Purulent tonsillitis in a 7-year-old child. Purulent sore throat in a child

Purulent sore throat in children, the treatment of which will require strict adherence to the recommendations of an ENT specialist or pediatrician, is diagnosed mainly in a preschool child, younger school age. The immune system is still in its formation stage and is vulnerable to the action of aggressive bacteria. The second surge of the disease is characteristic of the period of rapid puberty of a teenager. At this time, a restructuring of all body systems occurs and they are not able to repel a powerful attack from pathogens.

Purulent tonsillitis in preschoolers and adolescents in 80% of cases is caused by staphylococci or streptococci. Bacterial pathogens are transmitted by airborne droplets when communicating with a sick person. Or contact - through hygiene items, shared utensils, food. A child can be a source of infection already in the first hours of illness, when adults have not yet sounded the alarm. Therefore, mass diseases of this type are often recorded in children's groups, and quarantine is declared.

The main cause of purulent sore throat is a bacterium from a number of cocci that has entered the body. In children, an adenovirus can provoke inflammation of the tonsils. And concomitant factors complicating the course of the disease are:

• Weak immune system.
• Local (drinking an ice drink) or general systematic hypothermia.
• Disregard for hardening and physical activity.
• Poor nutrition with a monotonous menu.
• Chronic inflammatory diseases nasopharynx, dental problems(caries, stomatitis).

Under such conditions, phagocytes are unable to neutralize the infection and maintain the balance of the microflora of the nasopharyngeal mucosa.

Types of sore throat

There are three types of purulent sore throat in a child:

• Lacunarnaya. Exudate of a yellowish-white hue is located in the epithelial canals of the tonsils - lacunae, and a whitish coating is visible on the tonsil itself. Treatable better than others purulent forms. This type of sore throat is often a complication of catarrhal disease.
• Follicular. Characterized by the presence of pus in the follicles of the tonsils. The pustules are visible through the translucent epithelium. Accumulations of exudate are in close proximity to a branched capillary system and large vessels, so the risk of infection entering the blood is quite high. It is more difficult to cure this form of the disease than the previous one.
• The phlegmous form is rare in children. This type of disease involves the rapid formation of swelling of the tonsils, which covers not only the lymphoid formations, but also the areas adjacent to them. Intoxication is pronounced, and a narrowing of the respiratory lumen is observed. Children with a similar diagnosis are subject to immediate hospitalization.

A combination of symptoms of the lacunar and follicular forms is often observed. The attending physician oversees the healing process.

Symptoms and diagnosis

The presence of purulent sore throat can be accurately determined visually. Plaque, visible ulcers, swollen hyperemic tonsils directly indicate the development of tonsillitis. Clinical researches will help determine the type of pathogen. High-quality diagnostics will help clarify how to treat purulent tonsillitis in children at risk.

In some cases, you will need to take a swab from the throat to determine the type of bacterial infection and their sensitivity to active ingredients popular antibiotics. This step is justified if there is resistance of strains of pathogenic microorganisms to one of the types of antibiotics.

• Pain when swallowing, which gradually becomes constant or pulses to the ear area.
• Weakness, child complaints of drowsiness, lethargy, muscle aches, discomfort when moving the eyeballs.
• A sharp increase in temperature to 38-40 o C, chills.
• Consolidation of the submandibular lymph nodes.
• Enlarged swollen tonsils with visible ulcers.

These indicators are very average, since the disease develops differently in each baby, and the symptom can be individual.

Treatment of purulent sore throat: medications and folk recipes

Treatment of purulent sore throat in children involves the prescription of antibiotics. If there are no contraindications, then modernized penicillins with clavulanic acid are prescribed. Augmentin, Amoxiclav, Flemoklav - antibacterial agents wide range actions. They inhibit the process of division of pathogenic cells and prevent their development. For children, tablets are available with a citrus flavor or a sweet taste. If the dynamics are positive, the course of treatment will be a week, but the doctor may extend the use of antibiotics to 10 days.

If the baby has an inadequate reaction to penicillin or has concomitant diseases drugs of the azithromycin group are prescribed. Sumamed, Azitsin, Macropen are characterized by a prolonged action, their therapeutic concentrations last 5-7 days after completion of the drug. Therefore, three to five days of taking the medicine is enough.

Complicated conditions can be overcome by cephalosporins. These antibiotics have a powerful antibacterial effect; they are active when bacterial strains are resistant to penicillin or macrolides. Cefixime, Suprax Solutab overcome the protective barriers of infection, integrate into the cell membrane and destroy the bacteria from the inside.

With antibiotics quickly and effectively. On the second or third day of taking medications, the temperature normalizes and suppuration decreases. The scarlet mucous membrane approaches a physiological shade, much of the whitish coating disappears.

Antiseptics, analgesics, NSAIDs

Non-steroidal anti-inflammatory drugs will help lower the temperature and reduce inflammation: for babies it is better to use suppositories, for preschoolers it is preferable to give syrups. Teenagers will prefer tablets or instant teas with a dose appropriate for their weight. Popular: Nurofen, Nimesulide, Panadol, Ibuprofen.

Sprays will help reduce pain and disinfect the mucous membranes. Hypoallergenic Miramistin is recommended for infants and children under 3 years of age. It can be applied to the nipple and treated on the cheek. Small children should not irrigate the pharynx area: babies cannot regulate the contraction of the pharyngeal muscles and the rhythm of breathing, so a sharp spray of medication can cause laryngospasm. Givalex, Ingalipt, Kameton will help older children.

You can treat purulent sore throat in a child after 4 years of age using lozenges, lozenges, and lozenges. Grammidin with an antibacterial component will enhance the effect of systemic antibiotics. Isla Mint will relieve pain and have an antiseptic effect. Chlorophyllipt will help destroy cocci and relieve inflammation. Agisept, Anzibel will disinfect painful tonsils.

Can be used oil solution Chlorphilipta or the famous Lugol for treating tonsils.

Rinse

Adults often ask the doctor the question: “What should I use besides pharmaceuticals?” For older children preschool age and teenagers need to learn to gargle. This procedure will help remove purulent exudate and remove mucus with pathogenic microorganisms.

