clinically herpetic tonsillitis in children was first described in 1924 Zahorsky, and 1951-ohm Huebner et al with the virus was Coxsackie A. The most common pathogens are gerpanginy enteric viruses (Picornaviridae family, genus Enterovirus), CoxsackieA (serotypes 1-10, 16, 22), B (1-5), and echovirus (3, 6, 9,25).
most commonly affects children under 5 years old, at least teenagers.. Herpangina in children can manifest itself in an isolated form, or in combination with meningitis, myalgia, myelitis, etc. The source of infection is the only man: the sick and the convalescents who continue to shed virus for 3-4 weeks.
disease can be as sporadic as well as major epidemics.The primary infection is the gateway to the mucous membrane of the respiratory tract, where it forms a primary defect - papule, vesicle and then.
Clear signs of disease
Symptoms of herpetic tonsillitis discussed below.Herpangina children begins acutely, with a temperature rise to 39-40 ° C.It often worsens the general condition:
characterized by rapid growth of local changes.After a few hours on the mucosa of the palatine arches, the tonsils, the soft and hard palate, posterior pharyngeal wall there are small isolated papules, reddish in color and diameter 1 -2 mm, clearly demarcated, which turn into vesicles still a couple of hours (up to 5 mm in diameter), which never merge.The number of vesicles may range from 5 to 20. After 24-48 hours the vesicles are opened with the formation of a whitish-gray ulcers, surrounded by flushing rim.Sores may merge, forming defects up to 10 mm in diameter.Sore throat is not expressed or absent.
However, it should be remembered that, along with the typical symptoms, can be observed and erased forms in which there are only catarrhal changes in the oropharynx, mucosa without defect.
How sick sore throat?
fever usually lasts no more than 3-5 days and mucosal defects heal in 6-7 days without any trace.
Gerpanginu should first differentiate with aphthous mouth diseases (herpetic stomatitis, candidiasis, oropharyngeal chemical damage), varicella.
Usually the diagnosis of herpetic angina does not cause much difficulty, based on characteristic clinical picture.But for the final formulation of necessary data and or viral serologic studies.The material for virological examination are nasopharyngeal swabs, taken on the first or second week of disease.
For serological take paired sera (first up to the 5th day, the second - after the 14th day of illness).Diagnostically significant increase in antibody titer is 4 times or more.Typically used neutralization reaction, precipitation reaction in gel and others. Complete blood count uninformative.
Treatment isolated herpetic tonsillitis in children treated on an outpatient basis.Causal treatment is not developed.Children receive symptomatic and pathogenetic therapy.Assigned to bed.
When fever - antipyretics (paracetamol at a dose of 15-20 mg / kg body weight, in syrup, tablets, injections, suppositories, in the absence of contraindications);ibuprofen (at appropriate dosage) along with antihistamines (Claritin, loratadine, citrine).When the pain in the throat, oral antiseptics used with anesthetic action (septefril, septolete plus strepsils).
should also avoid eating food mechanically rough and having irritable effect (salt, spicy, acidic).Keep in mind that herpes sore throat in children, which is untreated, can lead to serious complications (encephalitis, myocarditis, hemorrhagic conjunctivitis).
specific prophylaxis has not been developed.Total prevention is restorative and recreational activities (hardening. Balanced diet, etc.), early detection and isolation of patients.
for patients and contact is established quarantine for 14 days.The current focus of infection is carried out and the final disinfection.