Phlegmonous tonsillitis in children: symptoms, treatment, photo

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To determine the type of angina at home is quite difficult, the classification here is very conditional. However, given the seriousness of the disease, it is necessary to pay attention to the symptoms in time, while understanding that it is not possible to treat different forms of angina by the same principle.

Incorrectly begun treatment even before the arrival of a doctor can provoke terrible complications.

Phlegmonous angina

The causative agents of true angina are always bacteria. The phlegmonous form( parathonsillar abscess) is one of the severe manifestations of acute bacterial infection caused by focal clusters of group A streptococcus in the near-meandinal cellulose and in the deep layers of the tonsils.

Significantly less inflammation causes staphylococci and haemophilus influenzae.

Palatine tonsils, performing protective functions, in some cases do not cope with the attacks of pathogens, which leads to pathological changes in these organs and beyond. Generalized inflammation of the throat is commonly called angina, but to choose a productive therapy the doctor must establish a more accurate diagnosis.

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Viral forms are less dangerous, they are not accompanied by purulent secretions and do not need antibiotics. Their application in this case is unproductive and dangerous.

Fungal lesions of the okolohlotoknoy space are treated with antifungal drugs. Symptomatic here is not acute in a fairly large area of ​​distribution.

Than angina caused by streptococcal infection is dangerous:

Causes of the disease

  • Consequence of follicular and lacunar angina.
  • Secondary infection after scarlet fever, diphtheria and pharyngitis.
  • Breaking the gland of Weber's glands( these pipe formations responsible for the removal of the products of the life of the pharyngeal cells can become inflamed or clogged).

Provoking factors, risk group

The development of pyogenic flora can be caused by several factors:

  • Mechanical throat injuries.
  • Diseases of the gums.
  • Caries.
  • Common infections.
  • Increased looseness of lymphoid tissue.
  • Weakness of the body after diseases, surgeries and antibiotics.
  • Respiratory and metabolic disorders.

Risk group:

  • People with impaired immune system.
  • Patients with diabetes mellitus.
  • Allergies.
  • Hormone-dependent patients.
  • Smokers.

Age criterion:

  • The most common disease affects adolescents and adults under 40 years.
  • Children get sick less often.
  • Elderly people are extremely rarely prone to this form of sore throat.

Symptoms and signs

The phlegmonous form of tonsillitis is always accompanied by the presence of an abscess in the area of ​​one of the glands. The area of ​​the second gland abscess usually does not affect, but bilateral foci are possible.

Depending on the location of the abscess, four types of this sore throat are distinguished:

  1. Outer( occurs from the side external from the glands).
  2. Rear( inflamed area between the gland and the posterior palatine arch).
  3. Bottom( the fiber is next to the lower pole of the amygdala).
  4. Anterior( localized behind the upper pole of the glands).

The abscess is formed on the second - the third day, his appearance is preceded by the following symptoms:

  • Sharp temperature jump up to 40 °.
  • Unilateral reddening of the palate.
  • Significant sore throat, especially when ingested.
  • Difficulty breathing on the background of edema.
  • Severe general malaise.
  • Lack of appetite.
  • Spasms of the chewing muscles.
  • Changing the timbre, nasal, possible loss of voice.
  • Increase and soreness of the submaxillary lymph nodes.
  • Putrid odor from the mouth.
  • Intensive work of the salivary glands.
  • Muscle and joint pain.
  • Intoxication.

On the photo signs of phlegmonous sore throat

In children

  • To the above symptoms, the child may be added diarrhea and vomiting. The younger the patient, the more likely is the destabilization of the gastrointestinal tract.
  • Against the background of high temperature, convulsions, movement coordination disorders and loss of consciousness are possible.
  • The general symptomatology is more acute.

It's not always possible to determine where a small child has a hotbed of pain. The rise in temperature to critical indicators already obliges to call the ambulance team.

Children should be treated in a hospital.

In adults

Timely detection of early symptomatology of phlegmonous sore throat in adults is sometimes delayed. This is due to several reasons:

  • Self-medication, when symptoms are mistaken for colds.
  • Visiting a polyclinic in a state of intense heat, which is required by the registration of a sick leave. First of all, it significantly worsens the condition and tightens the process of diagnosing, secondly contributes to contamination of others.
  • The district therapist, summoned to the house, does not have the proper equipment and qualifications to make an accurate diagnosis, and the surrender of the necessary tests again involves going to the hospitals.
  • The state of alcoholic intoxication also aggravates the symptoms and negates the effect of antibiotics, reducing the chances of alleviating the disease in the early stages.

At a temperature of 39-40 ° and with severe pain in the throat, it is most reasonable to call an ambulance, which at the first signs of bacterial sore throat will take the patient to the infectious hospital where he will be provided with the necessary treatment.


When communicating with a physician, it is necessary to clarify:

  • Symptoms and limitation of their development.
  • Recent infectious and viral diseases, if any.
  • Which medications were used for primary treatment.
  • Presence of chronic ailments and unwanted reactions to medicines.

Further it is made:

  • Primary examination of pharynx.
  • Hypopharyngoscopy( thorough examination with a glottal mirror).
  • Palpation of the lymph nodes.
  • Listening to the lungs and the heart.