Easy to purchase pharmaceutical drugs: solutions of Furacilin, Rotocan, Tantum Verde. Decoctions and infusions of herbs that have been used by traditional healers for centuries are effective.

Chamomile, sage, calendula will disinfect and soothe irritated epithelium. You will need a tablespoon of raw material per 250-300 ml of boiling water, the liquid must be brought to a boil. You can only rinse with warm broth.

Add 2 drops per glass of tea tree and sea buckthorn essential oil to water at a temperature of 40-45 o C.

Rinse after 2 hours; the doctor will tell you how many days it will take for treatment. Before starting the procedures, you should consult your doctor, since there are rare situations when the purulent plugs are too deep and rinsing can harm the treatment.

Manifestations of purulent tonsillitis in children, the treatment of which is quite intensive, indicate a weak immune system. Therefore, after recovery Special attention preventive measures should be taken.

Purulent tonsillitis in children is an infectious and inflammatory process that affects the palatine tonsils and is accompanied by the appearance of purulent plaque on their surface. The disease is widespread among people of both sexes and all ages. In children it occurs more often and is more severe, often accompanied by the development of complications. In the autumn-winter period, the incidence of purulent tonsillitis increases.

Yellow dots (festering follicles) on the surface of the tonsils - characteristic symptom purulent sore throat

Causes and risk factors

The causative agent of purulent sore throat in children can be various microbial agents, both viral and bacterial, but most often the disease is caused by group A β-hemolytic streptococcus (85% of all cases). The main route of transmission of infection is airborne droplets, but household contact is also possible, for example, through shared utensils and toys.

Factors that increase the risk of developing purulent tonsillitis in children are a decrease in general and/or local immunity, which occurs for the following reasons:

• acute respiratory disease;
• tonsil injury;
• presence of outbreak chronic infection in the oral cavity (stomatitis, caries);
• living in an area with unfavorable environmental conditions.

Forms of the disease

Depending on the cause, purulent sore throats in children are classified into several types:

• primary (ordinary, or banal)– caused by pathogenic bacteria, manifested by purulent lesions of the lymphoid tissue of the pharyngeal ring, intoxication syndrome;
• secondary (symptomatic)– is a symptom of some other disease (leukemia, agranulocytosis, nutritional-toxic aleukia); manifestations of the underlying disease are primary, angina occurs later and may proceed atypically;
• specific– purulent inflammation of the tonsils is caused by specific microflora (gonococci, spirochetes). This form of purulent sore throat practically never occurs in children.

Depending on the nature and depth of damage to the tonsils:

• necrotic purulent tonsillitis.

The incubation period for purulent sore throat in children lasts from several hours to several days. The disease begins suddenly, without a pronounced prodromal period. The child develops severe chills, against the background of which the body temperature rises to 39-40 ° C. Symptoms of intoxication rapidly increase, regional The lymph nodes. Children complain of intense sore throat, which intensifies when swallowing, and therefore refuse to eat and drink.

Pharyngoscopy reveals following symptoms purulent sore throat in children:

• severe hyperemia of the pharynx;
• infiltration and swelling of the tonsils;
• expansion of lacunae;
• the presence of purulent discharge on the surface of the tonsils.

With follicular tonsillitis, yellow dots are clearly visible on the bright red surface of the tonsils - suppurating follicles. This picture is called the “starry sky” symptom.

With the lacunar form of purulent tonsillitis, a loose purulent plaque forms on the surface of the tonsils in the lacunae. This plaque extends beyond the lacunae, but does not extend beyond the tonsils. Purulent plaque is easily removed with a cotton swab; the surface does not bleed after its removal (one of diagnostic signs, distinguishing the lacunar form from the necrotic).

In children, purulent tonsillitis occurs more often and is more severe, often accompanied by the development of complications. In the autumn-winter period, the incidence increases.

The necrotic form of purulent tonsillitis in children is especially difficult. It is characterized by a pronounced intoxication syndrome:

• confusion;
• persistent fever;
• repeated vomiting.

The tonsils have a dull, dense coating of greenish-yellow or gray color with jagged, pitted edges. After removal, bleeding lymphoid tissue is found underneath. The pathological process can spread to the arches, uvula, back wall throats. At the site of rejection of necrotic tissue, irregularly shaped defects with a diameter of 1–2 cm are subsequently formed.

Diagnostics

Diagnosis of the disease in most cases does not present any difficulties. It is carried out on the basis of the characteristic clinical symptoms of purulent tonsillitis in children and pharyngoscopy data.

To identify the causative agent of the disease and determine its sensitivity to antibiotics, if necessary, bacteriological examination tonsil smear.

Treatment of purulent sore throat in children

Treatment of purulent sore throat in children is carried out in most cases in outpatient setting. Only in severe cases of the disease is hospitalization in the infectious diseases or ENT department of the hospital indicated.

Antibiotics for purulent sore throat in children are the main means of therapy. Macrolides, penicillins, and cephalosporins are used. The duration of the course and dosage are selected by the attending physician on an individual basis. General treatment supplemented with local therapy. Gargling with antiseptic solutions (Chlorhexidine, Furacilin) ​​or decoctions is prescribed medicinal plants(pharmacy chamomile, eucalyptus leaf, calendula flowers). In addition, antiseptic and anti-inflammatory drugs can be used in the form of a spray for irrigating the tonsils (Faringosprey, Bioparox, Novosept). The duration and frequency of their use are also determined by the attending physician.

Rational antibiotic therapy significantly reduces the risk of developing both early and late complications purulent sore throat in children.

Nutrition for purulent sore throat

One of the main symptoms of purulent sore throat in children is a severe sore throat, making it difficult to swallow and, therefore, disrupting normal food intake. In addition, severe intoxication syndrome leads to sharp decline appetite. Therefore, on the first day of the disease, if the child refuses to eat, you should not insist, but it is necessary to ensure plenty of drinking (still water, tea, rosehip decoction, jelly, compote, fruit juice). Drinks should be warm and not irritate the inflamed mucous membrane (it is better to avoid citrus juices, compotes and fruit drinks made from sour berries). When the intensity of the symptoms subsides somewhat (usually after 1-2 days), the child’s diet is expanded.

