Angina In Children - Symptoms And Treatment. How And How To Treat Angina In A Child?

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-15 09:49

Angina in children

Angina in children is an acute disease with the localization of the process of inflammation in the tonsils. The process may involve the pharyngeal, lingual, tubal or palatine tonsils. Sore throat is most often caused by streptococci and staphylococci, although the viral nature of the disease is possible (adenoviruses, pneumococci). Even less often, mycotic organisms become the cause of inflammation of the tonsils.

Pathogenic flora gets the opportunity to actively reproduce in the presence of a favorable environment for it. It is most often formed under the influence of such factors as: severe overwork of the child's body, improperly organized diet, frequent viral infections, etc.

The treatment of the disease directly depends on which microorganism caused the inflammation. The severity of the disease and the age of the patient have an influence on the determination of the tactics of therapy.

Content:

• Causes of angina in children
• When should a child be hospitalized?
• Symptoms and types of angina in children
• Treatment of angina in children
• How to treat a catarrhal sore throat in a child?
• Possible complications of angina
• Possible complications of angina

Causes of angina in children

Most often, angina is diagnosed in the cold season - in autumn and winter. Children with weakened immunity are more susceptible to angina. Insufficient or poor-quality nutrition, frequent stress and overwork of the body, lack of walks in the fresh air, low physical activity lead to a deterioration in the defenses. As a result, any contact with the cold (being outside in frosty weather, drinking ice cream or cold water, etc.) is a serious test for the immune system and can provoke a sore throat. If the child often suffers from viral infections, then this is an additional help for the multiplication of pathogenic bacteria in the lacunae of the tonsils.

Thus, the risk factors that provoke angina in children are:

• Frequent viral diseases - ARVI and influenza.
• Deterioration of local immunity due to poor-quality nutrition, due to overwork. As a result, the tonsils are unable to realize their protective function.
• The presence of a chronic focus of inflammation in other organs. Often otitis media, sinusitis, sinusitis, overgrown adenoids become the cause of angina.
• Eating cold foods or drinks, general and local hypothermia can provoke a sore throat in a child.

Infection with a sore throat from a sick person is not excluded. Infection occurs by airborne droplets. Disease transmission is possible through contaminated food, through the use of shared utensils, sneezing and coughing.

If the treatment of the disease is not carried out qualitatively, then this leads to the chronicization of angina. As a result, streptococcus becomes a permanent "resident" of children's tonsils and provokes the development of other dangerous diseases, of which there are more than 100. Among such pathologies: rheumatoid arthritis, heart muscle damage, kidney disease, vascular disease. Therefore, if signs of angina are found in a child, it is necessary to seek the advice of a specialist as soon as possible, and not to treat the sore throat with improvised means.

When should a child be hospitalized?

Hospitalization for angina may be required in the following cases:

• The presence of serious concomitant diseases: diabetes mellitus, renal failure, impaired functioning of the hemocoagulation system, etc.
• The development of complications against the background of angina: rheumatic heart disease, abscess, phlegmon of the neck.
• The child is under one year old. In this situation, the opinions of experts differ. Some doctors recommend that all young patients with angina be admitted to the hospital, while others argue that if the disease is mild, it is best to leave the child at home. Thus, in their opinion, it will be possible to avoid stress on the nervous system and prevent the possibility of admission of hospital infections.
• Pronounced symptoms of intoxication of the body are the reason for placing the patient in the hospital. Indicates their attachment: confusion, high body temperature, which does not lend itself to correction with antipyretic drugs, respiratory failure, convulsions, vomiting and nausea.

Symptoms and types of angina in children

About how deeply the tonsils are affected, the following types of angina in children are distinguished:

• Follicular tonsillitis in children. With follicular angina, the mucous wall of the tonsils is always very inflamed. On it, numerous whitish-yellow dots are noticeable - purulent follicles, which, when ripe, can break through into the throat cavity with pus. The following initial symptoms are observed: intoxication, high fever, weakness, intense headache, pain when swallowing, lymph nodes are enlarged and painful when touched. The duration of follicular sore throat is approximately one and a half weeks. Sometimes, in extremely rare cases, recovery is delayed, and the disease develops into a chronic one.
• Lacunar angina in children. This type of sore throat is also extremely dangerous, especially for a small child. With inflammation of the larynx, fluid accumulates in the lacunae of the tonsils, whitish plaques appear, which in some cases join, but do not go beyond the boundaries of the tonsils. Removing them is easy. Such lacunar sore throat is well treated if the necessary medications were prescribed in a timely manner.

