Viral herpetic sore throat in children. Herpes sore throat in children

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

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

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

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

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

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

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

Herpangina signs and symptoms

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

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

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

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

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

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

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

Doctor Komarovsky about the disease

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

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

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

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

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

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

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

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

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

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

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

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

Tips for treating sore throat from Dr. Komarovsky

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

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

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

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

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

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

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

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

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

Prevention

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

Preventative measures at home:

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

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

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

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

(herpangina) is an acute infectious disease with an incubation phase of 1-2 weeks. The disease manifests itself in both children and adults. The initial stage is characterized by high fever and specific pinpoint rashes on the mucous membrane. The herpetic form is also called: herpangina, herpes tonsillitis, ulcerous tonsillitis and enteroviral vesicular pharyngitis.

Causes

The causative agent of the disease is the Coxsackie virus subspecies A and B. It is transmitted from one person to another by airborne droplets, through contact and food contaminated with the virus. The most common sources of contamination among food products are: vegetables, milk, fruits.

The virus, getting on the mucous membrane of the pharynx or intestines, begins to multiply rapidly. Having reached a certain stage, it enters the blood and disperses throughout the body. The infection appears in the blood 2-8 days after infection. As a rule, after a herpetic sore throat, a person develops lifelong specific immunity. Re-infection is extremely rare.

Symptoms

The first symptom of this form of the disease is severe pain or discomfort in the throat, manifested by soreness and a sensation of a lump. Then the patient begins to feel aches throughout the body. At this stage, many make the fatal mistake of mistaking a sore throat for the flu. Then the person begins to suffer from headaches, suffers from insomnia, and becomes nervous and irritable. The patient's general health deteriorates. Rashes characteristic of sore throat appear only 2-3 days after the onset of the first symptoms.

Classic symptoms of the herpetic form:

a sharp jump in body temperature to peak levels;
increasing soreness in the throat. It is incredibly difficult for the patient to swallow even semi-liquid food;
on the back wall of the nasopharynx, small pinpoint rashes of a crimson color appear, which after a day begin to transform into blisters and small ulcers;
sometimes the disease is accompanied by pain in the abdominal area.

Photo of herpetic sore throat: what it looks like

Small multiple red dots cover the mucous membrane of the palate and tonsils. The throat is red and inflamed. The tonsils are hyperemic.

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Diagnostics

The diagnosis confirming the disease of this form of angina can be established based on the results of serological and virological studies. For analysis, a pharyngeal swab and serum are taken from the patient and the material is sent to the laboratory, where the causative agent of the disease is determined. In addition to laboratory methods, doctors pay attention to the medical history, symptoms, and examine the patient’s nasopharynx.

Treatment of herpetic sore throat

Herpetic sore throat is treated comprehensively, symptomatically. The following medicinal forms are widely used in treatment: tablets, sprays, rinses. The patient is isolated in a separate room, given plenty of water to drink and fed only exclusively liquid food. The duration of the disease is 10-14 days. Most often, in the absence of aggravating symptoms, treatment is carried out at home.

Antibiotics for the herpetic form are prescribed only if complications occur.

Rinsing and irrigation

For irrigation of ulcerative rashes the following are used:

"Orasept"
"Hexoral"
"Inhalipt."

All these sprays have not only an antiseptic, but also an analgesic effect.

For gargling use:

"Iodinol"
"Dioxidin"
"Romazulan"
pharmaceutical calendula,
"Furacilin"
"Chlorhexidine"
"Miramistin"
solution of potassium permanganate for gargling.

You need to gargle 5-6 times a day (more often if possible) until complete recovery.

When using a solution of potassium permanganate for processing, you need to be extremely careful. It is important to thoroughly dissolve the product in water and be careful with the proportions. The finished solution should be slightly pink. Contact of undissolved particles with the inflamed mucous surface of the nasopharynx can cause severe irritation, even a burn. In addition, an overly concentrated solution of potassium permanganate significantly dries out the mucous surfaces, thereby increasing a sore throat and discomfort when swallowing.

Lubricating the mucous membranes of the tonsils

To lubricate the mucous membrane of the tonsils and ulcers with herpetic sore throat, the following solutions are used:

solution of "Marborane" in "Dimexide" 5%;
"Sodium tetraborate" in glycerin 10%;
Castellani liquid;
"Zovirax";
"Acyclovir";
"Tebrofen".

Treatment of ulcers with solutions is carried out until complete recovery, up to three times a day.

Inhalations

For herpetic sore throat, inhalation is not performed. The infection, along with the vapors, can sink even deeper and enter the lungs.

