Tonsillogenic intoxication. Symptoms of tonsillogenic lesions in the heart

Sometimes the simplest ones can provoke the development of other, more dangerous ones. For example, many adults do not pay special attention cold, believing that there is nothing terrible about it. Yes, this is indeed true if you start treatment on time.

But if everything is neglected, then a cold can provoke the development of chronic tonsillitis, which, in turn, is a rather serious disease.
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Chronic tonsillitis. What is this?

Chronic is very insidious disease, which affects the palatine tonsils. Inflammatory process, which occurs in them, can be triggered by many factors.

Like any other chronic illness, tonsillitis has both stages of remission (when nothing bothers the patient) and stages of exacerbation. At the moment when an exacerbation begins, the tonsils cease to perform their intended functions, and instead of protecting the body from infections, they become that “warm place” in which they find shelter.

Tonsils, or as they are also popularly called, tonsils, can be examined by every person. Just go to the mirror and open your mouth wider. Of course, an ordinary person may not understand that these are tonsils. The two tubercles located between the tongue and the palate are the tonsils. They perform very important function in the human body - prevent infection.

If the tonsils are absolutely healthy, then they are capable of stopping almost all infections that will try to penetrate inside a person. But if the patient was sick very often, and, moreover, this was not a simple runny nose, then over time the tonsils cease to cope with the task.

It is at that moment when the tonsils cannot perform their function, and instead of being a barrier to germs and infections, they begin to become inflamed. This inflammation is called tonsillitis. In cases where a person has frequent sore throat ( scientific name tonsillitis), and, moreover, it cannot be treated, over time it begins to move into the chronic stage.

If a person is diagnosed with “chronic tonsillitis,” this means that his tonsils are so affected that they have lost the ability to cleanse themselves and have themselves become a source of all sorts of problems. And, as you know, if the body is exposed to harmful substances, then this leads to intoxication.

And intoxication, in turn, triggers other processes, due to which the body’s reaction even to simple infection becomes “inadequate”, and this, as a rule, becomes the cause of allergies. That is why chronic tonsillitis is infectious and allergic in nature.

Chronic tonsillitis is a very serious disease that can lead to the development of complications. That is why you should pay more attention to your own health, and if any symptoms appear, contact a specialist for qualified medical help.

Causes

The main danger of chronic tonsillitis is that it provokes the development of other infectious diseases and weakened immunity. But, at the same time, chronic tonsillitis itself can be caused by many factors, which, sometimes, a person does not even pay attention to:

Weakening of the immune system. Very often, against the background of some other diseases, or simply due to vitamin deficiency, a person’s immunity is weakened, and the body becomes practically unprotected from various infections

Stress. As you know, during stress the body experiences a huge load on nervous system. And any malfunction in its robot can lead to the development of absolutely any disease

Poor nutrition. Flaw important vitamins and microelements can lead to weakened immunity

Adenovirus infection

Frequent colds

Infections of the upper respiratory tract

Infections that affect the nasopharynx

Chronic diseases such as sinusitis, adenoids, etc.

Dental caries, which a person does not treat for one reason or another, can become a source of infection and provoke the development of chronic tonsillitis

Frequent. There are people who suffer from sore throat almost every month, and most often it becomes more and more difficult for them to cure it each time, since many medications no longer valid

Breathing problems that are associated with some problems in the nasal cavity. Sometimes these are polyps, deviated septum, etc. Because of these problems, a person begins to breathe predominantly through the mouth, thereby causing hypothermia of the tonsils, which can reduce their ability to resist infections

Genetic predisposition. It often happens that a person simply has a predisposition to diseases of the nasopharynx. And it is these people who are least protected from the development of chronic diseases

Sometimes, in order to protect yourself from the development of tonsillitis, you just need to follow basic rules hygiene and treats yourself and your health more carefully. And besides, knowing the reasons why this disease can develop, you can easily try to avoid provoking factors.

Symptoms

Many people believe that indolent disease does not pose any particular danger. This is the most important misconception, since these are the diseases that are most dangerous. In order to start treatment on time and contact a specialist, it is necessary to know as best and accurately as possible what symptoms chronic tonsillitis manifests itself.

The main symptoms include:

In the throat, which accompanies a person constantly. The patient is noted that it can be either weak, causing simple discomfort, or very strong.

Pain in the tonsils themselves. Of course, rarely can anyone recognize pain in the tonsils, since it often radiates throughout the entire nasopharynx. But those who have ever had tonsillitis know very well what it is.

Edema. In most cases, with chronic tonsillitis, patients feel constant swelling in the throat, as if something is constricting it, and it becomes difficult to swallow

Formation of plugs in the throat. When a sore throat occurs, each person first goes to the mirror and begins to look to see if it is red and if the tonsils are inflamed. Very often a person notices some lumps of white or yellowish color on the mucous membrane. And he immediately tries to remove them, which is strictly prohibited to do on your own. Traffic jams are the result of harmful microbes

Various reactions to some products. Sometimes, cold water or acidic foods can cause a sore throat.

An increase in temperature, and it is very difficult to reduce it, and it lasts for quite a long period of time

Bad breath, which is mainly caused by the formation of plugs

Fatigue, general malaise. A person constantly wants to lie down and sleep, and any physical activity provokes an even greater deterioration of the condition.

Sore throat. This symptom is present in many throat diseases, but it is during chronic tonsillitis that it will be the main one, since it accompanies the person constantly

Knowing all the main symptoms of this disease, you can start treatment on time to prevent exacerbation.

The danger of chronic tonsillitis

Many patients think that chronic tonsillitis is not such a terrible disease, since the source of infection is in the throat, which, in principle, in their opinion, should not affect the general state body.

But everything is actually much more serious and complicated. First of all, it should be noted that such a diagnosis can only be made by a specialist after examining the patient.
If a person is diagnosed with this, this can lead to a number of consequences:

Frequent rise in temperature, especially in the evenings. Sometimes a person may feel unwell for no reason. And when measuring body temperature, he will see that it has risen to 37 degrees

Fast fatiguability. Very often, patients with this diagnosis feel incredibly tired in the evenings and find it difficult to endure even the lightest physical activity.

Problems with appetite, which in most cases appear due to severe fatigue, apathy, and also due to constant sore throat

Intoxication of the body. The above symptoms can be attributed to general concept, intoxication, but they don’t always talk about it. But due to the fact that the body becomes vulnerable to all infections, and they begin to attack it, intoxication may appear

Permanent. Usually in people with chronic tonsillitis, a sore throat occurs almost every month, which causes them a lot of inconvenience

Headache and muscle pain. This can be attributed to the consequences of intoxication of the body, which causes great harm to it.

