What is tonsillitis and its symptoms. How to properly treat chronic tonsillitis in adults. How to treat chronic tonsillitis

The palatine tonsils are considered the only major obstacle to pathogenic microorganisms spread by airborne droplets. Getting on their mucous membrane and in the gaps, which are a kind of gate through which a special secret is released that resists infections, microbes provoke a reaction aimed at fighting them. In some cases, the palatine tonsils cannot withstand the attack of the infection and become inflamed themselves. This phenomenon is known in medicine as angina.

Not cured inflammatory diseases throat and palatine tonsils can lead to such a phenomenon as chronic tonsillitis (photos in the article are provided). This ailment appears in most cases in childhood. What is this disease, what are its causes and symptoms, how is chronic tonsillitis treated? All this is worth discussing in detail.

Why does tonsillitis appear?

Several causes contribute to the appearance of tonsillitis, including repeated exacerbations of the acute form of the disease or frequent tonsillitis. It is interesting that chronic tonsillitis in a child in 90% of cases occurs precisely for these two reasons, while in adult patients the list of provoking factors is much wider. These include:

High levels of air pollution that people breathe.
High content in drinking water contaminants.
Decreased level of the body's natural defenses - immunity.
Systematic hypothermia of the body.
Stress.
Chronic respiratory and digestive diseases: caries, sinusitis.
Incorrectly composed diet with a predominance of foods containing carbohydrates and proteins.
Systematic fatigue.
The presence of bad habits: smoking and drinking alcohol.
hereditary predisposition.

Forms of the disease

As for such a disease as chronic tonsillitis, the reviews of experts indicate the presence of several of its forms. First, it is a relapsing form, which is characterized by frequent occurrence inflammation of the pharyngeal mucosa, that is, tonsillitis. Secondly, it is a protracted form, in which inflammation of the palatine tonsils proceeds sluggishly over a long period of time (up to 3 weeks). And, finally, the third form of the disease, in which exacerbation of chronic tonsillitis and tonsillitis do not appear for a long time. Each form of the disease requires special approach to the treatment and prevention of exacerbations. It is this knowledge that helps to understand how chronic tonsillitis is treated in each case and why this or that method is chosen.

Symptoms of the disease in adults and children

Chronic tonsillitis in adults and children manifests itself with various symptoms, which may not always directly indicate the presence of this particular disease. Let's consider the main ones. In an ailment known as chronic tonsillitis, in adults, the symptoms often resemble ordinary overwork and boil down to constant headache, weakness, and a significant decrease in performance. This symptomatic picture is due to intoxication of the body with the waste products of bacteria that live on the surface of the palatine tonsils and inside them. Chronic tonsillitis in a child also manifests itself. At the same time, parents may notice that he absorbs materials worse at school or kindergarten became irritable and tearful.

The second most notable sign of the presence chronic form tonsillitis - feeling foreign object in the throat. This phenomenon means that the lacunae of the palatine tonsils are clogged with large plugs, consisting of caseous masses, which, moreover, may not contain a large number of leftover food. As a rule, the appearance of such plugs is accompanied by bad breath even in the absence of diseased carious teeth and with absolutely healthy gums.

Staphylococci and streptococci that multiply in the palatine tonsils can cause unpleasant symptoms from almost all organs of the human body, as they penetrate almost any part of the body from the affected tonsils. Here are just a few of the symptoms that may bother adults and children in the presence of chronic tonsillitis:

feeling of ache in the joints and bones;
disturbances in the work of the kidneys, pain in their area;
disturbances in the work of the heart, weak cardiac colic;
skin rashes that do not respond to treatment;
systematic increase in body temperature to subfebrile values.

It is worth noting that this is how chronic tonsillitis manifests itself in adults and children from many organs, but this does not mean the absence of their pathology, since the microorganisms that have penetrated into them, unfortunately, cause inflammatory process.

Why is chronic tonsillitis dangerous if left untreated?

The chronic form of tonsillitis is dangerous, first of all, because it quickly becomes the cause of various complications that affect many body systems. Produced by pathogenic microflora that lives in the tonsils, toxins most often affect cartilage and ligaments, which is why a sick person can constantly suffer from pain in the joints and muscles.

However, the most terrible is the relationship of tonsillitis with heart disease. This is due to the fact that the specific protein material synthesized by streptococcus in the tonsils is similar to the protein that makes up the connective tissues of the heart. As a result of this similarity immune cells begin to attack not only foreign cells, but the heart itself, thereby causing myocarditis or bacterial endocarditis.

The same causes underlie the emergence and development of diseases such as glomerulonephritis and rheumatoid arthritis. As can be seen from the above information, you should not joke with a disease such as chronic tonsillitis. The symptoms and treatment of this disease require the most attentive attitude, otherwise its effect on the body can have serious consequences, especially in childhood.

Methods of treatment of chronic tonsillitis

Consider a few highlights of how chronic tonsillitis is currently treated. It is worth immediately reminding readers that the methods of treating diseases of the oral cavity and pharynx have changed somewhat due to the entry of high technologies into medicine. So, first of all, all methods of getting rid of the chronic form of tonsillitis are conservative or surgical methods.

