Lacunar tonsillitis. Lacunar tonsillitis - symptoms and treatment in adults

The oropharynx constantly encounters many microbes and bacteria, which, when penetrating through the mucosa, can cause inflammatory diseases. The body's protective functions are provided by lymphocytes and lymphoid tissue. Its accumulation in the pharynx provides local barrier properties. The accumulation of pathogenic bacteria and various provoking factors contribute to the active reproduction of pathogens. Tonsillitis often becomes chronic, has a protracted course, and exacerbations occur 2 or more times a year. To prevent such a condition, it is necessary to promptly, comprehensively and completely treat acute, first-time inflammation of the tonsils of the oropharynx.

Description

Lacunar tonsillitis is an acute inflammatory disease primarily affecting the tonsils. The palatines are most often affected. In their structure, they have narrow passages between accumulations of lymphoid tissue, called crypts. The crypts open on the surface of the tonsils with small depressions - lacunae. Mucus, exfoliated epithelium, and food particles can accumulate in them - all this is a breeding ground for microbes.

Under certain conditions (ingress of virulent microorganisms, decreased immunity), a pathological process may develop, manifested by symptoms of intoxication and damage to the palatine tonsils.

Along with the chronicity of the process, complications such as:

• abscess formation;
• phlegmon of the palatal region;
• pneumonia;
• bronchitis and others.

Age characteristics

The disease can develop at any age, regardless of gender, in people with intact tonsils (if surgery has not been performed to remove them).

Some time ago, almost all children with chronic tonsillitis had their tonsils removed, but today they are trying to preserve these anatomical structures whenever possible, since their significant contribution to the formation of immunity has been proven.

Lacunar tonsillitis is always an acquired disease and can affect even children. For a clinical picture to appear, the mucous membrane of the baby must become colonized with pathogenic bacteria. Even a small amount of them is enough to activate the inflammatory process, since newborns have virtually no immunity.

In children, the disease is much more severe than in adults.

Lacunar tonsillitis has a certain seasonality - it most often occurs in autumn and winter, when the body's immune response decreases due to low temperatures, lack of vitamins and sun.

Adults after 30-35 years of age suffer from lacunar tonsillitis several times less often, which is explained by a decrease in the reactivity of lymphoid tissue and age-related features of the structure of the upper respiratory tract. Older patients tolerate intoxication syndrome more easily, but the disease itself can last quite a long time. Pain when swallowing and swelling of almost the entire cervical region persist in adults for a long time.

Types and forms

Lacunar tonsillitis is one of the most severe and aggravated types of tonsillitis. Rarely occurs spontaneously and is usually chronic. The increase in clinical symptoms indicates another exacerbation or develops secondary, against the background of another inflammatory disease of the oropharynx.

We can talk about the occurrence of chronic tonsillitis if a repeated case of tonsillitis occurs within a year. It is usually more severe and more difficult to treat.

With constantly reduced immunity, tonsillitis bothers a person up to 4-6 times a year, accompanied by a pronounced and aggressive clinical picture.

The classification of the disease is presented in the table:

Fungal form of tonsillitis

The severity of a sore throat can be determined by the spread of the pathological process or the presence of symptoms of intoxication. All severe clinical cases require immediate hospitalization in a hospital, where specialized specialists decide on further therapeutic tactics. In some situations, purulent formations spread down into the mediastinum and chest area, so emergency surgery is necessary.

Bilateral lacunar tonsillitis

Depending on the type of pathogen, the degree of exposure, course of treatment and groups of drugs used differ. Even broad-spectrum antibioticsare not able to provide a therapeutic effect for tonsillitis of a fungal nature.

Causes

The most common cause of lacunar tonsillitis in adults is bacteria. The main pathogens include:

• staphylococci;
• streptococci;
• pneumococci;
• Haemophilus influenzae and Pseudomonas aeruginosa.

In children, the causative agents are often measles viruses, adenoviruses and others. But this does not exclude the possibility of developing viral tonsillitis in adults and bacterial tonsillitis in children.

Provoking factors:

• inflammatory diseases of nearby organs;
• chronic foci of infection in the body (caries, helminthic infestations);
• hypothermia, prolonged exposure to wind and low air temperatures;
• chronic stress and overwork;
• decreased immune response;
• frequent contacts with a person who has a chronic form with exacerbations.