• Catarrhal sore throat in children. This dangerous type of sore throat is characterized by an acute onset. Temperatures are usually low, sometimes up to 38 ° C. A sick child almost always has severe weakness, headache, and in some cases chills, excruciating pain in the lymph nodes, loose and enlarged tonsils, plaque on the tongue and pain when swallowing. On average, the disease lasts up to five days. There are cases of development of follicular or lacunar tonsillitis against a background of catarrhal. Modern medicine classifies this sore throat as strep throat.

Depending on which microorganism caused the inflammation of the tonsils, the following types of tonsillitis are distinguished:

• Bacterial sore throat. It can be streptococcal and diphtheria.
• Viral sore throat in children. With viral angina in children, there is a rather sharp increase in body temperature from 38 to 40 ° C. In addition, weakness, vomiting, body aches, diarrhea, abdominal pain, sore throat, loss of appetite or complete refusal to eat are characteristic. The tonsils swell and redden strongly, sometimes small vesicles up to 5 mm are formed, which burst, forming a kind of ulcers. Treatment of viral sore throat should be aimed, first of all, at the direct fight against the causative agent of the disease. Children under ten years of age are always put in an infectious diseases hospital, prescribe bed rest, abundant drink (milk, juice, broth, tea). From medications, the necessary antiviral, anti-inflammatory and immunity-enhancing drugs are prescribed. For local treatment, various rinses are used (decoctions of calendula, sage,chamomile) and modern throat sprays.
• Fungal tonsillitis in children. In fact, fungal sore throat is a consequence of dysbiosis in a patient, therefore, it is necessary to treat not only the sore throat itself, but also necessarily dysbiosis in the complex. Dysbacteriosis is a consequence of any minor changes in the child's body (changes in nutrition, subtle inflammation due to cold water drunk in hot weather). This inevitably causes a significant weakening of the immune system. For the treatment of fungal sore throat, modern pharmacological sprays with an antifungal effect are prescribed, as well as an antifungal antibiotic and gargling with a solution of fruit vinegar to restore a normal balance.

Another classification of the disease:

• Specific inflammation of the tonsils, when angina is provoked by fungal microorganisms and a spirochete.
• Primary tonsillitis, in which there is inflammation of the tissues of the tonsils and throat, and intoxication of the body as a whole develops.
• Secondary tonsillitis, which manifests itself against the background of other diseases: diphtheria, scarlet fever, mononucleosis, leukemia, agranulocytosis, etc.

A specific symptom for sore throat is a sore throat that gets worse when the child swallows. In this case, there is a sharp increase in body temperature to high levels, the patient does not eat anything, he may even refuse water. Perhaps the addition of vomiting and diarrhea. The child becomes lethargic, complains of headaches.

During examination of the throat, one can see severe redness of the pharynx, swollen tonsils and arch. If the child has diphtheria or candidal angina, then a plaque will be visible on the tonsils. After its removal, bleeding areas with erosion are exposed.

Another symptom of sore throat is inflammation of the submandibular lymph nodes. They become painful, increase significantly in size. Parents must know that inflamed lymph nodes should never be warmed up with compresses or other methods.

Often, sore throat affects the child's voice and becomes hoarse. This is because the vocal cords become inflamed. The average duration of the disease is about 10 days. The earlier angina was detected and the earlier the child begins to receive antibiotics, the lower the risk of developing complications of the disease and the faster recovery will come. However, in some cases it may not be necessary to take antibiotics, so it is so important that the child is examined by a doctor.

Diphtheria and bacterial sore throat cannot be distinguished independently. Only a doctor can do this. The diphtheria form of the disease is extremely dangerous because swelling of the neck, stenosis of the larynx and subsequent suffocation can develop very quickly. In addition, death from intoxication of the body is possible, damage to the heart muscle and the development of heart failure are not excluded.