Problems with the reproductive system, namely in men, according to the results of studies, chronic tonsillitis has a negative effect on potency. In the case of women, the disease can affect the menstrual cycle

Can provoke the development of diseases such as bronchial asthma and chronic bronchitis

Can provoke skin diseases such as psoriasis, dermatitis, eczema, acne, etc.

Liver damage may occur

IN in rare cases chronic tonsillitis can provoke the development of diabetes mellitus

In addition, due to this disease, a lot of complications can develop, which are often much more dangerous than the disease itself. The main complications that may arise include:

Hearing impairment

Kidney diseases

Rheumatism, which can affect not only the joints, but also the heart muscle

Infertility

Not every person knows what consequences can occur due to the fact that acute tonsillitis was once not cured. That is why, if the disease nevertheless turned into chronic stage, you need to be prepared for the fact that the quality of life may decrease, and you will have to make every effort to cure it.

Chronic tonsillitis and pregnancy

Almost all experts advise that before conceiving a child, you need to undergo a complete medical examination and try to cure all diseases, especially if they are chronic. Since some diseases can have a negative impact, both on the process of conception itself, and in the future on the development of the baby.

What can chronic tonsillitis lead to during pregnancy:

Firstly, very often tonsillitis becomes the most main reason in the appearance of late toxicosis

Secondly, a miscarriage may occur during an exacerbation

Thirdly, very often chronic tonsillitis, that is, depleted and infected tonsils can become the most important source of infections for the unborn baby, which can lead to intrauterine infection

Fourthly, as mentioned above, a person’s immunity noticeably decreases and he ceases to resist various infections which will constantly attack the body

Fifthly, scientists have proven that chronic tonsillitis can cause premature birth and poor labor performance.

Premature ones are dangerous because they can happen quite early early when the baby is not yet ready to be born. But the weak one labor activity is an indicator for a caesarean section

Therefore, if you know that you have chronic tonsillitis, then you need to make every effort to cure it before pregnancy, since already during pregnancy you can only be treated with certain drugs that will not help destructive influence for the baby.

The danger of chronic tonsillitis in children

As is known, in childhood Almost all children get sick very often, especially when the child is sent to kindergarten.
Kindergarten is, so to speak, a source of many infections that the baby will have to suffer from. But sometimes it happens that a child does not get sick as often as parents expect. This suggests that he has good immunity.

If we talk about children who have chronic tonsillitis, then we can say that they will be sick constantly, since the most important function of the tonsils, protective, does not work. That is why such children get sick very often, and quite severely. In addition, fatigue and sweating bring great discomfort.

Typically, during conservative treatment, the patient is prescribed:

Antihistamines to reduce mucosal swelling

Vitamin complexes

In addition, during the treatment of chronic tonsillitis, physiotherapy is usually prescribed, namely laser therapy, thanks to which all pathogenic bacteria and microbes are destroyed.

Separately, we need to talk about traditional medicine. There are many recipes that can help solve this problem. But before you start treatment with such drugs, you need to consult a doctor, who must give his consent. This must be done because each organism is individual and the course of the disease is different for each person. And besides, an allergic reaction may occur.

Chronic tonsillitis, as mentioned above, is quite dangerous, which can lead to the development of very severe complications. That is why there is no need to delay treatment, but you need to immediately consult a doctor who will prescribe everything necessary medications, with which the disease can be cured!

Chronic tonsillitis– this is common infection with localization of a chronic focus of infection in the tonsils with periodic exacerbations (angina). The palatine tonsils are the organ that receives Active participation in the formation of immunobiological defense mechanisms of the body. The greatest activity of the tonsils in these protective mechanisms manifests itself in childhood.

The palatine tonsils are located on the sides of the palatine curtain and are clearly visible through a wide open mouth. Despite the fact that the palatine tonsils are small in size, they have a fairly large area of ​​contact with environment, due to the presence of folds and crevices (lacunae). In every healthy person, desquamated epithelium, food particles, bacteria and white blood cells – leukocytes – accumulate in the lacunae. All this content forms so-called “plugs”, which are normally independently evacuated from the tonsils during chewing and swallowing movements. However, frequent sore throats lead to changes in the tonsils, as a result of which some of the lacunae narrow or close with scar tissue. Under these conditions, drainage of lacunae becomes difficult, which leads to activation of the microflora present in the lacunae - chronic inflammation of the tonsils. Microbes often spread through the lymphatic tract, which leads to enlargement of the cervical lymph nodes. In addition, there are diseases that can be directly or indirectly associated with chronic inflammation of the tonsils. First of all, it is rheumatism, systemic lupus erythematosus, periarteritis nodosa, scleroderma, dermatomyositis, psoriasis, eczema, polymorphic exudative erythema, nephritis, thyrotoxicosis, plexitis, radiculitis. Long-term so-called tonsillogenic intoxication can contribute to the development of thrombocytopenic purpura and hemorrhagic vasculitis.

The development of chronic tonsillitis is also facilitated by persistent impairment of nasal breathing (adenoids in children, deviated nasal septum, enlargement of the inferior turbinates, sinusitis, nasal polyps, etc.) infectious foci V nearby organs: carious teeth, purulent sinusitis, chronic adenoiditis.
Decreased immunity is of great importance in the development and course of chronic tonsillitis, protective forces body and allergic condition, which in turn may precede or, conversely, be a consequence of chronic tonsillitis.

In the diagnosis of chronic tonsillitis, it is necessary to evaluate the local clinical picture; as a rule, hyperemia (redness) and roller-like thickening of the edges of the palatine arches occurs, cicatricial adhesions are formed between the tonsils and the palatine arches, the palatine tonsils become loose or cicatricial, caseous-purulent plugs or liquid pus enlarged cervical The lymph nodes(regional lymphadenitis). Chronic tonsillitis often causes a prolonged increase in low temperature (low-grade fever), pathological auditory sensations (tinnitus), worsens the course of vasomotor dysfunction of the nose, vegetative-vascular dystonia, vestibular dysfunction, etc.

The diagnosis is made in the presence of local signs of chronic tonsillitis. There are two main forms of chronic tonsillitis: compensated and decompensated. In the compensated form, there are only local signs of chronic inflammation of the tonsils, the barrier function of which and the reactivity of the body are still such that they balance, i.e. compensate functional state palatine tonsils. In the decompensated form of chronic tonsillitis, there are not only local signs of chronic inflammation, there are often sore throats more than twice a year, paratonsillitis, paratonsillar abscesses, and diseases of other organs and systems. Before starting treatment for chronic tonsillitis, it is necessary to sanitize the oral cavity (carious teeth should be cured), diagnose and, if detected, eliminate inflammatory diseases in the nose and paranasal sinuses.