In tablet form, for herpetic type of sore throat, the following is used:

antipyretic drugs;
antihistamines;
vitamins “C” and “B”;
antiviral agents.

The following drugs are widely used in therapy: “Tavegil”, “Claritin”, “Suprastin”, “Citrine”, “Diazolin”. Antihistamines help relieve swelling, hyperemia and reduce intoxication.

Antiviral medications for the treatment of herpetic form - “Acyclovir”, “Viferon”, “Interferon”.

The following are used as antipyretics: Paracetamol, Efferalgan, Nurofen, Ibuprofen.

High temperature is an indicator of the immune system's response to the causative agent of the disease. It is strictly not recommended to lower the temperature until the limit reaches +38 degrees. The exception is people with an acute reaction to fever: spasms, loss of consciousness, etc.

Tonsil removal

Surgical intervention can only be used if a person constantly suffers from tonsillitis. Destroyed tonsils become an endless source of infection, which, penetrating into the blood, does not have the best effect on both the entire body as a whole and individual organs. Only in this case can the doctor recommend excision.

Indications for surgery:

lack of results from conventional treatment (medicines);
chronic tonsillitis, aggravated by the spread of infection to neighboring areas;
frequent recurring relapses of sore throat (at least 3 times a year).

Contraindications for surgery:

diabetes mellitus with complex course;
hemophilia - insufficient blood clotting;
heart defect of 2-3 severity levels.

Diet

It is important that the sick person adheres to proper nutrition. His table should consist of easily digestible foods, vitamins, liquid and puree dishes. Food can be ground in a blender, grated or boiled into porridge. Such dietary requirements are necessary for a faster and more comfortable recovery. After all, a person with a sore throat not only finds it uncomfortable to swallow, it even hurts to take a piece of food into his mouth.

The patient’s menu should consist of light and nutritious dishes;
all food should be liquid, neither cold nor hot;
healthy products - chicken broth, dairy products.

It is strictly forbidden to eat foods such as smoked meats, canned food, over-salted, spicy foods throughout the illness.

Treatment with folk remedies at home

Among the traditional methods for the treatment of herpes sore throat, you can use decoctions of various herbs and herbal mixtures, endowed with antibacterial and anti-inflammatory effects.

Herbs with anti-inflammatory effects:

coltsfoot,
chamomile,
sage,
Oak bark,
linden leaves,
calendula.

The decoction is prepared in proportions - 1 tablespoon of the mixture per 1 full glass of boiling water. Before use, the product should be infused for half an hour and strained. Rinsing is done 4-5 times a day for 2-3 minutes for the entire period until the patient’s throat is sore.

Herbal decoctions in the treatment of herpes sore throat can be supplemented with saline and soda solutions. To prepare the product, stir 1 teaspoon. soda and the same amount of salt in one glass of not hot water. Treat your throat with it every day 4-5 times a day.

A recipe made from “sea water” also relieves inflammation quite well. It differs from the previous one only by the inclusion of one more ingredient - iodine. Proportions - 2 drops per 1 glass. This rinse perfectly moisturizes and cleanses the mucous membranes. But it is better to use it only after the acute phase has passed, because The solution practically does not relieve pain.

Herbal collection

Take a couple of tablespoons of dried chamomile flowers and mix with a dried mixture of eucalyptus and calendula (1 tablespoon each). Brew everything with boiling water - 0.5 liters. Leave to stand for 3-4 hours, strain. You can gargle with this product up to 5-6 times a day.

All rinsing solutions should be at a comfortable temperature - warm, but not hot.

Oak first aid kit

One hundred grams of oak bark is soaked in 1 liter of water. Leave for three hours, filter and use for daily rinsing until complete recovery. You can treat the throat mucosa with this remedy up to 3-4 times a day.

Healing properties of sage

Add a portion of sage to a full glass of boiling water - 1 tablespoon. The resulting composition is infused for one hour, then filtered and used as a rinse - 3 times a day until recovery. The entire prepared broth is used in one procedure.

People often use warming compresses or rubbing the cervical area with alcohol balms. Carrying out such procedures for herpes sore throat is extremely undesirable. This is due to the fact that during the process of a warming compress or rubbing, blood flow to the diseased area of the pharynx increases, which creates a suitable environment for viruses or bacteria for rapid growth and reproduction. Tissues with sore throat are quite swollen, and heat exposure can cause even greater swelling. This condition is very dangerous, especially when it comes to young patients.

