What are the main symptoms of strep throat. How is strep throat diagnosed and treated. What complications can arise from untreated strep throat. How can you prevent the spread of strep throat.

Understanding Strep Throat: A Common Bacterial Infection

Strep throat is a bacterial infection caused by Streptococcus pyogenes, also known as group A streptococcus. This condition primarily affects the throat and tonsils, causing discomfort and a range of symptoms. While it accounts for only a small portion of sore throats, strep throat can lead to serious complications if left untreated.

Is strep throat contagious? Yes, strep throat is highly contagious and can spread through respiratory droplets when an infected person coughs or sneezes. It can also be transmitted through shared food, drinks, or contaminated surfaces.

Recognizing the Symptoms of Strep Throat

Identifying strep throat early is crucial for prompt treatment. The symptoms of strep throat often appear suddenly and can include:

• Severe throat pain
• Difficulty swallowing
• Swollen, red tonsils (sometimes with white patches or pus)
• Tiny red spots on the soft or hard palate
• Swollen, tender lymph nodes in the neck
• Fever
• Headache
• Body aches
• Nausea or vomiting (especially in children)
• Rash (in some cases)

Can you have strep throat without a fever? While fever is a common symptom, it’s possible to have strep throat without running a temperature. However, the absence of fever doesn’t rule out the infection.

Diagnosing Strep Throat: When to See a Doctor

It’s important to consult a healthcare provider if you or your child experience persistent or severe symptoms. Seek medical attention if you notice:

• A sore throat lasting longer than 48 hours
• Difficulty breathing or swallowing
• A sore throat accompanied by a rash
• Tender, swollen lymph nodes
• No improvement after 48 hours of antibiotic treatment (if strep has been diagnosed)

How is strep throat diagnosed? Doctors typically use a rapid strep test or a throat culture to confirm the presence of streptococcal bacteria. These tests help distinguish strep throat from viral infections, which don’t respond to antibiotics.

Treatment Options for Strep Throat

Once diagnosed, strep throat is usually treated with antibiotics. This approach helps:

• Reduce the duration and severity of symptoms
• Prevent the spread of infection to others
• Lower the risk of complications

What is the most effective antibiotic for strep throat? Penicillin and amoxicillin are typically the first-choice antibiotics for strep throat. For those allergic to penicillin, alternative antibiotics like erythromycin or cephalosporins may be prescribed.

Home Remedies and Symptom Relief

In addition to antibiotics, several home remedies can help alleviate strep throat symptoms:

• Gargling with warm salt water
• Drinking warm liquids (tea with honey, broth)
• Using over-the-counter pain relievers
• Resting and getting plenty of sleep
• Staying hydrated

Potential Complications of Untreated Strep Throat

If left untreated, strep throat can lead to serious complications, including:

1. Spread of infection to nearby tissues (tonsils, sinuses, skin, blood, middle ear)
2. Scarlet fever
3. Poststreptococcal glomerulonephritis (kidney inflammation)
4. Rheumatic fever (affecting the heart, joints, nervous system, and skin)
5. Poststreptococcal reactive arthritis

Can strep throat cause long-term complications? While rare, untreated strep throat can potentially lead to long-term issues such as rheumatic heart disease or kidney damage. This underscores the importance of prompt treatment.

Risk Factors for Strep Throat

Certain factors can increase your likelihood of developing strep throat:

• Age: Children between 5 and 15 years old are most susceptible
• Season: Strep throat is more common in winter and early spring
• Close contact: Being in crowded environments (schools, daycare centers)

Why are children more prone to strep throat? Children’s immune systems are still developing, making them more vulnerable to infections. Additionally, they often have closer physical contact with peers, facilitating the spread of bacteria.

Preventing the Spread of Strep Throat

Taking preventive measures can significantly reduce the risk of contracting or spreading strep throat:

• Practice proper hand hygiene (wash hands frequently with soap and water)
• Cover your mouth and nose when coughing or sneezing
• Avoid sharing personal items (utensils, drinking glasses)
• Stay home when sick to prevent spreading the infection
• Replace toothbrushes after starting antibiotic treatment

How long should you stay home with strep throat? It’s generally recommended to stay home for at least 24 hours after starting antibiotic treatment and until fever subsides.

