Herpetic pharyngitis
Herpetic pharyngitis is an inflammation of the lining of the throat caused by the herpes simplex virus types 1 and 2. The disease is rare and among the total mass of pharyngitis, herpetic pharyngitis is less than 5%. Inflammation manifests itself in the formation of painful erosions on the back of the throat and needs timely treatment.
Content:
- Causes of herpetic pharyngitis
- Symptoms of herpetic pharyngitis
- Diagnostics of the herpetic pharyngitis
- Treatment of herpetic pharyngitis
Causes of herpetic pharyngitis
The causes of herpes pharyngitis lie in infection with the herpes virus of the first and second types.
As a rule, infection occurs during childhood in one of the following ways:
- Contact and household transmission through kisses, common household items, through toys, etc.
- Airborne transmission during sneezing and coughing.
- The vertical path of transmission from mother to child, during its passage through the birth canal.
Primary herpetic pharyngitis develops acutely, and after the extinction of the symptoms of the disease, the virus remains in the human body forever. Thus, more than 90% of the adult population is infected with the herpes simplex virus, which is asymptomatic in their body. In order for herpetic pharyngitis to manifest in adulthood, for this, certain conditions must be created that negatively affect the state of both local immunity of the throat mucosa and the general immune defense of the body.
Factors that can trigger the development of the disease:
- Hypothermia;
- Overheating;
- Prolonged sun exposure;
- Strong emotional shock;
- Avitaminosis;
- Taking high doses of antibacterial drugs;
- Frequent ARVI, frequent exacerbations of chronic pharyngitis;
- Injuries to the mucous membrane of the throat of thermal, mechanical and chemical origin;
- Exacerbation of chronic diseases that undermine human immunity;
- Smoking, drinking strong alcoholic beverages, inhalation of gassed, smoky air.
Thus, any prolonged irritation to the throat mucosa can lead to inflammation and the development of herpetic pharyngitis, if there is a decrease in local immune defense.
Symptoms of herpetic pharyngitis
The symptoms of herpetic pharyngitis are similar to the symptoms of herpetic gingivostomatitis, as it is provoked by the same pathogen.
The clinical picture is characterized by the following features:
- A vesicular rash appears on the back of the throat, the size of the vesicles in diameter can reach 5 mm. Inside, the vesicles of the rash are filled with serous contents. The rash covers the tonsils, can spread to the mucous membrane of the cheeks and to the palate, later the tongue is involved in the process.
- The vesicles, after a short time, turn into erosion, which is very painful.
- Eating food and even liquids becomes difficult, since any effect on erosion is given by a sharp pain. Therefore, the sick refuse to eat and drink.
- An increase in body temperature is observed. Values on the thermometer can reach 38 ° C and above. The patient is often in a febrile state. High body temperature lasts about 2-7 days. During this time, symptoms typical for fever persist: pain in the muscles, in the abdomen, headache, weakness, photophobia, etc.
- Regional lymph nodes enlarge, become painful on palpation.
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When the fever passes, which happens most often 3-5 days after the onset of an exacerbation of pharyngitis, the patient's condition improves. After a week of erosion on the posterior wall of the pharynx, epithelialize.
Herpetic pharyngitis is especially difficult in children under the age of 3 years. Sometimes the disease has blurred symptoms and develops as a catarrhal pharyngitis. In this case, vesicles and erosions on the mucous membrane of the throat and in the oral cavity do not occur. It should be noted that such a high rise in body temperature as in children, herpetic pharyngitis in adulthood most often does not cause. However, the painful erosions formed by the opened vesicles persist until the moment of their epithelialization.
Diagnostics of the herpetic pharyngitis
Diagnosis of herpetic pharyngitis is based on the clinical picture of the disease, on the performed pharyngoscopy and anamnesis. Cytological, virological and serological studies are no less important.
A throat swab is taken to determine the type of pathogen, although the virus can be detected in saliva and serum.
Treatment of herpetic pharyngitis
Treatment of herpetic pharyngitis is carried out by an otolaryngologist. The patient is prescribed antiviral drugs, which should be taken in the first 2-4 days from the onset of the disease. After the vesicles have resolved and transformed into ulcers, antiviral drugs will be ineffective.
- Antiviral drugs in pills. Herpetic pharyngitis can be treated with a one-day course of high-dose modern medicines. Studies have shown that this treatment regimen is no less effective than with a weekly intake of the same drugs, but at a lower dose. Among such medicines are Famciclovir (Minaker, Famvir), Valacyclovir (Valavir, Valtrex). You can also use the drug Acyclovir, however, it is prescribed less and less for the treatment of herpes diseases.
- Antiviral drugs for topical treatment of herpetic pharyngitis. Local therapy is reduced to rinsing the throat with solutions and agents that have antiviral activity against the herpes virus. For this purpose, you can use the drug Miramistin. Then those erosions that are in the access zone need to be lubricated with Viferon gel. This drug has both antiviral and immunomodulatory effects.
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Symptomatic treatment. If the disease provokes an increase in body temperature, then an antipyretic agent should be taken. It can be Paracetamol, Ibuprofen, etc. You should not bring down the temperature if it does not exceed 38 ° C. This will allow the body to produce its own interferon and more effectively fight the exacerbation of the disease.
- To reduce the pain of ulcers, anesthetics such as Lidochlor, Lidocaine Asept, etc. are used. Antihistamines - Tavegil, Fenkarol, Diazolin help to relieve swelling.
- Immunomodulators are taken on the recommendation of a doctor. These can be drugs such as Cycloferon, Immunal, Polyoxidonium, Lysozyme, Taktivin, etc.
- When erosions are epithelized, it is necessary to apply keratoplastic agents to them - sea buckthorn and rosehip oil, Carotolin, vitamins E and A.
- During the acute phase of the illness, food should only be offered in liquid or pureed form, it is important to ensure that the food is not too hot or cold.
If herpetic pharyngitis often recurs, then it makes sense to contact an immunologist and find out the cause that provokes an exacerbation of the disease.
The author of the article: Lazarev Oleg Vladimirovich | ENT
Education: In 2009, he received a diploma in the specialty "General Medicine" at the Petrozavodsk State University. After completing an internship at the Murmansk Regional Clinical Hospital, he received a diploma in Otorhinolaryngology (2010)