Viruses and bacteria are transmitted by airborne droplets - this means that sore throat is contagious, and you can get it through contact with a sick person. With a significant decrease in immunity, the disease can also be caused by opportunistic microflora of the oral cavity (streptococci, Haemophilus influenzae, etc.). Microorganisms can also remain on dishes used by the patient and infect other people when eating food.

It is believed that lacunar tonsillitis is quickly transmitted and is one of the highly contagious diseases.

Symptoms

The disease begins acutely. The incubation period is short - from several hours to 2-3 days. The temperature rises sharply to febrile levels - 38-39 degrees. Fever is accompanied by a feeling of weakness, chills, headache and aches throughout the body.

Simultaneously with the increase in temperature, characteristic changes appear in the throat:

• the palatine tonsils increase in size and become red;
• there is soreness in the throat, which intensifies with swallowing movements;
• difficulty swallowing leads to a decrease in appetite, even to the point of refusing to eat;
• In addition to the tonsils, regional lymph nodes - cervical, submandibular - enlarge.

Associated symptoms of sore throat:

• weakness, headache, malaise, muscle fatigue;
• purulent contents that separate from the tonsils;
• pale skin (redness of the cheek area is clearly visible);
• bright red tint of the throat mucosa;
• chills;
• increased heart rate.

When examining the oral cavity, enlarged red palatine tonsils with purulent plaque are visible. At first, it can cover only the lacunae, and then grow and merge - in this case, the palatine tonsil will be completely covered with it. The plaque is easily removed, revealing enlarged hyperemic lacunae.

Treatment

With comprehensive treatment, the disease lasts 7-10 days, but the period can reach up to two weeks. To relieve severe symptoms and prevent complications (the development of an abscess, sinusitis, long-term cardiac consequences), competent therapy is extremely important.

First of all, it is necessary to observe bed rest. Considering that the disease is transmitted by airborne droplets, it is important to limit the patient’s contact with children, who are extremely susceptible to the pathogen. The room where the patient is located must be ventilated several times a day. The patient must use separate utensils during the therapy period.

Etiotropic treatment for bacterial tonsillitis includes antibacterial drugs, most often penicillins (amoxicillin, amoxiclav). If bacteria are resistant or allergic to these substances, macrolides (clarithromycin, azithromycin) are used. The course of antibiotic therapy is usually 7 days. For viral sore throats, antiviral agents are used - Acyclovir, Interferon, Viferon. For the fungal form, Fluconazole is prescribed.

In severe cases, drugs are prescribed in injections - Ceftriaxone or Cefazolin.

Sprays are prescribed locally, rinsing the pharyngeal cavity with antiseptic solutions (Miramistin, Nitrofural), and herbal decoctions (chamomile, sage). You can use absorbable tablets - Faringosept, Strepsils. To relieve symptoms of intoxication, non-steroidal anti-inflammatory drugs with analgesic and antipyretic effects (paracetamol, acetylsalicylic acid) are prescribed.

Physiotherapy is indicated during the rehabilitation process. The following have a pronounced therapeutic effect:

• inhalation;
• laser therapy.

Alternative medicine

Treatment with folk remedies is not used as the main one, but gives a proven effect as an auxiliary one.

During the day, it is recommended to drink fruit drinks and compotes based on cranberries, sea buckthorn and lemon. All these berries contain many vitamins, strengthen the body and relieve inflammation and swelling. Drinking large amounts of fluid reduces intoxication, improving the patient's condition.

Iodine has a negative effect on the purulent contents of the tonsils. It is sold in pharmacy form in the form of Lugol's solution, which is used to lubricate the affected tonsils at home. You can also use a regular alcohol solution. To do this, 10 drops of iodine are mixed with 1 tsp. soda and dilute in 150-200 ml of warm boiled water. Gargle with the resulting mixture every 3-4 hours.

Decoctions of linden and chamomile have a beneficial effect on the mucous membrane, reducing inflammation and swelling. Milk with honey and butter softens the soft tissues of the oropharynx and facilitates the act of swallowing.

Lacunar tonsillitis– a sharply beginning acute form of infectious inflammation of the lacunae of the palatine tonsils (lymphoid formations located in pairs in the oropharynx). The entire surface of the tonsils consists of small depressions (lacunae), branching into the body of lymphoid tissue, which become infected and inflamed.

