Angina – symptoms, treatment, purulent complications. The causes of angina

Proven content

Angina is an acute pharyngitis and tonsillitis, which is a consequence of streptococcal infection – Streptococcus pyogenes. Nearly 90 percent people during their lifetime have been or will be suffering from this common disease of the upper respiratory tract.

Angina — epidemiology

Streptococcal angina affects people of all ages, but is most commonly seen in school-age children and adolescents. The source of infection is usually sick people or, less frequently, carriers, and the infection is spread by airborne droplets. In temperate climates, the incidence of angina is observed mainly in late autumn, winter and spring, which may be related to more frequent close contact of children and adolescents at school. Angina, in addition to streptococci, can be caused by viruses and even fungi.

Angina symptoms and its course

The first symptoms of angina become apparent about 2-5 days after contact with a sick person, and the infection of patients with streptococcal angina is highest during an acute infection and gradually decreases over a period of several weeks. If an appropriate antibiotic for angina is used, the patient is no longer contagious after a day.

The onset of streptococcal angina is quite acute and is characterized by:

1. sore throat, fever reaching 39 degrees Celsius, accompanied by chills and general breakdown; nausea and vomiting may occur in children;
2. the throat is red, the palatine tonsils are swollen, red with the presence of purulent plugs;
3. The submandibular and cervical lymph nodes are enlarged and painful.

In young children under 3 years of age, streptococcal angina occurs relatively rarely, and the disease often differs from its characteristic symptoms. In the first stage of angina, rhinitis is particularly severe, followed by moderate fever, irritability, disgust to eat and enlarged lymph nodes.

In most patients, streptococcal angina lasts a short time, on average the symptoms disappear after 3-5 days, and the use of an antibiotic shortens the duration of the disease. For this reason, taking an antibiotic reduces the risk of possible complications.

Angina and a raid on the tonsils

Not always, but during tonsillitis, there may be a raid on the tonsils. The yellow and white discharge on the tonsils is a combination fibrin and leukocytes (immune cells) that have failed to fight bacteria. There may be very little of it, but sometimes it is not visible at all, because when swallowing it is rubbed off by food and saliva, during viral angina it does not form at all.

Angina – diagnosis

The diagnosis of strep throat mainly includes the clinical picture of the disease and the possible confirmation of streptococcal infection by pharyngeal cultures or on the basis of the identification of streptococcus. Streptococcus pyogenes in pharyngeal secretions by means of rapid tests performed directly on the patient.

You can now perform this test yourself in your own home. At Medonet Market you will find Home Angina Test – ANGINA STREP A.

Performing specific tests or classical pharyngeal cultures should be taken into account especially in children under three years of age, in order to differentiate viral pharyngitis and streptococcal angina, due to the similar picture of the disease and in adolescents the similarity in the clinical course of angina and infectious mononucleosis. Standard bacteriological tests in the form of pharyngeal swabs should be performed in cases of frequent recurrences of streptococcal angina or lack of treatment effect.

Angina – a slide test to detect streptococci in the throat

Slide test is a method thanks to which we can detect anti-angina antibodies and check their presence in the body within 2 minutes. It is worth mentioning that the validity of this method is debatable, as every person is in fact a carrier of streptococci. Sometimes a person’s angina may have been caused by another bacteria or virus.

Angina and complications

In most cases, streptococcal angina proceeds without complications, and complications are most often observed in people not treated with antibiotics. Complications of streptococcal angina can be divided into:

PUSH:

1. peritonsillar abscess – the most common complication in patients without antibiotics. The characteristic symptoms are: trismus, difficulty swallowing, a dumpling voice and a one-sided swelling of the palate. Basic treatment consists in incision of the abscess by an ENT or surgeon and taking an antibiotic;
2. otitis media;
3. rhinitis;

KIDNEY OPEN: are the result of our immune system reacting to a streptococcal infection. An autoimmune reaction occurs – as a result of infection, antibodies appear that attack selected structures of the heart or kidneys. Very rarely seen in adults;