Drinking plenty of fluids is important

During the acute stage, both adults and children are advised to drink as much fluid as possible - this will help remove toxins from the body and speed up the healing process. The drink should be at room temperature or slightly warm. The ideal drink is linden and raspberry teas, rosehip infusion, boiled water, dried fruit drinks, raisin infusion.

It is recommended to avoid lemon in tea for herpetic sore throat, since citrus acid, if it gets on vesicles and sores, can increase pain and give the patient a lot of unpleasant sensations.

Don't force him to eat

Under no circumstances should a person be forced to eat if the patient completely refuses to eat. Force-feeding may cause vomiting and worsening sore throat. In addition, all the forces of the sick person’s body are aimed at fighting the infection. There is no need to distract some of them to digest food. A person should eat only when he has an appetite.

Prevention

Viruses are very active. Once in the body of a healthy person, they quickly develop, and he, without even suspecting anything and visiting public places, becomes a carrier of the infection. Therefore, great importance is given to the prevention of herpetic sore throat. And it is quite possible to warn her.

Prevention measures:

if there is a sick person in the family, he must be isolated;
You should not visit shopping and entertainment complexes and hypermarkets during an outbreak of infections;
it is important to wash your hands after going outside, public transport, shopping, etc.;
thoroughly washing fruits and vegetables, purchasing dairy products only in specialized sealed packaging, and not at the market.

Complications and consequences

If you do not treat the herpetic form of sore throat or do it incorrectly, you can develop serious complications in the form of:

myocarditis,
encephalitis,
hemorrhagic conjunctivitis,
meningitis.

Treatment started at the wrong time can lead to damage to the meninges, its individual parts, and pathological changes in the heart muscle.

Is it contagious and how is it transmitted?

The main distributor of viruses of the herpetic form of the disease is humans. The virus is transmitted by airborne droplets, through contaminated food and through household contact.

Features in children

The herpetic form of the disease is considered childhood. It most often occurs in children between 0 and 10 years of age. Teenagers suffer from this type of disease much less often. Children of the “tender” age (up to 3 years) with not yet fully formed immunity suffer the disease most severely. The course of the disease in children and adults differs only in that children tolerate the infection much worse than adults.

Herpetic sore throat in an infant under one year old - possible signs:

excessive salivation;
constant whining and nervousness of the baby;
attempts to put hands in mouth;
refusal of food;
restless sleep.

If you find at least a few of the above symptoms in your baby, be sure to show him to the doctor. It is better to be safe than to miss the onset of the disease; it is much easier to stop painful manifestations.

During pregnancy

The herpetic type of sore throat in pregnant women manifests itself in exactly the same way as in other people.

But during the period when a woman is carrying a baby, such a disease can provoke a lot of consequences:

intoxication of the child’s body,
complications,
fetal hypoxia.

If treatment for the disease is started in a timely manner and fully adheres to the instructions of the treating specialist, then the disease can be cured without consequences for both the expectant mother and the child.

A woman carrying a child under her heart should be calm, eat well and experience the most positive emotions. This is impossible with angina. A sore throat prevents the expectant mother from eating; not only her well-being suffers, but also the physical condition of both. Therefore, it is very important for the herpetic subtype of sore throat not only to follow all the doctor’s prescriptions, but also to monitor the child’s condition.

Video about sore throat

The famous pediatrician Dr. Komarovsky talks about how not to confuse herpetic sore throat with the streptococcal form of the disease.

A young mother, whose child has just recovered from a herpetic form of sore throat, talks about the symptoms, the treatment performed and its effectiveness. The woman gives advice on how and how to alleviate the baby’s condition.

Forecast

If treatment of the disease is started on time, do not self-medicate and strictly follow the instructions of the attending physician, the prognosis is favorable. With adequate therapy, the possibility of complications occurring is very small. After an infection, a person develops a strong immunity to the causative agent of the disease.

Herpes sore throat in children is accompanied by the appearance of a large number of unfavorable symptoms. The disease affects children and adolescents under 14 years of age. If the pathological condition is not diagnosed early and adequate therapy is not started, there is a risk of developing dangerous complications.

Diagnostics.

A typical clinical picture of the disease allows a pediatrician or otolaryngologist to make a diagnosis without the use of laboratory and instrumental research methods. Herpes sore throat in a child is characterized by the appearance of small rashes on the tonsils and pharynx. A clinical blood test reveals a complex increase in the number of leukocytes, lymphocytes and an accelerated erythrocyte sedimentation rate.

In order to identify the causative agent of the pathological condition, serological and virological diagnostic methods are required, and it is necessary to exclude the penetration of other strains. A nasopharyngeal swab is taken from the child and a polymerase chain reaction is performed. Enzyme immunoassay allows us to detect an increasing titer, more than 4 times, of antibodies to enterovirus.