In contact with

Causes of lacunar tonsillitis

The primary form of the disease is caused by:

• pneumococci;
• staphylococci;
• viruses (some types);
• meningococci;
• fungi;
• Haemophilus influenzae.

The secondary form of sore throat is caused by:

• scarlet fever;
• , infectious in nature with frequent spread of inflammatory processes to the oral cavity and tonsils.

Infection with this form of sore throat can occur through contact with an infected person (airborne), through household contact with objects used by an infected person and with food.

How does the disease begin?

Very often this disease begins abruptly. Incubation of infecting pathogen microorganisms lasts from 1 to 3 days. All symptoms of a sore throat quickly begin to manifest themselves and reach their peak within 2–3 hours.
Usually the initial symptom is discomfort in the throat and mouth. A person feels enlarged lymph nodes, “tickling” and soreness in the throat, some pain when swallowing and a lump standing near the tonsils.

Is it possible to get infected with lacunar tonsillitis?

The disease is easily transmitted through airborne droplets and household contact, so it is very easy to become infected.

In order not to infect healthy people, a sick person must wear a special medical mask or gauze bandage, have a separate set of utensils and personal hygiene (towels, soap, etc.).

When a sick person and healthy people are in the same room, it must be constantly ventilated. You can place chopped garlic and dipped in water around the room or wrap its pieces in gauze. It has excellent antiseptic properties. Instead of garlic, you can smear your nostrils with oxolinic ointment or drip influenza.

The difference between lacunar tonsillitis and other types of tonsillitis

• The manifestation of all symptoms occurs rapidly;
• yellow-white purulent ulcers appear on the tonsils;
• plaque on the tonsils is easily removed with a special medical spatula, without leaving any marks or blood;
• severe course of the disease, unlike other types of tonsillitis. This is especially true for young children;
• children often experience asthma attacks;
• causes complications dangerous to the human body.

Symptoms of the disease

• A lump near the tonsils, constant soreness, enlarged lymph nodes, which can be felt very well;
• pressure in the throat and pain, aggravated by the influence of the tonsils on each other and foreign objects (swallowing, palpation);
• sudden onset of fever - elevated temperature (up to 38–39 degrees), accompanied by symptoms of intoxication of the body (severe chills, nausea, possible vomiting, headache, lack of appetite);
• aches in all joints and muscles (myalgia);
• tachycardia;
• Possible insomnia.

The most important symptoms of lacunar tonsillitis are a very rapid increase in the listed symptoms within 2-3 hours and soreness of the tonsils when swallowing.

Diagnostic methods

If symptoms of the disease appear, it is necessary to call a doctor at home, because a person suffering from lacunar tonsillitis is contagious.
The main diagnostic method is visual inspection and palpation. If the doctor cannot determine the type of sore throat, the plaque on the tonsils is removed with a medical spatula.
The initial examination is carried out by a general practitioner, who must send the patient to an ENT specialist to clarify the diagnosis.
Then a smear (culture) and a blood test are taken for analysis. Sore throat is manifested by an increase in leukocyte counts, lymphocytosis and an accelerated response to ESR. Bacteriological culture and blood tests are necessary to identify the cause and treatment of lacunar tonsillitis.

Methods for treating lacunar tonsillitis

Treatment methods for lacunar tonsillitis are divided into medicinal and non-medicinal. In severe cases of the disease, the patient is sent to hospital treatment. When undergoing treatment at home, you should follow all the recommendations of the attending physician and without changing the dose of the medications.

Basic treatment methods

• Compliance with the regime. Isolation from healthy people is necessary (wearing a gauze bandage, ventilation, separate dishes and personal hygiene products - towels, soap, washcloths, etc.).

Maintain bed rest in acute cases, when most of the symptoms have passed - semi-bed rest (rest more, take short walks).
Food should be warm and mostly liquid. It is worth limiting the consumption of fried, salty and fatty foods. Drinking plenty of clean water is recommended. Rejection of bad habits. Smoking irritates the mucous membrane, which is already irritated.

