Catarrhal quinsy - the clinical form of sharp tonsillitis caused by a bacterial or viral upper respiratory tract infection and which is characterized by a local inflammation of lymphoid fabrics of almonds. The main symptoms – irritation in a drink and moderate pain when swallowing, the subfebrilny temperature, feeling of weakness, weakness, decrease in working capacity. At a faringoskopiya hyperemic and edematous almonds, and also palatal handles come to light. Regionarny lymph nodes are quite often increased and painful at a palpation, in blood test there can be small also an increase in SOE. Treatment – an exception of physical activities, antibiotic treatment, rinsings of a throat, physical therapy.
Catarrhal quinsy is the easiest form of primary inflammatory process with defeat of a lymphoid ring of a throat. At the favorable course of a disease of change stop at a catarrhal stage, and recovery occurs in 5-7 days. At decrease in immunity and the untimely beginning of antibiotic treatment the purulent inflammation with defeat of follicles or lacunas develops. It is necessary to distinguish primary quinsy which is shown catarrhal changes and secondary pathology at sharp infections (measles, scarlet fever, herpes, a mononukleoza etc.). Disease outbreaks are noted during the autumn and winter period, is more often at children and at persons up to 30-40 years.
Reasons of catarrhal quinsy
The main causal factor causing development of pathological changes in almonds – a bacterial or viral infection.
- Bacterial activators. Stafilokokkam are more often presented by a beta and hemolytic streptococcus of group A and other types of streptococci, is more rare - a stick of an influenza, morakselly , meningokokka and pneumococci.
- Viral infection. At children up to five years during the epidemic period adenoviruses and enteroviruses prevail. At teenagers and adults quinsy can develop at penetration of viruses of flu and paraflu, gerpesvirus.
The main way of transmission of infection – airborne though infection can occur also in the household way when using of objects on which there are causative agents of an infection. Sharp tonsillitis develops against the background of decrease in immune protection, overcooling, chronic diseases of a nasopharynx more often.
Symptoms of catarrhal quinsy
The sharp onset of the illness with prevalence of local manifestations is characteristic: dryness and irritation in a drink, unpleasant feelings when swallowing. The feeling of weakness, slackness disturbs, temperature increase to 37-38 °C is noted. At survey of a throat the isolated reddening of almonds in the absence of purulent contents comes to light. When probing uglochelyustny lymph nodes their increase and morbidity is noted.
Timely detection of catarrhal quinsy allows to start etiotropny therapy in the onset of the illness and to prevent transition to the following clinical forms: follicular and lacunary. At a favorable current the symptomatology passes within 3-5 days. The late address to the doctor and refusal of treatment quite often leads to development of complications. It both formation of chronic tonsillitis, and defeat of the remote bodies with development of myocarditis and endocarditis, polyarthritis, a glomerulonefrit.
The clinical picture of catarrhal quinsy is similar to a set of other diseases of a throat, infectious diseases therefore it demands performing careful diagnostics with participation of specialists doctors of various profile: pediatrician and therapist, otolaryngologist and infectiologist.
- Fizikalny survey. At a faringoskopiya it is possible to find existence of the poured hyperaemia of palatal almonds and edges of handles, their puffiness and increase in the sizes. At the same time purulent contents in lacunas and on a surface are absent, the accompanying signs of an inflammation of a back wall of a throat are not noted. Regarding cases it is possible to find a hypertrophy and morbidity of regionarny lymph nodes.
- Laboratory researches. For identification of the etiologichesky agent bacteriological or virologic analyses of dab from a pharynx are appointed. Activity of an inflammation is defined when performing all-clinical blood test (increase in SOE and quantity of leukocytes), signs of damage of kidneys – existence of changes in the analysis of urine (emergence of protein and erythrocytes, increase in number of leukocytes). Development of a revmokardit and polyarthritis can be found in the analysis of biochemical indicators of blood (increase in SRB, the Russian Federation, ASL-O).
Differential diagnostics is carried out with other diseases of a throat and nose (rinofaringity, sinusitis, adenoides), sharp respiratory infections and flu, secondary defeats of almonds at diphtheria, scarlet fever, a mononukleoza. At the same time the symptom of tonsillitis is only one of displays of an infection along with which there are signs of defeat of nasal ways and a wall of a throat, bronchial tubes and lungs, a digestive tract and integuments, system of blood.
Treatment of catarrhal quinsy
Main objective of treatment – elimination of the causative agent of an infection, the fastest elimination of activity of an inflammation, the prevention of complications. At a bacterial etiology antibiotics of a penicillinic row, macroleads or tsefalosporina are appointed, at viral quinsies – antiviral means. Purpose of medicines with the anti-inflammatory, antiallergenic and all-strengthening action, vitamins is shown. Local treatment with use of anti-septic tanks for rinsing of a throat, and also symptomatic means in the form of the aerosols and tablets for a rassasyvaniye eliminating or reducing unpleasant symptoms was widely adopted.
Treatment of tonsillitis with catarrhal changes is usually carried out in house conditions at observance of a bed rest in the first days of a disease and the maximum restriction of physical activities. The average duration of a disease – 4-6 days. Accession of complications demands continuation of treatment in office of otolaryngology with inclusion of glyukokortikosteroidny hormones, the medicines supporting function of heart, breath, kidneys, the central nervous system. At development of pyoinflammatory processes in surrounding cellulose surgical intervention with opening of paratonzillyarny abscess is shown.