To carry out a differential diagnosis with serous meningitis, the baby is sent for a consultation with a neurologist. If there are complaints from the cardiovascular system, the child is referred to a cardiologist. Consultation with a nephrologist is indicated if an abnormality is detected in a general urine test. If the child does not present any complaints, the symptoms, laboratory and instrumental studies are fully consistent with the clinical picture, additional consultation with other specialists is not required.

Herpes sore throat must be distinguished from other pathological conditions occurring in the oral cavity, for example, from irritation of the cavity with chemicals.

Modern diagnostic measures for 2019 make it possible to identify the disease and begin therapy in the early stages of development. If delayed, the process may become complicated, which will affect health and may cause death.

You can read everything about it in the article.

What is herpes sore throat and what does it look like?

Herpes sore throat is an acute lesion of the lymphoid tissue of the pharynx, caused by the penetration of the ECHO and Coxsackie viruses into the child’s weakened immune system.

It occurs with a rise in temperature, the appearance of pain in the pharynx, lymphadenopathy, redness of the pharynx, vesicular rashes and ulcers in the pharynx and pharynx.

After infection, on the 2nd day a large number of reddish rashes appear in the mouth. In appearance, they resemble vesicles filled with serous contents. They can be localized either in one area or scattered over the entire surface of the tonsils. If you try to remove them, the bubbles will burst and bloody contents will leak out.

Already on the 5th day, some of the bubbles begin to burst. In their place, the affected mucous membrane is visible. Ulcers are scattered over the entire surface of the tonsils. If you accidentally touch them, they will immediately begin to secrete bloody contents. During this period, you should be careful when eating solid foods as they will also irritate the affected area.

The 7th day is characterized by attenuation of the process. Rashes disappear from the affected areas of the tonsils and the back of the throat. The mucous membrane is gradually healing.

Attention! If the child has chronic diseases or a weakened immune system, the disease may occur again on the 12-13th day. In this case, the specialist prescribes drugs to maintain immunity.

How is herpes sore throat transmitted?

Acute herpetic stomatitis in children often occurs while attending preschool institutions. In infants, the disease occurs in isolated cases, since their immunity is reliably protected by antibodies from mother's milk. During the entire feeding period, passive immunity protects the child from contracting a viral infection.

There is a congenital form of the pathology. The virus is small and freely penetrates the placental barrier. If a mother has herpes, the risk of having a baby with the infection is high.

The disease can be contracted through household contact and airborne droplets. The carrier is an infected person.

Provoking factors.

The development of the disease begins after the virus enters the body. This is facilitated by weakened immunity and frequent respiratory diseases. The pathological condition is dangerous because it quickly takes on an epidemiological course in small preschool and school groups.

The virus penetrates the cells of the oral mucosa. There they actively begin to share. The cells swell and gradually die. As a result, bubbles with pathological fluid are formed. If they are damaged, liquid leaks out. During this process, a small part of the viruses die. The rest are destroyed by the body's own antiviral system.

Symptoms.

The disease begins acutely after the incubation period. At its onset, herpetic pharyngitis in children lasts up to five days. The main symptom is that the lesion is localized in the oropharynx, there are no rashes on the body.

On the first day from the onset, body temperature reaches 40 degrees Celsius. The child complains of a sore throat, a large amount of saliva, and general malaise.
On the second day, symptoms increase. Redness of the pharynx and the appearance of blisters are observed. From the gastrointestinal tract - lack of appetite, pain along the intestines, vomiting, nausea. The temperature drops to 39 degrees.
On the third day, herpetic encephalitis in children is characterized by a repeated rise in temperature. The bubbles cause pain when swallowing saliva.
On the 4th day the vesicles open. Body temperature gradually decreases.
On the 5th day, the pain in the throat is not so pronounced. The baby can't eat yet.
Day 6 is characterized by a gradual improvement in general well-being. The temperature stays around 37 degrees.
On the 7th day, the pain and rash disappear, the child eats.
Herpetic dermatitis in children completely disappears on the 8th day.

When are laboratory tests ordered?

Laboratory tests are prescribed in all cases where symptoms of herpes sore throat are observed in children. A clinical blood test demonstrates an increased number of leukocytes. This indicates the development of an inflammatory reaction in the body. The test is required on an empty stomach. PCR helps isolate viral RNA taken from a swab. ELISA determines the level of antibodies to the pathogen in the blood.

