Angina – viral and bacterial. Symptoms, treatment, complications

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Angina is a condition characterized by acute papular or sinus tonsillitis – the most common form of tonsillitis. The disease is most often caused by bacteria (staphylococcus, streptococcus or diphtheria). The patient suddenly develops a sore throat, accompanied by high fever, headache and chills. There may also be shortness of breath.

Angina – an infectious disease of children and adults

Angina is an infectious disease, otherwise inflammation of tonsils usually occurring in young children. The disease is caused by bacteria, usually streptococci or staphylococci and pneumonia cleansing bacteria. The disease begins suddenly with a sore throat, accompanied by: increased temperature, chills, headache, general weakness, often shortness of breath – hence the name: angina – angina. We can get infected with angina through airborne droplets, so avoid contact with sick people, children usually get infected in kindergarten or school, while adults, e.g. at work. In addition, it is possible to get infected by touch, even by using the same computer keyboard as the patient, and by touching the nose or mouth with the hands.

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The role of tonsils in the human body

The palatine tonsils are located in the pharynx on the left and right sides and are part of the pharyngeal lymphatic system. Their task is to connect the entire lymphatic system through blood and lymph vessels and filter out germs that can get into our respiratory tract and cause infection. In normal conditions the size of the tonsils it resembles a pea, but at the time of infection, they capture viruses and bacteria, thus protecting the body against disease. Then they enlarge and are significantly bloodshot, which means that angina develops.

Viral angina

Viral angina is caused by a viral infection of the upper respiratory tract. Viruses infect the throat and nose, thus causing severe inflammation and irritation of the mucous membranes of the nose and throat. Viruses cause acute tonsillitis in more than 70% of cases, they are the most common: enteroviruses, coronaviruses, rhinoviruses, parainfluenza, Epstein-Barr virus. Pharyngitis is characterized by difficulty swallowing food and a general feeling of being unwell. In addition, there is a runny nose and a dry cough.

Symptoms of viral angina

A characteristic symptom of viral angina is congestion of the pharyngeal mucosa (palatine arches, back wall of the pharynx and tonsils). There are no raids on the tonsils, but serous exudate. This type of angina often occurs simultaneously with acute rhinitis and laryngitis, and therefore can sometimes be difficult to diagnose. Viral angina usually lasts about seven days, exactly the same as a viral cold.

Forms of viral angina

1. Angina, which occurs together with viral diseases – it can coexist with infectious mononucleosis, herpes zoster, measles, herpes virus and influenza.
2. Angina caused by Coxackie viruses – this is a characteristic type of angina, in which small vesicles are formed on the palatine-lingual arches and the uvula, which, as a result of rupture, take the form of painful ulcers. Additionally, there is a high temperature. 
3. Acute tonsillitis – usually occurs in children whose immune system is not fully developed (under 9 years of age). It can also appear in adults. The ailment usually attacks in winter and spring – then the immunity is additionally weakened by the lack of vitamins or heat.

Bacterial angina

Bacterial infection accounts for up to 30% of tonsillitis (tonsillitis). The bacteria that have the greatest impact on angina are mainly streptococci, most often Streptococcus pyogenes of group A. However, there may be angina, which is not affected by streptococci, and the bacteria:

1. Staphylococcus aureus (K+),
2. Moraxella catarrhalis,
3. Haemophilus Influenzae,
4. Streptococcus pneumoniae.

After all, it is streptococcal angina Group A Streptococcus pyogenes they account for over 90% of bacterial anginas. In some cases, microorganisms live on the almonds without any symptoms, only when the immunity is weakened or when they become cold, they become dangerous and cause angina. Angina caused by streptococcus makes the throat very bloodshot and causes a high fever. Unlike viral angina, there is no runny nose or hoarseness.

See also: Purulent angina – causes, symptoms, treatment

It should be mentioned that streptococcus is a very dangerous microorganism that can lead to rheumatism and even acute nephritis. Streptococci produce toxic compounds that destroy the patient’s tissues.

Angina in adults

Not only in children, but also in adults, angina is accompanied by high temperature, malaise and sore throat. Adults should not ignore strep throat as it can lead to complications. High temperature stresses the circulatory system, because the heart beats much faster then. The patient should stay in bed as much as possible, especially if there is a fever.

General symptoms of strep throat

The symptoms associated with angina are summarized below, and this ailment is caused by:

1. Headache,
2. lack of appetite
3. white or yellow raid on the tonsils,
4. small vesicles and ulcers in the throat
5. sore throat,
6. throat sensitivity
7. hyperemia of the tonsils,
8. chills,
9. high temperature,
10. enlarged lymph nodes of the jaw and neck,
11. hoarseness
12. sometimes loss of voice,
13. trouble swallowing saliva, food,
14. mouth breathing problems
15. bad smell from the mouth,
16. ear ache,
17. Additionally, children may develop abdominal pain, vomiting and nausea.

