Studies have shown that 40% ethanol tincture is most effective in the treatment of colds. It has hepatoprotective, antioxidant and antiseptic effects. Ledum contains substances such as quercetin, kaempferol and myricetin, which actively suppress infections of a viral, bacterial and mycotic nature.

Antibiotics for herpetic sore throat

Fungicidal (antifungal) and antibacterial agents not active against viruses. However, in some cases they are also prescribed for herpes sore throat. The fact is that some viruses (in particular, the influenza virus) lower the patient's immunity, which creates conditions for infection by fungi and bacteria living on the surface of the oropharyngeal mucosa. To prevent a secondary inflammatory process, antibiotics are prescribed.

As antibacterial drugs prescribe agents active against staphylococci and streptococci, often found in the microflora of the mouth, nose, and pharynx. These include:

1. Penicillins;
2. macrolides;
3. Cephalosporins;
4. Sulfonamides.

Analgesics and antipyretics

At high temperatures, metabolism is accelerated, each degree increases its intensity by 15%. This allows the immune system to deal with the infection faster. However, the high rate of metabolic processes entails an increased need for oxygen, which the body is unable to satisfy. This causes disturbances in the functioning of the kidneys, liver, nervous system and heart. Important! Hypoxia (lack of oxygen) of the heart muscle can lead to death. Changes in the nervous system are also very dangerous.

For the vital activity of the organism, a temperature of 42 ° is critical; when this value is exceeded, the destruction (denaturation) of proteins begins. These compounds are the main structural and regulatory components of any cells - when they are destroyed, a person dies.

So when the temperature rises above 40 °, the use of antipyretics (antipyretics) is indicated. With its value of 39 ° for adults and 38.5 ° for children within 3 days, it also needs to be reduced. The values ​​of the critical temperature can be changed on the recommendation of the attending physician, taking into account the age and condition of the patient, however, with an indicator of 37.5 ° and below, the intake special means usually not required. Most antipyretics also relieve the typical sore throat pain symptom. Recommended tools include:

• Analgin, and its analogues - baralgin, pentalgin;
• ibuprofen and nurofen;
• Aspirin;
• Paracetamol;
• Panadol.

Important! Aspirin is contraindicated in children under 15 years of age, it is only suitable for reducing temperature in adulthood.

Mucolytics

With angina, it causes sputum flowing down the wall of the oropharynx. It irritates the larynx and causes a reflex cough to remove it from the body. This can be unpleasant, with herpetic sore throat it is also very painful. In addition, the liquid secretion may contain viral virions, which will become a source of illness for other people.

1. Bromhexine;
2. Ambroxol;
3. ACC (acetylcysteine);
4. Sinupret;
5. Syrups with coltsfoot, chamomile, licorice.

You can also use breast fees for brewing and rinsing.

Prevention of herpetic sore throat

Specific vaccines are being actively developed against viruses that cause colds. For example, against the causative agent of influenza, you can get vaccinated today in ordinary clinics and hospitals. Unfortunately, the resulting immunity is not stable, so it is necessary to repeat the procedure annually.

A vaccine against the Coxsackie virus is under development. So far, the available drugs are sufficiently toxic, which does not allow their mass use. A vaccine against adenoviruses has already been created. It is used in the United States for military personnel serving in places where there is an increased risk of infection. In Russia, the human vaccine against adenoviruses is not used.

Nonspecific prevention of herpetic sore throat includes the prevention of contact with patients and the strengthening of immunity. To do this, it is recommended to use all types of hardening, especially in childhood, eat well and avoid stress. The main thing to remember is that it is easier to prevent a disease than to treat it.