The diet for children with purulent sore throat is developed taking into account the following principles:

• eat food often, but in small portions;
• food should be crushed (porridge, mashed potatoes, pureed soups, soufflé);
• food and drinks should be at room temperature or slightly warmed, since excessively hot or cold food increases the intensity of pain;
• dishes should be nutritious, but easily digestible. Dishes made from lean meat (preferably in the form of minced meat), cereals, thermally processed vegetables and fruits, dairy and fermented milk products are welcome.

From the diet you should exclude pickled, fatty, fried foods, hot, spicy, heavy dishes, solid foods, carbonated drinks, and confectionery.

Prevention

Prevention of purulent sore throat in children includes the following areas:

1. Avoiding hypothermia. Hypothermia, both general and local, leads to a deterioration in the blood supply to the tonsil tissue. In addition, a special slime layer. These factors create favorable conditions for the life of pathogenic and opportunistic microflora and can cause purulent tonsillitis in children.
2. Hardening. Allows you to increase the child’s body’s resistance to infectious factors.
3. Dental control. At least twice a year should be carried out preventive examinations at the dentist, and, if necessary, timely sanitation. In addition, it is important to maintain oral hygiene.
4. Control by an ENT doctor. With difficulty in nasal breathing (rhinitis, adenoiditis, deviated nasal septum), the child switches to mouth breathing instead of nasal breathing, which creates the preconditions for the development of purulent sore throat. Therefore, these pathological conditions require timely treatment.

If a child gets sick with purulent sore throat, it is necessary to take a number of preventive measures aimed at preventing infection of others:

• isolate the patient by placing him in a separate room;
• caregivers wear a gauze mask during contact with the patient;
• regularly ventilate the room in which the sick child is located, carry out wet cleaning in it 1-2 times a day;
• allocate separate dishes for the patient, after use, wash them separately from the general ones, and at the end of washing, pour boiling water over them.

Video from YouTube on the topic of the article:

Sore throat refers to infectious diseases in which an inflammatory process occurs in the lacunae of the tonsils. The causes of the development of the disease can be pathogenic microorganisms, in particular staphylococci and streptococci; less commonly, sore throat is caused by viruses and bacteria in conditions favorable for reproduction.

Factors contributing to the growth of bacteria can be viral infections, frequent hypothermia, reduced immune system, overwork and poor nutrition. Before starting treatment, it is important to identify the pathogen, since each form of purulent tonsillitis requires a special approach.

Causes of purulent sore throat in children

During the autumn-winter period, when there is a peak incidence in children, one of the most common diseases is tonsillitis. If a child lacks vitamins, does not eat properly, is not on enough food, fresh air, is not physically active - all this can become one of the reasons for decreased immunity and, as a consequence, for any negative factor, pathogenic microorganisms begin to multiply, leading to the development of sore throat.

The main factors provoking the development of the disease include:

• local or general hypothermia: a child’s prolonged exposure to the cold or consumption of cold foods and drinks;
• the presence of an inflammatory focus: caries, inflammation of the adenoids, otitis media, sinusitis;
• recent viral diseases: parainfluenza, influenza, ARVI;
• decline immune system due to a number of factors.

Sore throat is transmitted by airborne droplets or through household objects, so contact with a sick person can be another cause of a child’s illness.

Incorrectly prescribed treatment can lead to the development of chronic tonsillitis, and pathogens that are not destroyed can provoke a number of health-threatening complications (heart disease, vascular disease, kidney disease, allergic reactions, etc.). When warning signs, you must immediately consult a doctor and not self-medicate.

When is it necessary to hospitalize a child?

With the development of angina and the presence the following factors It is necessary to urgently hospitalize the child:

• renal failure, bleeding disorder, diabetes;
• severe tonsillitis: rheumatic carditis, abscesses, phlegmon of the neck;
• severe intoxication manifestations: high fever, nausea, vomiting, respiratory failure, confusion, convulsions.

If tonsillitis occurs in children under 1 year of age, treatment should take place in a hospital setting, with the exception of a mild form of tonsillitis, which can be treated at home in compliance with all doctor’s recommendations.

Forms of purulent sore throat and their manifestations

Tonsillitis can affect different areas and have a different course, from which the disease is divided into several types:

• ulcerative-membranous;
• follicular;
• lacunar.

At the initial stage of development of purulent tonsillitis in a child, regardless of the form, the symptoms appear the same. Correct diagnosis and treatment can only be prescribed by qualified doctor, based on the results of the examination and identification of the following signs:

• headache;
• high body temperature reaching critical levels;
• acute sore throat;
• soreness and burning in the throat;
• lack of appetite;
• chills;
• if in front of everyone acute symptoms there is no sore throat - this condition indicates the acquisition of chronic tonsillitis;
• redness and swelling of the tonsils;
• the presence of purulent plaque on the tonsils;
• bad breath;
• weakness, poor sleep;
• hoarseness of voice;
• enlarged and painful lymph nodes.

With timely diagnosis and proper treatment, the disease is tolerated by children without developing complications. If all recommendations are followed, it is possible to completely destroy the pathogen in 7-10 days. If any complications develop, the doctor may recommend that the child be hospitalized so that further therapy takes place under the supervision of a doctor.

Treatment of purulent sore throat in children

For more Get well soon The baby must strictly follow all the doctor’s recommendations. To rid the body of toxic waste products of bacteria, the child must be given a sufficient amount of warm liquid, use antipyretic and antibacterial drugs(see), systematically gargle, use antihistamines and vitamins.

During treatment of purulent sore throat, warming procedures are contraindicated: taking baths, using warming ointments and creams, compresses.

Gargling

One of the effective ways to combat pathogenic microorganisms is to gargle and use various sprays and aerosols. But it is worth considering that such methods do not apply to the main treatment and are only auxiliary measures; the main therapy for purulent sore throat is antibacterial drugs.

If a child has recently been ill with any disease that requires antibiotics, it is necessary to choose a different drug to treat purulent sore throat, since the bacteria may become resistant and the medicine will not be able to cope with the disease in the future.