If 25-30 years ago, when making a diagnosis, specialists tried to immediately resort to the removal of palatine tonsils, today ENT doctors try to use as many ways as possible to get rid of the disease with the help of medical technologies and medicines. This is due to the fact that when the tonsils are removed, the human body remains practically defenseless against infections transmitted by airborne droplets. What are the features of these methods, we will find out right now.

Conservative treatment of tonsillitis

Chronic tonsillitis (photo above) in clinics begins to be treated according to the following plan.

Cleansing of palatine tonsils clogged with a pathological secret with a syringe or a special Tonsilor apparatus. The first method is less effective and more traumatic than the second, therefore, in recent times it is used only in unequipped medical devices offices.
Effects on the tissues of the tonsils and rear wall palate with ultrasound, laser, vibroacoustic apparatus, medicinal solutions. This group of measures is aimed at eliminating swelling of the tissues of the throat and palatine tonsils, reducing the amount of bacterial microflora in them and improving natural trophism.
Drug therapy, taking antibiotics and immunomodulators of synthetic or plant origin.
The appointment of a diet aimed at preventing irritation of the palatine tonsils and strengthening immunity.

Surgical removal of palatine tonsils

Treatment of chronic tonsillitis in adults and children surgically subdivided into tonsillectomy and tonsillotomy. As a rule, during these procedures, the palatine tonsils are removed from both sides, and very rarely from only one. What is the data surgical operations? A tonsillectomy is complete removal tonsil tissue, and tonsillotomy is a partial surgical excision of the tonsils. Without exception, all operations to remove the palatine tonsils are performed under local or general anesthesia.

Along with these two operations, some medical institutions practice the so-called abscesstonsillectomy, which is surgical removal tonsils against the background of a fully developed paratonsillar abscess. The main disadvantage of this procedure is high level soreness during its implementation, since the suppuration of the removed tissues becomes an obstacle to the sufficient absorption of anesthetic drugs.

Chronic tonsillitis: treatment with folk remedies

Another fairly common way, which is even more popular than the conservative and surgical treatment of tonsillitis, is traditional medicine, which has absorbed the experience of hundreds of generations who have encountered this disease. There are hundreds of recipes to help mitigate the course of the disease and even completely eliminate chronic tonsillitis. Alternative treatment divided into external effects on inflamed palatine tonsils and normalization inner atmosphere body, which helps it to cope with the infection on its own.

External remedies include pastes for the tonsils, infusions or decoctions for gargling, poultices and compresses on the neck area from medicinal herbs and other products. The means for internal use include teas, decoctions, tinctures and infusions, extracts, inhalations and much more.

External means for the treatment of chronic tonsillitis

In order to get rid of sore throats and inflammation of the tonsils in a disease such as chronic tonsillitis, treatment with folk remedies offers several fairly simple recipes. Consider the most popular of them.

A poultice of dried violet flowers roasted in a little vegetable oil. In a warm form, they put it on the neck in front and leave it all night. This method is applicable at any age, but it is not recommended for pregnant women.
Propolis is one of the folk remedies, the effectiveness of which is recognized official medicine. It can be used in childhood, during pregnancy and lactation. The easiest way: keep a piece (1-2 g) of purified propolis in your mouth for an hour. In addition, you can use propolis infusion on medical alcohol (20 g per 100 ml of alcohol). Dissolve 10 drops of tincture in half a glass of boiled cooled water and gargle with this composition 5-6 times a day.
Paste for application to the tonsils. The composition of such preparations usually includes parts of plants that have a softening and antimicrobial effect. For example, one traditional medicine recipe suggests using flax seed, mustard (not mustard powder!), garden radish and parsley, as well as a small horseradish root. After grinding all the components to a state of thick mass, it can be slightly diluted boiled water to make it easier to lubricate the tonsils.
Inhalations using essential oils of tea tree, eucalyptus and chamomile are carried out either in the usual way using a saucepan with hot water or with a nebulizer. This method helps eliminate inflammation and helps reduce coughing. It is worth recalling that the greatest effectiveness of the treatment of chronic tonsillitis with inhalations occurs if they are carried out during the period of remission, that is, in the absence of pronounced inflammation in the tonsils.

Despite the fact that traditional medicine is considered by many to be absolutely safe and harmless, one should not forget that serious complications can occur when using some recipes. To such "dangerous" methods of treatment, experts include the use of kerosene and other petroleum products to eliminate inflammation of the palatine tonsils. Remember that such specific and not always justified remedies can lead to severe poisoning and burns of the digestive tract.

Drinks for the treatment of chronic tonsillitis

You ask: "How is chronic tonsillitis treated with tea?" Everything is simple! Firstly, health drinks include many herbs that are very useful not only for the throat, but also for the body as a whole. Secondly, healing drinks are much tastier and more pleasant to use than pastes that have to be applied to the tonsils, or frequent rinsing. And thirdly, it's just delicious!

The most effective against chronic tonsillitis are drinks containing bee products: honey and propolis, as well as citrus fruits, ginger, garlic and onions. Such components of teas and infusions help fight not only inflammation of the palatine tonsils, but also directly with the infection in them. Here are just some recipes for medicinal drinks, the use of which, according to traditional healers helps to get rid of chronic tonsillitis.

