Herpangina is one of the most common viral diseases in children. Almost everyone experiences this disease in childhood, although this diagnosis also occurs in adults. From a scientific point of view, the very name “herpetic sore throat” was incorrectly given to the disease. Previously, the disease was little studied. Scientists, noticing the similarity of rashes during the disease with those of herpes, came to the conclusion that the causative agent of the disease was the herpes virus, and gave the disease a name that has stuck and is found in the medical literature in exactly this form. Although the disease has nothing in common with herpes infection. It has been established that the cause of herpetic sore throat is enteroviruses - Coxsackie viruses of groups A and B and ECHO viruses (echoviruses). In medical reference books you can find different versions of the names of this disease: aphthous tonsillitis, vesicular pharyngitis, herpetic tonsillitis, herpangina, etc.
As already mentioned, children under ten years of age are at risk: infants, preschoolers and children of primary school age. The severity of the disease depends on the age of the child. The disease is most severe in children in the first year of life. Preschoolers are more often infected because at this age they do not pay due attention to hygiene, have contact with animals and are often in children's groups. To become infected, it is enough to eat unwashed fruit. This should also include the immaturity of immunity at an early age. The disease is highly contagious, and often its outbreaks become epidemic. It is noteworthy that this disease does not occur in babies in the first months of life - the antibodies found in mother's milk create some kind of immunity to herpangina.
One can trace the obvious seasonality of herpetic sore throat: the peak occurs in summer and autumn. As a rule, having been ill once, a child becomes immune to re-infection, so this disease is less common among adolescents and adults.
Infection can occur in one of three ways:
- airborne
- contact
- fecal-oral.
With the airborne method, infection occurs by sneezing, coughing, or talking with a carrier of the virus. In case of contact - through discharge from the nasopharynx. With the fecal-oral method - through dirty hands, through unwashed food, toys and pacifiers, which is especially typical for children.
Even a recovering person can still spread the infection around him for about a month, so it is believed that herpes sore throat is highly contagious: a child can easily become infected in kindergarten from a baby who does not even have obvious symptoms of the disease. If one family member gets sick, most likely everyone will suffer from the disease.
How does infection spread throughout the body? First, the virus from the nasopharynx reaches the intestinal lymph nodes through the lymph flow. Already in the intestines, the virus gains strength and enters the blood, and severe inflammation begins in the oropharynx.
What are white dots on the tonsils
Plaque can take the form of single white dots of varying sizes - from one to several millimeters. Their consistency can be soft, cheesy (caseous), dense or hard.
Every day, the tonsils encounter microbes that enter through the nasopharynx. In the lacunae, pathogenic microorganisms come into contact with the epithelium of the tonsils. In response to the penetration of bacteria, local inflammation develops. It activates the immune system and the production of antibodies.
The epicenter of resistance to infection is the follicles of the tonsils. They are groups of lymphoid immunocompetent cells. The result of the struggle is accumulation of destroyed cells and bacteria in the lacunae and at the site of the follicles. Gradually the plugs are impregnated with calcium salts and harden.
The resulting white dots on the tonsils consist of:
- from the remains of dead leukocytes;
- destroyed epithelial cells;
- microbes;
- calcium salts.
Bacterial examination of the contents of plugs reveals streptococci, staphylococci, and pneumococci.
What kind of disease is this and what are its causes?
Chronic tonsillitis is the most common cause of plug formation.
In addition, white lumps on the tonsils may appear:
- with weakened immunity;
- frequent sore throats;
- herpetic infection;
- fungal infection - candidiasis;
- caries;
- viral infections - influenza, ARVI.
With and without fever
The appearance of white spots on the tonsils may be accompanied by an increase in temperature. This is observed:
- with follicular or lacunar tonsillitis;
- influenza and acute respiratory viral diseases;
- herpetic infection;
- exacerbation of chronic tonsillitis.
The tonsils enlarge, their hyperemia and swelling are revealed, their surface loosens.