The following remedies are suitable for local treatment:

• to gargle, you can use drugs from the pharmacy, for example, Furacilin;
• rinsing with a solution of soda and salt;
• for children over 3 years old it is allowed to use sprays: Ingalipt, Tantum Verde, Hexoral spray, Lugol spray;
• for children over 6 years old - Hexasprey;
• rinsing with herbal decoctions: calendula, chamomile and sage;
• rinsing solutions: Miramistin, Iodinol;
• Children over 5 years old are allowed to use absorbable lozenges: Strepsils, Stopangin, Faringosept.

What to consider when treating children under 3 years of age

Before using local treatment for purulent sore throat, children under 3 years of age should consider the following:

1. The use of atomizers and sprays is contraindicated for children under three years of age, despite the fact that the composition of the drugs is safe for use. This prohibition is due to the fact that while irrigating the tonsils with a spray it is necessary to hold your breath for several seconds; this is impossible to do at a young age. Incorrect use of sprays can lead to laryngospasm, so for children under three years of age it is allowed to treat the back of the cheek or pacifier with the drug; together with saliva, the active components will reach the inflamed tonsils.
2. Already at the age of 2 years, it is necessary to teach a child to gargle.
3. Also, at this age, it is not advisable to give dissolving lollipops, since there is a risk that the child may accidentally swallow them.

Recommendations for the use of local remedies for purulent sore throat

Before use local funds You must know the following:

1. Before using the drug, you must read the instructions and use it in accordance with your doctor’s recommendations.
2. When using medicinal herbs and drugs, it is necessary to monitor the baby's standing, since many drugs can cause an allergic reaction.
3. Local treatment should be carried out only after consuming food and any liquid; after the procedure, you should refrain from eating for 30 - 60 minutes, otherwise the treatment will be meaningless.
4. In infancy, drugs that irritate the mucous membrane should not be used: Iodinol, Lugol and others. They are allowed to be used from the age of 1 year, processing oral cavity no more than 1 time per day.

To avoid overloading the body medications for the treatment of purulent sore throat, no more than 2 drugs are selected.

Antipyretic drugs

With purulent tonsillitis, until the ulcers open, the child’s body temperature will remain high, so it is necessary to use antipyretics, the effect of which lasts for several hours. With the simultaneous use of antibacterial drugs, the temperature returns to normal within 2-3 days, so taking the drugs should continue for at least 3 days. For such purposes, the following drugs are most often prescribed:

• Panadol in suppositories or suspension;
• Paracetamol in suspension;
• Ibuprofen;
• Efferalgan.

In adolescence, a specialist may prescribe Ibuklin, which contains Ibuprofen and Paracetamol.

In what cases is it necessary to lower the temperature?

The temperature must be brought down if the following conditions occur in a child:

• when the temperature rises above 38.5 degrees, since at lower temperatures the body is able to independently fight pathogenic microorganisms;
• in infancy, the temperature should begin to be reduced already at 38 degrees, and vomiting may be present;
• can be used to reduce temperature rectal suppositories(Nurofen, Efferalgan, Tsefekon);
• from the age of 1 year, antipyretics should be given at temperatures above 38.5-39 degrees;
• if the child previously experienced convulsions at a high temperature, then the temperature should be reduced already at 37.5 degrees.

In addition to medicinal antipyretics, you can use traditional methods. Children over three years old can be rubbed with a damp towel dipped in water or diluted vodka. In addition, the child needs to drink plenty of fluids, which increases sweating and, as a result, lowers the temperature.

Antibacterial therapy

When choosing antibacterial therapy preference is given to penicillins, since they are the most effective and do not cause side effects. The medications are taken regardless of food intake. Antibiotics should only be prescribed by a doctor after identifying the pathogen that caused the disease. But in some cases, if there is intolerance to penicillin antibiotics or resistance to the pathogen, the following antibacterial drugs may be prescribed:

• Amoxicillin;
• if the pathogen is resistant, Augmentin, Ecoclav, Amoxiclav, which contain Amoxicillin and clavulanic acid, are prescribed;
• in the presence of allergic reaction Azithromycin, Azitrox, Hemomycin, Macropen, macrolides are prescribed for penicillins;
• In case of severe purulent tonsillitis, cephalosporins (Cefixime, Cefuroxime, Cephalexin) are prescribed.

Antibacterial treatment lasts on average about 10 days, depending on the prescribed drug and the form of tonsillitis. Azithromycin is prescribed for 5 days - this is enough for the pathogen to be destroyed, in addition, the drug has a prolonged effect. The effectiveness of the antibiotic is assessed within 3 days, during which time the child should feel improvement, the temperature returns to normal, and there is no purulent plaque. If the child’s condition improves, treatment should not be stopped, since 3 days are not enough to completely destroy harmful microorganisms.

In addition to oral medications for purulent sore throat, it is necessary to use local antibacterial agents for children over 3 years of age: Bioporox, Fusafungin. But it is worth remembering that such drugs are auxiliary and cannot replace the main treatment. Do not forget that there is a danger, but as a rule, if the imbalance of the intestinal microflora is not severe, then the body is able to recover on its own, but we still recommend consulting with a doctor before taking antibiotics.

Bacterial sore throat may require the use of antimicrobial drugs: Bactrim, Biseptol.

Additional remedies for the treatment of purulent sore throat

In addition to local and primary treatment, the use of the following agents may be required:

1. Antihistamines - used when there is a risk of developing an allergic reaction and relieving laryngeal edema; for children, Fenistil, Zodak, Zirtec, Peritol, Cetrin can be prescribed.
2. Vitamins are necessary to strengthen the body's immune defense. For this, vitamin complexes (Alphabet, Pikovit, Multitabs, Centrum), vitamin C and B can be prescribed. But you should be careful when using vitamin complexes, because childhood Allergic reactions can often develop and in most cases the child can get all the necessary microelements from food.
3. Immunomodulators are used to strengthen the immune system, but are prescribed in extreme cases and used with caution. Some of the safe medications are Kipferon and Viferon.
4. Probiotics must be prescribed simultaneously with antibiotics, which have a detrimental effect on the intestinal microflora. The most effective probiotics are Bifiform, Atsilakt, Bifiliz, Lactobacterin, Linex, Acipol and others.
5. Herbal medicines help to have an anti-inflammatory effect in diseases of the upper respiratory tract, and also relieves swelling of the laryngeal mucosa (Tonsilgon). These drugs contain essential oils, chamomile, yarrow.

