Lacunar angina is a form of acute tonsillitis, which is characterized by purulent inflammation in the lacunae, that is, the folds of the tonsils. This form of the disease is more severe than follicular tonsillitis. In its pure form, it is rare. Most often it develops on the background of follicular.
The main risk group for the incidence of this type of sore throat are children aged 5 to 12 years. In adults, this type of angina is most common in combination with another variant of the disease, that is, there is a mixed type. Treatment of lacunar tonsillitis in adults, as in children, is carried out by a course of antibiotics that eliminate the unpleasant symptoms of angina.
Adults tend to tolerate the disease more easily than children, but in the absence of proper and timely treatment, even adults can develop undesirable complications, including myocarditis, acute otitis media, pyelonephritis, rheumatism, pneumonia, etc.
Why does lacunar tonsillitis occur, and what is it? Streptococci are the main causative agent, but it can also be caused by adenoviruses and staphylococci. That is why this disease is considered contagious. It is transmitted by airborne droplets when sneezing, coughing a sick person or by contacting children - through toys and other infected objects.
Also, a variety of surgical interventions in the oral cavity and dental diseases can cause sore throat. External factors can also cause disease. These include - hypothermia, drafts, sudden changes in air temperature, dampness, air pollution.
Features of this form of the disease
This clinical form of angina got its name due to the fact that during it the purulent-inflammatory process is localized in the gaps of the tonsils. There are a lot of these lacunae in the thickness of the tonsils, therefore, when the waste products of pathogenic streptococci, together with necrotic masses and desquamated epithelium, rise to the top, large patches of plaque appear on the lymphatic formations.
This distinguishes the lacunar tonsillitis from the follicular (another clinical form of angina), in which only some follicles located in the tonsils are inflamed, which looks like small pustules on the surface of lymphatic formations.
Symptoms of lacunar tonsillitis
The incubation period of lacunar tonsillitis lasts 1-2 days, and its symptoms develop rapidly and can appear in a couple of hours.
The main signs of lacunar angina in adults and children include:
- a sharp rise in body temperature to high numbers (38.5-40) s
- common manifestations of the infectious process in the form of weakness, malaise, fatigue and headache;
- recurrent chills, which is more common in children;
- pain in the joints;
- local manifestations in the form of severe sore throat and enlarged submandibular lymph nodes.
On examination, the doctor will find typical manifestations of the inflammatory process in the throat:
- redness in the larynx;
- swelling of tissues in the throat;
- yellowish-whitish plaque, which occupies most of the surface of both palatine tonsils, which is easily removed with a spatula.
The inflammatory process can affect both one and both tonsils. The average duration of the disease is 5-9 days, and full working capacity is restored to 14-17 days. In children, lacunar tonsillitis has a more severe course, accompanied by convulsions, asthma, abdominal pain, nausea, vomiting, diarrhea, pain in the stomach.
Further spread of the infection through the respiratory tract often causes the addition of bronchitis and even pneumonia. Inadequate treatment can provoke the appearance of a chronic form of the disease, often with a complication of other types of tonsillitis, pharyngitis.
The presence of infection and purulent processes occurring cause the separation of bacteria throughout the body, deposited on the heart, lungs, bones. The consequences of this phenomenon are very dangerous - inflammation of the kidneys (pyelonephritis, glomerulonephnitis), rheumatism, arthritis, myocarditis, staphylococcal meningitis, generalized lymph node injury, abscesses, sepsis.
Lacunar angina: photo
What this form of sore throat looks like, we offer to view detailed photos.
Treatment of lacunar tonsillitis
In most cases, conservative treatment is indicated, and in the absence of effect, in the case of an acute increase in the tonsils, with difficulty breathing, surgical removal of the tonsils is indicated.
When the first symptoms of lacunar tonsillitis appear, the patient must be isolated from others and provided with bed rest (a sore throat cannot be carried on the legs, this often leads to complications). The issue of hospitalization is dependent on the severity of the pathogenesis.
The course of treatment should appoint a specialist. He will interview the patient, examine his throat, determine the causative agent of the disease and its sensitivity to antibiotics with the help of analyzes, after which he will prescribe the necessary drugs in this case.
To cure a sore throat at home, we recommend the following:
- Reception appointed by the doctor of antibacterial drugs.
- To alleviate the general condition, antipyretic or nonsteroidal anti-inflammatory drugs can be taken. This is all known Aspirin, Ibuprofen, Paracetamol. The essence of this appointment is to alleviate the patient's condition by reducing the temperature, reducing laryngeal edema.
- It is very important, especially in the first 2 days of the disease, hourly gargling with antiseptic solutions - Miramistin, Chlorophyllipt, Iodinol, Furacilin (2 tablets per glass of water), a weak solution of potassium permanganate. At the stage of recovery, you can change them to infusions and decoctions of medicinal herbs - chamomile, calendula, oak bark, sage. For local treatment, you can use different sprays - Ingalipt, Geksoral, Tantum Verde.
- During treatment, it is important to pay great attention to drinking, so that there is no dehydration.
It is also important after the end of the acute period of the disease to undergo a course of vitamin therapy and probiotics, because purulent processes, prolonged intoxication weaken the immune system, and treatment with antibiotics violates the natural intestinal microflora.
Antibacterial therapy is indicated for the microbial etiology of lacunar angina. Antibiotics are used as drugs, and sulfanilamide preparations are much less common. The purpose of prescribing drugs - eradication (destruction of the pathogen).
Proper selection of antibiotics provides:
- complete destruction of the pathogen;
- elimination of side effects in various diseases associated with angina;
- balance of effect and safety of the antibiotic.
The first-line drugs for purulent sore throat are modern penicillins, combined with their reinforcing components, as they best deal with streptococci. Such drugs include Augmentin, Flemoklav, Ecoclav and many others. It is also allowed to take penicillins in monoform (Ampicillin, Amoxicillin).
If you are allergic to penicillins, they are treated with macrolide antibacterial drugs (Sumamed, Azithromycin, Zitrolide, Klacid). Cephalosporins antibiotics are prescribed for recurring angina or severe disease. These include Cefalexin, Ceftriaxone, Cefazolin, which in the hospital often put in the form of injections.
It is necessary to drink a full course of antibiotics prescribed by a doctor in order to avoid the recurrence of the disease and the development of complications. The course of antibiotics for lacunar tonsillitis is usually 7-10 days. If you feel better after 2-3 days, and you decide that you are cured, then in no case do not cancel the prescribed drug.