White spots on the tonsils may appear without fever. This happens:
- with candidiasis;
- with chronic tonsillitis without exacerbation.
To establish the cause of white dots on the tonsils, it is necessary to do a bacteriological analysis of them.
White lumps with an unpleasant odor
With chronic tonsillitis, white lumps with an unpleasant odor appear in the tonsils. They often have a cheesy or hard consistency. They are called tonsilloliths. The putrid odor is caused by the activity of pathogenic microorganisms. The disease occurs without sore throat.
With inflammatory processes in the throat or nasopharynx, tonsillitis increases.
Other symptoms
With exacerbation of chronic tonsillitis, follicular or lacunar tonsillitis, in addition to plaque on the tonsils, there is a sore throat, difficulty swallowing, enlargement and tenderness of the submandibular lymph nodes. Symptoms of intoxication appear: headache, weakness, lack of appetite. At night there may be heavy sweats and sleep disturbances.
With acute respiratory viral infections, patients complain of body aches, pain in the muscles and when moving the eyeballs, cough, runny nose, and chest congestion.
Symptoms of the disease
As a rule, the highest concentration of fungus is found on the surface of the inside of the cheeks, tongue, pharynx and tonsils, and palate. At an early stage of the development of the disease in children, redness of the mucous membranes is observed; they become swollen, the sensitivity of the mucous membrane increases, which is why children are often irritable, capricious, and their appetite and sleep are disturbed. The primary episode of the disease usually occurs in a more acute form; Patients may experience general symptoms: fever, headaches and dizziness, nausea or vomiting, deterioration in general health.
Some time after the onset of the disease, white grains begin to appear on the surface of the mucous membranes of the oral cavity, which gradually increase in size and merge together, forming plaques, and then plaque covering large areas of the mucosa. During this stage, patients suffer from severe dryness and swelling in the mouth. The mucous membranes become painful. Burning, itching and other unpleasant sensations are most often associated with the development of an allergic reaction caused by the proliferation of pathogenic microorganisms and the release of toxins during their life processes. The pain intensifies when eating and swallowing food, when eating hot, sour, spicy foods and drinks. Infants often refuse to eat.
The plaque formed during candidiasis has a very characteristic appearance and resembles milk films or remains of cottage cheese. It consists of destroyed cells of the mucous membranes, food debris, bacterial mass, fibrin and keratin. Flakes, scales and plaque can also appear outside the mouth - on the edges of the lips. The spread of infection to the lips is called candidiasis. Because of this disease, the skin in the corners of the lips dries out and cracks; In some cases, the infection affects the entire surface of the lips, resulting in cracking and peeling.
In mild and moderate forms of the disease, plaque is easily scraped off, and underneath it, areas of erosion (ulceration) or maceration (softening) of the mucous membrane are found. A longer course of the disease and the lack of adequate treatment leads to deep damage to the mucous membranes, as a result of which blood appears on their surface, turning the plaque brown or brownish.
After ARVI in a child
Children suffer from acute respiratory viral diseases quite often. This is due to:
- immaturity of the child’s immune defense mechanisms;
- high crowding in children's groups.
Sometimes after an acute respiratory viral infection, white dots or spots are found on the child’s tonsils, enlargement, swelling of the tonsils, and redness of the palatine arches. This indicates the addition of a bacterial infection and the development of a sore throat. In this case, you should immediately seek medical help.
Timely and correct treatment of sore throat will protect the child’s body from complications.
A white coating may appear on the child’s tonsils without fever. This happens when oral thrush occurs. Thrush is a fungal disease caused by pathogenic fungi of the genus Candida. Candidiasis often develops during antibiotic treatment. The diagnosis is made based on examining a smear from the tonsil under a microscope. Specific antifungal drugs are used in treatment.
White spots in a child's throat
In infants, the main cause of whitish plaque on the oral mucosa is candidiasis. This is due to the complete sterility of the baby’s skin and mucous membranes at birth.