In 0.5 liters of warm boiled water, add juice from two limes and two lemons, 10 tbsp. l. natural bee honey, stir well. Drink the resulting drink throughout the day. This tool can be used to treat patients from the very early age and during pregnancy, provided there is no allergy to the components that make up the drink.
Add a pinch of turmeric and ground white pepper to a glass of hot milk, stir and drink the drink before bed. It is necessary to use this remedy within 3-4 days.
To prepare ginger healing tea, you will need a piece of ginger root the size of thumb, a couple of medium-sized lemons, one large clove of garlic and honey to taste. The root is ground on a grater, lemon and garlic are also ground and placed in a bowl, pour 0.5 l clean water. The mixture is brought to a boil and heated for half an hour, without letting it boil too much. After straining, you can add honey to the drink. This tea can be used to treat chronic tonsillitis in pregnant women and children.
During pregnancy, traditional medicine advises using tea as a cure for chronic tonsillitis, which includes: 30 g of dried plantain leaves and wild mallow and the same amount of marshmallow root. For 1 cup of boiling water you need 1 tbsp. l. prepared healing mixture. It is necessary to insist the drink in a thermos for an hour, and take 1/2 cup twice a day before meals.

Treatment with folk methods of chronic tonsillitis is always longer than with drugs from a pharmacy. Therefore, choosing this method of getting rid of the disease, you need to be patient.

It is an inflammatory process of a chronic nature that occurs in the region of the palatine tonsils. In the human body, tonsils are considered one of the most important organs, which takes an active part in the formation of immune defenses.

The palatine tonsils are most at risk in childhood, and their active work helps to form strong immunity. It will be useful for many patients to know how to cure tonsillitis forever, what causes it to develop in the human body, and what traditional medicine recipes are considered the most effective?

When entering the human body bacterial infection an inflammatory process begins to develop in the area. This causes inhibition of the process of the formation of immunity, and the result of this is the appearance. In some cases, problems with the formation of the protective functions of the body can occur when the wrong treatment is carried out, as well as when taking antipyretic drugs at a not very high temperature.

In some cases, the cause of the development of tonsillitis is various problems with nasal breathing, arising from the following pathologies:

in childhood
in the nasal cavity

Often, the cause of local tonsillitis is foci of infection localized in nearby organs.

Pathology can develop in the presence of either chronic adenoiditis.

Not the last role in the course of chronic tonsillitis belongs to a decrease in the protective functions of the body, namely allergic reactions. This means that they can be both the cause of the development of the disease, and just a consequence of a chronic disease.

Acute tonsillitis is characterized by a pronounced onset with a syndrome of general intoxication of the body:

body temperature rises to 40 degrees
increased sweating
severe weakness of the whole body
decrease either complete absence appetite
pain and aches in muscles and joints
development of chills

Simultaneously with such symptoms or after some time, the patient begins to feel the occurrence pain in the throat, which gradually increase. Over time, the pain reaches such strength that the patient cannot swallow anything, and there are problems with sleep. reaction lymphatic system the inflammatory process in the throat becomes an increase in the lymph nodes and their increased soreness.

Useful video - The main symptoms of acute tonsillitis:

Chronic tonsillitis is characterized by the fact that periods of remission are replaced by an exacerbation of the disease. Most characteristic symptoms with such tonsillitis, there is a slight rise in body temperature, the appearance of discomfort in the throat when swallowing and a slight cough. The diagnosis at this stage of the disease is based on the results of a visual examination of the patient's throat.

Against the backdrop of respiratory viral diseases that occur when the protective functions of the human body decrease, the remission stage is replaced by an exacerbation:

body temperature rises to 39 degrees
there is a feeling foreign body in the throat, discomfort and pain
there are symptoms of intoxication of the body
the secret released from the tonsils causes the patient to cough constantly

Accompanied by the appearance of vivid symptoms, so it is quite difficult to miss it. If such signs occur, you should contact a specialist who will examine the patient and select the most effective treatment.

Medical treatment of the disease

When diagnosing acute tonsillitis in a patient, in most cases hospitalization is required. It should be remembered that the treatment of such a disease should be carried out only under the supervision of a doctor, which avoids the development of undesirable consequences and complications.

Tonsillitis is considered, therefore, isolation of the patient from others is required. AT medical institution the patient is placed in a box infectious hospital, and when treated at home, he needs to allocate a separate room.

Throughout the entire period of treatment, it is necessary to follow a sparing diet and drink as much warm water as possible. In addition, in acute period illness requires bed rest.

Medical therapy includes the following areas:

Lozenges and sprays of analgesic and anti-inflammatory action: Trachisan, Decatilene, Theraflu, Ingalipt.
Rinsing oral cavity antiseptic solutions: , .
Treatment of the tonsil area with antiseptic preparations: Solution, .
Appointment of antipyretic drugs with a rise in body temperature: Paracetamol, Ibuprofen.
Reception antihistamines with increased swelling of the tonsils:, Loratadine.
With lymphadenitis, the imposition of compresses with Dimexide and anti-inflammatory components on the zone of the lymph nodes.