1. rheumatic fever – “licks joints – bites the heart”. It is a multi-organ disease with symptoms that can affect the heart, joints, skin and subcutaneous tissue. It is most often seen between the ages of 5 and 15. Symptoms of rheumatic fever appear about 2-3 weeks after streptococcal angina and the classic symptoms include: fever, inflammation of large joints, heart inflammation, chorea (involuntary movements mainly of the muscles of the face and limbs), marginal erythema (pink-red, ring-shaped macular eruptions on the trunk subcutaneous nodules (painless in the area of ​​the elbow and knee joints on the extension side). The diagnosis is based on the clinical picture and on the increased values ​​of parameters such as ESR, CRP, ASO. The patient should be treated in a hospital and treatment consists of penicillin and anti-inflammatory drugs. The prognosis of the disease depends on the course of endocarditis and the number of relapses of rheumatic fever – the risk of a heart defect increases with each relapse;
2. acute glomerulonephritis – develops suddenly, usually 1-3 weeks after suffering streptococcal angina. The basic symptoms include: swelling – especially under the eyes, increased blood pressure, changes in the general examination of the urine: presence of protein and red blood cells above the norm. The diagnosis of the disease is based on the finding of abnormal changes in the general urinalysis and the presence of elevated ASO.

In some cases, it is also necessary to perform a kidney biopsy. Treatment is based on eliminating the source of infection by administering penicillin and restricting table salt in the diet, using diuretics and drugs that lower blood pressure. The prognosis is good, the acute symptoms of the disease disappear spontaneously most often after a dozen or so days, and the changes in urine within a year after the onset of the disease;

In exceptional cases, especially in people with significantly lowered immunity, sepsis may develop in the course of untreated angina.

Antibiotic for strep throat

The basic prevention of complications after streptococcal angina is adequate treatment, which consists in taking an antibiotic. The recommended antibiotic is penicillinas streptococci that induce strep throat are not observed. Another antibiotic should only be used if the patient is allergic to penicillin. A very common mistake in the treatment of streptococcal angina is to stop taking the antibiotic as soon as symptoms disappear. The antibiotic should be used absolutely for 10 days.

Should I stay in bed during my illness? Not necessarily. It is recommended to avoid the surroundings so as not to cause danger to others, but it is more important to follow other recommendations. Remember to drink plenty of water as the heat causes you to sweat and dehydrate faster. The patient’s diet should be semi-fluid to make it easier to swallow foods (hot and spicy ones should be avoided). You can relieve a sore throat with rinses, e.g. chamomile or sage infusion. Warm and dry compresses on the neck may be effective with enlarged lymph nodes in the neck.

After a history of angina, it is worth taking prophylactic measures:

-morphology,

-IF,

– general urine or ECG examination to exclude possible complications after the disease.

Is angina contagious?

We can infect another person with angina through droplet path (when the patient, for example, coughs or sneezes in our presence). On the other hand, it is less common that infection occurs due to the use of the same cutlery, glasses or cups as the sick person. Children very often become infected with the angina virus by kissing an infected person, e.g. with a sick friend in the yard or in kindergarten. Angina bacteria can live in our body ‘dormant’, only fatigue, stress, and chronic diseases cause the weakening of the body and multiplication of bacteria, which in turn attack the palatine tonsils. Then it comes to tonsillitis, this is technically called auto-infection.

Angina and tonsillectomy

When talking about angina, we often mention tonsillectomy. This procedure is performed when the patient develops a permanent hypertrophy of the palatine tonsils. Palatine tonsils it is mainly connective tissue, they do not protect against infection. Their overgrowth causes bacteria to settle between the fibers that do not respond to any antibiotics. If, during the examination, the doctor presses the tonsil and pus flows from it, we can talk about their removal, because purulent infection is a threat to the entire human body.

Angina – other information

1. Speaking of angina prophylaxis, remember to take care of your ears and teeth. They are the focus of infection, and because they are located close to the throat, bacteria can easily enter the tonsils.
2. Angina is described figuratively: it licks joints, it bites the heart, because a dangerous complication of the disease is a valvular heart disease.
3. Very often the appearance of angina is influenced by high temperature outside. When it is hot, the blood vessels in the throat dilate. When we eat ice cream, the tissues cool down locally (the mucosa becomes defenseless against bacteria), which in turn leads to the contraction of small vessels. Bacteria that live in the mouth very easily penetrate deep into the tissues of the throat and multiply. This leads to inflammation, strep throat.
4. Streptococci are not found in the milk of a nursing mother. Nevertheless, women should take particular care of hygiene during breastfeeding, as there is a risk of bacteria being transferred, for example, through the mother’s hands to the skin of the nipple).

Tekst: Mirosław Jawień, MD, PhD