The Connection Between Strep Throat and Other Conditions

Recent research has explored potential links between strep infections and other health issues:

PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections)

Some studies suggest a possible relationship between strep infections and the sudden onset or worsening of neuropsychiatric symptoms in children, such as obsessive-compulsive disorder (OCD) or tic disorders. However, this connection remains controversial and requires further research.

Invasive Group A Strep Infections

The Centers for Disease Control and Prevention (CDC) has reported an increase in invasive group A strep (iGAS) infections among children in the United States. These severe infections can include conditions like necrotizing fasciitis and streptococcal toxic shock syndrome.

What factors contribute to the rise in invasive strep infections? Possible factors include increased susceptibility due to reduced exposure during the COVID-19 pandemic, changes in bacterial strains, or improvements in disease surveillance and reporting.

Strep Throat in Special Populations

While strep throat can affect anyone, certain groups may require special consideration:

Strep Throat in Pregnancy

Pregnant women with strep throat should seek prompt medical attention. Untreated strep infections during pregnancy can potentially lead to complications for both mother and baby. Safe antibiotic options are available for use during pregnancy.

Recurrent Strep Throat

Some individuals experience frequent strep throat infections. In such cases, doctors may consider additional tests or treatments, including:

• Tonsillectomy (surgical removal of tonsils)
• Evaluation for strep carriers in the family
• Investigation of underlying immune system issues

What causes recurrent strep throat? Factors may include incomplete antibiotic treatment, reinfection from family members or close contacts, or a weakened immune system.

Advances in Strep Throat Research and Treatment

Ongoing research aims to improve our understanding and management of strep throat:

Vaccine Development

Scientists are working on developing a vaccine against group A streptococcus. While still in experimental stages, a successful vaccine could significantly reduce the incidence of strep throat and its complications.

Rapid Diagnostic Tests

Advancements in diagnostic technology are leading to more accurate and faster strep tests, potentially allowing for quicker treatment initiation.

Antibiotic Resistance Monitoring

Researchers continue to monitor antibiotic resistance patterns in strep bacteria to ensure that current treatment recommendations remain effective.

How can we combat antibiotic resistance in strep infections? Proper antibiotic use, including completing the full course of prescribed antibiotics and avoiding unnecessary antibiotic use for viral infections, is crucial in preventing resistance.

Living with Strep Throat: Coping Strategies and Recovery

Recovering from strep throat can be uncomfortable, but there are ways to manage symptoms and promote healing:

Dietary Considerations

Consuming soft, soothing foods can help ease throat pain. Consider:

• Warm soups and broths
• Smoothies and yogurt
• Mashed potatoes
• Ice cream or popsicles (for sore throat relief)

Voice Rest

Resting your voice can help reduce strain on the throat and promote faster healing. Avoid shouting or whispering, as both can irritate the throat.

Humidification

Using a humidifier in your room can help keep the air moist, potentially easing throat discomfort and reducing coughing.

How long does it typically take to recover from strep throat? With proper antibiotic treatment, most people start feeling better within 24 to 48 hours. However, it’s important to complete the full course of antibiotics to prevent recurrence and complications.

The Importance of Antibiotic Stewardship in Strep Throat Management

While antibiotics are crucial in treating strep throat, their appropriate use is equally important:

Avoiding Overuse

Not all sore throats require antibiotic treatment. Viral infections, which cause most sore throats, do not respond to antibiotics. Proper diagnosis through testing is essential before prescribing antibiotics.

Completing the Full Course

It’s crucial to finish the entire prescribed course of antibiotics, even if symptoms improve. This helps ensure complete eradication of the bacteria and reduces the risk of antibiotic resistance.

Proper Disposal

Unused or expired antibiotics should be properly disposed of, not saved for future use or shared with others.

Why is antibiotic stewardship important in managing strep throat? Responsible antibiotic use helps maintain the effectiveness of these crucial medications, reduces the risk of side effects, and helps prevent the development of antibiotic-resistant bacteria.