Inhalations in the treatment of tonsillitis are prescribed quite rarely, since they have been proven ineffective in such a disease. The choice of one or another method of therapy for tonsillitis is determined by the form of the disease, that is, the treatment can be both conservative and surgical.

Antibiotics for sickness

When diagnosing acute tonsillitis, antibacterial treatment is mandatory, and usually taking drugs is canceled 3-5 days after normalization of body temperature. In the treatment of children and adults, the same drugs are prescribed, and the difference is only in the dosage.

Despite the fact that treatment with antibacterial drugs for tonsillitis is considered quite effective, it is possible to finally get rid of this pathology only when the tonsils are removed.

In the event that the ongoing antibiotic therapy does not bring the desired result, the specialist may decide to perform an operation to remove the tonsils.

What kind of groups antibacterial drugs may be prescribed in the treatment of acute tonsillitis:

Cephalosporins: Cefodox, Cefix.
Penicillins:,.
Macrolides: Clarithromycin, Josamycin, Azitral, Hemomycin.

In addition, local antibacterial treatment is prescribed and the most effective drug counts . It should be remembered that when taking antibiotics in the treatment of tonsillitis, it is necessary to drink funds simultaneously with them to maintain the microflora of the digestive tract.

When a patient is diagnosed with a simple form of the disease, conservative treatment is usually carried out, which includes taking medications and performing physiotherapeutic procedures. Surgical treatment of tonsillitis is resorted to only when conservative therapy becomes ineffective.

A bilateral operation is performed, during which the palatine tonsils are removed. With this treatment, complete or partial removal of lymphoid tissue is possible, and the operation takes place quite quickly. The next day the patient goes home, and his performance is restored after 10-12 days.

Another method of surgical treatment of tonsillitis is lacunotomy, during which the tonsils are not removed. Such a surgical intervention is performed using a laser, and for the next 5-7 years, an improvement in the patient's well-being is observed. The tonsils are significantly reduced in size, and begin to perform their functions, and the risk of exacerbation of acute respiratory pathologies is also reduced.

Cryotherapy is considered an effective and safe procedure that is used in the treatment of tonsillitis.

With the help of nitrogen, damaged tissues are frozen out, and immunity is stimulated. The only disadvantage of this method of treatment is the appearance discomfort in the patient's throat. With cryotherapy, the development of bleeding is completely excluded and scars and scars are not formed.

Folk therapy against the disease

Tonsillitis can be treated with drug therapy and surgical intervention, and folk remedies. The most common folk remedy is considered to be gargling a sore throat with various decoctions and infusions.

For this purpose, you can use plants that have antibacterial and healing properties:

chamomile
St. John's wort
Oak bark

You can gargle with tonsillitis with a solution

Tonsils are small formations of lymphoid tissue that are located at the entrance to the respiratory tract. They belong to the immune system, they produce immune cells - lymphocytes, macrophages, plasma cells - that destroy the invader bacteria.

They got their name from the shape - they look like an almond, and are almost the same in size. But in an inflamed state, the tonsils can greatly increase in size.

Important! Their main function is to trap viruses and bacteria that are inhaled to prevent infection. respiratory tract- trachea, bronchi, lungs. Therefore, inflammation of the tonsils is much more common than bronchitis or pneumonia.

The tonsils are porous, inside them there are wide pores - lacunae. Bacteria from the inhaled air enter here and are recognized by the immune system. Weakened by frequent inflammations, the tonsils cannot cleanse themselves, so purulent plugs accumulate in the lacunae. They consist of pus, dead cells, bacteria and viruses, their metabolic products. These plugs are dangerous because:

cause permanent intoxication of the body;
reduce the functionality of the tonsils;
are a habitat for bacteria;
are the reason bad smell from mouth;
with a slight increase in the load on the tonsils cause inflammation.

What causes inflammation of the tonsils:

streptococci;
staphylococci;
pneumococci;
mushrooms Candida;
coli;
chlamydia;
anaerobic bacteria;
chronic sinusitis, in which bacteria from the sinuses enter the tonsils;
caries, especially "located" on back teeth, near the throat;
various viruses.

You can “pick up” a sore throat by contact with a carrier of the infection by drinking from a cup of the patient. Against the background of reduced immunity, chronic infections can also “move” to the tonsils.

Symptoms:

Pain - constant or when swallowing, perspiration (on initial stages can be described as a "tear in the throat").
Difficulty swallowing saliva.
Increased secretion of viscous saliva.
Temperature increase (from 37.7 to 39).
Pain when moving the tongue.
Difficult speech.
Sharp or aching pain in the ears, a feeling of congestion.
Discharge from the nose.
Body aches, aching pain in muscles and joints.
Enlarged submandibular lymph nodes.

On examination, redness and swelling of the mucosa, swelling of the tonsils, wide open gaps or purulent formations are noticeable. Often the patient loses his voice - due to severe swelling.

Important! With angina, there is no sneezing, as with influenza or SARS, there is rarely a cough - only if the infection has “leaked” into the throat and caused tracheitis or pharyngitis.

Types of inflammation of the tonsils

The disease is acute and chronic. Untreated enters the chronic stage acute infection. Let's consider both groups of diseases in more detail.

