Angina - causes, symptoms and treatment

Angina - causes, symptoms and treatment

Infectious Diseases

Angina is usually associated with relatively harmless childhood disease. However, it can also occur in adults and should not be underestimated, because complications as a result of it are sometimes very dangerous. So, it's worth knowing how to recognize angina, what to treat it with and when to go to the doctor.

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Angina is an acute tonsillitis of the palatine tonsils and mucous membrane caused by infection or irritation. Contrary to common opinion, this disease is most often caused by viruses, and only about 10 - 15% of angina in adults has a bacterial etiology (even less often fungal) and requires antibiotic treatment. So how do you distinguish between purulent and viral angina?

Symptoms of viral angina

Viral angina, or viral pharyngitis starts with an initial feeling of weakness, muscle and joint pain and an unpleasant scratching sensation in the throat. Over time, a moderate sore throat occurs, but it is a subjective symptom and can sometimes be particularly annoying. The throat is usually red and the palatine tonsils may be slightly enlarged, but without the bacterial streptococci characteristic of angina. With viral pharyngitis, a subfebrile fever state usually occurs (body temperature is within 36.7 - 38.0 ° C). Sometimes the temperature of the body is not increased at all, and fever is even less frequent (temperature above 38.0°C). Viral symptoms and a cough are very common in viral angina.

How to treat yourself in the case of viral angina?

A patient who suffers from a viral pharyngitis should be treated symptomatically. All sorts of home remedies that will help to relieve a sore throat will be perfect here. You can drink hot water with honey etc. or try a salt rinse to gargle with. It is imperative that you do not swallow a salt rinse. We recommend that you drink a lot of cold (but not ice-cold) drinks and avoid spicy foods. You can also buy lozenges, throat sprays or ready-made rinses at the pharmacy. Over-the-counter cough syrups and aerosols to reduce nasal mucosa are also available. However, the low-grade fever should not be reduced because it is a natural defensive reaction of the body. Taking paracetamol or non-steroidal anti-inflammatory drugs (i.e. ibuprofen) is recommended only in the case of particularly poor tolerance of elevated temperature or headache. Of course, the most beneficial method of dealing with this particular disease is rest, a large amount of sleep and healthy eating. Remember that antibiotics are not effective in the case of viral infections. However, the use of an antibiotic may be necessary if a bacterial infection develops as a result of viral pharyngitis, this is why it is especially important to wash your hands frequently and avoid large clusters of people.

Signs of bacterial angina

In the case of angina with bacterial etiology (most often caused by Streptococcus pyogenes), the rapid appearance of symptoms is characteristic. Inflammation is affected by both the throat and palatine tonsils, on which characteristic white or whitish-yellow deposits occur. This results in a very severe sore throat, which often hinders swallowing solid foods. In contrast to the viral pharyngitis, in the case of bacterial angina, fever is almost always present (temperature> 38 ° C), which sometimes reaches even 40 ° C and chills. There is usually no cough or runny nose. Very often, enlargement of the submandibular and cervical lymph nodes is also present.

How is bacterial angina treated?

In the case of symptoms characteristic of a bacterial infection, it is necessary to go to a general practitioner who, after examination, will prescribe an appropriate treatment. Please do not use any antibiotics unless you have been prescribed them by a doctor for this specific ailment because it is necessary to choose the right drug and dose. A poorly selected antibiotic or inadequate dose will not work and may cause side effects. In addition to the antibiotic, you should also take a probiotic, painkillers, and antipyretics (ibuprofen or paracetamol) and sore throat remedies (in the same way you might treat viral pharyngitis). Fighting fever can be aided by cold wraps on the forehead and neck, as well as proper hydration by sipping water, raspberry juice or lime tea.

How do doctors distinguish viral and bacterial angina?

Diagnosis is based on the patient's complaints and physical examination (it is necessary to look at the throat and mouth, as well as the assessment of lymph nodes). However, sometimes physicians find it difficult to make a proper diagnosis. For this purpose, it is helpful to use the Centor scale below in the McIsaac modification.

Symptom/feature Number of points
body temperature >38°C 1
there is no cough 1
enlarged frontal lymph nodes 1
tonsillar exudate and swelling 1
3–14 years old 1
15–44 years old 0
age >45 years old -1

Total points: 0-1

Total points: 2-3

Total points: 4

How long does it take for angina and when the patient stops infecting?

Viral inflammation:

Zapalenie bakteryjne (paciorkowcowe):

What are the risks of untreated bacterial angina?

In the case of viral angina, the prognosis is good, and the main complications are usually are prolonged dry cough or bacterial infection. In contrast, untreated streptococcal sore throat, although it resolves spontaneously, can lead to the development of serious complications, such as:

  1. Purulent complications (early) – periparous abscess, purulent cervical lymphadenitis, purulent otitis media and/or mastoiditis, purulent inflammation of the paranasal sinuses.
  2. Late immunological complications (very rare in adults) – rheumatic fever, acute glomerulonephritis.
  3. Other (very rare) – bacteremia, pneumonia, meningitis.
  4. In infection with etiology of F. necrophorum – Lemierre syndrome (intraocular abscess with thrombophlebitis), sepsis with abscesses in various organs.
Bibliography:
  1. Interna Szczeklika 2018 Internal Diseases Handbook, Authors: Piotr Gajewski, Andrzej Szczeklik Publisher: Medycyna Praktyczna
  2. Inflammation of the throat and angina, December 12, 2012, Author: Bożena Skotnicka,
  3. Centor scale in McIsac's modification
  4. http://www.mp.pl
  5. https://www.mp.pl/pacjent/
  6. https://www.mp.pl/pacjent/pediatria/choroby/laryngologia/78438,zapalenie-gardla-i-angina
  7. https://www.mp.pl/pacjent/otolaryngologia/lista/120798,leczenie-anginy
  8. https://www.mp.pl/pacjent/pediatria/lista/83564,powiklania-anginy
  9. https://pediatria.mp.pl/choroby/laryngologia/78438,zapalenie-gardla-i-angina
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