Video: angina, “Doctor Komarovsky”

Herpetic sore throat is an acute infectious disease, accompanied by a sudden change in body temperature, pharyngitis, dysphagia (swallowing disorder), in some cases, abdominal pain, possible nausea, and vomiting. Herpetic sore throat, the symptoms of which are also characterized by the appearance of rashes from the side soft palate or posterior pharyngeal wall, prone to ulceration, is mainly diagnosed in children, so it can rightly be called a "childhood" disease.

general description

Herpangina can also be referred to as such synonyms as aphthous / vesicular pharyngitis, herpetic tonsillitis or herpangina. With this disease, inflammation of the palatine tonsils develops, provoked by Coxsackie enteroviruses, as well as ECHO viruses. Basically, herpangina is detected in preschoolers and in children of the primary school age group, that is, it is an interval from 3 to 10 years.

Most severe course herpetic sore throat is characterized in children under three years of age. The detection of herpetic sore throat in children at the age of the first months of their life occurs much less frequently, this is due to the fact that they have the appropriate antibodies obtained through breast milk from the mother, in other words, in this case we are talking on the presence of passive immunity.

The pathogen is transmitted by airborne droplets(for example, during sneezing, coughing, talking, etc.), however, the fecal-oral route of transmission is also allowed, which, however, occurs less frequently. With the fecal-oral route of infection, it occurs through dirty hands, nipples, food, toys, etc. And, finally, among the possible routes of infection - contact way transmission, which implies infection through the nasopharyngeal discharge.

The main natural reservoir is the virus carrier and the sick person (infection through animals occurs somewhat less frequently). Convalescents (recovering patients) can also be considered as a source of infection, which is explained by the fact that they shed the virus for several more weeks (usually 3-4).

For herpetic sore throat, seasonality is also determined, in particular, it can be indicated that the peak incidence falls on the period from June to September. The disease is characterized by an increased degree of contagiousness, for this reason, in the indicated summer-autumn period, infection of children occurs quite often both within individual families and in organized groups of groups (kindergartens, camps, etc.).

When the causative agent of herpetic sore throat enters the body through the nasopharynx (through its mucous membranes), it spreads to the intestinal lymph nodes. Here it actively reproduces, after which it enters the bloodstream, which contributes to the development of such a condition as viremia. Actually, viremia refers to a condition in which the virus is in the bloodstream, which allows it to further spread throughout the body.

Features of further spread are determined by the properties of viral pathogens, as well as the characteristics of the individual defense mechanisms that the child's body has. When viral pathogens spread throughout the body, they are fixed in certain areas of the tissues, due to which they subsequently develop inflammatory processes, processes are dystrophic, as well as necrotic.

Coxsackie enteroviruses, like ECHO, have a high degree of tropism (that is, the ability to choose the most "attractive territories") in relation to mucous membranes, nervous tissue, muscles (including the myocardium).

It also happens that herpetic sore throat in children manifests itself with an already existing adenovirus infection or the flu. In the future, after the child has suffered herpetic sore throat, he develops a stable form of immunity against the corresponding strain of the virus. Meanwhile, if infection occurs with another form of the virus, then this again can cause the development of herpangina.

Herpetic sore throat: symptoms

The duration of the incubation period of the disease is about 7-14 days. Note that the incubation period is the time period between the moment a microbial agent enters the body environment and the moment the first symptoms of the disease provoked by it appear.

The manifestation of herpetic sore throat begins with symptoms corresponding to the picture of the flu, respectively, weakness and malaise, loss of appetite are noted here. Besides, characteristic symptom given state there is a high fever, the temperature at which reaches 39-40 degrees. There are complaints of pain in the muscles noted in the limbs, as well as in the abdomen and back. There is also nausea and vomiting, diarrhea, headache. In addition to the general type of symptoms, sore throat, pain when swallowing, cough, runny nose, profuse salivation are also added.

Herpetic sore throat in children is accompanied by a rapid increase in local changes. So, already during the first day, it can be found that papules of small sizes appear on the reddened mucous membrane of the palatine arches, tonsils, palate and uvula in the oral cavity (elements of a skin rash in the form small size bubbles of a dense type, towering above the skin). Gradually, papules begin to transform into vesicles - otherwise, vesicles, that is, cavity-type elements of the rash, reaching an average of 5 mm in diameter, serous contents are located inside their cavity.