Depending on the form of chronic tonsillitis, two main treatment methods are used: conservative for the compensated form of chronic tonsillitis and surgical for the decompensated form of chronic tonsillitis. Each method has its own varieties and options.

Conservative treatment chronic tonsillitis consists in prescribing drugs that help increase the body's defenses, hyposensitizing drugs, and immunocorrection agents. Gargling with antimicrobial drugs is prescribed locally. IN outpatient setting The doctor washes the lacunae of the tonsils and lubricates the tonsils with medications.

Physiotherapeutic treatment methods are widely used. As a rule, a course of conservative treatment of chronic tonsillitis usually consists of 7-10 procedures; the course of treatment must include agents that affect many parts of the pathological process.

If conservative treatment is not effective, surgical treatment is indicated. Surgery to remove the palatine tonsils (tonsillectomy) is prescribed for decompensated forms of chronic tonsillitis and in cases where repeated conservative treatment has not improved the condition of the tonsils. There are several methods surgical treatment chronic tonsillitis. To date the following have been developed: laser lacunotomy, tonsillectomy using a surgical laser, tonsillectomy using the Surgitron device, tonsillectomy using surgical ultrasound. There is a cryosurgical method for the treatment of chronic tonsillitis.

Objectively, slight pallor of the skin, moderate tachycardia, and severe symptoms of chronic tonsillitis are noted. Changes in the heart are not detected by clinical and instrumental methods. Blood test is within normal limits. This form is essentially initial stage development of cardiovascular changes against the background of chronic tonsillitis.

Tonsillogenic cardiodystonia occurs in 60% of children with tonsillogenic changes in the heart. Patients, as a rule, complain of frequent sore throats and exacerbations of chronic tonsillitis, ARVI (rhinopharyngitis, tracheobronchitis, less often - laryngotracheobronchitis and pneumonia) from a very early age. Against this background, chronic tonsillitis occurs with frequent exacerbations. In approximately 25% of patients, even the most careful history taking fails to identify any complaints indicating the onset of the development of a focal infection in the tonsils. It is detected accidentally during examination of children due to the presence of many complaints. This gradually developing process in the tonsils is called the “non-anginal form of chronic tonsillitis.”

With subsequent exacerbations of tonsillitis and repeated acute respiratory viral infections, the child’s well-being worsens, pain in the joints (knees and ankles) appears, which serves as the main argument for seeing a doctor.

Then pain appears in the heart area, mainly with excitement or overload at school, mental overstrain, and less often with physical stress. The pain is short-lived, localized to the left of the sternum, and does not radiate. In some children it occurs repeatedly. In approximately 50% of cases, there is a periodic increase in body temperature to subfebrile levels; less often, fever during ARVI is replaced by a long-term (1-4 months) subfebrile condition (37.2-37.4 ° C).

Consequently, the initially compensated chronic tonsillitis in these children with the deepening of the focal process after viral infection takes on the character of sub- and then decompensated. Symptoms of tonsillogenic intoxication appear. Some children complain of shortness of breath during physical activity, which, however, does not prevent them from moving quickly (running) and leading the usual active lifestyle characteristic of this age. Only 6.6% of children showed reduced activity and inertia.

During the period of remission, increased fatigue is observed, which is especially pronounced in schoolchildren. While playing with other children, they feel weak and tired, which often forces them to take only passive participation. Pain in the heart area is often short-term, stabbing, and does not radiate beyond the heart. Complaints of headaches towards the end of school or towards the end of the day (in the evening), and increased sweating are often noted. Joint pain is not accompanied by swelling and is not associated with physical activity. Sleep is often restless, children have difficulty falling asleep and wake up repeatedly at night. Appetite is reduced. There is often a tendency to constipation. Increased chilliness in children is observed as a result of rapid cooling, which is apparently associated with insufficient adaptation of the vascular system to changing temperature conditions. As a result, an imbalance of vascular reactions (“vascular neurosis”), which has been studied in detail in rheumatism, may occur.

With such an abundance of complaints, minor changes in the cardiovascular system are detected. Parents consider their child to be seriously ill and therefore endlessly turn to numerous consultants for help. Often a diagnosis of rheumatism or other pathology is made (in the presence of a heart murmur - congenital heart disease), which dooms such a child to long-term unnecessary treatment, restriction of movements harmful to his health and endless repeated examinations.

70% of children have mildly expressed symptoms of chronic intoxication - pale skin, blue under the eyes, decreased (in 5% - increased) nutrition. Wherein general phenomena do not always correspond to the size of the tonsils and their visible changes. Characterized by an increase (up to 5-12 mm, occasionally up to 20-25 mm) of the submandibular and anterior cervical lymph nodes, sometimes lymph nodes located along the posterior edge of the sternocleidomastoid muscle, often sensitive to palpation.

The tonsils are enlarged, scarred, fused to the arches, with deep lacunae, often filled with pus. In some children, the tonsils are small, but pathologically altered, indicating the presence of chronic inflammation. The process in the palatine tonsils can be combined with adenoids or chronic pharyngitis.

Changes in the cardiovascular system are accompanied by an increase in heart rate (15-20 times higher than the age norm), sometimes a decrease. The boundaries of the heart are within the age norm. Heart sounds are often slightly weakened, an unclean first sound is heard above the apex, sometimes a short weak systolic murmur at the sternum or in the second intercostal space on the left. Arterial pressure may be normal, in some children it is increased by 1.3-2.6 kPa (10-20 mm Hg), less often - decreased by 1.3-2.0 kPa (10-15 mm Hg. ).

During the period of remission, moderate anemia, leukopenia (less often moderate leukocytosis), lymphocytosis or slight neutrophilia are detected in the blood. ESR is normal.

Minor changes are detected during biochemical examination. So, total protein blood serum fluctuates within 7.6% ± 0.12%, and the proteinogram and albumin-globulin coefficient are not changed. Rarely, the content of gamma globulin is slightly increased.

The reaction to C-rp is negative, the diphenylamine indicator, the content of sialic acid, fibrinogen, mucoproteins and ceruloplasmin are within normal limits.

ASL-0 titers are within normal limits, less often - increased to 300 units/ml, in isolated cases- up to 400 units/ml. Elevated titers are detected mainly in children after exacerbation of focal infection in the tonsils. With repeated studies, a decrease is noted.

Antistreptohyaluronidase (ASH) titers are often within normal limits, less often - increased to 300 units/ml, in isolated cases - up to 600 units/ml.