Treatment of angina in children

A prerequisite for a speedy recovery is strict adherence to all medical recommendations. A small patient should receive antibacterial drugs in accordance with the prescribed scheme, parents should provide the child with an abundant warm drink. Children receive antipyretic and antihistamines as needed. Local treatment is reduced to frequent gargling of the sore throat. It is possible to take eubiotics and vitamin-mineral complexes.

Any thermal procedures are absolutely prohibited. We are talking about all kinds of hot compresses, applying warming ointments and creams to the neck area. Purulent angina prohibits such manipulations.

How to gargle with angina in children?

Older children can gargle on their own for a sore throat. If we are talking about small patients, then they are treated with tonsils using various sprays. However, gargling is not a substitute for taking antibiotics - it is only a supportive measure.

Do not treat your child's throat with the same product all the time. For example, if the baby had ARVI not so long ago and Ingalipt or Lugol spray was used to irrigate the throat, then the next time it is necessary to replace them with Faringosept or another remedy.

• It is possible to treat inflamed tonsils for children after three years with the help of ready-made pharmacy products, including: Hexoral spray, Lugol spray, Ingalipt, Tantum Verde. The last drug is ineffective. Hexasprey is approved for use in children over 6 years of age.
• You can use a solution of Miramistin of 0.01% concentration to irrigate the throat. It is possible to independently prepare a solution for gargling a throat based on hydrogen peroxide. To do this, dissolve 2 tablespoons of peroxide in a glass of warm water.
• You can also use a weak solution of potassium permanganate (the color of the gargle should be barely pink), or prepare a solution of Iodinol. You need to take a tablespoon of the drug in a glass of water. Another remedy for rinsing a sore throat is Furacilin's solution. To prepare it, you will need two powdered tablets and a glass of warm water.
• Antiseptics in the form of ointments should not be applied to inflamed tonsils, as this will damage their mucous membranes. As a result, the course of the disease will worsen.
• A good effect can be obtained after gargling with herbal decoctions. Most often, doctors prescribe chamomile, sage, calendula, or ready-made preparations based on them: Rotokan, Ingafitol, Evkarom.
• You can prepare such a solution yourself: add half a teaspoon of soda and salt to a glass of water, as well as a few drops of iodine.
• Older children with angina can dissolve lozenges and tablets with an antiseptic effect, for example: Geksoral Tabs, Grammidin, Stopangin, Faringosept, Strepsils (children over 5 years old).

Features of local treatment of angina in children

• Before offering a child this or that drug, parents should thoroughly study the instructions attached to it.
• When taking any medication, including when using herbs, there is always a risk of developing an allergic reaction. Therefore, you should carefully monitor the condition of the sick child.
• The throat should be treated every 3 hours. This should be done after eating. When the child has rinsed his throat, he is not given water or food for half an hour. Otherwise, the procedure becomes meaningless.
• For the local treatment of angina, 1-2 means are enough, which will prevent the child's body from being overloaded with drugs.
• Drugs such as Lugol and Iodinol can strongly irritate the oral mucosa. Therefore, they are not prescribed for infants. Babies older than one year are treated with such drugs no more than 1 time per day.

Features of local treatment of angina in children under 3 years of age

• It is necessary to start teaching the child to gargle on his own from 2 years old.
• Do not use sprays to treat children under 3 years of age. Although they do not contain components hazardous to the health of the child, at this age children still cannot hold their breath while the throat is irrigated. Therefore, the use of a spray can provoke laryngospasm. For the treatment of infants, doctors recommend applying the drug to the nipple. Children under 3 years old need to direct the spray onto the cheek, together with saliva it will still be on the tonsils.
• Lozenges should not be offered to children under the age of 3 years, although pediatricians recommend limiting the intake of this form of the drug to children under 5 years of age. Most often, babies do not have the patience to suck the lollipop to the end, in addition, the risk of suffocation by a foreign body remains high.