After 1-2 days, the formed vesicles begin to open, after which grayish-white sores remain at their location, surrounded by a crown of redness. In some cases, such ulcers begin to combine with each other, which leads to the formation of a confluent type of surface defects. Erosions formed on the mucosa have severe soreness, which leads to the refusal of children to eat and drink. In addition, herpetic sore throat is accompanied by the development in children of bilateral parotid, cervical and submandibular lymphadenopathy- that is, the state of enlargement of the lymph nodes in the indicated areas.

Simultaneously with the typical forms of manifestation of the disease, in children with herpetic sore throat, erased signs of the disease can also be observed, which implies only the development of catarrhal changes in the oropharynx, in the absence of defects in the mucous membrane. With weakened immunity in children, herpetic eruptions, manifested in this disease, may appear in a wave-like manner every 2-3 days, and in this case, the rashes will be accompanied by fever in combination with symptoms of intoxication. In some cases, herpetic sore throat is accompanied by the appearance of a papular rash on the extremities in the distal regions (hands, feet) and along the trunk, similarly, this location is relevant for a vesicular rash.

In the case of a typical course of herpetic sore throat, the fever begins to subside after 3-5 days, after about 6-7 days, epithelialization processes (healing of the affected mucosa (in this case) with the appearance of a layer of epithelium in such areas) begin on the mucous membrane of the oral cavity and pharynx, due to which the past defect is to be repaired). If the patient's body has a low degree of reactivity or if the viremia has reached a high degree, then generalization may occur. enterovirus infection(its spread to other areas and organs), due to which, for example, encephalitis, meningitis, pyelonephritis, myocarditis or hemorrhagic conjunctivitis can develop.

Diagnosis

The diagnosis of herpetic sore throat is established on the basis of previous serological and virological studies. Pharyngeal swabs seized in the first 5 days of the course of the disease are used as material for conducting a virological study. The serological study is based on the study of serum withdrawn during the first days of the onset of the disease, as well as 2-3 weeks after that. by the most informative method diagnosis in this case is the method of immunofluorescence.

AT differential diagnosis based on data in the form of the age of the child, the characteristics of the disease in terms of its seasonality, the localization of the elements of the rash in the environment of the oral cavity. Herpetic sore throat is not accompanied by the appearance of a herpetic rash on the face, the mucous membrane does not bleed, and gingivitis does not develop. AT frequent cases herpetic sore throat is accompanied by the appearance of such a symptom as pain in the abdomen, this is due to the myalgia of the diaphragm that is relevant to it.

The main directions of diagnostics: blood test; determination of the pathogen (examination of smears, swabs of the nasopharynx).

Treatment

Treatment of herpetic sore throat is complex and symptomatic. First of all, sick children are subject to isolation, the treatment applied to them must be both general and local. The child needs to drink plenty of fluids, food is served in a semi-liquid or liquid form - this will eliminate additional irritation of the oral mucosa.

Hyposensitizing drugs are prescribed (diazolin, claritin, etc.), immunomodulators (for example, immunal or imudon), antipyretic drugs (for example, ibuprofen). In order to avoid layering a secondary infection, oral antiseptics should be used, it is also necessary to provide a gargle with antiseptics (every hour), decoctions of various herbs are recommended (oak bark, sage, calendula, etc.). Additionally, treatment with appropriate preparations of the tonsils and the posterior pharyngeal wall is prescribed. Aerosols with antiseptic, analgesic and enveloping mucous effect (inhalipt, etc.) are also applied topically.

An unacceptable measure in the treatment of herpetic sore throat is the use of inhalations, and compresses cannot be used - due to the thermal effect, blood circulation is to be increased, which predisposes to the spread of the virus with blood throughout the body.

When symptoms appear that indicate possible appearance herpetic sore throat, it is necessary to contact the attending pediatrician, a consultation with a neurologist will help to exclude serous meningitis, changes detected by urinalysis may require a consultation with a nephrologist.