lacunar tonsillitis - a type of bacterial tonsillitis, considered the most difficult and dangerous. When the disease is an inflammation of the tonsils captures in the gaps (ducts and "pockets" within the tonsils) and pus is spread across the surface of the tonsils, causing necrosis and sloughing of epithelium.
The severity of the disease is not so much the defeat of the tonsils, but with the strong intoxication patient, concomitant angina. The state of the sick often reaches a critical limit, and the complications of the disease can be life-threatening.
Features occurrence lacunar angina
Lacunar tonsillitis affects pharyngeal, palatine, lingual tonsil and pipe, but in most cases, purulent lesions found in the gaps of the palatine.
The disease has a bacteriological nature, ie. its causative agents are beta-hemolytic streptococci (at 90% cases), staphylococci, Haemophilus influenzae, pneumococci, Klebsiella.
Viruses do not cause angina, they only can greatly reduce the immune system, with the result that the bacteria are beginning to "settle" on the surface of the tonsils.
Important! Lacunar angina does not occur due to hypothermia or cold drink consumption. These factors can only provoke a decrease in the body's resistance, against the background that increased susceptibility to bacteria.
Lacunar tonsillitis - a highly contagious disease. It can develop within a few hours after infection completely healthy-looking person. Most often, the infection occurs in the common cluster and following a healthy human contact with the patient. It is for this reason more prone to infection angina children, who are more often in larger teams.
Ways of infection lacunar angina:
- Airborne. Particularly increased pathogen spread by sneezing and coughing.
- Domestic. When using a common personal care products (towels, bed linen).
- alimentary. Through food (when food intake, He had eaten an infected person) and drink (eg, one cup with a patient).
Often it happens so, that "live" bacteria in the body (nasopharyngeal, carious teeth, sinuses), and when enabling factors, including supercooling, low immunity, cold drinks consumption, etc., infection gets into the throat and begins to develop lacunar tonsillitis.
In the occurrence of lacunar angina determining factor is the state of the immune system: with a strong immunity angina occurs much less frequently and its treatment is easier and faster.
On the development of the disease can affect the following states:
- adverse environment (inhalation dusty and dirty air);
- pathology of the nasopharynx;
- Suppurative diseases in the paranasal sinuses;
- Chronic inflammation of the tonsils.
Contact infection may be associated with trauma tonsils - e.g., if damaged bone or tooth fragment.
Lacunar tonsillitis is most common in childhood and adolescence. The development of this disease in adults is most often associated with chronic lesions of the tonsils. In people over 50 s disease occurs in very rare cases.
How does lacunar tonsillitis: photos and symptoms
In its manifestations lacunar angina is similar to some other infectious diseases, because it is important to know the typical signs and differences, to early treatment and avoid complications.
According to the ICD-10 code disease lacunar tonsillitis - J03.0 (common name - streptococcal tonsillitis). This code has the same disease and angina follicular and catarrhal, tk. they all cause the same pathogen.
Follicular and lacunar purulent tonsillitis have similar clinical symptoms, tk. are phases of the same infectious process. Moreover, the patient can occur simultaneously and lacunar tonsillitis and at different tonsils.
On examination of the throat extensive ulcers observed in lacunar angina, covering the tonsils (cm. a photo). It was the size of pustular formations and merge them into the net or large spots is an important distinction lacunar angina from other pathologies tonsillitis.
From fungal and viral pathologies lacunar tonsillitis differs, that the disease ulcers develop solely on the tonsils, They never go to the palatal arch and on the area of the palate.
Lacunar tonsillitis always starts and proceeds rapidly in the acute phase, almost instantly causing the characteristic symptoms.
phase of the disease:
- incubation period. The patient is already infected, but do not feel any particular symptoms. This period can last from several hours to 2-3 day.
- The acute period. Acute lacunar tonsillitis is characterized by a rapid increase in symptoms: increase in temperature, sore throat, symptoms of intoxication. The severity and symptoms depend on the methods and effectiveness of treatment. Usually after receiving antibiotics disease begins to subside 2-3 day, and on 6-8 day symptoms hardly observed
- recovery period. The main symptoms are absent, but the patient's condition is still far from the norm, and requires further treatment.
How many days will last illness, It depends on correctly prescribed treatment. The mean duration of disease lacunar angina - 8-12 days, but the recovery period may take a longer time and to reduce the risk of complications.
Symptoms in adults
The first signs of the disease is a sharp rise in temperature, and all increasing pain in the throat. With the development purulent processes the temperatures may rise to 39-40 degrees, in rare cases, the temperature is low grade (37 -37,5 degrees).
Important! Lacunar tonsillitis without temperature - it is a fiction. If the temperature does not rise at all, these are signs of other diseases - may, infectious mononucleosis or fungal tonsillitis.
Lacunar tonsillitis in adults also has the following features:
- Symptoms of intoxication (fatiguability, weakness);
- Redness, swelling of the tonsils;
- Aching muscles and joints;
- And the absence of sleep disorders and appetite;
- excessive salivation;
- Chills, fever;
- The feeling of "lump" in the throat;
- Pustular formation on the tonsils;
- Tingling in the heart or tachycardia (in some cases);
- The increase in cervical lymph nodes, their tenderness to touch.
Temperature fluctuations may be a day 2-3 degrees. But most of the high temperature is kept stable, and it is quite difficult to reduce by conventional antipyretic.
Symptoms in children
The child's body is always difficult to cope with infection, so the kids more severe disease. Disease begins acutely - to raise the temperature to the highest rates. In young children (to 6-7 years old) against the backdrop of rise in temperature may develop seizures, loss of consciousness, up to respiratory arrest.