Taking antipyretic drugs

Until there is purulent plaque on the tonsils, the body temperature will remain high enough. Taking medications allows you to reduce it by only a few hours. However, if an antibiotic is given to the child, the body temperature should return to normal within 2-3 days. Therefore, antipyretic drugs are not given to children longer than this period.

Most often, drugs such as are prescribed:

• Ibuprofen (Nurofen, Ibufen).
• Efferalgan.
• Paracetamol in suspension.
• Panadol in suppositories and in suspension form.
• Calpol.
• Ibuklin is used to treat adolescents.

When is it necessary to bring down the temperature in children?

• You should not offer a child an antipyretic agent if his body temperature has not exceeded 38 ° C. It is at a high temperature that antibodies begin to be produced in the body, which effectively fight the disease. If the child's well-being is normal at a temperature of 38.5 ° C, then this temperature can not be knocked down.
• An antipyretic should be given to infants when the body temperature rises to 38 ° C. It is possible that the baby may start vomiting, therefore it is preferable to use preparations in the form of suppositories: Nurofen, Tsefekon, Efferalgan.
• If earlier the child had seizures against the background of an increase in body temperature, then it is necessary to give him antipyretic drugs after the mark on the thermometer reaches 37.5 ° C.

When drugs do not lower body temperature poorly, alternative methods can come to the rescue. You can wipe your child with a damp towel or vodka diluted with water (children over a year old). Warm drinks will help to lower body temperature due to profuse sweating. Especially if these are salicylates: tea or a decoction with cherries, raspberries, cranberries or black currants.

Choice of antibacterial drugs

The drug of choice for angina always remains penicillin, since it is he who most effectively destroys streptococci. In addition, drugs in this group are well tolerated by children and can be given regardless of food intake.

No antibiotic can be offered to a child without a doctor's recommendation.

• The first row drugs that are used to treat angina are Amoxicillin or Flemoxin solutab.
• If the disease is chronic and the bacteria have developed resistance to Ampicillin, then Ampicillin, reinforced with clavulanic acid, is prescribed. These drugs include: Amoxiclav, Ekoklav, Augmentin. Clavulanic acid drugs are second-line drugs.
• If there is no opportunity to prescribe penicillins, then macrolides are used. Azithromycin-based drugs: Azitrox, Sumamed, Hemomycin. Preparations based on Midecamycin - Macropen.
• Cephalosporins are used in extreme cases. These can be drugs such as: Cefixim (Suprax, Pantsef), Cefalexin, Cefuroxime (Axetin, Cefurus, Zinnat).

Treatment of angina with antibiotics should be continued for 10 days. Sumamed is taken for 5 days, as it works for a long time. However, with angina, its dosage is increased. After 3 days from the start of taking antibacterial drugs, it is necessary to assess their effectiveness. If there is an improvement (the plaque has become less, the body temperature has decreased), then this is not a reason to reduce the dose of the antibiotic or to refuse the drug. Otherwise, surviving streptococci will make themselves felt by the development of rheumatic heart disease.

For the treatment of angina, drugs such as Biseptol and Bactrim are not prescribed, since bacteria in 50% of cases are resistant to them.

Taking antihistamines, vitamins and phytopreparations

• gene agents. Children with angina are prescribed drugs such as Cetrin, Suprastin, Zirtek, Zodak, Peritol, Fenistil.
• Vitamin complexes. Some doctors advise taking vitamins of group B, Ascorbic acid or complex vitamin preparations (Alphabet, Multitabs, Centrum, Pikovit and others) for angina. However, many vitamins are capable of provoking allergic reactions, so if a child is well nourished, he will have enough vitamins from food.
• Immunomodulators. These drugs should be taken very carefully. The safest are considered to be Kipferon and Viferon, however, they should not be used without medical advice.
• Taking probiotics. Against the background of treatment with antibacterial drugs, the child should receive eubiotics, including: Linex, Acipol, Bifidumbacterin Forte, Bifiform, Biobacton, Lactobacterin, Bifiliz, Acylact.
• Reception of phytopreparations. Tonsilgon is prescribed for infants and preschool children. Babies are prescribed 5 drops, 5 times a day, the dosage is doubled for preschool children. This drug helps to reduce inflammation in respiratory diseases. It contains essential oils, oak tannins, flavonoids (marshmallow, yarrow, chamomile). Thanks to this, it is possible to achieve an anti-edema effect on the mucous membrane of the throat.

