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Acute tonsillitis (angina) and acute pharyngitis in children

 
, medical expert
Last reviewed: 23.04.2024
 
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Acute tonsillitis (tonsillitis), tonsillopharyngitis and acute pharyngitis in children are characterized by inflammation of one or more components of the lymphoid pharyngeal ring. For acute tonsillitis (angina), a typical acute inflammation of the lymphoid tissue is mainly palatine tonsils. For tonsillopharyngitis is characterized by a combination of inflammation in the lymphoid pharyngeal ring and pharyngeal mucosa, and for acute pharyngitis is characterized by acute inflammation of the mucous membrane and lymphoid elements of the posterior pharyngeal wall. In children, tonsillopharyngitis is often noted.

ICD-10 code

  • J02 Acute pharyngitis.
  • J02.0 Streptococcal pharyngitis.
  • J02.8 Acute pharyngitis due to other specified pathogens. J03 Acute tonsillitis.
  • J03.0 Streptococcal tonsillitis.
  • J03.8 Acute tonsillitis caused by other specified pathogens.
  • J03.9 Acute tonsillitis, unspecified.

Epidemiology of angina and acute pharyngitis in children

Acute tonsillitis, tonsillopharyngitis and acute pharyngitis develop in children mainly after the age of 1.5 years, which is due to the development of lymphoid tissue of the pharyngeal ring at this age. In the structure of acute respiratory infections, they constitute at least 5-15% of all acute respiratory diseases of the upper respiratory tract.

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Causes of angina and acute pharyngitis in children

In the etiology of the disease there are age differences. In the first 4-5 years of life, acute tonsillitis / tonsillopharyngitis and pharyngitis are mainly viral in nature and are caused most often by adenoviruses, in addition, the viruses of herpes simplex and enteroviruses Coxsackie can cause acute tonsillitis / tonsillopharyngitis and acute pharyngitis. Since the age of 5, the B-hemolytic streptococcus of group A (S. Pyogenes), which becomes the leading cause of acute tonsillitis / tonsillopharyngitis (up to 75% of cases) at the age of 5-18 years acquires great importance in the onset of acute tonsillitis . Along with this, the causes of acute tonsillitis / tonsillopharyngitis and pharyngitis can be streptococci of group C and G, M. Pneumoniae, Ch. Pneumoniae and Ch. Psittaci, influenza viruses.

Causes of angina and acute pharyngitis in children

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Symptoms of angina and acute pharyngitis in children

For acute tonsillitis / tonsillopharyngitis and acute pharyngitis is characterized by an acute onset, usually accompanied by a rise in body temperature and deterioration of the state, the appearance of pain in the throat, the refusal of young children from eating, malaise, lethargy, other signs of intoxication. On examination, the redness and swelling of the tonsils and mucous membrane of the posterior pharyngeal wall, its "granularity" and infiltration, the appearance of purulent exudation and raids mainly on the tonsils, the increase and soreness of the regional anterolateral lymph nodes are revealed.

Symptoms of angina and acute pharyngitis in children

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Classification of angina and acute pharyngitis in children

Primary tonsillitis / tonsillopharyngitis and pharyngitis and secondary can be isolated, which develop in infectious diseases such as diphtheria, scarlet fever, tularemia, infectious mononucleosis, typhoid fever, human immunodeficiency virus (HIV). In addition, they release a mild form of acute tonsillitis, tonsillopharyngitis and acute pharyngitis and severe, uncomplicated and complicated.

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Diagnosis of angina and acute pharyngitis in children

Diagnosis is based on a visual assessment of clinical manifestations, including mandatory examination of the otolaryngologist.

In severe acute tonsillitis / tonsillopharyngitis and acute pharyngitis, and in cases of hospitalization, peripheral blood analysis is done, which in uncomplicated cases reveals leukocytosis, neutrophilia and shift of formula to the left with streptococcal etiology of the process and normal leukocytosis or a tendency to leukopenia and lymphocytosis in the viral etiology of the disease.

Diagnosis of angina and acute pharyngitis in children

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Treatment of angina and acute pharyngitis in children

Treatment varies depending on the etiology of acute tonsillitis and acute pharyngitis. With streptococcal tonsillopharyngitis, antibiotics are shown, when viral, they are not shown, with mycoplasmal and chlamydia - antibiotics are shown only in cases when the process is not limited to tonsillitis or pharyngitis, but descends into the bronchi and lungs.

The patient is shown bed rest in the acute period of the disease on average 5-7 days. Diet is normal. Rinsing of the throat with 1-2% Lugol solution is shown. 1-2% hexethathium (hexoral), etc. Warm drink (milk with Borjomi, milk with soda - 1/2 teaspoon of soda for 1 glass of milk, milk with boiled figs, etc.).

Treatment of angina and acute pharyngitis in children

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