Acute inflammation of the tonsils, or acute tonsillitis

Occurs rapidly, with a strong infection. Depending on the type of pathogen and the nature of the infection, there are several types:

Catarrhal angina- the most common and mild form diseases. The infection is present only in the tonsils, the pharyngeal wall practically does not change color. Symptoms: sore throat, which is especially strong when swallowing (it is not even felt at rest), weakness and body aches, slight fever, general intoxication. With proper treatment, catarrhal angina can be cured in a few days. Enough local application of antibiotics (rinsing, irrigation).
Lacunar– more complex shape. The temperature rises to 39-40, the patient refuses food, complains of pain in the limbs and lower back. Sore throat radiates to the ear, possibly hearing loss. On the lacunae, white accumulations of pus are noticeable, soon covering the entire surface of the tonsils. Purulent plaque is easily cleaned off, but quickly grows again.
At follicular purulent accumulations-follicles appear through the mucous membrane of the tonsils, but they do not come to the surface. The spleen is enlarged, there is often pain in the abdomen, vomiting, diarrhea. The illness lasts 5 to 7 days.
fibrinous often joins the lacunar. A yellow-white film forms on the mucous membrane. Dangerous severe intoxication, penetration of infection into the brain.
Phlegmonous- rare and most dangerous, with it the destruction of the tonsils occurs. You can recognize it by a specific smell from the mouth. Severe pain is aggravated by the inability to swallow: even liquid food flows out through the nose. Urgent antibiotics are needed to prevent the formation of a peritonsillar abscess.
herpetic angina is caused by a virus, accompanied by a blistering rash on the back of the tongue and throat. Often associated with gastrointestinal symptoms: vomiting and abdominal pain.
Ulcerative necrotic often found in the elderly. Its causative agent is a spindle-shaped stick, which is present in the bacflora of every person. With a decrease in immunity, it is activated. The reasons may be cardiovascular diseases, chronic infections of other organs. Symptoms: no fever and weakness, instead of a sore throat, there is a sensation of a foreign body. When plaque is removed, a bleeding ulcer opens.

Chronic tonsillitis

It develops as a consequence of acute - with incomplete treatment, as well as with the accumulation of adverse factors: weakened immunity, insufficient oral hygiene, existing infections.

Important! Approximately 15% of the world's population suffer from chronic tonsillitis. Often its causes are sinusitis, caries, chronic and undertreated infections, including the genitourinary system.

It is characterized by:

Loose tonsils with gaping gaps or plugs in them, the presence of plaque.
Permanent increase in submandibular lymph nodes.
Smell from the mouth.
Subfebrile temperature.
Increased fatigue.

Exacerbations occur 2-3 times a year, have the form of a mild cold or severe sore throat, which are complicated by disorders of the gastrointestinal tract, kidneys and urinary system, nervous system. Pus accumulates in the tonsils, over time they lose protective function.

Chronic tonsillitis is dangerous because it often causes complications:

Localization	Manifestation
From the excretory system	Inflammation of the bladder and kidneys (active bacteria that live in the tonsils pass through them) - cystitis, pyelonephritis, glomerulonephritis. Some antibiotics cause sand to form in the kidneys
From the gastrointestinal tract	Dysbacteriosis, colitis, gastritis, disorders in the liver, enlargement of the pancreas
Bone and cartilage tissue	Structure destruction cartilage tissue, risk of arthritis and arthrosis, rheumatism
immune and lymphatic systems
The cardiovascular system	Myocarditis, endocarditis, tonsillogenic myocardial dystrophy

Treatment of inflammation of the tonsils

Acute inflammations of a viral and bacterial nature are treated differently. When viral infection conditions must be created for the immune system coped with the stimulus on her own. For this you need:

Provide the patient with adequate rest bed rest, minimum physical activity, good sleep.
Plentiful drink, especially in the first hours of the disease. In addition to herbal anti-inflammatory teas, you need to drink plenty of warm water - it will help to quickly flush out the toxins produced by viral cells. You need to drink at least 3 liters of fluid per day.
To more effectively rid the body of dead viral cells and their metabolic products, sorbents are used ( Sorbex, Maalox, Sorbolut). You need to drink them two hours before or two hours after taking other drugs.
Antiviral and immunostimulating drugs ( IRS-19, Broncho-munal, Levamisole) will help to quickly restore the body's defenses.
Gargle every one and a half to two hours with a weak salt solution (1/2 tsp per glass of warm water), decoctions of herbs ( calendula, chamomile, eucalyptus) 7-10 days. Pharmacy funds based on antibiotics in this case are ineffective.

Bacterial inflammation of the tonsils begins more slowly, it is characterized by: severe sore throat, often one-sided, the presence of white plugs. In this case, antibiotics are needed - otherwise the inflammation will move deep into the respiratory tract.