Disease prevention

If there are frequent manifestations of purulent tonsillitis in a child, it is necessary to ensure that the feet are always warm and try to avoid hypothermia. For preventive purposes, it is worth hardening the throat; for this it is necessary to gargle: first with warm water, then gradually reducing the temperature of the water.

It is also very important to strengthen immune protection the child’s body, for this it is necessary to be in the fresh air more often, to feed only healthy products, consume natural vitamins from vegetables and fruits.

For frequent viral colds, the doctor may recommend taking immunomodulatory drugs (Broncho-Vaxom, etc.) for 10 days for prevention; after 3 weeks, the drug must be taken again. For prevention, it is recommended to undergo 3 courses of immunotherapy.

Possible complications

It is important to start treatment immediately after the first symptoms of purulent tonsillitis appear, since the lack of treatment or its incorrect prescription can provoke a number of complications:

• acute otitis;
• laryngitis;
• abscess;
• lymphadenitis;
• sepsis;
• meningitis.

After some time (months or years), the following complications may occur:

• glomerulonephritis;
• pyelonephritis;
• heart pathologies: pericarditis, myocarditis;
• damage to the central nervous system;
• kidney dysfunction;
• vascular diseases;
• heart failure.

Correct and timely treatment will help overcome purulent sore throat in short time, and will also prevent the child from developing serious illnesses.

Sore throat is an acute infectious disease when inflammation of the tonsils (pharyngeal, lingual, palatine or tubal) occurs. Banal microorganisms - streptococci, staphylococci, less often other pathogenic bacteria and viruses (pneumococci, adenoviruses, spirochetes, fungal flora) when favorable conditions for reproduction arise - hypothermia, viral infections, poor nutrition, overwork, are the causative agents of sore throat in a child, the treatment of which depends on the type of infectious agent, the severity of the inflammatory process, and the age of the child. This article is about how to treat a sore throat in a child.

Causes of sore throat in children

One of frequent illnesses in children during the autumn-winter season it is a sore throat. If a child does not eat well, or eats not entirely healthy foods, rarely spends time in the fresh air outside the city, is not interested in active physical training, for such a child the cold is a serious stress for the immune system and any hypothermia, frozen feet in the cold, ice cream or a cold drink - provoke the proliferation of pathogenic microorganisms in the oral cavity, more precisely in the lacunae of the tonsils. So, the provoking factors in this case are:

• weakening of the child’s local immunity, that is, the tonsils cannot cope with barrier function- from overwork, irrational, insufficient nutrition
• past viral infections - ARVI, influenza, parainfluenza
• Another option for the development of sore throat may be a focus of inflammation in another organ, for example, if a child has sinusitis or otitis media, caries or.
• general or local hypothermia, that is, the presence of a child long time at low temperatures or consumption of cold drinks and foods

In addition, in close contact with a sick person, a child can become infected through airborne droplets, that is, pathogenic bacteria enter from the outside through coughing and sneezing, through shared utensils or contaminated food (see).

Incorrect treatment can lead to chronic tonsillitis, and the causative agent of sore throat, streptococcus, in turn provokes the occurrence of more than 100 other dangerous diseases such as allergies, rheumatoid arthritis, kidney, vascular, and heart diseases. As soon as the child appears alarming symptoms, you should immediately consult a doctor and do not rely only on folk remedies for treating red throat.

When does a child need to be hospitalized?

• Concomitant diseases - renal failure, diabetes mellitus, bleeding disorders, etc.
• Complicated tonsillitis - neck phlegmon, abscesses, rheumatic carditis.
• Severe intoxication in a child - confusion, breathing problems, fever that cannot be controlled by antipyretics, vomiting and nausea, convulsions.
• For tonsillitis in children under one year of age, many doctors strongly recommend treatment in a hospital, but uncomplicated tonsillitis is better treated at home (the child is at home, in a calm environment, there is no chance of a hospital infection).

Types and symptoms of sore throat in children

Depending on how deeply the tonsils become inflamed in a child, there are several types of sore throat in medicine:

• catarrhal sore throat (today it is not considered a sore throat, it is acute pharyngitis)
• ulcerative membranous

Also classified into:

• Primary tonsillitis - tonsillitis with general intoxication and signs of tissue damage to the pharyngeal ring
• Secondary tonsillitis - occurs against the background of some acute infectious diseases - diphtheria, etc., as well as blood diseases - agranulocytosis, leukemia, etc.
• Specific sore throat - fungal infections, spirochete.

Depending on the causative agent of the inflammatory process, they are classified into:

• bacterial (diphtheria, streptococcal)
• fungal
• viral (enteroviral, herpetic, adenoviral)

But in all cases, the most basic symptom is refusal of food and even water, high body temperature, it can rise from 38 to 40C, while the child becomes sharply weaker, capricious, has a headache, vomiting and diarrhea may occur due to severe intoxication . On examination, there is bright redness of the pharynx, swelling of the arches and tonsils. In a number of sore throats (candidiasis, diphtheria), after removing the plaque, bleeding, eroded surfaces open.

In addition to pain and temperature during tonsillitis in children, the cervical and submandibular lymph nodes increase and become painful (in no case should they be warmed with compresses or other procedures). Inflammatory process with angina, it always affects the vocal cords, so the appearance of a hoarse voice in a child is also a symptom of angina. Usually this illness does not last more than a week or 10 days, successful treatment depends on correct diagnosis and timely initiation of antibiotic therapy. Therefore, the doctor first determines what type of sore throat the child has and only then prescribes treatment.

You should definitely contact a pediatrician, since it is impossible to distinguish bacterial tonsillitis from diphtheria on your own, the toxic form of which can very quickly cause swelling of the neck, stenosis of the larynx and suffocation, the child can die from intoxication, and inflammation of the heart muscle with the development of heart failure is also possible.

Treatment of catarrhal tonsillitis in children

With angina, the child usually has a temperature of 38-39C, the child becomes apathetic, lethargic, feels pain during swallowing, and nausea. The inflammatory process and pain in the lymph nodes with this type of sore throat are not intense and most often such a sore throat occurs after ARVI or influenza.