ECG changes in children with tonsillogenic cardiodystonia are insignificant and occur less frequently (26%) than in adults. Marked sinus tachycardia, bradycardia or sinus tachybradyarrhythmia. Disturbances of atrioventricular conduction and extrasystolic arrhythmia are rarely detected, and a decrease in voltage and jaggedness of the P, R and T waves are often detected. It is important to note that in most children, individual changes on the ECG occur without their combination.

Tonsillogenic cardiodystonia is often accompanied by a slight decrease in the amplitude of the 1st and 3rd sounds, and less often by an increase in the duration of the sounds on the FCG. Often (38%) children hear a mid-frequency, low-amplitude systolic murmur with its epicenter in the fourth intercostal space at the left edge of the sternum, less often in the second intercostal space or above the apex. A murmur of the decrescendo type, diamond-shaped or spindle-shaped, occupies protomesosystole. The shape, amplitude, and duration of the murmur often change even with the same recording in different cardiac cycles.

In 16% of children on PCG, a phase syndrome of physical inactivity was noted.

At x-ray examination no changes are detected.

Thus, in children with tonsillogenic cardiodystonia, objective data and results auxiliary methods studies provide grounds for excluding carditis, and the presence of pronounced symptoms of chronic tonsillitis and numerous complaints allows us to establish correct diagnosis. During the period of remission, the disease is easy to distinguish from rheumatic carditis, in which children present fewer complaints, but there are pronounced and persistent changes in the ECG, FCG, PKG, and pathological changes laboratory research, indicating heart damage. After a comprehensive pathogenetic treatment changes in the cardiovascular system along with complaints usually disappear.

It is especially difficult to make a diagnosis of tonsillogenic cardiodystonia during the period of exacerbation of chronic tonsillitis or the accumulation of ARVI. In such cases, the condition of children, as a rule, worsens significantly, complaints increase, and changes in ECG and FCG are more common. Leukocytosis is observed in the blood, less commonly - leukopenia, eosinophilia, neutrophilia or, conversely, lymphocytosis; ESR in 14% of patients increased to 25-35 mm/h.

The titers of antistreptococcal antibodies and the content of mucoproteins increase, C-rp appears, which is typical for rheumatic carditis and infectious-allergic myocarditis. However, slight changes in the heart, despite pronounced complaints, rapid normalization of blood counts and instrumental methods research should be leading in making the correct diagnosis.

An important differential diagnostic criterion for tonsillogenic heart disease is the dynamics of changes that occur as a result of complex therapy. When the exacerbation of tonsillitis subsides, laboratory values ​​decrease significantly, and sometimes completely return to normal. This indicates a connection between the existing changes and the exacerbation of focal chronic infection in the tonsils.

After treatment (1-2 weeks) with amidopyrine, acetylsalicylic acid and sanitation of the tonsils, as a rule, the child’s well-being improves, arthralgia and pain in the heart area disappear, children become cheerful and active. Pathological changes in blood tests and ECGs disappear or significantly decrease.

During follow-up observation, the majority of children who, after discharge from the hospital, underwent measures for the primary prevention of rheumatism, had positive results. In some children, sore throat often worsens in the future, and catarrhal symptoms of the upper respiratory tract develop. Tonsillectomy performed due to failure conservative therapy, often gives good effect. In some cases, there is no obvious improvement at first, however, in such children, as they grow, the symptoms of intoxication decrease and then completely disappear. Effective repeat courses desensitizing therapy, carried out along with local treatment of the lesion in the nasal pharynx (if necessary, adenotonsillectomy).

With careful implementation of treatment and preventive measures in children with chronic decompensated tonsillitis and cardiodystonia, rheumatism usually does not develop ( primary prevention rheumatism).

Chronic tonsillitis may be accompanied by other diseases and focal infections: cholecystocholangitis (up to 40%), chronic sinusitis, otitis media, pyelocystitis, etc. They can affect the indicators of clinical, laboratory and instrumental research methods, intensifying and increasing the frequency of pathological changes. In this case, chronic tonsillitis is especially difficult to distinguish from rheumatism and infectious-allergic myocarditis, the diagnosis of which is established upon admission to the clinic or by the local doctor in 50% of such children.

Along with the complaints typical of tonsillogenic cardiodystonia, symptoms uncharacteristic for it are revealed: pain in the right hypochondrium, lower abdomen and lumbar region, headache, increased sweating. Most children exhibit severe chronic intoxication. There are no significant changes in the heart or they are insignificant. To make a correct diagnosis, the child must be hospitalized and additional studies must be performed.

With tonsillogenic myocardial dystrophy, pronounced subjective and objective symptoms are observed, indicating a widespread pathological process in the body, accompanied by dysfunction of many organs. Significant changes in the central nervous system, heart muscle and other organs in this disease fully justify the term “tonsillar disease”.

Children with tonsillogenic myocardial dystrophy are usually sent to the clinic with suspected rheumatism, with a diagnosis of rheumatic carditis or infectious-allergic myocarditis. Often their chronic tonsillitis is combined with other foci of chronic infection (cholecystocholangitis, less often - sinusitis, pyelitis). Due to the presence of systolic murmur, a diagnosis of left atrioventricular valve insufficiency is often made or congenital heart disease is suspected.

Most patients with tonsillogenic myocardial dystrophy have a history of frequent exacerbations of tonsillitis, repeated tonsillitis (usually catarrhal, less often follicular or lacunar), and acute respiratory viral infections.

During the period of remission there are prolonged low-grade fever, sudden, unreasonable short-term increases in body temperature to high numbers (38-39 ° C), mainly during the day. Children are asthenic, somewhat stunted and physical development, are often withdrawn, secluded, do not like their peers and avoid them, get tired quickly while playing, and have low physical endurance. They often complain of shortness of breath during physical activity (fast walking, climbing a mountain, etc.), pain in the joints without swelling, not associated with physical activity, pain in the heart, headache, loss of appetite, increased sweating.

Children with tonsillogenic myocardial dystrophy may experience the same complaints as with indolent rheumatism. However, the frequency of various complaints is not the same. Thus, complaints of fatigue, lethargy, pain in the heart, shortness of breath during physical activity, and with low-grade rheumatism are more common than in children with tonsillogenic myocardial dystrophy. At the same time, the frequency of arthralgia, low-grade fever, increased sweating, nosebleeds in both diseases are approximately the same. Complaints about increased fatigue, pain in the heart area, palpitations and shortness of breath with little physical exertion are characteristic of sluggish rheumatism. Therefore, such a complex of complaints in the presence of other data and clinical changes in the heart, pathological changes ECG and laboratory indicators indicate rheumatism.