Video - Angina: signs, symptoms, treatment

How to treat bacterial sore throat

Rinses based on antimicrobial pharmaceutical preparations (Givalex, Angilex, Chlorophyllipt, Furacilin, Miramistin etc. - a teaspoon of the drug in a glass of warm boiled water), herbs and fees with antibacterial properties ( Elekasol). You need to gargle 4-5 times a day. After rinsing, refrain from eating and drinking for about an hour. Rinsing should be continued even after the symptoms disappear. The course is at least 10 days.
Irrigation of the mucous throat with antibiotic sprays (Ingalipt, Hexaspray, Bioparox, Tantum Verde) 3-4 times a day, at regular intervals. After this, do not eat or drink for an hour and a half. Sprays are used for the first 5 days of treatment. Do not use the spray more than 4 times a day, so as not to cause a spasm of the larynx.
Soothing and analgesic throat lozenges with antimicrobial ingredients.

To alleviate inflammation in the throat, a remedy based on herbal dry extract and essential oil Sage lozenges from Natur Product has proven itself well. Sage lozenges from Natur Product is a combined preparation containing a complex of biologically active substances (1). It has anti-inflammatory, antimicrobial and expectorant effects, and also has astringent properties (1). Sage lozenges from Natur The product has vegetable composition With a small amount side effects(1,2). Sage lozenges by Natur The product is produced in Europe according to international production quality standards (1).

THERE ARE CONTRAINDICATIONS. BEFORE USE, IT IS NECESSARY TO CONSULT WITH A SPECIALIST

(1) Instructions for medical use of the medicinal product Sage lozenges
(2) Allergic reactions - according to the instructions for medical use

Antibiotics: Penicillin, Ampicillin, their derivatives are Amoxicillin, Amoxiclav. If the patient is allergic to these substances, sulfonamides are used - Sulfalen, Biseptol, Norsulfazol; cephalosporins - Cefodox, Cefix, Ceftriaxone; macrolides - Azithromycin, Erythromycin, Macropen. The course of antibiotic treatment is at least 5 days. If necessary, the course of treatment is extended up to 7-10 days. At severe course angina the drug is prescribed intramuscularly. Before taking this group of drugs, you should consult your doctor. An incorrectly chosen antibiotic leads to the formation of pathogen resistance to treatment and development chronic inflammation tonsils.
Antihistamines can help relieve swelling and make breathing easier: Loratadine, Cetrin, Suprastin- 1 tablet per day for 5 days.
Antipyretics and painkillers - Paracetamol, Nimesil, Ibuprofen(the latter only in patients older than 12 years), 1-2 times a day, depending on the condition.

Important! In case of acute inflammation, you can not drink hot, do compresses and warm up the whole body: this will lead to the spread of infection throughout the body and systemic infection.

Video - Treatment of angina at home with folk remedies

Treatment of chronic tonsillitis

Conservative treatment gives positive effect in 75% of cases. But it takes months and even years. Treatment consists of several stages:

1. Cleaning lacunae from pus:

Washing the tonsils in the ENT room is much more effective than ordinary rinsing: the liquid penetrates deep into the lacunae, washing out pus and pathogens from there. Solutions used for rinsing Furacilina, Penicillin, Albucid. Washing is carried out in courses of 10-15 procedures, twice a year.
Vacuum therapy is an alternative to tonsillectomy. The procedure consists of two stages: first, pus is sucked out of the lacunae, then they are washed with an antiseptic. A course of 15 procedures can save even those tonsils that were recommended for removal. The procedure can be used for children and pregnant women, when other methods are not always possible and safe. According to the results of studies, this method of treatment has shown effectiveness in 90% of cases.

Important! Conservative treatment should be under medical supervision. Any amateur activity of the patient and his relatives - for example, squeezing out purulent plugs with a false or using a clean lemon juice rinsing may cause serious consequences: penetration of infection deep into and burns of the mucosa.

2.Antibacterial therapy:

Antibiotic therapy. For complex treatment a combination of topical application is used (irrigation and washing of lacunae with antibacterial solutions, the same drugs are used as for the treatment acute inflammation) and internal reception(oral, in the form of injections or infusions, usually antibiotics of the macrolide group - Macropen, azithromycin and cephalosporins – Ceftriaxone, Cefodox). A more accurate selection of antibiotics is carried out by the doctor based on the results of a smear from the mucous membrane of the throat. Sometimes antibiotics are injected directly into the tonsils. To reduce pain, the antibiotic is used together with novocaine. The course lasts from 5 to 10 days at the discretion of the doctor.
Oral hygiene - treatment of caries, brushing teeth, treatment of gum disease.

3. Formation of stable immunity:

Physiotherapy procedures start the process of tissue repair and natural cleaning of the tonsils, improve blood circulation. Apply UV irradiation of the tonsils, UHF on the submandibular lymph nodes. Physiotherapy is carried out in a course of 10 days at least twice a year.
Immunotherapy. Supporting and strengthening the immune system will help the body fight bacteria on its own and recover faster. Often used Imudon, IRS-19. The dosage is selected based on the age of the patient.

Surgical treatment is indicated in rare cases - when the tissue of the tonsils is partially destroyed, there are serious complications for the whole organism.

Video - How to treat tonsillitis with folk remedies

Preventive measures

It is impossible to completely protect yourself from infections. But it is possible to create conditions under which the tonsils will provide maximum resistance to the invasion of bacteria. For this you need:

Wash your hands regularly.
Keep your mouth clean and healthy.
Support the immune system (vitamins, proper nutrition, sports and hardening).
Do not drink too cold or hot drinks, especially before going outside in cold weather.
From time to time, do a preventive massage - just tilt your head back and make a few strokes from the jaw to the chest. This method is especially effective before going outside in the cold.
Avoid hypothermia, especially in the neck, head and legs.

