Viral tonsillitis in children most often means secondary acute inflammation of the palatine tonsils in viral diseases of various etiologies.. Symptoms of the disease, depending on the pathogen, can manifest themselves with different intensity and are most often a sign of an acute respiratory viral infection..

Viruses that cause angina are most often transmitted by airborne droplets. Inflammation of the tonsils can occur under the influence of influenza and parainfluenza viruses, Coxsackie A and B, adenoviruses, rhinoviruses, respiratory syncytial virus, Epstein-Barr virus and others.

Coxsackieviruses of group A and less often group B cause herpetic sore throat, Epstein-Barr virus - infectious mononucleosis.

The inflammatory process in the palatine tonsils can cause the influenza virus. Infection transmission occurs mainly by airborne droplets, less often by contact and food.. Viruses are characterized by low resistance in the external environment, are very sensitive to the action of disinfectants, heat, ultraviolet radiation and drying.. The source of infection is a sick person or a healthy bacterial carrier. Symptoms may begin several hours after infection.

Viral diseases are widespread, but acute tonsillitis does not always develop against the background of infection.. This is primarily due to the reactivity of the body, the presence of concomitant diseases, as well as mechanical, chemical or thermal damage to the mucous membrane of the tonsils.. Predisposing factors may also include:.

the presence of chronic foci in the ENT organs;

immunodeficiency states or features of the immune response;

passive smoking, in which tobacco smoke irritates the mucous membranes and leads to a violation of the barrier function;

various anomalies in the development of the upper respiratory tract.

It should be remembered that frequent viral infections are not a sign of immunodeficiency, but only indicate a high level of contact between the child and the source of infection..

If bacterial complications occur, the specialist selects an antibiotic depending on the allergic history, the age and weight of the child, the suspected or proven bacterial agent.

Peak susceptibility to viral infections occurs between 6 months and 3 years of age..

Symptoms of viral tonsillitis in children Common signs of a viral lesion of the palatine tonsils include the following symptoms:.

acute onset of the disease;

an increase in body temperature up to 39 ° C and above;

chills, general weakness;

headaches, dizziness;

sharp pain in the throat, aggravated by talking, swallowing;

hoarseness of voice, nasality;

muscle and joint pain;

runny nose, difficult nasal breathing;

enlargement and soreness of regional lymph nodes.

During illness, the child prefers pureed food that does not irritate the sore throat Due to pain in the throat, the child refuses to eat or prefers soft, non-irritating food. Possible dyspeptic symptoms: nausea, vomiting, loose stools.

Diagnosis of viral sore throat Primary examination and diagnosis can be carried out by a pediatrician, otorhinolaryngologist or infectious disease specialist.

Primary diagnosis includes examination and history taking. When making a diagnosis, anamnesis data and clinical manifestations are taken into account.. The doctor conducts an examination and pharyngoscopy. In the photo of the throat taken during pharyngoscopy, you can see the main pathological changes in tonsillitis.

According to the indications, laboratory and instrumental methods of research are prescribed. In severe situations, the help of specialized specialists is required: a rheumatologist, a cardiologist, an immunologist.

The pharyngoscopic picture of acute inflammation of the tonsils against the background of a viral infection is characterized by the presence of bright hyperemia and swelling of the mucous membrane of the oropharynx, mainly in the region of the palatine arches, tonsils and posterior pharyngeal wall.. Easily removable plaque is determined on their surface..

In a clinical blood test with a viral infection, a shift in the leukocyte formula to the right is observed due to an increase in the number of lymphocytes.. Often the number of leukocytes is reduced. But depending on the reactivity of the body, leukocytosis is possible..

Virus isolation by serological testing is rarely used for practical purposes..

It should be remembered that bacterial tonsillitis may be hidden behind the clinical picture of a viral lesion..

In order to further confirm the preliminary diagnosis or possible correction of treatment (if a bacterial agent is detected), it is recommended to do a bacteriological culture of discharge from the surface of the tonsils and the posterior pharyngeal wall.

To exclude pyogenic streptococcus, an express test is performed To exclude the presence of beta-hemolytic streptococcus in case of sore throat, an express test is performed, which makes it possible to recognize classic streptococcal tonsillitis in time, in which it is very important to start antibacterial treatment from the first days of the disease. This is due to a number of complications from the heart, kidneys and other organs, which leads to group A beta-hemolytic streptococcus..

Features of diagnosisDepending on the etiological agent, the disease may have its own characteristics in the clinical picture and in diagnosis..

Adenovirus tonsillitis is manifested by fever, pharyngitis and conjunctivitis. The disease begins acutely with fever and muscle pain.. Within a few hours, there is a sore throat, inability to swallow, watery eyes, itching and photophobia.

With adenovirus angina, photophobia and lacrimation occur. On examination, redness and swelling of the conjunctiva of the eyeball, eyelids, enlargement and pain on palpation of the parotid, cervical and submandibular lymph nodes are noted..

With pharyngoscopy, pronounced manifestations of acute pharyngitis are determined. There is hyperemia and swelling of the palatine arches, tonsils, uvula, posterior pharyngeal wall, on the mucous membranes - point or confluent whitish plaques.

In a clinical blood test with a viral infection, a shift in the leukocyte formula to the right is observed due to an increase in the number of lymphocytes.. Often the number of leukocytes is reduced.

With adenovirus infection, acute otitis media and tracheobronchitis may develop..

Herpetic sore throat is more common in children of a younger age group. The disease begins acutely with high body temperature and chills.. Older children complain of sore throat, abdominal area and headache. Frequent vomiting and loose stools. The child becomes lethargic, lethargic.