Herpetic eczema in children has an incubation period from 3 days to 14 days. Depends on the state of the child’s immune system, as well as the presence or absence of chronic diseases. From the moment the pathogen enters the body until the first signs appear, children are not worried about anything. Parents cannot detect the infection in a timely manner.

How to treat herpes sore throat in children.

After making a diagnosis, the medical professional tells parents how to treat herpes sore throat in children. Therapy is carried out on an outpatient basis. In severe cases, hospitalization is required. Hospital conditions will ensure timely administration of medications, compliance with the regimen and dynamic monitoring of the small patient.

If the condition worsens or symptoms of complications appear, the doctor adjusts the treatment. You can completely get rid of the pathological condition in 7-10 days. The child is treated for 14 days until the symptoms disappear completely.

Parents should give their child plenty of fluids. This helps remove the breakdown products of the virus from the body. If the condition worsens, detoxification therapy is prescribed. If signs of serous meningitis appear, the amount of fluid is limited. Otherwise, it may cause swelling of the brain.

Diuretics are prescribed.

It is required to carry out wet cleaning in the room where the child is located at least 2 times a day.

The child must constantly remain in bed until complete recovery. Otherwise, severe complications will develop under the influence of the virus.

Food should be high in calories and contain vitamins. It is recommended to puree food to avoid irritation of the mucous membranes.

Drug therapy.

The drugs are aimed at eliminating symptoms and alleviating the child’s general condition.

prescribing a throat gargle to prevent a bacterial infection. Use a decoction of chamomile or calendula. Cool to room temperature before use. If an infant falls ill, the oral cavity is washed with a syringe without a needle;
the tonsils and pharynx become swollen, so antihistamines are prescribed, for example, Suprastin;
When body temperature rises, antipyretics are prescribed - Ibuprofen. In children, they are knocked down when they reach 38 degrees;
pain in the oropharynx is relieved by Hexoral spray;
acyclovir for herpes sore throat in children is used as an ointment on the affected areas;
to stimulate the immune system, immunomodulating drugs are prescribed, for example, Immunal;
Antibiotics are prescribed when a bacterial infection occurs.

Physiotherapy.

Treatment of herpetic sore throat in children is effectively carried out with physiotherapy. The doctor prescribes ultraviolet irradiation of the nasopharynx. Inhalations and compresses are prohibited, as this increases blood circulation, which contributes to the spread of the virus.

Traditional methods of treatment.

Herpetic rashes in the throat of a child are treated with traditional medicine. Used for intolerance to anti-inflammatory drugs and as an additional remedy.

Propolis infused with alcohol. Place 30 g of propolis in the freezer overnight. In the morning, it is finely crushed, placed in a small glass container and filled with alcohol in a ratio of 1:3. The container is placed in a dark place for 2 weeks. Shake the jar every day. Use as a compress for 10 days.

Beet water. Take medium beets and grate them. Add hot water in a 1:1 ratio. The resulting mixture is aged for 7 hours and filtered. Rinse the oropharynx with liquid 3 times a day. The course of treatment is 7 days.

Complications.

Complications are observed in exceptional cases. Occurs in children with weakened immune systems. Complications caused:

rash on the body;
problems from the SSS;
penetration of a bacterial pathogen;
herpetic meningoencephalitis in children;
serous meningitis;
the appearance of Kerning's symptom, one of the important and early signs of irritation of the meninges during meningitis, hemorrhages under the membranes and some other conditions;
pyelonephritis.

Attention! If a child experiences convulsions, loss of consciousness or spatial disorientation, you should immediately call a medical professional.

After an infection, children develop stable immunity to a specific strain. However, when another type enters the body, the disease recurs.

Preventive actions.

If a child in a team falls ill, quarantine is declared for a period of two weeks for everyone who has been in contact with him. There is no vaccination against the pathological condition; emergency preventive measures are the administration of gamma globulin.

Other measures:

early diagnostic measures;
carrying out work to prevent viral infection in a team;
vitamins and medicines to support immunity;
after visiting crowded places, the child needs to wash his hands with hot water and soap;
if contact with a sick child is suspected, the oropharynx is rinsed with a weak solution of potassium permanganate. It is lightly pink so as not to burn the oropharynx;
In public catering establishments, before eating, wipe hands with a damp antibacterial wipe.

Attention must be paid to the possible addition of a bacterial etiology infection as a secondary one. It is important to prevent complications that arise when bacteria spread from the lesion through the lymphatic and blood vessels to all tissues of the body. As a result, sepsis will develop.

Herpes sore throat (synonyms - herpetic, ulcerous, enteroviral or aphthous pharyngitis) is an infectious disease that is accompanied by specific vesicular rashes on the mucous membrane of the soft palate and pharynx.