When examined in the clinic, most patients with tonsillogenic myocardial dystrophy are found to have chronic intoxication, often quite pronounced, chronic decompensated tonsillitis, often in parallel - adenoids and pharyngitis.

All children have clear changes in the heart, often tachycardia, less often bradycardia. After physical activity, the pulse increases by 15-20, but quickly (after 1.5-2 minutes) returns to normal. Approximately 50% of patients have respiratory arrhythmia. The size of the heart in most patients is within the age norm, less often - slightly increased to the left (up to 1 cm). Tones are weakened. In 71% of children, a fairly distinct systolic murmur is heard, better at the sternum and in the fourth intercostal space at the left edge of the sternum, in some patients it intensifies above pulmonary artery. After loading it intensifies, in vertical position is heard weaker, is not carried out beyond the heart or is carried out only slightly. In a number of patients, the noise is clearer, is heard above the apex, often has a musical tone, is not carried to the left axillary region, and disappears in an upright position. In this case, one can suspect a vibrational systolic murmur not associated with a focal infection (localized mainly in the third or fourth intercostal space at the left edge of the sternum, musical tone, slight irradiation), which is confirmed using PCG.

Systolic murmur can be heard especially clearly over the pulmonary artery. In this case, there is often a suspicion of congenital heart disease, non-union interatrial septum. The diagnosis is clarified after a comprehensive clinical, laboratory and instrumental examination of the patient.

Blood pressure in children with tonsillogenic myocardial dystrophy is often not changed. Less common is a moderate decrease maximum pressure by 1.3-2.6 kPa (10-20 mm Hg).

Consequently, changes in the heart in children with tonsillogenic myocardial dystrophy are unclear, and therefore they are not enough to establish a diagnosis of rheumatic carditis. Such a diagnosis can be made only when changes in dynamics increase. A pronounced systolic murmur heard in children with myocardial dystrophy of a tonsillogenic nature and suspected rheumatism, which is the cause of an erroneous diagnosis mitral insufficiency, often turns out to be physiological (vibrational).

To make a correct diagnosis, it is necessary to use data from auxiliary research methods that have important in recognizing sluggish rheumatism developing against the background of tonsillogenic intoxication.

ECG changes do not always correspond to clinical data. Some children do not have them, despite clinical data. And, conversely, in some patients, ECG changes are clearly expressed with minor clinical manifestations.

Repeated electrocardiographic studies after treatment (desensitizing therapy, tonsillectomy) reveal a reverse development of abnormalities, which is also observed in patients with profound degenerative changes. Only in a few children persistent changes on the ECG (extrasystole) persist for a long time.

X-ray examination of the chest organs does not reveal any special abnormalities.

Blood changes in patients with tonsillogenic myocardial dystrophy are characteristic of active tonsillitis.

In case of exacerbation of the process, antibody titers increase briefly but significantly, the number of complaints and changes in the heart increase. If we take into account the significant deterioration in the indicators of laboratory and instrumental research methods, then the difficulty of establishing the correct diagnosis in such children becomes obvious. Our observations have shown that in a number of patients it is not possible to make a correct diagnosis immediately, but only after observation over time. When antibacterial (antiviral) and anti-inflammatory therapy is prescribed, the condition of patients quickly improves. The indicators of auxiliary research methods are normalized. Changes characteristic of chronic decompensated tonsillitis and tonsillogenic myocardial dystrophy remain.

Consequently, the rapid dynamics of disorders, unusual for rheumatic carditis or infectious-allergic myocarditis, even with the persistence of small changes in the heart, is often the main, decisive criterion for the correct diagnosis.

The reaction to S-rp is often negative, but in children after an exacerbation of a focal infection in the nasopharynx it is positive. Upon repeated examination, rapid disappearance of C-rp from the blood serum is observed. Thus, during the study, already in the 2nd week from the start of treatment in most children, a weakly positive reaction to C-rp becomes negative. In this regard, it can be assumed that the main reason for the positive test in these children was an exacerbation of focal infection.

Changes in protein fractions in most patients persist for a long time and reflect a chronic process in the tonsils. After exacerbation of chronic tonsillitis, they become more pronounced.

When comparing protein spectrum data with data serological studies their parallelism is not always noted. However, it should be noted that in patients with persistently high titers of ASL-O, ASH and a positive test for C-rp, more pronounced changes in the serum protein spectrum are observed.

In most children, an increase in antibody titers is combined with changes in the heart, sometimes with ECG data, which makes it especially difficult to recognize tonsillogenic myocardial dystrophy.

Under the influence of the therapy, intoxication decreases, joint pain disappears, and the general form patients, the majority of the body temperature normalizes, the tonsils slightly decrease in volume, their swelling and hyperemia disappear. Painful symptoms decrease, but often do not disappear completely.

Typically, in children with tonsillogenic myocardial dystrophy, the dynamics of clinical changes in the heart under the influence of treatment are insignificant: tachycardia decreases, but pulse lability remains, data functional tests slightly deviated from the norm, which is mainly due to a violation nervous regulation work of the heart. During observation, the boundaries of the heart do not change. Tones often remain weakened.

Systolic murmur decreases but persists in most children.

More distinct dynamics of changes in the heart are observed in children with concomitant acute diseases. Their reverse development as they recover from an acute illness is observed in all children in a relatively short time. It should be noted that the coincidence of clinical changes with electrocardiographic, serological or biochemical changes in the same patient is observed only during the period of exacerbation of chronic focal infection (mainly in the nasopharynx). In a number of children, data from anamnesis, objective, instrumental and laboratory studies do not allow us to completely exclude the diagnosis of rheumatism or myocarditis (infectious-allergic) even upon discharge from the clinic, although there is not enough data for the final approval of such a diagnosis during this period.

To clarify the diagnosis of these patients, it is necessary to monitor them after discharge from the hospital.

We have observed patients with tonsillogenic myocardial dystrophy for many years; All patients underwent repeated electrocardiographic, serological and biochemical research at different intervals (from 2 to 6 months). In 27.6% of children, painful phenomena persisted for a long time. The chronic inflammatory process in the tonsils and nasopharynx was supported by repeated sore throats, exacerbations of tonsillitis, and acute respiratory viral infections. In turn, the chronic inflammatory process supported the phenomena of intoxication. Changes in the heart were detected for a long time even in cases when repeated sore throats and acute respiratory viral infections were not observed (or were observed rarely), which reflects deep neuroregulatory and dystrophic changes in the myocardium.

Upon repeated examination, new foci of chronic infection are often discovered (cholecystopathy, cystitis, sinusitis, etc.), which enhance the effect of tonsillogenic intoxication, and sometimes themselves (for example, after tonsillectomy) can cause functional changes in the cardiovascular system, similar to those in tonsillogenic intoxication.