Herpetic sore throat is characterized by a pronounced intoxication syndrome.. Fever can lead to seizures. Muscle, joint and headaches cause painful perception of external stimuli (sound, light, touch). Regional lymph nodes are enlarged and painful.

Herpetic sore throat is characterized by the appearance of vesicles on the mucous membrane of the pharynx. In pharyngoscopy, diffuse hyperemia of the mucous membrane of the pharynx, tonsils, palatine arches, uvula and soft palate, small reddish vesicles are determined.. The largest number of bubbles is located on the tonsils. Rashes appear non-simultaneously: in some places they form, in others they scar. 1-2 days after the appearance of the bubble, its contents become cloudy, burst and form a surface erosion of irregular shape, covered with a fibrinous coating.. Within 3-4 days, ulcerations are scarred. By this time, the body temperature decreases, and the severity of the clinical manifestations of the disease decreases..

In the clinical analysis of blood, leukopenia and a shift of the leukocyte formula to the right are noted..

Infectious mononucleosis is characterized by an acute onset - with chills and a sharp increase in body temperature. There are rapidly growing symptoms of intoxication, sore throat. Angina with mononucleosis is also a symptom of the disease, not the cause.

With pharyngoscopy, the tonsils are sharply enlarged, uneven, bumpy with a yellowish or gray coating on the surface.. The lingual tonsil is often affected. Pronounced swelling of the anterior arch. All this leads to difficulty breathing, especially in young children with damage to the pharyngeal tonsil.. There is a putrid smell from the mouth. In rare cases, there may be ulcerative necrotic changes in the tonsils..

With infectious mononucleosis, there is a systemic generalized enlargement of the lymph nodes A distinctive feature of infectious mononucleosis is a systemic generalized enlargement of the lymph nodes. Cervical, submandibular, axillary, inguinal, mesenteric and abdominal lymph nodes are affected. They increase in size, but at the same time they are not painful and do not suppurate..

On examination, the doctor may detect an increase in the liver and spleen, which are observed on the 2nd–4th day of the disease and disappear after a few weeks after recovery. Rarely edema of the cervical tissue is found.

With pharyngoscopy, a significant swelling and hyperemia of the palatine tonsils, the posterior pharyngeal wall is determined, on which a significant number of enlarged follicles is visualized.

With infectious mononucleosis, a lymphocytic reaction is clearly visible in a clinical blood test.. An increase in the number of monocytes is determined, the appearance of atypical mononuclear cells.

How to treat viral sore throat in a child With viral sore throat, antiviral, symptomatic, restorative and local treatment is used. Most often, therapy is carried out on an outpatient basis..

It is important to improve nutrition. Salty, spicy and sour foods are excluded. Food should be rich in vitamins, but not irritating or rough..

Frequent drinking recommended. With fever, the drug Regidron is prescribed to restore the water-salt balance.

Local treatment includes frequent gargling with disinfectant and antiseptic solutions:.

Chlorhexidine or Miramistin solution;

sodium bicarbonate solution;

hydrogen peroxide solution;

warm decoction of sage, calendula, chamomile.

Antiseptics can be prescribed in the form of spraysAntiseptics are also prescribed in the form of a spray or lozenges: Tantum Verde, Geksoral, Grammidin.

Drug treatment of viral sore throat in children occupies a leading position. It must be remembered that the use of antibiotics for respiratory viral infections is unreasonable.. They do not act on the virus and do not prevent bacterial complications..

The range of antiviral drugs approved for use in pediatric practice is quite narrow..

Herpetic sore throat is more common in children of a younger age group. The disease begins acutely with high body temperature and chills.. Older children complain of sore throat, abdominal area and headache.

Not numerous are a number of drugs that activate the nonspecific resistance of the child's body: interferons and their inducers, as well as adaptogens of various origins..

Isoprinosine has an immunomodulatory and antiviral effect, which increases the production of interleukins..

Symptomatic therapy is aimed at stopping concomitant symptoms: headache, runny nose, fever.

With an increase in body temperature above 38 ° C, non-steroidal anti-inflammatory drugs are recommended: Paracetamol, Ibuprofen. With subfebrile condition, it is not advisable to use antipyretics.

To reduce tissue edema, antihistamines are prescribed (Zodak, Suprastin).

If bacterial complications occur, the specialist selects an antibiotic depending on the allergic history, the age and weight of the child, the suspected or proven bacterial agent.

Side effects of drugs develop more often in children than in adults, therefore, when symptoms of angina appear, it is important to seek treatment from a specialist.

Complications of viral tonsillitis in children The treatment of acute tonsillitis should be taken very seriously and comprehensively, otherwise the risk of complications increases.

One of the possible complications of angina is otitis media. Most often in children, inflammation of the tonsils against the background of viral infections is complicated by otitis media, tracheobronchitis, pneumonia and other diseases as a result of the addition of a bacterial pathogen..

An important role is played by the state of general and local immunity of the baby.. With inflammation of the tonsils, the biocenosis of the oropharynx changes, which often leads to the transition of the saprophytic flora of the lacunae of the tonsils into pathogenic.

The following complications are also possible:.

regional lymphadenitis;

abscesses and phlegmon of the neck;

mediastinitis;

meningitis;

encephalitis;

myocarditis;

glomerulonephritis.

PreventionMany doctors, including pediatrician Komarovsky E. , believe that it is better to prevent a disease than to treat and, moreover, deal with various consequences. Therefore, specific and non-specific prophylaxis is recommended..

Specific prophylaxis involves the administration of vaccines. Not applicable for all diseases.

Compliance with the rules of personal hygiene reduces the likelihood of pathology Non-specific measures include various methods of hardening the body, vitamin therapy in the autumn-winter period, a balanced diet, moderate physical activity. It is also important to teach the child the rules of personal hygiene..

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