The Global Impact of Strep Throat and Group A Streptococcal Infections

While strep throat is often considered a relatively mild condition in developed countries, group A streptococcal infections have a significant global health impact:

Rheumatic Heart Disease

In many low- and middle-income countries, untreated strep throat can lead to rheumatic fever and subsequent rheumatic heart disease, a major cause of cardiovascular mortality in young people.

Invasive Infections

Severe invasive group A strep infections, while less common, can occur worldwide and carry high mortality rates if not promptly treated.

Economic Burden

The global economic impact of strep throat and its complications is substantial, including healthcare costs, lost productivity, and long-term disability from complications.

How can we address the global burden of strep infections? Strategies include improving access to healthcare and antibiotics in resource-limited settings, enhancing surveillance systems, and supporting research into prevention methods like vaccines.

Strep Throat in the Context of Other Respiratory Infections

Understanding how strep throat relates to other common respiratory infections can help in proper diagnosis and management:

Strep Throat vs. Viral Sore Throat

While symptoms can be similar, viral sore throats often include additional cold-like symptoms such as runny nose and cough, which are less common in strep throat.

Strep Throat vs. Tonsillitis

Tonsillitis refers to inflammation of the tonsils, which can be caused by various pathogens, including strep bacteria. Not all cases of tonsillitis are due to strep infection.

Strep Throat in the Era of COVID-19

The COVID-19 pandemic has complicated the diagnosis of strep throat, as some symptoms overlap. Proper testing is crucial to differentiate between these conditions.

How can healthcare providers effectively distinguish between strep throat and other respiratory infections? A combination of clinical assessment, patient history, and appropriate diagnostic tests (such as rapid strep tests and throat cultures) is key to accurate diagnosis.

In conclusion, strep throat remains a significant health concern, particularly due to its potential complications and global impact. By understanding its symptoms, seeking timely medical care, and following proper treatment and prevention strategies, we can effectively manage this common bacterial infection and reduce its burden on individuals and communities worldwide. Ongoing research and advancements in diagnosis and treatment continue to improve our ability to combat strep throat and its associated conditions.

Strep throat – Symptoms & causes

Overview

Strep throat is a bacterial infection that can make your throat feel sore and scratchy. Strep throat accounts for only a small portion of sore throats.

If untreated, strep throat can cause complications, such as kidney inflammation or rheumatic fever. Rheumatic fever can lead to painful and inflamed joints, a specific type of rash, or heart valve damage.

Strep throat is most common in children, but it affects people of all ages. If you or your child has signs or symptoms of strep throat, see your doctor for prompt testing and treatment.

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Symptoms

Signs and symptoms of strep throat can include:

• Throat pain that usually comes on quickly
• Painful swallowing
• Red and swollen tonsils, sometimes with white patches or streaks of pus
• Tiny red spots on the area at the back of the roof of the mouth (soft or hard palate)
• Swollen, tender lymph nodes in your neck
• Fever
• Headache
• Rash
• Nausea or vomiting, especially in younger children
• Body aches

Strep throat infection

Strep throat usually causes throat pain and difficulty swallowing. This photo of strep throat shows inflammation and red spots, caused by the infection.

It’s possible for you or your child to have many of these signs and symptoms but not have strep throat. The cause of these signs and symptoms could be a viral infection or some other illness. That’s why your doctor generally tests specifically for strep throat.

It’s also possible for you to be exposed to a person who carries strep but shows no symptoms.

When to see a doctor

Call your doctor if you or your child has any of these signs and symptoms:

• A sore throat accompanied by tender, swollen lymph glands
• A sore throat that lasts longer than 48 hours
• A fever
• A sore throat accompanied by a rash
• Problems breathing or swallowing
• If strep has been diagnosed, a lack of improvement after taking antibiotics for 48 hours

Causes

Strep throat is caused by infection with a bacterium known as Streptococcus pyogenes, also called group A streptococcus.

Streptococcal bacteria are contagious. They can spread through droplets when someone with the infection coughs or sneezes, or through shared food or drinks. You can also pick up the bacteria from a doorknob or other surface and transfer them to your nose, mouth or eyes.