• Taking antibiotics. The course of treatment is at least a week. The most commonly prescribed drugs are Cephalexin, Amoxicillin, Ampicillin;
• preparations containing probiotics(Acipol, Bifiform, Linex, etc.) to avoid problems with intestinal microflora and the occurrence of diarrhea;
• painkillers and anti-inflammatory drugs (Ibuprofen, Ibuklin, Nimesulide);
• antipyretics(Aspirin, Paracetamol, Nurofen);
• if severe swelling of the pharynx occurs and the lymph nodes are enlarged, sometimes prescribed antihistamines(Suprastin, Diazolin);
• drops with herbal composition for diseases of the oropharynx (for example,);
• rinsing infusions of herbs (sage, oak bark), herbs, furatsilin, soda at least 3 times a day. At the onset of symptoms - every hour;
• sprays throat medications (Igalipt, Hexaral, Tantum-Verde, etc.) after meals, at least 3-4 times a day;
• vodka compresses those done on the neck area are carried out after the temperature subsides;
• physiotherapy. Treatment is carried out using the Tonsilor medical device. It affects the inflamed tonsils with ultrasonic waves. The result is that the swelling subsides and the pus disappears.

After completing the full course of treatment, patients are prescribed drugs that help improve immunity - immunomodulators(Immunal, Imudon).

Surgical intervention

Surgical treatment is indicated when the disease becomes chronic with persistent complications. Lakunotomy the patient's condition is alleviated in severe cases of the disease. Using a surgical scalpel, a small incision is made in the superficial tissues of the inflamed tonsils, through which purulent discharge comes out. Another, more complex operation - tonsillectomy. It involves removing the tonsils. This method of treating angina is used when a chronic form of the disease occurs and its treatment is constantly unsuccessful.

Treatment with folk remedies

The use of any folk remedies can only be done in conjunction with conservative methods. In this case, consultation with the leading attending physician is required. Ingredients in some products taken for relief may be incompatible with medications.

Traditional medicine:

1. Drinking black and green tea with raspberries, lemon, honey, cranberries and lingonberries;
2. Squeeze pieces of 3-year-old aloe and mix with honey. Add squeezed juice. Lubricate the tonsils with the resulting mixture 3–5 times a day for 7–10 days;
3. Mix citric acid on the tip of a knife with a glass of warm water. Rinse 3 times a day;
4. Buy an infusion of St. John's wort and calendula in alcohol at the pharmacy or make it yourself (fill a container with flowers, fill it with alcohol and leave for 14 days in a dark place). Add 40 drops per glass of water and rinse every 3 hours.

Possible complications

Without proper treatment, the infection can spread deep into the body, causing life-threatening complications. One of these complications that can arise against the background of lacunar tonsillitis is inflammatory processes in the lungs and other internal organs (pneumonia, bronchitis,

Lacunar tonsillitis (lacunar tonsillitis)– an acute inflammatory disease of the tonsils of an infectious nature, characterized by filling their lacunae with purulent contents.

Most often, the palatine tonsils, also known as tonsils, are affected by infection, because They are located in the oral cavity closest to the external environment. However, other tonsils - laryngeal, lingual and tubal - can also take the blow.

The most characteristic symptoms of lacunar tonsillitis are the presence of diffuse purulent deposits on the surface of the lacunae (tonsil crypts).

Sometimes the follicles of the tonsils are also involved in the pathological process, in which case a diagnosis is made - follicular-lacunar tonsillitis.

Other symptoms of lacunar tonsillitis usually include– increased and high body temperature, enlarged cervical lymph nodes, general weakness and malaise, sore throat, especially when swallowing.

The main cause of lacunar tonsillitis– infection of the tonsils, rarely – with a fungus. However, if the immune system is not weakened, the infection practically cannot seriously harm the tonsils, more often causing only their local inflammation.

According to statistics, people from 7 to 40 years of age most often suffer from angina. In 90% of cases, the culprit of purulent sore throats is streptococcus bacteria.

Development of lacunar tonsillitis

One of the main functions of the immune system is to protect the body from unfavorable factors - infection, thermoregulation disorders, etc.

An integral part of the immune system is the lymphatic system, in the lymph nodes of which lymphocytes and other protective immune cells are produced.

1.2. Antiviral drugs

Antiviral drugs are prescribed for viral nature of sore throat. However, the use of such drugs is usually quite rare - if the immune system cannot cope with a viral infection.

Treatment of a viral infection is aimed at increasing the reactivity of the immune system and maintaining the body.

In addition, viral drugs are also selected based on diagnostic data, after identifying a specific pathogen.

Among the popular antiviral drugs are “”, “Viferon”, “Acyclovir”.

