Follicular angina in children: features of the disease

Follicular angina in children almost always proceeds very hard, with fever to febrile values, severe intoxication and severe malaise. The main feature of this disease is that it requires mandatory systemic administration of antibiotics to protect the sick child from complications on the heart and kidneys that can cause the pathogen.

At the same time, follicular angina in a child may resemble, in its clinical picture, some fungal and viral diseases that do not require the use of antibiotics and are treated with completely different means.

Therefore, in children it is extremely important to diagnose the disease and correctly prescribe medications with it.

What does follicular angina look like in children?

The main distinguishing feature of follicular angina in children is the presence of characteristic white or yellowish points on the surface of inflamed tonsils. These are festering follicles, in which a large number of bacteria, the products of their decay, and also the remnants of phagocytic cells of the immune system accumulate.

The photo shows a typical follicular sore throat in a child:

It can be seen that the abscesses themselves are under the surface of the amygdala and simply appear through the epithelial layer. Nevertheless, because of their size, they can slightly protrude the film and appear protruding on the surface.

Ulcers in follicular angina can have a round or elongated shape, but they are always well separated from each other. If they begin to merge with the transformation into a stain or a purulent mesh, the disease is already passing into the lacunar form with pus filling the mouths of the crypts.

For comparison, in the photo - lacunar angina:

And here again - follicular:

On a note! The transition of angina from one form to another is a rare phenomenon. Usually this occurs in the absence of treatment and a rapidly progressive inflammatory process. In children, the change in the form of the disease occurs more often than in adults. There is nothing critical in this transition, but lacunar angina occurs in children even heavier than follicular.

In parallel with the appearance of ulcers themselves tonsils with follicular angina inflame, become red and increase in size. Sometimes due to excessive inflammation they completely close the pharyngeal ring, and the child can not take any food at all.

In the photo - heavily inflamed tonsils with follicular angina:

Follicular angina is characterized by the spread of inflammation to the tissues surrounding the amygdala - soft palate, non-lingual and palate-pharyngeal arch. Moreover, the abscesses themselves are found only on tonsils.

In the language of the disease, whitish plaque may appear.

Follicular angina in children is almost always very difficult. It is characterized by:

1. A sharp increase in body temperature to 39-40 ;

2. Signs of intoxication: fever, chills, severe malaise;

3. Acute pain in the throat. A child with a sore throat can not swallow rough food - apples, bread, biscuits. He even has to drink, overcoming pain;

4. Pain in the muscles and head;

5. Increase and soreness of lymphatic vessels.

The bump on the neck on the left is the enlarged lymph node.

It is characteristic that the pain in the throat with follicular angina is often given in the ear, and the child can complain, including such feelings.

Children are also characterized by some symptoms of the disease, which are rarely seen in adults.

For example:

1. A child with a sore throat can vomit, sometimes vomiting begins;

2. Because of severe intoxication, there may be symptoms of meningism. The child is dizzy, he can lose consciousness.

At the same time, the follicular sore throat without temperature in the child does not arise. In this situation, we are talking about chronic tonsillitis, in which tonsils can appear on the surface of the tonsils, and sometimes even stoppers. Externally, this picture really resembles a follicular sore throat, but it is the absence of severe symptoms that indicates that the process is not acute, which means that there is no sore throat.

It can be clearly seen that hyperemia in chronic process does not extend to the palate and arches.

In detail about the cases when there is a suspicion of an atypical chronic angina without temperature, we talked separately.

When analyzing the blood in a child with a follicular sore throat, the following changes are observed:

1. ESR increases to 25-30 mm / h;

2. Increase in the number of stab granulocytes;

3. Neutrophilic leukocytosis to 13-14 * 109 / L.

In general, to diagnose follicular sore throat, the blood test is rarely done, because the visible signs of it are quite obvious.

At what age angina occur most often?

It is important to understand that the amygdala itself begins to form at the age of 6 months. Before that, they do not have it at all, and on the walls of the pharynx there is a small amount of lymphoid tissue, into which epithelium gradually grows.

This means that the follicular sore throat in a child younger than six months in principle can not occur, and in children under the age of 1 year is extremely rare. Around the year, the baby already has tonsils themselves, and from this age they can become inflamed, including when streptococcus is affected with the development of a typical sore throat.

Streptococcus is a bacterium that causes angina.

Likewise, follicular angina in a child of 2 years, although not a rarity, but also a frequent phenomenon does not happen. At this age, children communicate mostly with parents and close friends and rarely find themselves in a situation where infection is possible. Moreover, caring parents usually ensure that their child does not communicate with someone who has obvious signs of illness.

Usually, follicular angina occurs in a child 3 years and older. At this age, children are already actively communicating with their peers, visit the kindergarten and various development centers and, therefore, can become infected.

The causative agent of disease and modes of disease transmission

In 80% of cases, follicular angina in children is caused by hemolytic group A streptococcus, in 10% of cases - by some types of staphylococci, in about 10% of cases - by a mixed streptococcal-staphylococcal infection. There are practically no other forms of bacterial angina in children.

Follicular sore throat is never caused by viruses and fungi. Some viral infections can be accompanied by rashes and the appearance of a plaque on the tonsils, similar to those in follicular angina, but they can be distinguished from typical festering follicles.