Risk factors

Several factors can increase your risk of strep throat infection:

• Young age. Strep throat occurs most commonly in children.
• Time of year. Although strep throat can occur anytime, it tends to circulate in winter and early spring. Strep bacteria flourish wherever groups of people are in close contact.

Complications

Strep throat can lead to serious complications. Antibiotic treatment reduces the risk.

Spread of infection

Strep bacteria may spread, causing infection in:

• Tonsils
• Sinuses
• Skin
• Blood
• Middle ear

Inflammatory reactions

Strep infection may lead to inflammatory illnesses, including:

• Scarlet fever, a streptococcal infection characterized by a prominent rash
• Inflammation of the kidney (poststreptococcal glomerulonephritis)
• Rheumatic fever, a serious inflammatory condition that can affect the heart, joints, nervous system and skin
• Poststreptococcal reactive arthritis, a condition that causes inflammation of the joints

A possible relationship has been suggested between strep infection and a rare condition called pediatric autoimmune neuropsychiatric disorder associated with group A streptococci (PANDAS). Children with this condition experience worsened symptoms of neuropsychiatric conditions, such as obsessive-compulsive disorder or tic disorders, with strep. This relationship currently remains unproved and controversial.

Prevention

To prevent strep infection:

• Wash your hands. Proper hand-washing is the best way to prevent all kinds of infections. That’s why it’s important to wash your own hands regularly with soap and water for at least 20 seconds. Teach your children how to wash their hands properly using soap and water or to use an alcohol-based hand sanitizer if there is no soap and water available.
• Cover your mouth. Teach your children to cover their mouths with an elbow or tissue when they cough or sneeze.
• Don’t share personal items. Don’t share drinking glasses or eating utensils. Wash dishes in hot, soapy water or in a dishwasher.

Strep Throat: All You Need to Know

Increase in Invasive Group A Strep Infections, 2022–2023

CDC is looking into an increase in invasive group A strep (iGAS) infections among children in the United States. iGAS infections include necrotizing fasciitis and streptococcal toxic shock syndrome.

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Worried your sore throat may be strep throat? Doctors can do a quick test to see if a sore throat is strep throat. Antibiotics can help people with strep throat feel better faster and prevent spreading it to others.

• Bacteria cause strep throat
• How you get strep throat
• Symptoms often include pain and fever
• Some people are at increased risk
• A simple test gives fast results

• Antibiotics are used for treatment
• Not everyone needs antibiotics
• Serious complications are not common
• Protect yourself and others

Bacteria cause strep throat

Viruses cause most sore throats. However, strep throat is an infection in the throat and tonsils caused by bacteria called group A Streptococcus (group A strep).

How you get strep throat

Group A strep bacteria are very contagious. Generally, people spread the bacteria to others through

• Respiratory droplets
• Direct contact

Rarely, people can spread group A strep bacteria through food that is not handled properly (visit CDC’s food safety page).

It usually takes two to five days for someone exposed to group A strep bacteria to become ill with strep throat.

Respiratory droplets

Group A strep bacteria often live in the nose and throat. People who are infected spread the bacteria by talking, coughing, or sneezing, which creates respiratory droplets that contain the bacteria.

People can get sick if they:

• Breathe in respiratory droplets that contain the bacteria
• Touch something with those droplets on it and then touch their mouth or nose
• Drink from the same glass or eat from the same plate as a person infected with group A strep bacteria

Direct contact

People can also spread group A strep bacteria from infected sores on their skin. Other people can get sick if they:

• Touch sores on the skin caused by group A strep bacteria (impetigo) or come into contact with fluid from the sores

People are contagious even with no symptoms

Some people infected with group A strep do not have symptoms or seem sick. People who are sick with strep throat are more contagious than those who do not have symptoms.

Symptoms often include pain and fever

In general, strep throat is a mild disease, but it can be very painful.