1.3. Other methods of etiotropic therapy

Gargling. This procedure is aimed at constantly washing out purulent contents from the lacunae and the surface of the tonsils, so it must be done every 1-2 hours.

As a gargle, you can use a weak salt solution, as well as infusions based on plants that have antiseptic properties - calendula, chamomile, sage. Among the medicines used for gargling, solutions based on Furacillin, Eludril, Rivanol, Lugol, Miramistin, Iodinol, Chlorophyllipt can be distinguished.

Just remember that when gargling because of a purulent sore throat, do not swallow the liquid so that the pus with infection does not penetrate the digestive organs, otherwise complications of the disease may develop.

Washing lacunae. This procedure is aimed at more targeted washing of pus from lacunae. The procedure is done using a syringe - a solution with antiseptic properties - a solution of furacillin and others - is injected into the lacuna under pressure.

Suction of pus. In case of serious damage to the tonsils with pus, suction is used. The procedure is performed using a vacuum pump. At the same time, the lacunae are washed with a syringe, as described above.

2. Pathogenetic therapy

Pathogenetic therapy is aimed at correcting the functioning of the immune and other systems, which is necessary for a speedy recovery.

Pathogenetic treatment of lacunar tonsillitis includes:

Immunocorrection– drugs are used that increase the reactivity of the immune system, making it easier for the body to cope with the disease and the accompanying pathological processes. It is especially important to correct the functioning of the immune system during viral sore throat.

As immunocorrectors we can highlight “Normal human immunoglobulin”, “Cytotect”, “Sandoglobin”.

Vitamin therapy– additional intake helps strengthen the immune system, increase resistance to disease, normalize metabolism, reduce pain and symptoms characteristic of.

Novocaine blockades– used to relieve severe sore throat. To do this, Novocain is injected into the mucous membrane. For a more pronounced effect on pain relief, “Lidocaine”, “Dicaine” are added to novocaine. To prolong the effect of the blockade, ethyl alcohol is also added to novocaine, as well as an 8% gelatin solution.

If necessary, the doctor can add an antibiotic, vitamins and other drugs to the novocaine blockade.

Detoxification of the body. This event is aimed at removing the infection and its waste products from the body. It is these components, which are actually toxins (poison) for the body, that cause a whole set of symptoms characteristic of infectious diseases - loss of appetite, aching joints, high body temperature, headaches, as well as a number of complications of sore throat, which we listed earlier in the article.

To remove toxins from the body, you need to drink plenty of fluids (adding it to your drink has a particularly beneficial effect) and take sorbents that bind toxins and remove them from the body - Atoxil, Activated Carbon, Enterosgel.

Normalization of intestinal microflora. It is carried out to restore beneficial microflora in the intestines, which, if antibiotics are used, partially die along with pathogenic bacteria. If this is not done, digestive problems may be present, accompanied by the development of other complications.

To restore beneficial intestinal microflora, probiotics are used - "Bifidumbacterin", "Linex", "Lactobacterin", "Bifikol" and prebiotics - "Duphalak", "Hilak-Forte".

Physiotherapeutic treatment. Physiotherapy is used to relieve swelling of the tonsils, normalize metabolic processes, minimize the symptoms of sore throat and speed up the patient’s recovery.

Physiotherapy procedures for lacunar tonsillitis include inhalations, electrophoresis, ultraviolet irradiation, UHF, and magnetic therapy.

3. Symptomatic therapy

Lubricating the tonsils. To relieve the inflammatory process of the tonsils, soreness and minimize sore throat, the tonsils are lubricated with wound-healing solutions based on oils.

Sucking lollipops. They are used to anesthetize the throat and irrigate the tonsils with antiseptic substances. Although there are many disputes about such lollipops, because... many doctors claim that when such lozenges are used, infection and purulent contents enter the stomach, after which the patient may experience complications of the disease.

The most popular sucking lozenges against sore throat and other throat diseases are Strepsils, Faringosept, Falimint.

Antipyretics. To lower body temperature and relieve the inflammatory process in the tonsils, non-steroidal anti-inflammatory drugs (NSAIDs) are used - "", "", "", "", "Aspirin", "Efferalgan-UPSA", "Children's Panadol".

Contraindications to removal of tonsils are heart failure, renal failure, pregnancy, hemophilia, acute phase of other infectious diseases.