Angina diagnosis

Before the treatment of strep throat is started, the cause must be established. For this, the doctor conducts a special streptococcal test (Strep A Test) or a bacterial culture swab from the throat for testing. Both of these methods involve rubbing the back of your throat with a cotton swab and sending the material to a laboratory to see if you are infected with the bacteria. It is worth mentioning that viral infection will not be detected in the test, so it can be assumed that we are dealing with viral angina if no bacteria are detected. Sometimes, based on the mere observation of the patient and his symptoms, it is assumed that we are probably suffering from a bacterial infection. In this case, an antibiotic is prescribed without a prior test.

Treatment of bacterial angina

Treatment of bacterial infection is based on taking antibiotics. They are given to patients in the form of oral tablets (5-10 days) or in the form of injections. It is important not to stop taking your medications even if your symptoms improve after 2-3 days as all bacteria should be eliminated. Occasionally there are times when it is necessary to take the antibiotic again to completely heal the angina.

Treatment of viral angina

1. Rest a lot.
2. Drink very cold drinks to relieve a troublesome sore throat. 
3. Make sure that the air in the room you are in is sufficiently humidified.
4. You can use rinses with warm water and salt for a sore throat.
5. During the period of illness, try to eat delicate products, e.g. mousses, ice cream, which will not irritate the throat.
6. You can use lozenges for pain relief.
7. Try to take an increased dose of vitamin C.
8. You can take painkillers that contain ibuprofen or paracetamol.
9. Use warm compresses on enlarged lymph nodes.
10. Remember to drink fluids as a fever causes a loss of water from your body.

Also check: Home remedies for angina

Angina and tonsillectomy

As mentioned above, tonsils are a very important immune element of our body, so removing them is a last resort. This course of action should be considered when the tonsillitis is recurrent, and the tonsils themselves, due to their swelling, obstruct the respiratory tract and make it difficult to eat any food. Such situations may be an indication for their surgical removal. Typically, this procedure is performed using a conventional scalpel, but alternative methods currently exist which use laser, ultrasound, radio waves, or electrocoagulation. This method not only cuts the tonsils, but also burns them out.

The type of treatment is selected after careful consultation with a doctor who presents the advantages and disadvantages of each method.

How is the surgery going?

Tonsilectomy is usually performed under general anesthesia, and the procedure itself lasts from 30 to 45 minutes. Usually, the surgery is performed on children who are discharged home even a few hours after the procedure. Full recovery usually takes 7-10 days, and the doctor will prescribe medications to relieve pain.

During the recovery period, give your baby plenty of rest and rest and drink plenty of fluids. Despite the pain, the child should start eating as soon as possible, as it results in faster regeneration. You may have a high fever and a small amount of blood in your saliva or nose. It is worth consulting a doctor then to make sure that the child is safe. Important advice! For the first 24 hours after surgery, do not give your baby any dairy products.

Angina – complications

Treatment that is too short or its implementation too late may cause complications. The most common are extra-amygdala and peritonsillar abscess. It appears as a result of the infection spreading to the throat wall, then pus accumulates between the almond capsule and the pharyngeal muscular wall. The reasons for this may be a wrongly selected antibiotic (e.g. too low dose) or wrong treatment.

An abscess is an indication for a visit to an ENT specialist, as it must be incised and the secretion removed. Doing so brings immediate relief to the patient. A peritonsillar abscess may also be an indication for tonsillectomy.

Another complication of angina may be nephritis (the most dangerous is glomerulonephritis), which develops even 3 weeks after angina. The consequence of this ailment may be not only impaired kidney function, but even complete failure of the kidneys. A complication may also be rheumatic fever, which leads to changes in the heart.

In children, complications of angina may include:

1. pus in the ears
2. sinusitis,
3. inflammation of the lymph nodes in the neck,
4. appendicitis.

Angina – interesting facts

1. Prevention in angina it should primarily rely on taking care of the ears and teeth, as they are the focus of infection and bacteria can easily penetrate the tonsils.
2. Angina is said to bite the heart and lick joints, and all because it is a serious complication of it is a heart valve defect.
3. Although streptococci are not found in breast milk, a nursing mother should take care of hygiene, as there is a risk of bacteria being transferred through the hands to the nipple.
4. Angina can appear due to high temperatures outside. Why is this happening? The heat outside dilates the blood vessels in the throat, and when we eat ice cream, the local tissues are chilled, so the mucosa cannot defend itself with bacteria. Due to this, small vessels contract and bacteria very easily penetrate the tissues of the throat and multiply. As a consequence, angina develops.

Read also:

1. Fungal pharyngitis and tonsillitis – symptoms and treatment
2. Acute catarrhal pharyngitis
3. Chronic inflammatory diseases of the larynx