The term “herpangina” was given to the disease back in the days when the causative agent of the infection was not identified. The name was given on the basis of rashes similar to herpetic rash. Scientists have concluded that the herpes virus is a provocateur of the development of the disease. But later microbiological studies revealed the main reason. It became the Coxsackie virus (enterovirus). Since the name “herpes” has already become familiar, it was decided not to change it. The treatment and symptoms of this type of sore throat in children are discussed in the article.

Children as a risk group

Children are at greatest risk of contracting herpangina:

newborns;
infants;
preschoolers;
schoolchildren up to 10-12 years old.

This is due to violation of personal hygiene rules and lack of compliance with sanitary standards. Children, due to their age and inexperience, do not understand the need to wash their hands and food before eating and after a walk.

The infection is transmitted fecal-orally (food contaminated with the pathogen, hands), contact and airborne droplets (during conversation, coughing, sneezing). The source of herpangina is an infected person or a bacteria carrier. The greatest number of cases of herpangina is observed during the summer holidays, vegetable and fruit seasons.

Herpangina in children is characterized by the development of stable specific immunity to the serotype of the virus that caused the infection. Herpangina is highly contagious, so all family members usually get sick along with the child.

It is important to know! Herpes sore throat is characterized by the fact that literally immediately after the virus enters the body, a person becomes a source of infection, although symptoms of the disease appear within 2 weeks.

Symptoms

The first manifestations of herpangina in a child are the following:

hyperthermia above 38°C;
weakness;
headache;
decreased or complete lack of appetite;
irritability and nervousness;
dyspeptic symptoms (nausea, vomiting);
abdominal pain.

Herpetic sore throat, which occurs in children under 3 years of age, may be accompanied by convulsive attacks, muscle pain, and aching bones. The symptoms are similar to those of an acute respiratory viral infection.

Local clinic

In parallel with the picture of intoxication, local changes develop. A herpangina-specific rash appears: small bright red dots that become small blisters filled with serous fluid. Their localization is the tonsils, soft palate, and back of the pharynx. The main disease with which differentiation must be made is scarlet fever.

A hyperemic rim is observed around each vesicle. The bubbles do not tend to merge and can appear from a few to 20-30.

After a few days, the bubbles open, their contents pour out, exposing the erosive surfaces. They tend to unite and resemble inflamed gray sores. Herpangina is a serious disease in which the appearance of rashes is accompanied by severe pain, in which children refuse to eat and drink.

The disease is characterized by the fact that all this time the mucous membrane in the area of the rash remains red and swollen. On both sides, the cervical lymph nodes become inflamed and increase in size.

Duration of manifestations

In its normal course, without complications, herpes sore throat in children lasts for a week. Usually after 2-3 days the body temperature returns to normal levels, and after another 2-3 days the mucous membrane begins the processes of regeneration of erosive surfaces.

The course of herpes sore throat can be undulating or prolonged in the following cases:

immunodeficiency state;
development of complications;
high level of pathogen in the blood.

Possible complications

The disease in children can cause the development of the following pathologies:

pyelonephritis – inflammation of the renal pelvis;
meningitis, encephalopathy - inflammatory diseases of the membranes of the brain;
myocarditis – pathology of the heart muscle of bacterial origin;
Hemorrhagic conjunctivitis is an inflammation of the mucous membrane of the eyelids with the presence of hemorrhages.

It is important to know! Any complication of herpangina requires urgent hospitalization and inpatient treatment.

Diagnostics

The diagnosis of “herpes sore throat,” the complex treatment of which is described below, is made by a pediatrician or ENT doctor after examining the patient and conducting clinical examinations. A general blood test for herpangina shows leukocytosis and increased ESR.

To detect the pathogen, bacteriological culture or swabs from the nasopharynx are performed. The result is most reliable in the first 5 days of herpangina. Serological studies can determine the presence of antibodies to the pathogen within 3 weeks from the moment of infection.

Treatment

Herpangina requires complex therapy. A prerequisite is compliance with bed rest and drinking plenty of fluids. The child is isolated due to the highly contagious nature of the disease.

Since ulcers on the mucous membrane of the pharynx with herpetic sore throat cause pain, the diet should be adjusted:

give up spices;
eat food in liquid form;
steam;
give up carbonated drinks;
eat food often, but in small portions.

Etiotropic treatment

Herpes sore throat requires the use of antiviral drugs. For this purpose, Influcid, Acyclovir, Viferon, Cycloferon are used. The use of antiviral drugs is a prerequisite for the treatment of herpangina in children under 3 years of age. Treatment with antibiotics is necessary only if bacterial microflora is attached, when a purulent rash appears, and complications develop.

