Definition of angina

L’angina corresponds to an infection in the throat, and more precisely in the tonsils. It can extend to the whole of pharynx. Angina is caused either by a virus – this is the most common case – or by bacteria and is characterized by a severe sore throat.

In case of angina, itching and pain may be felt when swallowing. It can also make the tonsils red and swollen and cause fever, headaches, difficulty speaking, etc.

When the tonsils turn red, we talk aboutred sore throat. There are also white tonsillitis where the tonsils are covered with a white deposit.

Angina is particularly common in children and in about 80% of cases it is viral. When it is of bacterial origin, it is caused by a streptococcus (most often streptococcus A or SGA, group A β-hemolytic streptococcus) and can present serious complications such as, for example, rheumatoid arthritis or kidney inflammation. This type ofstrep throat must be treated by antibiotics, in particular to limit the risk of suffering from a complication. The viral tonsillitis disappear within a few days and are generally harmless and inconsequential.

Prevalence

Angina is a very common disease. Thus, there are 9 million angina diagnoses in France each year. Although it can affect all ages, angina more particularly affects children and, and in particular the 5 – 15 years old.

Symptoms of angina

• Sore throat
• Difficulty swallowing
• Swollen and red tonsils
• Whitish or yellowish deposits on the tonsils
• Glands in the throat or jaw
• Headaches
• Frissons
• Loss of appetite
• Fever
• Hoarse voice
• Bad breath
• Aches
• Stomach aches
• Embarrassment to breathe

Complications of angina

Viral angina usually heals within a few days without complications. But when it is of bacterial origin, angina can have important consequences such as:

• a pharyngeal abscess, which is pus on the back of the tonsils
• an ear infection
• sinusitis  
• rheumatic fever, which is an inflammatory disorder affecting the heart, joints and other tissues
• glomerulonephritis, which is an inflammatory disorder affecting the kidney

These complications can sometimes require hospitalization. Hence the importance of treating it.

Angine diagnostics

The diagnosis of angina is quickly made by a simple physical examination. The doctor takes a close look at the tonsils and pharynx.

Differentiating viral angina from bacterial angina, on the other hand, is more complicated. The symptoms are the same, but not the cause. Some signs likeno fever or a gradual onset of the disease tip the scales in favor of a viral origin. Conversely, a sudden onset or significant pain in the throat and the absence of coughing suggest a bacterial origin.

Bacterial tonsillitis and viral tonsillitis, although showing the same symptoms, do not require the same treatment. For example, antibiotics will be prescribed only for bacterial angina. The doctor must differentiate with certainty the angina in question and therefore know the origin of the disease. Hence the use, if in doubt after clinical examination, of a rapid screening test (RDT) for strep throat.

To perform this test, the doctor rubs a kind of cotton swab on the patient’s tonsils and then places it in a solution. After a few minutes, the test will reveal whether or not there is a bacteria in the throat. A sample can also be sent to a laboratory for further analysis.

In children under three years old, RDT is not used because angina with GAS is extremely rare and complications such as rheumatic fever (AAR) are not seen in children in this age group.

Our doctor’s opinion