Common symptoms may include:

• Fever
• Pain when swallowing
• Sore throat that can start very quickly and may look red
• Red and swollen tonsils
• White patches or streaks of pus on the tonsils
• Tiny, red spots on the roof of the mouth, called petechiae
• Swollen lymph nodes in the front of the neck

A healthy throat

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Signs of strep throat

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Less common symptoms may include vomiting and headache

Some people, especially children, may have other symptoms, too.

Other symptoms may include:

• Headache
• Stomach pain
• Nausea or vomiting
• Rash (scarlet fever)

Symptoms do NOT include cough or runny nose

The following symptoms suggest a virus is the cause of the illness instead of strep throat:

• Cough
• Runny nose
• Hoarseness (changes in your voice that make it sound breathy, raspy, or strained)
• Pink eye (conjunctivitis)

• Up to 3 in 10 children with a sore throat have strep throat
• About 1 in 10 adults with a sore throat has strep throat

Some people are at increased risk

Anyone can get strep throat, but there are some factors that can increase the risk of getting this common infection.

Age

Strep throat is more common in children than adults. It is most common in children 5 through 15 years old. It is very rare in children younger than 3 years old.

Adults who are at increased risk for strep throat include:

• Parents of school-aged children
• Adults who are often in contact with children

Group settings

Close contact with another person with strep throat is the most common risk factor for illness. For example, if someone has strep throat, the bacteria often spread to other people in their household.

Infectious illnesses tend to spread wherever large groups of people gather. Crowded settings can increase the risk of getting a group A strep infection. These settings include:

• Schools
• Daycare centers
• Military training facilities

A simple test gives fast results

Your doctor may swab your throat to test for bacteria.

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A doctor will determine what type of illness you have by asking about symptoms and doing a physical exam. If they think you might have strep throat, they will swab your throat to test for strep throat. There are two types of tests for strep throat: a rapid strep test and throat culture.

Rapid strep test

A rapid strep test involves swabbing the throat and running a test on the swab. The test quickly shows if group A strep bacteria are causing the illness.

• If the test is positive, doctors can prescribe antibiotics.
• If the test is negative, but a doctor still suspects strep throat, then the doctor can take a throat culture swab.

Throat culture

A throat culture takes time to see if group A strep bacteria grow from the swab. While it takes more time, a throat culture sometimes finds infections that the rapid strep test misses.

Culture is important to use in children and teens since they can get rheumatic fever from an untreated strep throat infection. For adults, it is usually not necessary to do a throat culture following a negative rapid strep test. Adults are generally not at risk of getting rheumatic fever following a strep throat infection.

Antibiotics are used for treatment

Doctors treat strep throat with antibiotics. Benefits of antibiotics include:

• Decreasing how long someone is sick
• Decreasing symptoms (feeling better)
• Preventing the bacteria from spreading to others
• Preventing serious complications like rheumatic fever

Someone with strep throat should start feeling better in just a day or two after starting antibiotics. Call the doctor if you or your child are not feeling better after taking antibiotics for 48 hours.

When to return to work or school

People with strep throat should stay home from work, school, or daycare until they:

• No longer have a fever

AND

• Have taken antibiotics for at least 12 to 24 hours; ask the doctor how long you should stay home after starting antibiotics

Use antibiotics properly

1. Take the prescription exactly as the doctor says to.
2. Keep taking the medicine even if you or your child feels better. Don’t stop unless the doctor says to stop.

You can find more guidance on taking antibiotics on CDC’s Antibiotic Do’s & Don’ts Page.

Not everyone needs antibiotics

Someone who tests positive for strep throat but has no symptoms (called a “carrier”) usually does not need antibiotics. They are less likely to spread the bacteria to others and very unlikely to get complications.

If a carrier gets a sore throat illness caused by a virus, the rapid strep test can be positive. In these cases, it can be hard to know what is causing the sore throat.

If someone keeps getting a sore throat after taking the right antibiotics, they may be a strep carrier and have a viral throat infection. Talk to a doctor if you think you or your child may be a strep carrier.

Serious complications are not common

Complications can occur after a strep throat infection. This can happen if the bacteria spread to other parts of the body.