Symptomatic treatment

Herpangina requires the use of the following groups of medications:

Antipyretics means – Ibuprofen, Paracetamol, Cefekon.
Antihistamines drugs can reduce swelling of the mucous membrane and discomfort. Representatives of the group are Erius, Zirtek.
Antiseptics for treating mucous membranes - Chlorhexidine, Miramistin.
Pastilles for sore throat- Septolete, Lysobakt.
Aerosols, which have anti-inflammatory and antiseptic effects. Herpangina requires the use of Panavir, Orasept, Hexoral, Tantum Verde.
Rinse furatsilin, salt solutions, decoctions of medicinal plants (sage, chamomile, eucalyptus).

Herpangina, the manifestations, symptoms and treatment of which are discussed in the article, has favorable outcome in 90% of clinical cases. The important point is to follow the advice of specialists, which will speed up recovery and prevent the development of complications.

Like other types of sore throat, herpes is an acute infectious disease. It is characterized by damage to the mucous membrane of the throat, tonsils and the entire larynx. A distinctive feature of this type of sore throat is the appearance of bubbles with liquid in the oral cavity during the disease - on the palate and back wall of the pharynx. Typically, when this rash becomes noticeable, treatment for the disease begins. Interestingly, this type of sore throat is in no way connected with the herpetic virus (herpes virus), so in medicine you can find other names for this disease: herpes sore throat, aphthous, vesicular, vesicular, or the more familiar tonsillitis or pharyngitis.

The disease most often affects children - preschoolers and children of primary school age (from three to ten years). In infants, the likelihood of getting sick is negligible - thanks to the antibodies that are part of mother's milk, babies acquire immunity. But the infection occurs quite often in adults. In the latter, treatment is more difficult, since the herpes infection can take root firmly in the body of an adult.

The causative agents of herpangina are Coxsackie enteroviruses, as well as ECHO viruses. Varieties of these viruses surround humans everywhere. Herpangina is a seasonal disease. Its peak occurs in summer and autumn.

Herpes infection is transmitted from a sick person to a healthy one. Even a random passer-by can become infected. Less commonly, carriers are domestic animals, such as pigs. The most common methods of infection are contact (when pathological contents of the nasopharynx fall on the hands or into the oral cavity of a healthy person) and airborne droplets (during sneezing, coughing or when talking with a sick person). There is also a fecal-oral route of infection (penetration through the mouth). With this method, you can become infected through dirty handshakes, contaminated food, and nipples. This method of infection is more common among children, since adults are more careful about observing hygiene rules. Even a patient who is already recovering can be a carrier of the virus. After recovery, the patient remains a source of spread of the virus for several weeks (up to a month). The contagiousness of the disease is so great that if one family member gets sick, everyone is likely to get sick.

Once in the body, the infection reaches the lymph nodes, from where the disease gains momentum. The infection then enters the bloodstream and spreads unhindered throughout the body, so herpes sore throat develops very quickly. But having once had a herpes sore throat provoked by a specific virus, the possibility of getting sick again is practically reduced to zero. If infected with a different strain of the virus, the disease may return again, and the treatment methods will be different.

Symptoms of the disease

The first symptoms appear no earlier than after one or two weeks - this is the incubation period of this disease. Initially, the patient experiences the following symptoms:

high body temperature (38-40°C), fever
sore throat, difficulty swallowing food
abdominal pain, diarrhea, vomiting
pain in the muscles of the arms, legs and back, “aches” in the body
headache
loss of appetite or complete refusal to eat
weakness, general malaise

That is, the disease begins like a regular flu. Then a runny nose and drooling are added to the general symptoms. Inflammation covers the entire oral cavity - reddish rashes appear on the back wall of the pharynx, then bubbles with liquid become noticeable, reminiscent of a herpes rash, which greatly simplifies the diagnosis of herpangina. Subsequently, these bubbles burst, forming white-grayish ulcers. Bubbles appear chaotically - they appear in one place, and already heal in another. The sensation in the mouth becomes unpleasant and even painful. It is difficult for the patient to swallow not only food, even water. Many patients, especially children, begin to refuse food. The disease is severe regardless of the patient’s age. In particularly severe cases and severely weakened immune systems, the rash may appear on the feet, hands and body.

If the disease passes without complications, recovery occurs within a week. By the third day after the first symptoms appear, the fever usually subsides; on the fifth day, the blisters begin to burst. At the time of exacerbation of the disease, the patient is a very strong spreader of the virus, so it is necessary to reduce the number of people in contact with him as much as possible.