To clarify the diagnosis, a laboratory diagnosis is performed:

  • A general blood test( the lymphocyte, monocyte and leukocyte counts are compared).
  • Bacteriological method( seeding the pathogen on a nutrient medium to isolate a pure culture).
  • Smear from the beet with a spatula( to determine the type of pathogen).
  • Serological methods( give an idea of ​​the severity of inflammatory reactions).
  • Antibioticogram( studies the resistance of bacteria to different antibiotics).
  • Echocardiogram( it is desirable and after recovery to identify possible cardiac complications).
  • Radiography of bones and joints( with suspected rheumatic fever, as complications of sore throat).

Picture of throat with visual inspection

Treatment of

Factors that accelerate recovery:

  • Calm and bed rest in a hospital.
  • Refusal of smoking and alcoholic beverages.
  • Maintaining a strict personal hygiene.
  • Exception from the diet of sweet, smoked and fatty foods.
  • Food is preferably liquid or crushed.
  • Consume large amounts of pure water and natural juices.


  1. In the first stages of the disease( before maturation of the abscess) conservative antibiotic treatment is practiced:
  • For primary infection, penicillin is prescribed intramuscularly or tablet preparations of penicillin series( Ampicillin, Ospen, Amoxicillin, Amosin, Sultasin).
  • In case of allergy to penicillin macrolides are used( Azithromycin, Sumamed, Zimaks).
  • If phlegmonous tonsillitis is a complication of less severe or chronic forms, the choice of drugs is individual. In such cases, the doctor may prescribe Cephazoline, Cefadroxil or other preparations of a series of cephalosporins.
  1. Anti-inflammatory and antipyretic drugs( paracetamol, aspirin, Nurofen, Ibuklin) are prescribed together with antibiotics.
  2. With severe swelling and allergic reactions, antihistamines help( Cetrin, Zirtek, Chloropyramine).
  3. For gargling throats Bioparox, Lugol solution, Hexetidine are effective.

Means for complex therapy of phlegmonous sore throat

Surgical way

  1. During the maturation of the abscess, needle aspiration is performed( pumping pus with a syringe).Pus sent to the laboratory to determine the sensitivity of bacteria to antibiotics.
  2. Completely matured abscess is opened with a scalpel. This leads to a significant relief of symptoms, but if medication does not eliminate the cause of the abscess, pus can start to accumulate again in the affected tissue. That is why independent autopsy of abscesses at home is not recommended, besides it can lead to the spread of infection to other organs.
  3. Tonsillectomy( removal of glands) is carried out mainly with chronic acute tonsillitis.

Patients with severe cardiovascular pathology and thrombosis of the brain vessels surgical treatment is contraindicated.

Video demonstration of autopsy of abscess in phlegmonous sore throat:

Folk remedies

Use "grandmother's methods of treatment" with phlegmonous tonsillitis is strictly contraindicated. It is especially dangerous to lubricate the abscess zone with self-made ointments and use all kinds of inhalations.

Only in the remission phase it is acceptable to use throat rinses based on herbal preparations, beekeeping products and various vegetable decoctions. Before their application, a doctor's consultation is mandatory.


For the prevention of recurrences during the period of remission, the following procedures are prescribed:

  • Irradiation of the tonsils with ultraviolet.
  • Electrophoresis.
  • Heating.
  • Light therapy.
  • Laser treatment.
  • Magnetotherapy.

To completely remove the risk of possible complications, it is desirable to have a second examination and the subsequent sanatorium treatment.

Features of therapy for pregnancy

Any initiative for phlegmonous angina can lead to intrauterine malformations and even fetal death. When choosing antibiotics, the doctor is guided by the features of the course of the pregnancy, its timing and the severity of the symptoms of the disease.

Modern medications approved for pregnancy are much safer for a child than complications of acute tonsillitis.

  • Before the arrival of a doctor, the heat must be lowered, it is dangerous. Use aspirin and strong painkillers can not, usually enough to wipe the legs with acetic-alcohol solution and paracetamol tablets. In extreme cases, you can take a contrast shower.
  • The use of thermal procedures can lead to premature birth.
  • Food intake is extremely difficult, but you can not refuse to eat. When choosing food, broths, liquid cereals, baby food and fruit puree are preferred. The most important thing for future mothers is to avoid stressful situations. Possible reception of mild sedatives.

The timing of treatment for a favorable course of the disease in pregnant women is the same as for the rest.

Possible complications of

  • Infection of the blood.
  • Meningitis.
  • Cerebral abscess.
  • of the phlegmon of the neck. Necrosis of the nearest tissues.
  • Rheumatism.
  • Jade.
  • Cholecystitis.
  • Orchitis.
  • Otitis.

More information about complications after sore throat in our video:

Prevention and precautions when communicating with a patient

There is no specific prevention of this disease.

  • General actions should be directed to support of immunity, observance of sanitary norms and personal hygiene.
  • During the period of the spread of bacterial and viral diseases, it is necessary to limit to a minimum the attendance of mass events.
  • When communicating with an infected person it is important to understand that any purulent diseases are contagious. Even after leaving the hospital for a couple of weeks, a person can be an infection carrier. Therefore, at home, you should conduct regular wet cleaning using disinfectants and several times a day to ventilate the room.


Modern medicine has enough medicament and surgical means for the treatment of phlegmonous sore throat. If all the medical prescriptions are observed, complications do not occur very often, but still the probability of their occurrence exists.

The disease always proceeds in acute purulent form and is not subject to home treatment, especially in children and pregnant women.

The terms of the cure are individual, can last up to several months.

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