Complications can include:

• Abscesses (pockets of pus) around the tonsils or in the neck
• Swollen lymph nodes in the neck
• Sinus infections
• Ear infections
• Rheumatic fever (a disease that can affect the heart, joints, brain, and skin)
• Post-streptococcal glomerulonephritis (a kidney disease)

Protect yourself and others

People can get strep throat more than once. Having strep throat does not protect someone from getting it again in the future. While there is no vaccine to prevent strep throat, there are things people can do to protect themselves and others.

Wash your hands often to help prevent germs from spreading.

Good hygiene

The best way to keep from getting or spreading group A strep is to wash your hands often. This is especially important after coughing or sneezing and before preparing foods or eating.

To prevent group A strep infections, you should:

• Cover your mouth and nose with a tissue when you cough or sneeze.
• Put your used tissue in the waste basket.
• Cough or sneeze into your upper sleeve or elbow, not your hands, if you don’t have a tissue.
• Wash your hands often with soap and water for at least 20 seconds.
• Use an alcohol-based hand rub if soap and water are not available.

You should also wash glasses, utensils, and plates after someone who is sick uses them. These items are safe for others to use once washed.

Antibiotics

Antibiotics help prevent someone with strep throat from spreading the bacteria to others.

Related diseases

Scarlet fever

Impetigo

Necrotizing fasciitis

Cellulitis

• Conjunctivitis (Pink Eye)
• Food Safety Homepage
• Handwashing: When and How to Wash Your Hands
• Hygiene Etiquette and Practice: Coughing and Sneezing
• PANDAS — Questions and Answers
• Sore Throats and Antibiotic Use

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Viral and bacterial angina – (Di Center clinics)

The word angina comes from the Latin “ango” – to squeeze and choke. And although no one has yet died of suffocation during a sore throat, the name has taken root not only among doctors, but also among patients.

The second name of the disease is acute tonsillitis. Acute tonsillitis (tonsillitis) is an inflammation of the palatine tonsils of the pharyngeal lymphoid ring, and less often other lymphoid formations of the pharynx (palatine folds, adenoids). It can be one or two sided. More than half of all tonsillitis is caused by viruses, the rest by various bacteria, the most significant of which is beta-hemolytic group A streptococcus (the modern name is Streptococcus pyogenes). Angina caused by this microbe can give a variety of complications to the internal organs. In a small percentage of cases, angina can be caused by fungi or parasites.

Who is most likely to get angina?

Acute tonsillitis (tonsillitis) is widespread, especially among children. At the age of 5-15 years, bacterial (streptococcal) tonsillitis is more common, while viral tonsillitis mainly affects children under 5 years of age and adults.

Types of angina

Of greatest importance is the difference between angina caused by streptococcus and angina caused by other microbes. Depending on this, streptococcal and non-streptococcal tonsillitis are distinguished, since this is of fundamental importance for further treatment.

In Russian medicine, the classification of angina is accepted, based on the stage of the inflammatory process and the appearance of the tonsils.

There are the following types of angina:

• Catarrhal angina – the tonsils are enlarged, red, there are no raids, it is considered the mildest form.

• Follicular tonsillitis – a small-point purulent plaque appears.

• Lacunar tonsillitis – the lacunae of the tonsils are filled with pus, is considered the most severe form.

In European and American medicine, this type of classification is not given any importance. In Russia, you can often hear the word “tonsillitis” as the designation of streptococcal tonsillitis, although in fact this word does not have such a meaning.

Depending on whether one or both tonsils are inflamed, angina can be one- or two-sided. In many cases, angina is combined with pharyngitis – inflammation of the posterior pharyngeal wall, the lingual tonsil, palatine ridges, etc. may also be involved.

Treatment of viral and bacterial sore throats

Treatment of angina (for example, catarrhal) caused by a virus consists in alleviating the symptoms of the disease, because viral sore throat usually goes away on its own. In this case, to alleviate the symptoms of the disease, it is recommended: gargle with salt water, drink plenty of warm tea, take painkillers, and use other home treatments.