It is very difficult to diagnose herpetic sore throat on your own, since the onset of the disease is similar to other diseases: ARVI, intestinal infections, influenza, etc. Therefore, when identifying the first symptoms, it is necessary to contact an otolaryngologist who can make the correct diagnosis and determine effective treatment.

Treatment of herpetic sore throat

Treatment of herpes sore throat in adults should be comprehensive. Typically, the treatment regimen includes the following measures:

the patient is isolated and placed on bed rest
you need to drink plenty of fluids and gargle with herbal decoctions
strict adherence to taking medications prescribed by the doctor for treatment.

First, antihistamines are prescribed to relieve swelling, for example, Suprastin or Claritin. Sore throats are effectively relieved by gargling with decoctions of chamomile, sage, oak bark, tincture of calendula, eucalyptus, and irrigating the throat with antiseptics (Hexoral, Tantum-Verde, Miramistin, Ingalipt, etc.). You can dissolve lozenges for pain in throat. It is recommended to gargle every hour. If you have a severe runny nose, you should rinse your nasal cavity with saline solution.

With herpetic sore throat, you cannot do inhalations, warm up or apply compresses - the thermal effect will only provoke the spread of infection throughout the body.

At temperatures above 38°C, you need to take antipyretic drugs, for example, Ibuprofen. Antibacterial agents are not prescribed for the normal course of the disease. Antibiotics are administered when bacterial complications, such as bronchitis or tracheitis, are added.

It is important to follow a special diet: nothing hot, spicy, or hard that could irritate the mucous membrane of an already sore throat. Food should ideally be liquid-like. It is better to grind the prepared food into puree.

If you adhere to a clear treatment regimen and follow the doctor’s prescriptions, recovery will not take long, and all unpleasant symptoms will quickly disappear.

Herpetic sore throat in pregnant women.

Herpangina, like other viral infections, is dangerous for the development of the fetus, especially in the first trimester of pregnancy. When the virus enters the mother's blood, the supply of nutrients to the fetus is disrupted, which slows down its development. Hypoxia occurs, which can lead to diseases of the heart and nervous system. Taking antibiotics and many antipyretics is contraindicated for pregnant women. Self-medication or lack thereof is fraught with dangerous consequences. Herpetic sore throat is not a common cold; it will not go away on its own. As a rule, for herpetic sore throat in pregnant women, antiviral homeopathic drugs, gargling, plenty of warm drinks and strict adherence to bed rest are prescribed.

If the expectant mother has a sore throat at the very beginning of pregnancy, the likelihood of fetal malformations or miscarriage increases. Sore throat in the second and third trimesters threatens premature birth. You should immediately seek help from an otolaryngologist if you have the slightest suspicion of herpes sore throat, the treatment of which will be carried out under the supervision of a specialist. Only this will help avoid serious consequences for both the expectant mother and the baby.

Possible complications and prevention

Severe herpes sore throat can lead to the spread of infection throughout the body and damage to internal organs - so-called complications arise. The most common complication after suffering from herpes sore throat is serous meningitis, or inflammation of the brain. The disease can lead to disturbances in the functioning of the heart and cause myocarditis, which is diagnosed by an electrocardiogram. Kidney diseases (pyelonephritis), liver, hemorrhagic conjunctivitis - this is just an incomplete list of complications with late diagnosis of the disease and delayed treatment. If you have the slightest suspicion of a disease, do not delay visiting a doctor!

To date, no vaccines have been developed to prevent herpangina disease. During an epidemic, if possible, do not take your child to kindergarten or school. Adults should try to avoid places with a lot of people and remember the rules of hygiene. Both children and adults need to strengthen their immune system in general, eat healthy and balanced, take vitamins and harden themselves.

If there is a sick person at home, it is necessary to ventilate the room frequently, and provide the sick person with individual dishes, linen and a towel.

Treatment of herpetic sore throat at the ENT Clinic of Doctor Zaitsev

The many years of experience of our clinic’s specialists allows us to confidently assert that within the walls of the ENT Clinic of Doctor Zaitsev you will receive competent, qualified assistance. Our price list for procedures and manipulations has not changed for 3 years. Professionalism of doctors, affordable prices, modern equipment and personal responsibility of the chief physician of the clinic V.M. Zaitsev for the recovery of each patient is supported by numerous positive reviews from our patients.

Herpetic sore throat, as a rule, ends favorably for the patient. To avoid complications and unpleasant consequences, you need to seek help and treatment in its early stages. Please do not delay visiting your doctor. Contact us - call and come. We will help you.