Kids are susceptible to various infectious diseases, and almost every parent has heard the diagnosis of angina. A special place among throat diseases is occupied by viral tonsillitis in children, because the nature of this disease differs from the usual bacterial tonsillitis. The causative agents of viral sore throat are viruses that specifically affect the child's body.
The treatment of viral tonsillitis in children differs from the usual scheme, therefore it is important to recognize the disease correctly and in time. But how to define a viral disease in children and distinguish it from bacterial tonsillitis? We will talk in this article about what parents must know, what should be paid special attention to when treating a disease.
What is viral sore throat?
Viral sore throat is an infectious disease caused by viruses, which is manifested by damage to the mucous membrane of the oropharynx, intestines and other internal organs.
Causes of viral sore throat in children
Adenoviruses and enteroviruses can cause angina. Particular importance is attached to the most common form - herpangina, which is caused by enteroviruses.
Herpetic sore throat got its name due to the similarity of lesions of the mucous membrane with a rash with herpes. A blistering rash can spread to the area around the mouth, lips, which causes many errors in the diagnosis of the disease. A more accurate name for the disease is enteroviral vesicular pharyngitis or stomatitis.
Enteroviral sore throat is most often caused by Group A Coxsackie viruses, group B viruses are less often isolated, in 25% of cases, another type of virus is found - ECHO. All these pathogens are highly contagious (infectious).
The features of the Coxsackie virus are as follows:
- the danger of infection with a virus is due to the possibility of an infectious agent to infect the nervous system, internal organs of the child;
- the favorite habitat of the pathogen is a humid environment, open bodies of water, soil, sewage. The presence of a virus on food, household items is not excluded;
- the pathogen is highly resistant, can remain viable for several years under the influence of low temperatures. Alcohol, antibiotics, lysol cannot get rid of the virus;
- the pathogen is sensitive to high temperatures, and dies instantly when boiled. Of antiseptics, solutions containing formalin or chloramine are suitable for fighting the virus;
- not all people get sick when exposed to the virus. People with weakened immunity are most susceptible to the development of infection;
- most cases of infection with the virus end in full recovery and do not have negative health consequences;
The development of a viral disease for pregnant women is very dangerous. The virus often leads to damage to the fetus and even to its intrauterine death. The disease is also unsafe for people with weakened immunity, in whom the disease is severe with the development of complications.
- the incubation period for a viral infection ranges from 2 to 10 days.
A less common cause of viral sore throat is adenovirus. Causes not only damage to the tonsils, but also conjunctivitis, runny nose, cough, diarrhea. Adenoviral sore throat is characterized by membranous deposits, which are removed during processing.
Virus penetration routes
- alimentary;
When eating contaminated food, drinks, the pathogen may enter the gastrointestinal tract.
- airborne;
The virus enters the environment when the carrier of the infection sneezes or coughs, after which the pathogen enters the mucous membrane of a healthy child.
- contact and household;
With close contact with the carrier of the infection, especially in the first 5 days from the onset of the disease, the virus is easily transmitted through household items, toys, dishes. Especially dangerous are kissing and contact with saliva or secretions from the mouth, pharynx.
- water.
Often outbreaks occur in children attending the same pool. Often, the disease overtakes babies on vacation near water bodies.
Distribution mechanism
The virus enters the child's body through the mucous membrane of the nasopharynx or mouth. With the flow of lymph, the infectious agent enters the lymph nodes, where it actively multiplies and spreads through the circulatory system throughout the body. A large number of viruses concentrate on the mucous membrane of the oropharynx, in vesicles and plaque. In the case of the prevalence of the process, bubbles can form on the internal organs.
In severe cases, a specific rash can affect the internal organs - the gastrointestinal tract, kidneys, heart, nervous system. The child develops convulsions, indigestion, pain in the heart.