Chronic tonsillitis is an infectious disease in which the palatine, nasopharyngeal, laryngeal and lingual tonsils become inflamed. The disease can occur in acute () and chronic form, people of all age groups suffer from it. If on early stage the disease responds well to treatment, then at the later stage it will not be possible to get rid of inflammation forever. Turning into a chronic form, the disease regularly reminds of itself with an inflamed throat.
You need to know what tonsillitis is and how it is treated in adults before you have to deal with the disease. Awareness will allow you not to be afraid of going to the clinic.

Acute tonsillitis can occur in follicular, phlegmonous and catarrhal forms. Depending on this, it differs clinical picture. How to treat tonsillitis, the doctor also determines based on the type of disease.

The follicular form manifests itself as follows:

poor appetite;

a feeling of chills;

· migraine;

periodic or permanent swelling larynx;

· sweating;

Pain and aches in muscles and joints;

Weakness, fatigue.

The catarrhal form is characterized by the following symptoms:

dryness, itching and sore throat;

Difficulty swallowing

migraine during the day;

· weakness;

elevated temperature (38 ° and above).

The phlegmonous form is characterized by the following features:

dizziness, aching in the temples, forehead and neck;

perspiration and severe sore throat;

Pain when swallowing

· strong highlight saliva;

chills, sweating;

poor appetite;

· weakness;

enlarged cervical lymph nodes;

pus in the larynx;

puffiness soft palate and palatine arches;

sensation of a foreign object in the throat;

dryness of mucous membranes;

general malaise;

temperature increase up to 38-39°;

· headache, weakness.

Symptoms of toxic-allergic tonsillitis

In order to make it easier to select therapeutic methods, doctors divide this type of disease into the first and second degrees of severity. Symptoms and treatment of tonsillitis in adults are different in both cases.

Symptoms characteristic of the first degree:

severe fatigue;

fever, chills, fever;

· heartache;

aches in the joints;

signs of intoxication;

· allergic manifestations(runny nose, lacrimation);

Decreased immunity.

The second degree has similar symptoms, but the patient's condition is complicated by concomitant diseases. They are caused by a malfunction of the immune system or streptococcus, which is common cause tonsillitis.

Why does tonsillitis appear?

The palatine tonsils and adjacent areas of the mucous membranes can become inflamed as a result of the vital activity of pathogenic microbes that are in the mouth of every person. These are fungi candida, streptococci, pneumococci, staphylococci and other pathogenic bacteria. difference healthy person from the patient that the body of the first is able to prevent the number of microbes from exceeding a critical level, and the immune system of the second is too weak to withstand the onslaught of pathogenic microbes. Inflamed tonsils, unlike healthy ones, cannot perform a protective function, as a result, the disease progresses.

The root cause in all cases is the same - pathogenic bacteria. There are also factors in the presence of which the disease passes from an acute form to a chronic one:

· Unfinished treatment of angina. Some patients do not consider it necessary to take drugs for the treatment of tonsillitis for as long as the doctor prescribes, and stop taking the medication when it seems to them that the state of health has already returned to normal. This approach leads to the fact that the disease fades, but does not disappear, and in the future, with a decrease in immunity, tonsillitis reappears.

· Lack of treatment for Patients believe that with this disease it is not necessary to consult a specialist - everything will go away by itself. Against the background of frequent pharyngitis, acute tonsillitis often develops, while the patient also does not take action, and the pathology becomes chronic.

The list of factors provoking the appearance and development of the disease in patients of different ages:

polyps in the nose

untreated caries;

frequent hypothermia;

deformed nasal septum;

sinusitis, inflammation of the adenoids;

· genetic predisposition;

diet with low content vitamins and microelements;

· bad habits(drinking alcohol, smoking, sedentary lifestyle);

frequent nervous and physical overload;

a weakened immune system;

stresses;

Chronic diseases of the respiratory and digestive systems;

allergic reactions.

Important: the treatment of tonsillitis in adults is sometimes delayed for the reason that patients do not consider it necessary to give up bad habits.

Diagnosis of tonsillitis

Makes a diagnosis otolaryngologist to which the patient is directed by the local therapist. Medicines for treatment tonsillitis the doctor prescribes on the basis of an external examination of the patient, symptoms, test results and data in the medical history. The easiest way to diagnose the disease is during an exacerbation, since at this time symptoms the most pronounced.

With tonsillitis, there is hyperemia, swelling of the palatine arches and adjacent tissues, purulent plaque, and in some cases, fusion and adhesion of the tonsils with a triangular fold and arches. In children, tonsillitis is accompanied by loosening of the soft tissues of the tonsils. Almost always, patients have increased regional The lymph nodes.

If the ENT diagnoses toxic-allergic tonsillitis, the patient may be recommended to undergo additional examinations, the purpose of which is to identify concomitant diseases.