5. Diet for lacunar angina

Following a diet for angina is necessary to relieve the load on the body that is present when eating foods that are difficult for the digestive system. This is necessary for the body to accumulate strength, which will subsequently help it cope with the disease more quickly.

If you have a sore throat, you should not eat spicy, fatty, fried, smoked and very salty foods.

In addition, it is necessary to avoid coarse, hard, cold and hot foods, which is aimed at preventing additional irritation and injury to damaged tonsils.

Nutrition for angina should be balanced, filled with vitamins and. Give preference to cereals, soups, broths, pureed vegetables and fruits.

For patients with acute respiratory diseases (ARI) M.I. Pevzner developed a special dietary menu -.

For the same purpose, to save energy, as well as for epidemiological purposes, a patient with acute respiratory infections is recommended to observe bed and semi-bed rest.

Treatment of lacunar tonsillitis at home

Soda-salt solution. Dissolve ½ teaspoon of salt, ½ teaspoon of soda and a few drops of iodine in a glass of boiled warm water. Gargle with the solution about 4-5 times a day. This remedy helps reduce pain, rinse out pus, and disinfect tonsils.

Beetroot juice. Mix together 1 cup of finely grated beets and 1 tbsp. spoon of 6% apple cider vinegar, leave the product for about 4 hours in a dark place, strain it thoroughly and gargle with the resulting juice 3-4 times a day.

Collection. Make a collection of 4 parts roots, 4 parts leaves, 3 parts pine buds, 3 parts eucalyptus leaves, 2 parts, 2 parts inflorescences and 2 parts grass. Next, pour 3 tbsp. spoons of the collection 500 ml of boiling water, leave the product for 45 minutes, strain it and use it as a “gargle” for the throat - 3-4 times a day, or as an inhalation.

Cabbage. Mash the cabbage leaf lightly, apply it to the throat and bronchial area, wrapping it on top with a woolen scarf or scarf. Cabbage leaf will not only help cope with a sore throat, but also stabilize body temperature.

Basil oil. Dissolve a few drops of basil oil in a glass of warm boiled water (you can find it in pharmacies). Gargle with the solution 3-4 times a day. This remedy will help cope with various inflammatory diseases of the mouth and throat.

Aloe. Fill the glass container half with crushed leaves, the remaining half, i.e. add granulated sugar to the top. Tie the neck of the container with gauze and set it aside for 3 days to infuse, then strain and squeeze the juice out of the mixture. Drink the resulting syrup 1 teaspoon 3 times a day. The course is until recovery.

Natural antiseptics. Pour 2 teaspoons of chamomile, or chamomile, or sage with a glass of boiling water. Infuse the product for 30 minutes, strain and use as a gargle, 3-4 times a day.

Prevention

Prevention of lacunar tonsillitis includes:

• Avoiding hypothermia;
• Cold liquid should not be drunk in one gulp;
• Compliance ;
• Good nutrition, giving preference to foods with a high content of vitamins and minerals;
• Active lifestyle;
• Compliance with the work/rest/sleep regime, you need to get enough sleep;
• Avoidance, or learn to overcome them;
• Timely cleaning of air conditioners, air purifiers, vacuum cleaners, humidifiers and other climate control equipment;
• Timely wet cleaning at the place of stay - at least 2 times a week;
• Patients with acute respiratory infections should be provided with separate dishes, kitchen utensils, and linen for personal use;
• Avoiding visiting places with large crowds of people during the period of greatest spread of acute respiratory infections;
• Do not leave to chance, especially of an infectious nature, because they can become not only a focus for the development of acute respiratory infections, but also a negative factor that reduces the body’s protective functions.

Which doctor should I consult for a sore throat?

Video

Every person experiences an inflammatory process in the throat. This condition causes a lot of inconvenience: loss of ability to work, weakness, lethargy, and a desire to close yourself off from the people around you. These signs symbolize the development of angina. But increased body temperature and the formation of a yellowish coating in the lacunae distinguish the usual form of tonsillitis of the purulent or catarrhal type from the lacunar one. This type is more severe than others and is characterized by a specific method of therapy. To quickly get rid of the problem at home, you need to know how to treat lacunar tonsillitis.

Features of the disease

Lacunar tonsillitis is an infectious disease characterized by a bacterial origin. During the development of the acute form of tonsillitis, inflammation occurs not only of the tonsils, but also of the subcervical lymph nodes.