It is important to emphasize that if there are no sufficient grounds for the diagnosis of rheumatism, then it should not be established. Chronic tonsillitis and pharyngitis, along with the identified new focus of infection (cholecystocholangitis), support symptoms of intoxication and small but non-progressive changes in the heart.

Despite prolonged chronic intoxication, repeated periods of elevated temperature to subfebrile and deterioration in the well-being of patients with exacerbations of the process in the nasopharynx and other foci, and sometimes general infections, progression of changes in the heart is not observed. This fact is considered an important differential diagnostic point, allowing to distinguish rheumatism from focal chronic infection, causing change in the cardiovascular system.

Systolic heart murmur may remain persistent. At detailed study it turns out to be functional or physiological (vibratory and pulmonary systolic murmurs) and cannot, despite its persistence, serve as a basis for the diagnosis of rheumatism and heart disease.

Repeated short courses of desensitizing therapy, along with sanitation of the nasopharynx, have a positive effect in some patients.

Timely tonsillectomy has a beneficial effect. In the immediate postoperative period, most children's complaints disappear; less often, only improvement is noted with a gradual, slow subsidence of the painful process. In a small proportion of children, complaints, changes in the heart and intoxication remain after surgery and may be due to the ongoing inflammatory process on the back wall of the pharynx (pharyngitis). It is believed that changes in the heart caused by focal chronic infection in the nasopharynx, after eliminating the focus (tonsillectomy), undergo reverse development. Our observations have shown that this is not always the case. In 19% of children with tonsillogenic intoxication, mild changes in the heart were observed for a long time. However, they did not progress, which made it possible to make a correct diagnosis.

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Allergic tonsillitis is a familiar sore throat, which is an infectious-allergic disease in which the inflammatory process is localized mainly in the tonsils.

Basic information

To begin with, it is necessary to clearly indicate that the concept of allergic tonsillitis is somewhat arbitrary: in International classification diseases of the 10th revision, such a nosological unit, that is, a separate disease with an assigned code, is absent. It would be more correct to talk about toxic-allergic tonsillitis, which, in turn, is one of the forms.

The disease is quite widespread: about 16% of the population suffers from chronic tonsillitis. Chronic tonsillitis, in particular allergic-toxic ones, are not as harmless as it might seem, because they have adverse influence on the body, especially on children, and can be aggravated by systemic complications.

Causes and provoking factors

The cause of toxic-allergic tonsillitis is a disruption of the immune system, namely: a violation of the formation of acquired immunity. If a person often suffers from acute respiratory viral infections, we can conclude that his memory cells are poorly formed for a particular infectious agent. Such people often suffer from the same infection.
Among the provoking factors can be noted:

• the presence of infectious foci in the body, especially chronic rhinitis, sinusitis, sinusitis;
• hypothermia;
• untreated caries;

Signs and symptoms

The allergic form of tonsillitis is characterized by the following symptoms:

• sensation of a lump in the throat, a foreign body;
• a feeling of swelling in the throat, sometimes a feeling of lack of air;
• bad breath due to the accumulation of caseous-purulent discharge in the lacunae;
• headache due to chronic inflammation in the pharynx, prolonged tension of the neck muscles, impaired venous outflow;
• general weakness.

Complaints of sore throat are rare.

Forms of the disease

Chronic tonsillitis is usually divided into several forms: simple, toxic-allergic I and II degrees, and the last two will be discussed in more detail below. As for the simple form: such a sore throat is characterized only by local manifestations.

1st degree

The toxic-allergic form of tonsillitis of the first degree is characterized by the following manifestations and signs:

• low-grade fever (with the temperature rising periodically);
• cervical lymphadenitis (inflammation of the cervical lymph nodes);
• periodically worsening pain in the joints.

Also, tonsillogenic intoxication almost always manifests itself as a general malaise - fatigue, weakness, loss of appetite in both adults and children. In some cases, functional disturbances of cardiac activity may be observed, but they occur only during exacerbations. Patients complain of pain in the heart, but during objective research(for example, electrocardiography) violations are not determined. Changes in laboratory parameters are not stable.

2nd degree

Unlike toxic-allergic sore throat of the first degree, toxic-allergic sore throat of the second degree is characterized by functional disorders cardiac activity, which are recorded during an electrocardiographic study. Shifts in laboratory parameters as the exacerbation subsides are constantly recorded.

Besides, this form characterized by the following manifestations:

1. Constant joint pain of varying intensity, which does not stop even when the exacerbation of tonsillitis subsides.
2. Heart pain and various kinds arrhythmias.
3. Long-term low-grade fever.
4. Functional disorders of the liver, kidneys and other organs and systems, which are recorded through various diagnostic measures.

Complications

Against the background of toxic-allergic angina of the second degree, metatonsillar diseases develop, which have common etiopathogenetic connections with angina. The course of tonsillitis is associated with the development of an autoimmune process associated with the destruction of one’s own connective tissue, with the kidneys being the first to suffer, the cardiovascular system, joints.

Speaking in simple language, this form of tonsillitis leads to pronounced changes internal organs, as well as worsening the course of existing diseases, which is caused by allergic, endotoxic and other factors. For example, with chronic tonsillitis, the course of schizophrenia and schizophrenia spectrum disorders is aggravated.

Among general complications– cardiovascular diseases, infectarthritis, tonsillogenic sepsis and other diseases of infectious and allergic nature. It is possible to develop a paratonsillar abscess, which is acute inflammation, which has spread to the peri-amygdala tissue, which produces purulent cavity. Also, the inflammatory process can develop in the mucous membrane of the posterior pharyngeal wall, as well as in the peripharyngeal tissue (pharyngitis and parapharyngitis).

In addition, there is an opinion among parents that the child should “get over it” in childhood. If a sore throat returns very often, it is advisable to talk about the presence of a chronic process and periodic exacerbations, which, of course, requires adequate treatment and elimination of the root cause.

The disease has a negative impact on the child's body. For example, chronic tonsillitis can negatively affect the development reproductive system in girls, and in general, people with chronic tonsillitis often have an intersex physique due to inharmonious development.

Treatment methods

Treatment tactics should be determined by the form of the disease. Thus, simple tonsillitis requires conservative therapy, and in the absence of significant improvements after several courses, the question of removing the tonsils is raised.