The main condition in the treatment of catarrhal sore throat in children is bed rest, plenty of warm drinks, frequent gargling or treatment of the throat with various sprays in young children. At adequate treatment With antibiotics, this form of acute tonsillitis goes away in 7-10 days.

Treatment of follicular and lacunar tonsillitis in children

These forms of sore throat in children are quite severe, as they are accompanied by fever; body temperature can be above 40C. Distinctive feature is that the tonsils are covered with yellow pustules (follicles up to 3 mm), as if creating a “starry sky”, and when lacunar angina- white-yellow purulent plaque in the lacunae that are located between the lobes of the tonsils.

Treatment for both sore throats is identical. The main thing is to choose an antibiotic that will accurately help cope with the causative agent of sore throat. The best option is to take a smear test bacterial culture, which will determine the sensitivity of bacteria to a specific antibiotic.

They take a swab from the throat and nose for BL, a Lefler stick (on the first day from the moment of treatment) for differential diagnosis with diphtheria. But since clinics do not have such an opportunity today, first-line antibiotics are prescribed - penicillin (ampicillin, flemoxin), second-line - macrolides (sumamed, hemomycin, azithromycin). Preference is given to the penicillin series, since in a 10-day course penicillin destroys bethemolytic streptococcus, which is threatened by rheumatism, and aminoglycosides do not guarantee that streptococci will not survive and rheumatic fever will not occur after a sore throat.

Usually, if a child is 1-3 years old with tonsillitis, treatment is recommended in a hospital setting, under the supervision of a pediatrician. But today this is not necessary - attentive, caring parents can provide the best care for the baby at home, and the doctor’s control is determined by the financial condition of the family - you can always call a paid pediatrician to your home, and if injections are prescribed and necessary, a nurse.

However, if the child’s condition is serious and there are concomitant diseases, the decision is made by the doctor and parents in favor of the hospital. Older children can undergo treatment at home, on an outpatient basis, provided that the sick child is isolated from other children, since purulent tonsillitis is a contagious disease.

How to treat a sore throat in a child?

For a speedy recovery of the child, you should strictly follow all the recommendations of the treating pediatrician. Treatment of sore throat consists of generous drinking regime, taking antibiotics, antipyretics, antihistamines, gargling, vitamin therapy and taking eubiotics.

Important! No warming procedures: compresses, hot steam inhalations, warming creams and ointments in the neck area are unacceptable for purulent sore throat!

Gargling for a sore throat

One of the directions in the treatment of sore throat in children is gargling for older children and treating small children with sprays and aerosols. However this is only in auxiliary ways, since the main treatment is taking antibacterial drugs. For more information on gargling options, see the article.

Important! Do not use the same remedy several times in a row; if you recently gave your child Faringosept during an acute respiratory infection, use Ingalipt, Lugol spray or another remedy next time.

• You can gargle with a variety of ready-made pharmaceutical products, such as sprays (use for children after 3 years) - Lugol spray, Hexoral spray, Tantum Verde (weakly effective), Ingallipt, Hexasprey (after 6 years).
• And also solutions - 0.01%, hydrogen peroxide - 2 tbsp. spoons per glass of water, a weak solution of potassium permanganate, a solution of Iodinol (1 tablespoon per 1 glass of warm water), dissolving 2 furatsilin tablets in a glass of water.
• Decoctions of herbs - sage, chamomile, calendula or ready-made collections of these herbs Ingafitol, Evcarom, Rotokan, as well as a simple solution of salt and soda (0.5 teaspoon each) and a few drops of iodine are well disinfected.
• But many pediatricians do not recommend lubricating the tonsils with antiseptics, since this damages the protective layer of the mucous membrane, which worsens the situation with purulent sore throat.
• In older children with sore throat, you can use absorbable tablets and lozenges - Faringosept, Stopangin, Strepsils (after 5 years), Hexoral tabs, Grammidin.

Local remedies for sore throat for children under 3 years of age - what should be considered?

• Sprays are contraindicated for children under 3 years of age, however, the composition of most solutions is safe for children; their use is limited due to the impossibility small child hold your breath when injecting, which is dangerous due to the occurrence of laryngospasm. Therefore, infants can spray a pacifier, and for children under 3 years of age, direct the spray onto the cheek, and not into the throat; the solution will still end up with saliva on the tonsils.
• Teach your child to gargle from the age of 2.
• Also, small children cannot keep lozenges in their mouth for a long time, so it is better not to use them in children under 3 years of age (or even 5 years of age, as there is a risk of asphyxia foreign body and resuscitation course).

What else should you know when using topical sore throat remedies?

• Be sure to read the instructions for any remedy for sore throat, use drugs only according to age recommendations and as recommended by your pediatrician.
• Some drugs (Bioparox, which will soon be discontinued), medicinal herbs, and any drug can cause an allergic reaction in children; carefully monitor your baby’s reaction to each drug.
• Any local treatment should be carried out after eating, and the frequency of treatment of the oral cavity should be every 3 hours; after the local procedure, you cannot eat or even drink for half an hour, otherwise there is no point in the treatment.
• Medicines that are highly irritating to the mucous membrane - Lugol, Iodinol - should not be used by infants, and children after one year should not treat the oral cavity with them more than once a day.
• Typically, 1-2 drugs are selected for local therapy for angina various actions so as not to overload the body medicines and adequately assess their effectiveness.

Antipyretics

With bacterial sore throat, purulent plaque does not stop yet, the child’s temperature is very high and is reduced by antipyretics only for a few hours, but when taking an effective antibiotic, it should decrease within 2-3 days. Therefore, these medications should not be taken for more than 3 days. Typically used are Calpol, Panadol (susp. and suppositories), Efferalgan, and also (Ibufen, Nurofen). Teenagers can be given Ibuklin (paracetamol + ibuprofen in the table) to reduce the temperature with a sore throat.

For a detailed description of drugs with prices and dosages, see our article.

When should you lower your temperature?

• At high temperatures, taking antipyretic drugs is indicated only when the temperature is above 38C, since during fever maximum production of antibodies against sore throat pathogens occurs, the body independently tries to fight pathogenic bacteria, and if the child tolerates 38.5C more or less calmly, then it is advisable not to knock it down.
• In infants, it is recommended to bring down the temperature already at 38C, since such a high temperature can be accompanied by vomiting, it is better to use rectal suppositories (Cefekon, Efferalgan, Nurofen).
• After one year of age, it is better for children to lower their temperature after 39C.
• If the child previously had convulsions at a high temperature, bring it down already at 37.5.