The disease appears more often in childhood. This is due to the large number of contacts between babies, visits to childcare facilities, and non-compliance with preventive measures. Children from 3 to 10 years old are most susceptible to the disease. Newborns and infants, under the condition of natural feeding, are reliably protected from disease by maternal antibodies.
In adults, viral tonsillitis is rare, and its manifestations are erased. The disease overtakes people with weakened immunity, systemic diseases who have not previously had a sore throat.
After a person has suffered an ailment, a strong immunity to the viruses that caused the disease is formed. The disease cannot recur again over time and does not become chronic.
Seasonality of the disease
In most cases, viral angina makes itself felt in the warm season (enteroviruses) and in the off-season (typical for adenovirus). Outbreaks of the disease often occur in the summer and autumn, when the pathogen is especially active.
Source of infection
The disease is very common among children attending child care facilities. A sick child quickly infects others, because there are several ways of infection. In addition, the source of infection can be a baby who has had a disease. Isolation of the pathogen during the carrier of the virus lasts for a month.
Although the disease is mainly transmitted from person to person, cases of infection from pigs have been recorded.
Infection factors
Although the disease is very common and highly infectious, not all people exposed to the virus get sick. The disease can occur with a combination of various factors.
- decreased immunity;
The inability of the immune system to give a proper response when the infection penetrates, low immunoreactivity is the main factor in the development of the disease.
- stress;
Stressful situations noticeably reduce the defenses of the child's body. Stress can be attributed to unfavorable relations in the family, the adaptation of the baby to a new team, kindergarten or school.
- overwork;
Excessive stress at school, physical and mental fatigue increase the risk of developing an illness.
- background diseases;
Children with chronic diseases, metabolic disorders, adenoid vegetations who have had infectious diseases are more likely to get viral sore throat.
- congenital pathologies of immunity.
With immunodeficiencies, oncological diseases, the child is susceptible to the development of infectious diseases.
Signs of viral sore throat in children
The first signs of the disease can occur at different times, it all depends on the body's resistance to infection. Usually, the first manifestations occur 3 to 14 days after the child's contact with the source of the disease. The incubation period passes without visible changes in the baby's condition, nothing betrays the development of the disease.
After the end of the latent period, the first manifestations of the disease appear, the severity of which is also individual. Some children tolerate the disease well and easily, others feel a significant deterioration in their general condition from the very first day of the development of the disease.
Symptoms of viral sore throat in children include a number of manifestations.
Hyperthermia
The disease usually occurs with a high febrile temperature, up to 40 ºС. The temperature rises quickly and is hard to get off with conventional anti-inflammatory drugs. Hyperthermia is characterized by 2 peaks of temperature rise - on the first and third days, high numbers remain on the remaining days. The symptom persists for about 4 to 5 days, then gradually decreases against the background of the treatment.
Rash on the palate and on the tonsils
2-3 days after the temperature rises, a characteristic rash appears in the mouth. The rash is small reddish papules. Nodules are located on the mucous membrane of the tongue, pharynx, tonsils and palate in the amount of 3 to 7 pieces. In severe infections, the disease begins with a profuse rash containing more than 20 papules.
It happens that papules appear in small numbers and it is difficult to notice them, which leads to diagnostic errors.
Gradually, the papules increase in size and turn into vesicles (vesicles with serous contents). After 24 - 48 hours, the vesicles break open, and gray-white ulcers are formed on the mucous membrane, surrounded by a red crown. If the sores are close together, they can coalesce and form a larger defect.
The resulting ulcers bring significant pain to the child. The usual meal or drink becomes a real test for the crumbs. The child cries, complains of a sore throat, often there is a feeling of "coma" and burning.
With adenovirus sore throat, the rash looks like white millet grains or membranous translucent plaques located on the tonsils.
Lymphadenopathy
Since the lymphatic system plays a significant role in the spread of the virus, enlargement of the lymph nodes is very characteristic of the manifestation of infection. Cervical lymph nodes are most susceptible to changes, they become dense, swollen, painful when touched.