In the event that streptococcus has become the cause of angina, then antibiotic therapy is necessary to treat angina (for example, follicular or lacunar). Taking antibiotics will help control the spread of the infection and prevent rare but serious complications (for example, rheumatism, myocarditis).

If frequent recurrences of tonsillitis occur, the disease becomes chronic, and conditions are created for local destruction of the tonsils. Which in turn leads to the failure of the tonsils in the performance of their protective functions of the immune system. In addition, the constant presence of infection in the tonsils contributes to the entry of microbes into the general bloodstream, thereby affecting other organs and systems. To exclude complications associated with this phenomenon, doctors recommend the removal of pathologically altered tonsils.

Contraindications for the removal of the tonsils are: heart defects of 2-3 degrees of severity; hemophilia – a violation of blood clotting; severe diabetes mellitus.

Viral tonsillitis in children. What is Viral angina in children?

IMPORTANT
The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.

Viral tonsillitis in children is an infectious inflammation of the lymphoid tissue of the tonsils of the pharynx, which occurs when infected with adenoviruses, herpesviruses, enteroviruses. The disease is manifested by intense sore throat, aggravated by swallowing, subfebrile body temperature, redness and swelling of the tonsils. The basis of the diagnosis is the examination of the throat and the identification of typical external signs of tonsillitis, and to clarify its etiology, a bacteriological smear from the mucous membrane of the pharynx, general clinical and serological reactions of the blood are prescribed. Treatment of viral sore throats requires a sparing regimen and diet, gargling with herbal decoctions and antiseptics.

ICD-10

J03 Acute tonsillitis

• Causes
• Pathogenesis
• Symptoms
• Complications
• Diagnostics
• Treatment of viral sore throat in children
• Prognosis and prevention
• Prices for treatment

General

Angina (acute tonsillitis) accounts for 3-7% of the number of acute diseases of childhood and 17-42% of all visits to pediatricians and pediatric otolaryngologists. The disease occurs in children of any age, with the exception of the first year of a baby’s life, when the lymphoid tissue is not yet sufficiently developed. The peak of viral tonsillar inflammation falls on the age range from 3 to 7 years, in adolescents they are diagnosed extremely rarely. Girls and boys get sick equally often. The disease is dangerous with local and systemic complications, the transition to a chronic form.

Viral angina in children

Causes

Angina occurs as a primary disease or complicates the course of systemic viral infections. In children, the main causative agents of tonsillitis are adenoviruses 1-9 types and Coxsackie enteroviruses. A typical cause of sore throats in preschoolers is infectious mononucleosis caused by Epstein-Barr herpesvirus. In extremely rare cases, the pathology develops with influenza, parainfluenza, rhinovirus infection.

The predisposing factors on the part of the body include the lymphatic-hyperplastic type of constitution, the presence of acute and chronic diseases of the nasopharynx, changes in the reactivity of the immune system. The likelihood of a sore throat is increased by nervous overexertion and constant stress in a child, recently suffered debilitating infectious or somatic diseases. External provoking factors include hypothermia, sudden changes in the weather, too dry air in the house.

Pathogenesis

Penetration of viral pathogens occurs by airborne, contact or alimentary routes. Given the crowding in kindergartens and schools and the children’s non-compliance with hygiene rules, the spread of the infection is very fast. Viruses are introduced into the tonsillar mucosa, begin to have cytopathic effects. The palatine tonsils are most commonly affected.

Viruses cause an inflammatory process, increase the release of specific mediators, resulting in increased swelling, hyperemia, and rashes. Angina is characterized by an allergic-hyperergic reaction, since the lacunar microflora and cell decay products act as antigens that sensitize the body. This is a prerequisite for the development of complications in children.

Symptoms

Angina begins acutely with complaints of soreness, burning and sore throat. At first, the child experiences pain only at the moment of swallowing and when talking, but after 12-24 hours he has severe constant pain. There is no runny nose, a slight cough may disturb, but severe coughing attacks do not occur. Because of discomfort, children refuse solid food, drinking liquids also gives them discomfort.