If you can't bring down the temperature medicines can be used traditional methods. Just undress the child and wipe with a damp towel, an older child (after a year) can be wiped with vodka diluted with water, and you should always remember that drinking plenty of fluids, especially with plant salicylates (black currant, cranberry, raspberry, cherry) increases sweating and helps reduce temperature by 0.5C, which can significantly alleviate the child’s condition.

Choice of antibiotic

Which antibiotic is best for sore throat in children? When choosing an antibiotic for sore throat, preference is always given to penicillins, since they are most effective against streptococcal infections and are quite easily tolerated by children, and their use does not depend on food intake. You should not give antibiotics to your child without a doctor’s recommendation.

• First-line drugs - Amoxicillin (Flemoxin solutab)
• For chronic tonsillitis and pathogen resistance, Amoxicillin with clavulanic acid is prescribed - Amoxiclav (120-300 rubles suspension), Augmentin (140-250 rubles suspension), Ecoclave (170-280 rubles suspension). When the flora is resistant to conventional penicillins, amoxicillin with clavuanic acid is indicated as a second-line antibiotic.
• If a child is allergic to penicillin antibiotics, then macrolides are used, azithromycin - Sumamed (240-400 rubles in double dosage), Azitrox (170-300 rubles), Chemomycin (suspension 140 rubles), midecamycin - Macropen (260-320 rubles) .
• Cephalosporins are prescribed in extreme cases, since these drugs are considered alternative to penicillins and macrolides. Among them:
  • Cephalexin (suspension 60 rubles)
  • Cefuroxime - Zinnat (300 rubles) Cefurus (100 rubles), Aksetin (100 rubles)
  • Cefixime - Suprax (500 rubles), Pantsef (400 rubles)

The course of antibiotic treatment should be 10 days. For azithromycin (Sumamed), 5 days are enough, since it has a prolonged effect, but for angina, the dosage of sumamed is increased. The effectiveness of the antibiotic is assessed within 3 days (based on general condition, temperature, plaque state). You cannot shorten the course of treatment when the child feels better, the temperature has dropped, the plaque has gone away - the streptococcus will survive and take revenge (rheumatic carditis) .

• If a doctor prescribes antimicrobial drugs for bacterial sore throat (staphylococci, streptococci, pneumococci) - sulfonamides, such as Biseptol, Bactrim (in tablet and syrup), you should know that today sulfonamides are not used in pediatric practice, except for Biseptol (see. ?) and other sulfonamides in last years in 50% of cases resistance is detected in bacteria.

Antihistamines, vitamins, herbal medicines

• Antihistamines

It is important to take when a child has a sore throat antihistamines, (for children over 2 years old), Suprastin, Peritol in syrup, Zyrtec, Zodak, Fenistil (see full list).

• Vitamins

Many doctors recommend taking B vitamins, vitamin C, using vitamin complexes - Centrum, Multitabs, Pikovit, Alphabet (dietary supplement), etc. But today the attitude towards vitamin complexes, especially for children, is not clear, since taking them increases the risk of developing allergic reactions, and when good nutrition the child gets enough vitamins from food (see).

• Immunomodulators

Regarding the use of other antiviral agents and immunostimulants, their use in children should be treated very carefully (see), the safest are Viferon, Kipferon, but they should not be used without a doctor’s prescription.

• Probiotics

When treating with antibiotics, eubiotics must be added to the treatment. Find as much detail as possible about all probiotics for children in our article - and also why it is preferable to use not dietary supplements, but drugs, such as Linex, Bifidumbacterin Forte, Lactobacterin, Biobakton, Bifiliz, Acylact,.

• Herbal remedies

You can use the herbal medicine Tonsilgon in drops, for infants up to 5 drops 5 times a day, for preschool children 10 drops. This is a combined herbal preparation that has an anti-inflammatory effect in diseases of the upper respiratory tract. It contains oak tannins, essential oils, chamomile flavonoids, marshmallow yarrow, so it reduces swelling of the mucous membrane of the throat.

In conclusion about possible complications

Sore throat is a formidable infectious disease that, with inadequate or delayed treatment or a weak immune response of the child’s body, can become a trigger for the development of diseases of the genitourinary, cardiovascular, bone, nervous systems body.

Therefore, it is important to take a test after recovery general tests, ECG, and also refuse any vaccinations and Mantoux test for a month. If your child experiences shortness of breath, swelling, pain in the joints or chest, consult a doctor immediately. Frequent sore throats in a child are a sign of chronic tonsillitis; contacting an ENT doctor will help proper prevention exacerbations.

Complications that may occur during the disease:

• laryngitis,
• regional lymphadenitis with abscess or cellulitis
• infection entering the bloodstream with the development of meningitis or sepsis
• involvement of mediastinal organs in the infectious process.

Complications that may occur months or years later:

• Acute rheumatic fever (arthritis of large joints, fever, carditis, chorea) with outcome in chronic rheumatic disease, with the development of heart defects and heart failure
• Encephalitis - rheumatic damage to the central nervous system
• Cardiac pathologies: pancarditis, pericarditis
• Thrombocytopenic purpura
• Acute pyelonephritis, glomerulonephritis

Content

The concept of “purulent sore throat in children,” as such, does not exist in modern pediatrics, but all parents are well aware of the symptoms of a characteristic illness - acute sore throat, high fever, complete absence appetite. Officially, this disease is called lacunar or follicular tonsillitis and is caused by pathogenic bacteria. Acute inflammation confines a small patient to bed and requires timely initiation of conservative therapy.

What is purulent sore throat in children

This pathological process inflammation of the tonsils, which causes a severe sore throat, and the presence of purulent deposits on the lacunae eloquently describes the characteristic ailment. Lack of therapy leads not only to the patient’s sudden weight loss, but also to chronic tonsillitis with relapses. Purulent sore throat can be cured using conservative methods if a specialist has selected adequate treatment.