On the question of radical treatment: When is it advisable to remove tonsils? Most the right approach– consideration of the problem of allergic tonsillitis in the context of disruption of the functioning of the whole organism, or more precisely, the immune system. The palatine tonsils are not the only lymphoid formations in the pharynx; they are part of the lymphadenoid pharyngeal ring Pirogov-Valdeera. This is a powerful barrier that any infection transmitted by airborne droplets encounters on its way.

In chronic tonsillitis, the lymphoid tissue hypertrophies and becomes inflamed, and caseous-purulent discharge appears in the lacunae of the tonsils. Sometimes scarring of the tissue occurs. The disease occurs with periodic complications. At the same time, hypertrophied tonsils should not be perceived as the cause of frequent illnesses. On the contrary, the proliferation of lymphoid tissue is compensatory mechanism, which indicates that the glands are functioning intensively.

During tonsillectomy, that is, loss of tonsils, in a patient with impaired processes of formation of immunological memory, the infection freely descends below, therefore chronic tracheitis, bronchitis and other diseases are added to the list of problems. Although, of course, in some cases without radical intervention not enough.

Based on the above, it must be concluded that the doctor should strive to preserve the tonsils as fully functioning components of the immune system. To do this, a full course of conservative treatment should be carried out, aimed, among other things, at restoring the functioning of the immune system. Chronic tonsillitis requires an integrated approach and long-term treatment:

1. Sanitation of foci of chronic infection: washing of tonsil lacunae.
2. Antibacterial (less often antiviral) therapy.
3. Correction of the immune system.

Thus, both symptomatic and pathogenetic, that is, treatment aimed at eliminating the cause of the problem, should be carried out. It is impossible to cure the disease completely, but achieving stable remission for several years is a completely solvable task. It is advisable to sanitize your tonsils once a year.

Medications

Typically used antibacterial therapy. The course is compiled individually. Antihistamines (which are usually taken for allergies) must be prescribed. As local treatment- rinsing the throat with antiseptics, treating the tonsils with sodium tetraborate during an exacerbation.

Folk remedies

Often (but not always) methods of the so-called traditional medicine Not only do they not bring a clinically significant effect, but they can also provoke a worsening of the condition, especially if the patient becomes addicted to them without seeking qualified help. Application folk recipes for allergic tonsillitis, in no case should it replace complex treatment prescribed by a specialist. All alternative medicine must be agreed upon with the attending physician.

However, an excellent proven solution is a solution of iodine, soda and salt for rinsing. To prepare, you will need a few drops of iodine, a level teaspoon of soda and half a teaspoon of salt. The ingredients are dissolved in a glass of warm water.

Gargling from time to time will not give any significant effect: you must not be lazy and thoroughly rinse your throat several times a day so that the solution reaches your back wall. Due to the presence of iodine in the composition, it is advisable not to store it, but to use the prepared liquid at a time.

Physiotherapy

In some cases, physiotherapeutic treatment demonstrates good results. Among these methods wide application find:

1. Ultrasound therapy.
2. Ultraviolet irradiation.
3. Ultra-high frequency inductothermy.
4. Microwave therapy.

An absolute contraindication to physiotherapeutic treatment is oncological diseases or suspicion of the presence of cancer pathology.

Prevention

It must be remembered that any form of chronic tonsillitis requires increased attention, because they are associated with high risk development of many serious somatic diseases due to a decrease in the body's adaptive capabilities.

Even healthy man With good immunity may become a victim of sore throat. The development of the disease sometimes occurs literally in half a day. The main symptom of tonsillitis is inflammation of the tonsils. The onset of the disease is accompanied by sore throat.

General information about the disease

Intoxication with sore throat, as with ARVI and other diseases of the cold-infectious group, occurs quite often. Initially, the patient cannot swallow normally solid food, then liquid. Because of this, the patient’s appetite decreases and against the background general weakness the body has nowhere to get additional nutrition.

After this, a sharp rise in body temperature begins, as well as lethargy and direct poisoning of the body. Doctors say that sore throat itself is not so terrible disease. But this is only taking into account that the victim will begin to receive appropriate treatment on time.

It is much more difficult to get rid of the consequences of a sore throat that, for some reason, has not been completely cured. This course of the disease is especially dangerous among young children, whose immunity is still weakened. What adds to the insidiousness of sore throat is that the consequences can make themselves felt after recovery occurs.

It is extremely dangerous to endure a sore throat “on your feet” when the patient has a fixed easy stage diseases. Working patients are rarely willing to remain in bed required deadline, which ends in worsening the clinical picture.

During a sore throat and immediately after it, the kidneys and liver are especially affected. The patient can develop chronic tonsillitis, as well as various heart diseases and even rheumatism (joint damage). That is why you should listen to the doctor’s prescription and not postpone the visit until the condition worsens.

Most often, after an examination, the doctor prescribes tests, while at the same time trying to remove sharp pain in the throat. To relieve inflammation and swelling, rinsing and inhalation are used. But without antibiotics, such aids will only temporarily alleviate the condition, relieving some acute symptoms.

Characteristic signs of poisoning

Each person individually tolerates intoxication with sore throat, but there are a number of clinical signs which are suitable for most patients. The list looks like this:

• Fever that may last for about a week. In some cases, the patient also experiences chills.
• Painful sensations. In addition to the standard headache, a person experiences pain syndrome in the lumbar region and different groups muscles.
• General depression. A person is haunted by lethargy and weakness. He gets tired quickly no matter what he undertakes to do.
• Decreased appetite. If your throat hurts very badly, you may even experience a complete loss of appetite.
• Insomnia. Occurs due to constant muscle aches, as well as incessant sore throat.
• Vomit. Often this symptom is characteristic of children, as is inflammation of the meninges.
• Inflammation of the lymph nodes. Meaning regional hubs located in the area under the jaw.
• Impaired functioning of the cardiovascular system.

Tachycardia after a sore throat for some time is not uncommon. And during the course of the disease the patient experiences painful sensations near the heart. The patient's pulse is constantly elevated. This is explained by one of two reasons: high temperature, or the results toxic influence on the heart muscle. An ECG during such a period can demonstrate changes in the functioning of the heart.

Much less common is an enlarged liver and spleen, as well as the detection of red blood cells in the urine.

Why does intoxication occur?

Most often, the basis for the development of the disease is B-hemolytic streptococcus of group A. Because of it, infectious process, striking lymphoid tissue throats. After streptococcus enters the stage of active reproduction, a person begins to suffer from inflammatory changes in the tonsils.

During the life of bacteria, their toxins are simultaneously released. These can be mucopeptides, as well as streptolysins.

After generation large number harmful bacteria, they, together with the poisons produced, begin to rapidly spread throughout lymphatic system. So dangerous bacteria enter not only the lymph nodes, but also the tissues surrounding them, gradually infecting the entire body. In the end, the person experiences severe intoxication, which is expressed in the symptoms described above.