The child becomes moody and irritable, He refuses to eat and drink, because it is concerned about the persistent pain in the throat. and it would be hard to swallow. Tonsils greatly increase in size, baby becomes hard to breathe (babies can be choking).
The history of the disease in lacunar tonsillitis in children may be supplemented by the following features:
- Nausea and vomiting;
- pain, radiating to the ears;
- development of conjunctivitis;
- abdominal pains.
Such manifestations can knock parents confused, tk. they may be confused with symptoms of other diseases (eg, suspected poisoning), and then the treatment will not be assigned correctly. But it lacunar tonsillitis in children can cause a dangerous condition, including rheumatism, heart complications, kidney disease.
Stages treating angina lacunar
Before, how to treat angina lacunary, should verify the accuracy of diagnosis, which can supply only a doctor. Before the visit to the clinic and call the doctor should ensure that the patient certain conditions, facilitate disease symptoms:
- Provide bed rest, eliminate all the psycho-emotional and physical stress.
- Impose on the throat of a bandage or a scarf for warmth.
- Provide diet and drinking plenty of fluids. The diet should be gentle and ensure delivery of vitamins in the body. Prepare meals should be steamed or boiled, preference shredded food room temperature. The child does may refuse food - should not insist, enough to give the kid a sweet tea or broth.
note! From the diet is recommended to exclude products with lacunar angina, which can cause allergic reactions, and with them the lymphoid tissue swelling (sweets, chocolate, nuts, et al.). Dairy products in its pure form it is better not to use, tk. they can contribute to the spread of infection in the oral cavity.
To treat a sore throat and can be at home, hospitalization is necessary in severe disease and detection of disease in young children.
treatment with antibiotics
Mandatory condition lacunar angina treatment - antibiotics. Apply them independently, without a doctor's referral is impossible, This can cause incorrect course of the disease, and instead of recovery lead to complications.
Used antibiotics for lacunar angina, acting on the cause of the disease:
- penicillin drugs: Flemoclav, Augmentin, ampicillin, ekoklav, amoxicillin.
- Preparations macrolide (administered in the presence of allergy to penicillin): azithromycin, Sumamed, Klaricid, Zitrolid.
- Tsefalosporinы (with long-term, severe disease): Cefazolin, cephalexin, ceftriaxone.
In any case it is impossible to interrupt treatment with antibiotics, even if later 2-3 days after their reception there is a relief. This can lead to the progression of infection in a latent form and the appearance of complications.
The general course of receiving antimicrobial drugs is generally 5-10 days. after 3 days after receiving the doctor assesses the effectiveness of the administration of the drug, and replaces another antibiotic if necessary.
Lacunar angina always accompanied by high fever. Reduce the temperature readings, as well as to eliminate the associated symptoms (head, muscle pain, sore throat) It makes use of nonsteroidal anti-inflammatory drugs: Ibuklin, Nurofen, Friends.
These drugs can continue to take even when the temperature drops as the prevention of rheumatic fever during 2-3 days.
Some antipyretics may cause side effects while taking their medications with penicillin. Therefore, you need to take medication after consultation with the doctor.
Children antipyretics appointed as syrups and suspensions, as well as in the form of suppositories (candles).
Antibiotics accompanied by a number of side effects. Therefore, simultaneously with antibacterial agents are appointed:
- probiotic (for the prevention of dysbiosis): Lineks, Entyerojyermina, Hilak. Their drink between meals antibiotics, and after a course of antibiotics even 5-7 days.
- antihistamines: Loratidin, Erius, diazolin, Zodak. Means improve breathing, removing the swelling of the tonsils and larynx spasm.
When lacunar angina necessarily topical treatment, which can be carried out at home:
- Gargling solution of potassium permanganate, furacilina, boric acid, hydrogen peroxide.
- irrigation sprays: Kameton, Geksoral, İngalipt, TANTUM Verde, Bioparoks.
- resorption lozenges (tablets, candies): Strepsils, Gramatsidin, Faringosept, Lizobakt.
These means help to reduce symptoms of the disease, throat disinfection, washout pustules with tonsillar surface.
Folk remedies are used as a supplement to the conservative medicine and help to significantly speed up the recovery and reduce the symptoms of the disease.
Good effect gives gargling infusions of medicinal herbs (sage, chamomile), soda and salt and iodine solutions.
Popular recipes with lacunar angina:
- Mix equal amounts soda, honey and butter melted butter. All mixed to homogeneity. Rassasyvat teaspoon means in the form of heat 3-4 times a day.
- In a glass of fresh beet juice to pour a teaspoon of apple cider vinegar. Heated tool gargle several times a day.
- Gargle can propolis tincture, spreading it with warm water, or chewed in the mouth piece of propolis for 5 minutes.
If lacunar tonsillitis can not be cured by conventional methods (what happens in recurrent forms of the disease), applied surgery. It aims at opening and emptying of pus lagoons ways, how galvanokaustika, laser lakunotomiya, diathermocoagulation, cryosurgery. In extreme cases shown tonsillectomy - surgical removal of the tonsils.
Complications and prognosis
With adequate treatment of the symptoms of purulent lacunar angina subside on 3-4 day, and the total duration of the disease 5-10 days.
Without timely treatment, and misdiagnosis infection causes severe complications:
- Pneumonia and bronchitis;
- Fibrinoznaya angina (state, threatening brain injury and fatal);
To ensure full recovery, after lacunar angina should be returned to the general analyzes (urine, blood), to make an electrocardiogram. This will prevent possible complications after the disease.
The best prevention of lacunar tonsillitis - avoiding contact with infected persons. Additional measures to prevent the disease is a general strengthening of the body, balanced diet, which includes vitamins and minerals, Moderate and regular exercise.