Symptoms

The patient looks depressed, refuses food, is capricious and constantly wants to sleep. Symptoms of purulent tonsillitis differ by age and increase in the acute stage of the pathological process. It all starts with a reddened throat and painful swallowing, but further signs of a characteristic illness may be as follows:

acute pain in the throat, radiating to the ear;

• acute attacks migraine;
• symptoms of intoxication;
• pallor skin;
• cold sweat, fever;
• swollen lymph nodes lower jaw;
• inflamed lacunae of the tonsils.

Signs of purulent sore throat in children

The process of damage to the tonsils has bacterial nature, and acute inflammation starts with an increasing pain syndrome, which intensifies when chewing and swallowing food. In addition, with purulent sore throat, the child looks lethargic, behaves passively, and constantly wants to sleep. Other signs of the disease are presented below:

lack of appetite;

• lethargy, passivity;
• disturbed sleep phase;
• weight loss;
• sore throat;
• visible swelling of the neck;
• high body temperature.

Reasons for appearance

Purulent sore throat in a child is infectious in nature, and is provoked by increased activity pathogenic pathogens such as staphylococcus, streptococcus, pneumococcus, diplococcus. When identifying the causative agent of infection, one should not exclude the penetration of influenza, parainfluenza, and adenovirus viruses into the child’s body. Other provoking factors for inflammation of the tonsils are presented below:

prolonged hypothermia of the body;

• environmental factor and climate change;
• physical or emotional fatigue;
• decreased immunity;
• diseases of the ENT organs.

Complications

If a purulent sore throat is not treated in a timely manner, dangerous abscesses form on the tonsils. Photos of such clinical pictures are shocking, so it is recommended to pay attention to the first symptoms of an infectious disease. In the absence of timely comprehensive measures to eliminate purulent sore throat, other potential complications are presented below:

otitis media, sinusitis;

• rheumatic heart disease;
• peritonsillar abscess;
• arthritis;
• poststreptococcal glomerulonephritis;
• purulent lymphadenitis.

Diagnostics

A visual examination of the inflamed mucous membranes alone is not enough to definitively determine the nature of the pathology. Doctors prescribe laboratory and clinical examinations, conduct differential diagnosis. The symptoms of purulent tonsillitis in children are the first to be studied; in the future, the little patient will have to:

take a smear of pus from the tonsils to identify pathogenic flora;

• undergo pharyngoscopy to clarify the diagnosis;
• perform PCR analysis to identify the variety of microbes by their DNA;
• submit the crops to a nutrient medium;
• pass general and biochemical analysis blood.

Treatment

This health problem cannot be solved by oral administration of antipyretic drugs; it can only be temporarily stabilized temperature regime Nurofen tablets or syrup. To finally cure purulent tonsillitis, general recommendations from otolaryngologists are presented below:

It is necessary to use all approved methods to increase immunity at home, as an option - multivitamin complexes, vitamins from natural products nutrition.

1. It is necessary to take antibacterial drugs to destroy pathogenic flora. It is better to give an antibiotic for purulent sore throat in children in the form of a suspension, for example, the same Augmentin.
2. At high temperatures, the child requires complete rest and bed rest, and must drink medicinal decoctions from herbs and other warm drinks, ventilate the stale air in the room.

Drug treatment

In order to reduce and finally eliminate foci of pathology, the child is prescribed a comprehensive treatment, which includes not only conservative methods, but also physiotherapeutic procedures in a hospital setting. Emphasis needs to be placed on such pharmacological groups and their prominent representatives:

At local treatment purulent tonsillitis, the doctor prescribes antiseptics to treat the affected tonsils. This is Lugol's solution, the medications Miramistin, Stopangin, Chlorophyllipt (treat sore throat It’s much easier for a child to use sprays).

1. To reduce high body temperature, it is necessary to take antipyretic drugs orally or use rectally for the child. These are sweet syrups Nurofen or Panadol, Viferon suppositories.
2. Clinical pictures with local inflammation in the disease include symptomatic therapy, the features of which depend on the specifics of the pathological process and concomitant ailments.

Here are effective medications that will make painful attacks of purulent tonsillitis a thing of the past. So:

Instead of being treated with gargles, it is better to treat foci of pathology Lugol. This is a burning solution, which it is advisable to rub on the oral mucosa in the morning and evening for 5 to 10 days. The advantages of treatment are affordable price, high efficiency. Disadvantages - risk of burns to the mucous membrane, selective effect.

1. Miramistin. This effective treatment sore throats in children with a minimal list of contraindications, side effects. Irrigation of a sore throat is required in the morning and evening for 2 weeks. The advantage is a proven result, the disadvantage is selective action.

Antibiotics

To reduce foci of inflammation, penicillins are prescribed in order to productively destroy pathogenic flora. It is possible that representatives of the amoxicillin group may be used orally in combination with clavulanic acid, which is combined in the following medications: Augmentin, Flemoxin Solutab, Amoxiclav, Ecoclave, Flemoclav Solutab. If the body is prone to an allergic reaction to synthetic components, you can introduce an equally worthy replacement - macrolides in the form of Sumamed and Hemomycin tablets.

Here are the most effective pharmacological positions among antibiotics:

Flemoxin Solutab. Fourth generation antibiotics with systemic action V children's body. It is recommended to take the concentration of the active component (125, 250, 500 mg), according to the age category, 1 tablet in the morning and evening for a week. The disadvantage of treatment is the risk of side effects.

1. Augmentin. It is a tablet or suspension suitable for the treatment of children with early age. You should take up to 3 tablets per day in between meals. Course – 7 – 10 days. Advantages - quick effect, affordable price. Flaw - drug interactions, side effects.

Physiotherapeutic procedures

If lymph nodes are involved in the pathological process, mandatory procedure in a hospital setting, UHF is applied to the tonsil area. The treatment course is 7 – 10 sessions, positive dynamics are noticeable after 2 – 3 procedures. Other physiotherapeutic interventions are presented below:

oxygen treatments;

• electrophoresis and microwave therapy;
• universal pine baths.

Folk remedies

For purulent sore throat, it is recommended to use time-tested methods as an auxiliary treatment alternative medicine. At hypersensitivity In addition to paracetamol, doctors recommend the following folk remedies that can be prepared at home. So.