Particularly affects the heart muscle and blood vessels. This is due to the negative effects of streptolysin-O, which can destroy the heart. An additional burden is placed on the nervous system and organs of the digestive tract.

The effects of toxins are most poorly tolerated in the kidneys basement membranes glomeruli. The poison that streptococcus produces is dangerous in itself, causing intoxication. But in addition to tonsillitis, toxins also cause the formation of immune complexes, circulating through the vessels. They cause damage to the renal glomeruli, destroying their wall. This contributes to impaired blood flow.

Some symptoms of poisoning make themselves felt immediately after the onset of the disease. But most of the consequences and signs of intoxication develop after the patient considers himself completely cured.

The risk group includes all those who have had a sore throat more than once and become easily ill each subsequent time. Also susceptible to the disease with subsequent intoxication are those who suffer from chronic tonsillitis with frequent exacerbations. Genetic predisposition is also an important factor here.

Early complications of angina

Period early complications falls in the first week. At this time, the patient may experience poisoning the following consequences for the body:

• Peritonsillitis. Inflammation of the tissues near the tonsils, causing additional pain.
• Sinusitis. Inflammation in the sinuses near the nose.
• Otitis. Inflammatory process in the ear.
• Endocarditis. Inflammation of the heart valves.
• Swelling of the larynx.
• Retropharyngeal abscess. Melting of the lymph nodes, accompanied by pus. In particularly advanced cases, the fiber of the entire retropharyngeal space is also affected.
• Cervical phlegmon. An inflammatory process that affects the subcutaneous tissue.
• Sepsis. General infection.
• Meningitis. An inflammatory process affecting the meninges.
• Infectious-toxic shock.

Most often, such complications can be traced among children or adults whose the immune system failed. This could happen due to stress, a recent illness, an exacerbation of a chronic illness, or poor nutrition.

Late complications of tonsillitis

The late period of complications can make itself felt a week after the disease. Some patients believe that by this time they have already managed to recover, but this is not entirely true.

Intoxication can manifest itself even after 10 days, or even two weeks. Most often it is expressed in:

• rheumatic fever;
• acute glomerulonephritis.

In the first case we're talking about about damage to the heart muscle and joints. Fever is often accompanied by changes skin on the background elevated temperature bodies. If the valves are damaged, then the patient enters the stage of development of heart defects of varying degrees of complexity.

Acute glomerulonephritis can be detected using a urine test. The diagnostic result indicates increased content leukocytes and erythrocytes. Casts and protein also appear.

Patients suffering from chronic tonsillitis deserve special attention. In them, poisoning with streptococcal poisons almost always occurs regularly, since it remains in the tonsils, as well as in the oral cavity. You can even find streptococcus in teeth that are susceptible to caries or in the sinuses near the nose.

Heart complications

One of the most common scenarios after a sore throat is heart complications. This happens because the body begins to produce antibodies during illness. They cause the body to suppress proteins that form connective tissue.

Rheumatism of the heart is called disorganization of connective tissues. The process leads to the formation of rheumatic nodules on the tissue, which begin to scar over time. For the same reason, the heart valves stop working stably, which guarantees a new diagnosis for the victim - heart disease.

Besides cardiac rheumatism Another popular complication from the segment of cardiovascular diseases is called myocarditis. This inflammation quickly affects the heart muscle. IN ordinary life it is expressed in:

• rapid heartbeat;
• arrhythmias;
• pain in the heart area;
• swelling of the lower extremities;
• shortness of breath;
• swelling of veins in the neck area;
• cyanosis.

These symptoms appear approximately 3-3 weeks after the patient has suffered a sore throat “on his feet”, ignoring bed rest. It is the refusal of the doctor’s recommendations that often becomes the reason for a new round of an old disease or the emergence of several new ones.

Rheumatic complications after tonsillitis

In addition to cardiac rheumatism, sore throat can provoke the development of rheumatism of other connective tissues. Most often, the concept of rheumatism refers to diseases associated with the joints.

If a sore throat has not been properly treated, streptococci penetrate first into the bloodstream and then into other systems of the body. The characteristic features here are called:

• wandering type pain,
• swelling,
• swelling,
• redness,
• increased body temperature,
• fever.

The signs are especially clear in large joints upper and lower extremities.

Such a complication can be cured only by selecting the correct complex therapy, which is prescribed by a doctor. Otherwise, the patient will experience wave-like joint damage. This means that at first some joints become inflamed, after a while the inflammation goes away and others begin to hurt. You can get rid of subsequent attacks with the help of physical therapy and medications.

Consequences of sore throat in children

Children are always the first at risk, especially those who suffer concomitant diseases. Most often, preschool children develop a retropharyngeal abscess. This indicates that the baby is gradually growing an abscess in the spine and back of the pharynx. This is where the lymph nodes are located in children.

Because these lymph nodes almost always disappear by age six, there is no risk of this complication among adolescents and adults. But in younger children preschool age poorly treated sore throat can result in respiratory failure. In the worst case scenario, the child will suffer from suffocation.

In order to prevent the abscess from growing to large volumes that overlap respiratory function, you should resort to surgical intervention. During surgery, the doctor opens an abscess filled with pus.

Standard Treatments

The first point of the plan should be a trip to the local doctor. If the therapist believes that the patient is suffering mild form tonsillitis, then he will not be hospitalized. If the disease is at an advanced stage, then treatment in a hospital cannot be avoided. You shouldn't resist him.

After choosing the type of treatment (outpatient or inpatient), doctors prescribe a therapeutic course. It necessarily includes compliance with bed rest, as well as the following aspects:

• prescribing drugs from the group of antibacterial agents according to individual tolerance;
• drinking plenty of fluids, including herbal infusions and teas;
• painkillers to reduce pain;
• anti-inflammatory drugs aimed at fighting fever;
• antihistamines.

Quite often you can hear that people take suprastin for sore throat. But the doctor does not always prescribe this particular antiallergic drug, focusing on the patient’s current condition.

Prevention after a sore throat

To prevent all of the above, experts advise carefully monitoring your health and not self-medicating. It will also be useful to get rid of all problematic infectious foci, which include:

• teeth affected by caries,
• sinusitis,
• pharyngitis,
• chronic tonsillitis.

Observation by a doctor after recovery should include a period of three months. In addition to routine blood and urine tests, an ECG is additionally prescribed. Don't forget about rational nutrition. As a preventive measure, drugs from the immunostimulant segment are welcome.

If a patient suffers from sore throats very often, then he may be advised to remove his tonsils altogether.