General symptoms
The child's well-being is disturbed, the baby becomes lethargic, capricious, irritable. Sleep and appetite are significantly impaired, symptoms of intoxication appear. Muscle pains may occur, especially in the neck. Often, babies complain of headache, malaise, catarrhal phenomena appear - runny nose, cough.
The development of intoxication and dyspeptic disorders is more typical for children; in adults, the disease most often goes away without complications.
Indigestion
Problems from the gastrointestinal tract are associated with both general intoxication and the effect of enterovirus or adenovirus on the intestinal mucosa. Often there is nausea, vomiting, loss of appetite, diarrhea may develop.
Rashes in the oral cavity persist on average for 3 - 5 days, the healing of ulcerated areas begins from the 6th - 7th day of illness. But there are cases of a wave-like course of the disease, when the appearance of a rash is repeated every 2 to 3 days. This course is typical for weakened children with somatic diseases. In the case of a severe course of the disease, a vesicular rash appears on the trunk, hands and feet.
Rash on the body
In some children, the rash is not limited to the oropharyngeal cavity, elements can be found on the skin of the hands and feet. Rashes are localized more often on the palms of the hands and soles of the feet and are small bubbles with a corolla of redness along the periphery. Usually the rash lasts from 5 days to a week and disappears without leaving a scar.
Diagnostics and differential diagnostics
The disease is determined by a pediatrician or otorhinolaryngologist; for an experienced specialist, the diagnosis of the disease is not difficult and includes the following methods.
- collection of anamnesis;
The doctor pays attention to the age of the baby, visits to the children's team and the possibility of contact with sick children. Chronic somatic diseases and disorders in the functioning of the immune system also indicate the possibility of developing sore throat.
- inspection;
To establish a diagnosis, a specialist carefully examines the baby's oropharynx (throat), paying attention to the presence of a specific blistering rash or plaque. In the presence of rashes not only on the mucous membrane of the oropharynx, but also on the body, it is worth differentiating the disease with the hand-foot-mouth syndrome.
The course of the disease is sometimes similar to the hand-foot-mouth syndrome, also caused by enteroviruses. But, unlike herpangina, with the syndrome, the rash does not spread to the tonsils.
Viral sore throat must be distinguished from other pathologies, for example, with thrush on the tongue, palate, inner surface of the cheeks, a whitish coating is noticeable, bubbles do not appear with thrush.
Viral sore throat is easy to confuse with herpetic stomatitis, in which the rash is also blistering, and the disease goes away with an increase in temperature. But with stomatitis, the rash is located mainly on the tongue and gums and never spreads to the tonsils.
Bursting vesicles with serous contents and plaque with adenovirus infection can be confused with purulent discharge with bacterial sore throat. Diseases can be distinguished by paying attention to the localization of the rashes; with tonsillitis, the discharge does not go beyond the tonsils. In addition, viral sore throat is characterized by the presence of a runny nose, which may not be present with bacterial sore throat.
- laboratory diagnostics:
- clinical blood test - will show an increase in leukocytes;
- sowing swabs from the pharynx - will help exclude other microflora;
- enzyme immunoassay - helps to determine the presence of specific antibodies that are formed in response to the penetration of the virus. With an increase in antibodies by 4 times, one can confidently diagnose "viral angina";
- polymerase chain reaction (PCR) - is needed to detect the virus itself in swabs from the patient's throat. This method helps to identify the DNA of the virus for accurate diagnosis;
- lumbar puncture - performed to study the cerebrospinal fluid. Diagnostics is prescribed only for children with signs of damage to the nervous system.
- expert advice.
In the case of a severe course of the disease and suspicion of damage to internal organs, consultation of a neurologist, urologist, nephrologist, cardiologist is required.
How to treat a viral sore throat in a child?
According to Dr. Komarovsky, the treatment of viral sore throat in children should be aimed at eliminating the symptoms of the disease, preventing dehydration. The use of antibiotics does not reduce the risk of complications of a viral infection, and the treatment of herpetic sore throat in children with Acyclovir is unreasonable, since the drug does not act on the virus.