Appearance of the patient's throat with fungal infection.

On a note! It is because of the fact that follicular angina is caused only by bacteria, this disease always requires the use of antibiotics. No other means can destroy bacterial infection. The lack of such effective treatment condemns the child to complications that can cause streptococcus, sometimes deadly, sometimes leading to disability, sometimes requiring surgery.

The causative agent of follicular angina is transmitted mainly in children's groups by airborne droplets. The child can also get infected from adults with other streptococcal infections - scarlet fever, erysipelas, chronic tonsillitis.

Colony of streptococcus on tonsillar mucosa

Less often follicular tonsillitis is transferred alimentary way (through food) and household - through clothes, hygiene items, utensils. To do this, the child must either live with the sick or vector of the infection, or for a long time to communicate with him in the kindergarten, camp or school.

Incubation period and course of follicular sore throat in a child

Follicular angina is always an acute disease. It develops very quickly, lasts for 10-12 days and ends. Neither in children, nor in adults, this disease never takes place in chronic form.

The incubation period with follicular angina lasts usually 2-3 days, in children it can sometimes be even less in cases of weakened immunity. As a rule, already in the middle - by the end of the second day after infection there are the main symptoms - sore throat, temperature and malaise. The further course of the disease depends on whether the antibiotic is taken or not.

If effective antibacterial therapy is performed:

1. 1-2 days after the onset of antibiotic treatment, the child becomes lighter, the temperature decreases slightly, the malaise diminishes, and the appetite appears;

2. On days 3-4 the diseases begin to ulcerate abscesses, erosions appear in their place, which after 2-3 days heal;

3. Approximately in 5-6 days after the beginning of treatment the inflammation of tonsils decreases, the temperature normalizes, the child starts to swallow normally food. At the same time, with normal health, you can walk with him;

4. After 10-12 days, a full recovery occurs.

When taking antibiotics, follicular angina in children is contagious for about 2 days. Already by the end of the first day of treatment of the pathogen in tonsils practically does not remain and to catch from the patient it is impossible. The remaining symptoms persist because of the restoration of streptococcal-affected tissues.

If antibiotics are not taken, the course of the sore throat may be unpredictable. Usually for 3-4 days break abscesses, on 6-8 days the temperature drops and passes inflammation. At the same time, manifestations of complications can begin - pain in the heart, development of abscesses, symptoms of meningitis and otitis.

Do tonsillitis contagious during the incubation period?

In the incubation period, follicular angina in children is contagious only at the end with the appearance of the first symptoms - a swelling in the throat, fever, malaise. Until the symptoms are manifested, the pathogen in the tissues is not much and it does not stand out with saliva, which means that the disease is not contagious.

Nevertheless, it is impossible to unequivocally determine the moment when a sick child begins to spread the infection. If yesterday two healthy-looking children were playing together, and today one of them has fallen ill with a sore throat, perhaps the second day will fall ill.

Diagnosis of follicular sore throat

In most cases, follicular angina in children is diagnosed by a doctor when examining the throat and assessing the symptoms. In contrast to the catarrhal form of the disease, follicular angina is difficult to confuse with viral pharyngitis and laryngitis, and therefore special tests are required very rarely.

In some cases, it is necessary to diagnose the causative agent of the disease, then to designate effective antibiotics. For this, a rapid test for streptococcus or staphylococcus is performed, sometimes a smear is applied for bacterial inoculation. However, in these situations, angina is already established and only the identification of its pathogen is made.

In diagnosis, follicular tonsillitis usually has to be distinguished from such diseases:

1. Infectious mononucleosis, in which the white thick coating covered tonsils. In this case, the plaque itself does not form points characteristic for follicular angina;

2. Gerpangines, in which vesicles characteristic of herpes infection appear on the palate, gingiva, back of the throat and tonsils. It is their inexperienced parents who can be confused with suppurative follicles. The doctor will confidently distinguish these papules from abscesses in angina, and additionally their spread to the surrounding tonsils tissues will not allow him to make a mistake in diagnosis;

3. Viral stomatitis. Here the situation is similar to the herpangina - sores in stomatitis are well distinguished from ulcers and are present in those areas where the abscesses themselves do not appear;

There are sores on the surface of the soft palate with viral stomatitis. They are very painful, but pass quickly enough

4. Fungal tonsillitis or pharyngitis, in which cheesy plaque covers the entire throat and is easily removed, unlike pus in the places of inflamed follicles;

5. Chronic tonsillitis and congestion in the tonsils. From them, angina differs acute course and severe symptoms.

In addition, with viral infections of the throat, in most cases, a runny nose develops. With angina, a cold does not happen.

Typically, the doctor without any problems distinguishes follicular angina from these diseases when examining the throat. These diseases are confused more often by parents who do not want to lead the sick child to the hospital and expect to cope with the sore throat on their own. This approach is very dangerous, because with him you can make mistakes both in diagnosis and in choosing medicines.

Suffer in the end is the child: if the follicular sore throat is taken for a viral illness and does not conduct the correct treatment, it is possible the development of severe complications. Therefore, at the slightest suspicion of a sore throat of a sick child, it is necessary to show the doctor. The treatment itself is then carried out at home, but by those funds that the specialist will prescribe.

Read on how the follicular sore throat is treated in children.

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