Therefore, by inhaling air, receiving mother’s milk or formula from a bottle, or putting his fingers into his mouth, the baby populates the oral cavity with microflora. Sometimes in this way he becomes infected with a fungal infection, which causes unpleasant symptoms.
On the throat of a preschool child, a white coating most often forms against the background of acute tonsillitis.
Sore throat is an exclusively bacterial disease, fraught with serious complications, therefore it must be treated with the utmost care and not neglect antibiotics.
A red throat with white dots in a child rarely indicates the presence of diphtheria, since most modern people are vaccinated against this extremely dangerous infectious disease.
- Thick white snot in adults and children - causes and treatment
Attention
If you suspect the development of this pathology, you should immediately call an ambulance and go to the hospital inpatient department for the administration of anti-diphtheria serum. This can save a child's life.
In any case, if a child has spots on the tonsils, especially against the background of fever and poor general health, he should be seen by a doctor immediately.
How to remove white dots
In order to remove white lumps in the tonsils, use local antiseptic bactericidal agents. They are available in a wide range in the form of sprays, lozenges or tablets. Rinsing helps a lot. Traditionally, solutions of soda, table salt with iodine, furatsilin, chamomile and sage decoctions are used for this. You can use a solution of Metrogyl, Miramistin.
It is impossible to clean the tonsils from white lumps at home. This is done by an otolaryngologist by vacuum extraction of plugs or washing the tonsils with antiseptic solutions.
It is not recommended to remove a white dot containing pus from the tonsil on your own. In the acute period of the disease, this is prohibited.
Treatment of herpes sore throat in children
There is no specific antiviral treatment. Treatment of the cause of herpetic disease should be carried out according to the following scheme:
- isolation of the patient
- drinking plenty of fluids, bed rest
- actions aimed at relieving and alleviating symptoms.
At the moment, no drug has yet been invented that can kill the causative agent of the disease. You can only alleviate or remove the symptoms. A person recovers completely only when the body develops immunity to the virus. Usually the body takes a week to do this.
First of all, it is advisable to isolate the child from other family members - separate dishes, linen and towels - the disease is contagious. For herpetic sore throat, children are prescribed antihistamines to relieve swelling and irritation. "Claritin", "Suprastin" and others are suitable. To reduce the temperature, use antipyretics: Nurofen, Efferalgan, Paracetamol, etc. To relieve pain in the throat, gargle with decoctions of sage, chamomile, calendula, salt or soda solution. Rinsing should be done every hour. You can use special sprays and aerosols: Hexoral, Ingalipt, Tantum-Verde. Tablets and lozenges relieve pain. It is advisable to use the antiseptic agents Miramistin and Chlorhexidine.
For successful recovery it is necessary to create favorable conditions for the child. It is necessary to provide conditions for sleeping in a well and frequently ventilated room. The diet should consist of soups, purees, and cereals. Food should not be hot so as not to irritate a sore throat. Don't forget about drinking plenty of warm drinks. The patient can be given rosehip decoction, tea with jam or honey.
Note to parents! In case of herpes sore throat, do not inhale, warm up or apply compresses under any circumstances. Such measures will only activate viruses, and the disease will drag on.
Some parents mistakenly lubricate the bubbles in the larynx with iodine or brilliant green. This measure is absolutely ineffective, does not bring any practical benefit, but causes severe pain to the baby.
There is no need to give your child antiherpetic drugs such as Acyclovir and its analogues. As we have already mentioned, the course of the disease has nothing to do with the herpes virus.
Correct treatment
For the treatment of sore throat, or exacerbation of chronic tonsillitis, in an adult the following is prescribed:
- Broad-spectrum antibiotics.
- Irrigation or washing of the tonsils with an antiseptic solution.
- Gargling with bactericidal agents.
- Complex vitamin therapy to improve immunity.
- Physiotherapy.
White lumps on the tonsils are removed by vacuum cleaning the tonsils.
Accurate fulfillment of all doctor’s orders contributes to a quick recovery. Incorrect or self-treatment can lead to the development of complications.