The clinic of viral tonsillitis is characterized by subfebrile temperature, general weakness, and malaise. The child becomes lethargic, apathetic, does not participate in children’s games. Some kids complain of headaches. Given the high frequency of enteroviral tonsillitis in children, the disease is often combined with intestinal disorders. There is frequent watery stools, pain and cramps in the abdomen, nausea and vomiting.

Complications

The most common consequence of viral sore throat in children is the addition of bacterial flora, since the mucosa is damaged and local immunity is impaired. In this case, prolonged follicular or lacunar purulent inflammations occur, the treatment of which is difficult. Among the typical local complications of angina are called peritonsillitis, paratonsillar abscess, otitis media. They mainly develop with untimely initiation of therapy.

Systemic metatonsillar complications in children are much less common, but they are the most dangerous for the health of the child. After suffering a sore throat in the period of convalescence, infectious-allergic myocarditis, glomerulonephritis may begin. Pathologies are autoimmune in nature, appear no earlier than 8-10 days after the onset of clinical symptoms.

Diagnostics

Examination and treatment for uncomplicated forms of angina is carried out by a pediatrician, according to indications, he directs the child to consult an infectious disease specialist and an otolaryngologist. The doctor receives valuable information when examining the throat: he reveals hyperemia and swelling of the palatine arches, a loosened, granular tonsillar surface, there may be bubbles with transparent contents that quickly open with the formation of erosions. To clarify the diagnosis, the following methods are used:

• Throat swab. The study is performed in all cases of angina to exclude bacterial inflammation caused by hemolytic streptococcus, Haemophilus influenzae, mycoplasmas or chlamydia. Be sure to take a smear for diphtheria, which in the initial stages can proceed without characteristic physical symptoms.
• Complete blood count. Detection in the hemogram of an increased number of atypical lymphocytes (mononuclear cells) is a pathognomonic sign of infectious mononucleosis. Viral inflammations are often accompanied by leukopenia. For the diagnosis of Epstein-Barr, Coxsackie, adenoviruses, blood ELISA is prescribed for antibodies.

Treatment of viral sore throat in children

Treatment of viral sore throat necessarily includes a sparing regimen, restriction of salty, spicy, cold or excessively hot dishes. In order not to irritate the throat, food should be in the form of soups and mashed potatoes without hard and sharp pieces. A plentiful warm drink is useful: dried fruit compotes, herbal decoctions, weak teas. In the first days of illness, in the presence of temperature, the child must observe bed rest.

With viral tonsillitis, the basis is local treatment. To cleanse the tonsils, remove pathogenic pathogens and mucus, children are prescribed gargling with antiseptic solutions, chamomile decoction, calendula tincture. With an increase in temperature of more than 38-38.5 ° C, treatment with antipyretic drugs from the group of non-steroidal anti-inflammatory drugs is recommended. With an uncomplicated variant, recovery occurs in 5-7 days.

Antibiotics for viral tonsillitis in children are used only in case of bacterial infection. In pediatrics, penicillin preparations, macrolides, cephalosporins are used. With massive intoxication, an infusion of infusion solutions is performed. To reduce swelling of the tonsils, to stop the allergic component of angina, treatment with antihistamines may be prescribed.

Prognosis and prevention

Therapy of viral tonsillitis in most cases is not difficult, so children recover within 5-10 days. The danger of the disease lies in the risk of developing systemic complications with damage to the heart, kidneys, and joints. To prevent tonsillitis, it is necessary to teach the child the rules of hygiene, dress him according to the weather and avoid hypothermia, do not give too hot or cold food. An important role is played by the identification and treatment of other ENT pathologies.

You can share your medical history, what helped you in the treatment of viral sore throat in children.

Sources

1. Differential diagnosis of tonsillitis syndrome in infectious diseases in children / A.T. Shaimbetov, Z.K. Dzholbunova, S.V. Chechetova // Universum: medicine and pharmacology. – 2016.
2. Acute tonsillitis in children / A.I. Kryukov, A.Yu. Ivoilov, M.I. Kulagina, A.P. Kravchuk // Medical Council. — 2015.
3. Clinical recommendations of the Ministry of Health of the Russian Federation (treatment protocol) for the provision of medical care to children with tonsillitis.