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Herpetic pharyngitis is an inflammation of the mucous membrane of the throat caused by the herpes simplex virus of the first and second types. 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.
Causes of herpetic pharyngitis
The causes of herpetic pharyngitis lie in infection with the herpes virus of the first and second types.
As a rule, infection occurs in childhood in one of the following ways:
Contact-household transmission through kisses, common household items, through toys, etc.
Airborne transmission through sneezing and coughing.
The vertical route of transmission from mother to child, during its passage through the birth canal.
Primary herpetic pharyngitis develops acutely, and after the symptoms of the disease subside, the virus remains forever in the human body. Thus, more than 90% of the adult population are infected with the herpes simplex virus, which exists in their body asymptomatically. In order for herpetic pharyngitis to manifest in adulthood, certain conditions must be created for this, which negatively affect the state of both local immunity of the throat mucosa and the overall immune defense of the body.
Factors that can trigger the development of the disease:
hypothermia;
Overheating;
Prolonged insolation;
Strong emotional shock;
Avitaminosis;
Taking high doses of antibacterial drugs;
Frequent SARS, frequent exacerbations of chronic pharyngitis;
Injuries of 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, inhaling polluted, smoky air.
Thus, any prolonged irritation to the mucous membrane of the throat can lead to inflammation and the development of herpetic pharyngitis if there is a decrease in local immune defense.
Symptoms of herpetic pharyngitis
Symptoms of herpetic pharyngitis are similar to those 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 bubbles of the rash are filled with serous contents. The rash covers the tonsils, can spread to the mucous membrane of the cheeks and the palate, later the tongue is involved in the process.
Vesicles, after a short time, turn into erosions, which are very painful.
Eating and even liquids becomes difficult, since any effect on erosion is given by a sharp pain. Therefore, patients refuse to eat and drink.
There is an increase in body temperature. The values on the thermometer can reach 38 ° C and above. Often the patient is in a feverish state. High body temperature lasts about 2-7 days. During this time, symptoms typical of fever persist: muscle pain, abdominal pain, headache, weakness, photophobia, etc.
Lymphatic regional nodes increase, become painful on palpation.
When the fever passes, which happens most often on the 3-5th day from the onset of exacerbation of pharyngitis, the patient’s condition improves. A week later, erosions on the back of the pharynx are epithelialized.
Herpetic pharyngitis is especially difficult in children under the age of 3 years. Sometimes the disease has blurred symptoms and develops according to the type of catarrhal pharyngitis. At the same time, vesicles and erosions on the mucous membrane of the throat and in the oral cavity do not occur. It is worth noting that herpetic pharyngitis in adulthood most often does not cause such a high rise in body temperature as in children. However, the pain of erosions formed by opened vesicles persists until the moment of their epithelialization.
Diagnosis of herpetic pharyngitis
Diagnosis of herpetic pharyngitis is built on the basis of the clinical picture of the disease, on the conducted pharyngoscopy and history taking. No less significant is the cytological, virological and serological examination.
To determine the type of pathogen, a throat swab is taken, although the virus can be detected in saliva and blood 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 manifestation of the disease. Once the vesicles have resolved and transformed into ulcers, antiviral medication will be ineffective.
Antiviral drugs in tablets. Herpetic pharyngitis can be treated with a one-day course of taking modern medicines in high dosages. Conducted studies prove that such a treatment regimen is no less effective than with a weekly intake of the same drugs, but at a lower dose. Among such drugs are Famciclovir (Minaker, Famvir), Valaciclovir (Valavir, Valtrex). You can also use the drug Acyclovir, but for the treatment of herpetic diseases it is prescribed less and less.
Antiviral drugs for the local treatment of herpetic pharyngitis. Local therapy is reduced to gargling 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 must be lubricated with Viferon-gel. This drug has both antiviral and immunomodulatory effects.
Symptomatic treatment. If the disease provokes an increase in body temperature, then an antipyretic 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 soreness of ulcers, anesthetics such as Lidochlor, Lidocaine Asept, etc. are used. Antihistamines – Tavegil, Fenkarol, Diazolin – help 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 epithelialized, it is necessary to apply keratoplastic agents to them – sea buckthorn and rosehip oil, Karotolin, vitamins E and A.
During the acute phase of the illness, food should only be offered in liquid or pureed form, and 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.