Lacunar tonsillitis as an independent disease occurs extremely rarely. Most often, it is a consequence of a prolonged or untreated cold, and also, if not treated correctly, flows from the follicular one. The manifestation of this type of tonsillitis is characterized as an acute severe form of the disease.

With follicular angina, pus appears in the form of small, insignificant formations. In the case of lacunar tonsillitis, the lesion grows on the palatine tonsils, as well as on the pharyngeal, tubal and lingual tonsils. There is complete filling of the lacunae with purulent content.

Attention! The main risk group for lacunar tonsillitis: - from 5 years old and schoolchildren - 7-12 years old.

When infected at a conscious age, lacunar-type tonsillitis is part of another disease, complementing its symptoms with a complication on the tonsils. Children endure the pathological process more severely than adults.

Causes

The main reason for the development of lacunar tonsillitis is an increase in the number of pathogenic bacteria or opportunistic bacteria that are constantly present in the oral cavity. The causative agents of the disease are the following microorganisms:

• Staphylococcus;
• Streptococci;
• Gonococci;
• Pneumococci;
• Pfeiffer sticks;
• Klebsiella;

Opportunistic microorganisms contribute to the appearance of the inflammatory process in lacunar-type angina, due to the influence of certain factors on the body:

• Decreased protective function of the body, decreased strength of the immune system;
• Presence of an infectious agent;
• Decreased local immunity - the protection of the oral mucosa is reduced;

The appearance of an infectious agent can occur in several ways, but most often the disease is transmitted by airborne droplets. The process of colonization of pathogens into the body occurs during contact and conversation with an infected or recently ill person.

When pathogenic microbes enter the mucous membrane of the mouth or nose, the bacteria settle in the folds of the palatine tonsils (lacunae). If the patient’s immunity is strong, then the body independently suppresses the infection. Otherwise, inflammation develops and is transmitted to the human lymph nodes.

A number of reasons have been identified that increase the likelihood of developing lacunar tonsillitis:

• General hypothermia of the body or its individual parts;
• The patient's food is rich in protein foods, due to this there is a lack of vitamins C and B;
• Poor ecology and severe air pollution in the area where the patient lives;
• Injury to the palatine tonsils;
• Sudden changes in weather conditions, decreased air temperature;
• Impaired inhalation of air through the nose due to injuries to the nasal passages or a deviated septum;
• Diseases of the ENT organs that last a long time and progress to the chronic stage;
• Anomalies in the formation of tonsils;
• Stressful situations;
• Bad habits;

Lacunar-type tonsillitis is a fairly contagious disease. Therefore, if a person is sick, then he should be isolated from the rest of society. Treatment of lacunar tonsillitis begins after consulting a doctor and identifying the main signs of pathological inflammation.

Symptoms of leakage

The incubation period of lacunar tonsillitis in adults, as well as in young patients, lasts no more than 1-2 days. The clinical picture of the course develops brightly and rapidly. In some situations, the first signs of virus growth appear within a couple of hours.

With the development of lacunar tonsillitis in children and patients of conscious age, the same type of symptoms are observed:

• A sharp increase in temperature to high levels - 39-40 degrees;
• Periodically occurring chills (more often recorded in young children);
• Weakness, fatigue, severe headache;
• Pain in joints and muscles;
• Severe sore throat, especially when swallowing drinks or food;
• Increased volume of submandibular lymph nodes;

In addition to the first symptoms, during the course of the disease, signs of intoxication are revealed: possible nausea, profuse vomiting or refusal to eat food due to severe pain and general discomfort in the body.

Attention! In children, the symptoms of lacunar tonsillitis are much more serious. Signs include cramps, pain in the abdomen, nausea, profuse vomiting, loose stools, and possible attacks of suffocation. It is very important to monitor the child’s condition so as not to miss a dangerous moment in the development of acute tonsillitis.

Lacunar tonsillitis in adults tends to occur without a sharp increase in body temperature, remaining at the subfebrile level (37.1-37.5 degrees). It depends on the patient's body. Each person is individual and reacts differently to the possibility of infection by pathogenic bacteria.

Pathogenic bacteria can occupy the surface of one tonsil or be localized on both tonsils. The duration of inflammation lasts on average from 5-6 days to 9 days, depending on the degree of intoxication of the body and how correctly lacunar tonsillitis is treated according to the identified symptoms.