- bed rest;
A simple but important way to speed up the recovery time and prevent the development of complications.
- fight against hyperthermia;
For lowering body temperature and pain relief, anti-inflammatory drugs based on paracetamol and ibuprofen are suitable.
- gargling;
To prevent the attachment of a secondary infection, it is recommended to rinse the oropharynx with solutions for gargling the throat, antiseptic agents, for example, Miramistin, Ajisept, Biocid. If a viral sore throat has developed in a child under one year old, the oropharynx should be irrigated with a syringe without a needle.It is possible to rinse with decoctions of medicinal herbs - chamomile, calendula.
- local anesthesia;
To relieve pain and inflammation in the throat, aerosols are suitable: Ingalipt, Geksoral, Tantum-Verde or lidocaine solution.
- antiallergic drugs;
Drugs such as Cetrin, Fenkarol, Claritin will prevent the development of allergic reactions and have a decongestant effect.
- physiotherapy.
UFO of the oropharynx can accelerate the healing of ulcers and shorten the recovery time.
Pay attention to the child's drinking regime, suggest that the child choose the right drink. Although the baby's appetite is reduced, make sure to consume enough food and drinks in crumbs. From food recommended soups-mashed potatoes, jelly, porridge. All products must be of a liquid consistency, so as not to further injure the delicate mucous membrane.
What not to do?
- Treat the disease with antibiotics and anti-herpes virus drugs, such as Acyclovir.
- Treat the throat with Lugol's solution, which additionally injures the tissues and causes allergic reactions.
- To carry out inhalations, put compresses. Such treatments locally increase blood circulation, increase body temperature, and can provoke the spread of infection.
Complications
This infection is dangerous due to the possibility of the virus infecting not only the mucous membrane of the baby's oropharynx, but also the nervous and muscle tissue. The most dangerous complication is considered damage to the brain and its membranes in the form of meningitis and encephalitis.
With a generalized form of the disease, damage to internal organs is possible with the development of pyelonephritis, myocarditis, hemorrhagic conjunctivitis. A protracted course of the disease creates the prerequisites for an abnormal immune response and the development of a rheumatic process.
The virus significantly reduces the body's defenses and creates soil for the attachment of bacterial microflora. The bacteria cause suppuration of the mucous membranes with the formation of abscesses and phlegmon.
Prevention
Since the probability of catching the virus from a sick child is very high, anti-epidemic measures become a method of prevention:
- identification and isolation of a sick child;
- introduction of quarantine for contact persons for at least 14 days;
- a baby who has suffered an infection can return to the team no earlier than a week after the onset of the disease;
- the introduction of specific gamma globulins to children who have come into contact with an infected child;
- disinfection of the epidemiological focus;
- strengthening the body's defenses by rationalizing the regime of work and rest, healthy nutrition, hardening;
- obligatory daily walks, wet cleaning of the premises;
- the baby's compliance with the rules of personal hygiene, washing hands, using personal personal care items.
Enteroviruses and adenoviruses differ in a large variety, therefore, specific vaccinations against them have not been developed, with the exception of vaccines against poliomyelitis. But immunity from re-infection after an illness persists for life.
Conclusion
Infection with viruses is common in children under 5 years of age. The development of viral sore throat in babies is no exception.
The disease has characteristic features, and in a typical course, it is not at all difficult to suspect and identify the disease. Difficulties arise with a small number of elements of the rash or with localization of the rash in atypical places. In doubtful cases, laboratory diagnostic methods and consultation of an experienced specialist will help to recognize the ailment.
The appointment of adequate therapy also depends on the correct diagnosis. Parents should know that it is wrong to treat an ailment with anti-herpes drugs or antibiotics, that attention should be paid to the child's care and drinking regime during illness. Although the disease brings a lot of painful sensations and anxiety to the baby, most often the disease is benign and does not cause any complications.