How to treat a catarrhal sore throat in a child?

The catarrhal form of the disease is indicated by an increase in body temperature to 38-39 ° C, a deterioration in the general well-being of the child, sore throat, which intensify during swallowing movements. The lymph nodes are not very inflamed. Catarrhal sore throat very often occurs after a viral infection.

Treatment of catarrhal sore throat is reduced to the child's adherence to bed rest. It is important that the patient receives a sufficient amount of fluid, often gargle the sore throat. You can use sprays to treat tonsils. Also, the patient is prescribed antibacterial drugs, provided that they are effective, catarrhal sore throat will be eliminated in 7-10 days.

How to treat follicular and lacunar angina in children?

Lacunar and follicular tonsillitis has a rather severe course. The disease is accompanied by an increase in body temperature to high values (up to 40 ° C and above). The follicular form of the disease is indicated by the presence of abscesses on the tonsils. If the child has lacunar tonsillitis, then the tonsils will be covered with a whitish-yellow bloom. It is localized in the lacunae, which are located between the lobes of the tonsils.

Both of these forms of inflammation are treated in the same way. It is very important to choose an antibiotic that will destroy the causative agent of the inflammatory process. To minimize the risk of misuse, it is best to have a cultured smear. This procedure will make it possible to determine which bacteria have led to the inflammation, and to which drugs they are sensitive.

At the first visit, a sample of mucus from the nose and throat is taken from the patient on BL and on Lefler's stick, which will exclude or confirm diphtheria. However, the doctor does not always have the opportunity to send the child for a smear test and wait for the test results. Therefore, most often prescribed for the treatment of angina first-line antibiotics - this is penicillin (Flemoxin, Ampicillin). Or, second-line antibacterial drugs are prescribed - macrolides. These include drugs such as: Azithromycin, Sumamed, Hemomycin.

Nevertheless, doctors with angina almost always give preference to drugs of the penicillin series, since they are guaranteed to destroy streptococcus, which is a frequent causative agent of this disease and provokes serious complications. In turn, aminoglycosides do not guarantee the complete destruction of this pathogenic agent, which further threatens the development of rheumatic fever.

Although the general recommendation for the treatment of sore throat in children 1-3 years old is to admit the child to a hospital, doctors often refuse this measure. If the parents are able to provide adequate care for the child, then it is quite possible to leave him at home.

If the disease has a severe course, then the child must be hospitalized. Older children can be at home, however, they should be isolated as much as possible from other people, since angina is a contagious disease.

Possible complications of angina

A disease such as angina requires competent and timely treatment. If the child's immunity is weakened, then complications from the urogenital area, heart, blood vessels, nervous system, bones and joints may develop.

After recovery has come, the child must be sent for an ECG, as well as a general blood and urine test. For a month, children receive a medical withdrawal from any vaccinations, including from the Mantoux test. As soon as possible, you need to see a doctor if the child has joint pain, shortness of breath or chest pain. If a child has a sore throat on a regular basis, then it is necessary to consult an otolaryngologist, since we are talking about chronic tonsillitis.

Possible complications during sore throat:

• Otitis media and laryngitis.
• Lymphadenitis with phlegmon or abscess.
• Meningitis and blood poisoning.
• Inflammation of the heart and blood vessels.

Long-term complications of angina:

• Acute rheumatic disease with subsequent chronicity of the process. In the future, this will lead to the development of heart disease and heart failure.
• Encephalitis.
• Heart disease: myocarditis, pancarditis, pericarditis.
• Thrombocytopenic purpura.
• Hemorrhagic vasculitis.
• Glomerulonephritis and pyelonephritis in acute form.

The author of the article: Sokolova Praskovya Fedorovna | Pediatrician

Education: Diploma in the specialty "General Medicine" received at the Volgograd State Medical University. A specialist certificate was immediately received in 2014.