Restoration of working capacity in the adult population occurs only 14-18 days after signs of the disease are identified.

Diagnostics

If symptoms of lacunar tonsillitis are detected in adults, treatment should be prescribed by a doctor. The appearance of the first signs suggests that you should visit a doctor and identify the inflammatory process. It is recommended to consult not only a general practitioner, but also an infectious disease specialist and an otolaryngologist.

When examined by a doctor, the doctor identifies the following signs of lacunar tonsillitis:

• Expansion of lacunae;
• Redness of the palatine arches, tonsils and posterior wall of the larynx;
• The palatine tonsils are slightly enlarged;
• A whitish or yellowish coating that is easily separated from the surface of the tonsils using a medical spatula;
• Painful, enlarged cervical lymph nodes;
• Swelling of tissues in the oral cavity and larynx;

After identifying symptoms, the doctor prescribes additional necessary tests. Such diagnostics are important for correctly establishing the analysis and prescribing effective medications. It is recommended to undergo the following examinations:

• Electrocardiography;
• Laryngoscopy and pharyngoscopy;
• Immunological examination;
• Taking a scraping from the oral cavity to identify the pathogen, on the basis of which an effective antibiotic is determined;
• General urine analysis;
• Blood test - clinical type and general;
• Palpation of lymph nodes;
  Important! Many tests are needed to eliminate the possibility of developing diphtheria. This is necessary because the disease's symptoms are very similar to lacunar tonsillitis.

Only after the examination result has been identified, the doctor establishes the correct analysis and prescribes effective medications that can quickly and without consequences cure lacunar tonsillitis.

Treatment

Timely initiation of therapy allows you to quickly cope with lacunar-type angina. When the first symptoms develop, the patient is prescribed bed rest. In case of severe cases, urgent hospitalization is necessary. Acute disease can be treated at home, but under the supervision of a local doctor.

Lacunar tonsillitis must be treated with medication. The following drugs are used for its treatment:

• Antibiotics – without medication, acute tonsillitis of the lacunar type cannot be treated. To accurately determine the drug, it is necessary to conduct a number of examinations. But usually, there is not enough time for this, and therefore the doctor recommends the use of certain antibacterial drugs, with a wide spectrum of action, eliminating a large list of pathogenic microorganisms: penicillins (Ampicillin or Oxacillin), macrolides (Sumamed or Azithromycin), amoxicillins (Amoxiclav, Augmentin) or cephalosporins (Cephalexin or Ceftriaxone).
• Local medications for the affected throat - necessary as rinsing of the mouth and larynx, resorption of lozenges. Herbal solutions can be used as a rinse. It is recommended to prepare an infusion or decoction of water with chamomile, sage or calendula. Septolete, Strepsils, Neo Angin, Lizak, Faringosept lozenges are suitable for resorption. To irrigate the larynx and tonsils, you can use Hexoral, Tantum Verde, Bioparox, Kameton, Orasept.
• At high temperatures, you should take antipyretic medications - Ibuprofen, Nurofen, Analgin, Paracetamol, Panadol. The duration of exposure to such medications should not exceed 3 days.
• To eliminate swelling of the laryngeal tissue, antihistamines must be used - Suprastin, Tavegil, Loratodin, Zodak, Diazolin.

Use of antiviral drugs– Kagocel, Viferon, Amiksin, Cycloferon.

Additionally, you can treat a sore throat by gargling with antiseptic agents, such as Furacilin, Miramistin or soda-iodine solutions. Such an effect on the oral cavity and tonsils is necessary when the purulent content on the tonsils matures well and is quickly washed out under the influence of antiseptics.

Prevention

In order not to provoke the development of lacunar tonsillitis, you should adhere to certain rules and maintain personal hygiene, both of the whole body and the oral cavity. Dress according to the weather conditions, trying not to overcool the body. During seasonal epidemics, stay away from large crowds of people, and also boost your own immunity with vitamins.

Don't forget about proper nutrition. Eat more fiber-rich foods. Treat dental diseases in a timely manner and treat advanced diseases of the nose and gums.

Thus, the disease is most often detected as a complication after follicular. To prevent its development, it is necessary to begin treatment at the first sign. Lack of therapy leads to the formation of serious health problems, such as neck cellulitis, sepsis, pneumonia and kidney damage.