The danger of tonsillitis during pregnancy

All women should know that tonsillitis is very dangerous during pregnancy. He can inflict serious harm health of the unborn child. Among pregnant women, patients with tonsillitis (chronic tonsillitis) are quite common. This is because women, having become ill before conception, do not consider sore throat so serious illness to go to the clinic about it.

Symptoms of which appeared already during pregnancy, require immediate medical attention. Otherwise, pathogenic microbes will enter the fetus with blood. This can lead to miscarriage or the development of intrauterine pathologies. If a woman cares about the safety of pregnancy and safe delivery, she should not leave purulent tonsillitis untreated.

Conservative treatment of tonsillitis

When choosing how to treat how to treat in adults, doctors often use A complex approach. A versatile drug capable of destroying different types pathogens, stop the inflammatory process and relieve all symptoms, does not exist. Patients are treated with antibiotics, physiotherapy, rinses, antihistamines, and anti-inflammatory drugs. In some cases, surgery is indicated.

Medical therapy

Of the antibiotics, cephalosporins and drugs belonging to the group penicillins:

Augmentin;

Amoxiclav;

Amoxicillin;

Ceftriaxone;

Cefazolin.

Effective anti-inflammatory drugs:

Ibuprofen;

aspirin;

Nurofen.

Antihistamines(required to relieve swelling and as a preventive measure):

· Suprastin;

· Tavegil;

· Claritin;

· Tsetrin.

Lollipops and lozenges for resorption:

· Septolette;

Gramicidin;

Septefril.

Sprays and medicines for rinsing and rinsing:

· Nitrofural;

Biofarox.

Physiotherapy

Physiotherapeutic procedures are prescribed to patients for treatment on an outpatient basis or in a hospital setting. If the state of health allows you to come to the procedures from home, the patient may refuse to be hospitalized.

Procedures give good effect if you do them every other day for 1-2 weeks. It is important not to stop treatment prematurely, because as a result, acute tonsillitis will turn into a chronic form. Complications may also develop in the form of sepsis (general infection), rheumatic heart disease, abscesses, meningitis, rheumatism.

Depending on the symptoms and severity of the disease, the patient is prescribed:

heating with a laser

Infrared lamp

· phonophoresis;

· electrophoresis;

tube-quartz.

Surgical intervention

Surgery is indicated if all other methods of treatment have failed. Before surgical method used very often, because it is easier to do an operation once than to treat chronic tonsillitis for a long time. Now that scientists have proven that the tonsils are important to the body, doctors are trying to do everything possible to preserve them, but it also happens that removal is indispensable. The operation is performed under local anesthesia, so there is no need to be afraid of pain.

Tonsils are removed not with a scalpel, as before, but with a laser, radioknife or ultrasound. Also practiced cauterization liquid nitrogen, while only the affected tissues die. Usually, the operation is not accompanied by bleeding, and the risk of postoperative infection is reduced to zero. Already a day after the removal of the tonsils, the patient is discharged, and further treatment continues on an outpatient basis.

Traditional medicine

It is impossible to cure adults at home without consulting a doctor, but folk methods can be a good addition to traditional therapy, so do not neglect them. How to treat tonsillitis in children should be determined by a doctor, and adults can rinse and rinse their throats, drink medicinal teas and infusions.

propolis extract

It's inexpensive medicinal product with pronounced antiseptic and cleansing properties. helps relieve sore throat and reduce swelling of the mucosa. You need to use the medicine according to the instructions.

Salt solution

For 200 ml of water you need to take 0.5 tsp. salt, dissolve and gargle in the morning and evening, as well as several times during the day (the more often the better). The solution cleans the tonsils well from plaque and purulent plugs. You can add 0.5 tsp to water. soda, then it will also have anti-inflammatory properties.

Infusion of cloves and turmeric

You need to take 1 tsp. each spice, pour boiling water and insist in a thermos for 5-6 hours. Gargle three times a day, immediately after breakfast, lunch and dinner.

Warm tea with honey

Tea is brewed as usual, add 1-2 tsp. honey in a glass and drink warm.

Thus, with tonsillitis in adults folk remedies are not contraindicated, the main thing is not to be limited to them, but to follow all the doctor's recommendations. It is very important not to postpone a visit to the clinic: timely treatment will save you from many problems that are inevitable if acute form becomes chronic.

Tonsillitis is a common disease. Children are most susceptible to it (approximately 60–65% of all acute respiratory infections), especially often at the age of 5–10 years. Symptoms of pathology in adults and children depend on the course of the inflammatory process, the presence of concomitant diseases.

What is tonsillitis? Tonsillitis (from Latin tonsillae - tonsils) is an infectious disease, the leading symptom of which is an acute or chronic inflammatory process in the palatine tonsils.

Chronic inflammation often contributes to the development of various complications. Acute tonsillitis, or tonsillitis, is a common disease, which is characterized by rises in incidence in the spring and autumn. In adults, pathology occurs in 5-20% of cases of acute respiratory infections.

Causes of tonsillitis

The disease develops when pathogenic bacteria or viruses enter the body. The most common pathogens among viruses are:

adenovirus;
parainfluenza virus;
respiratory syncytial virus;
rhinovirus;
enteroviruses;
Epstein-Barr virus.

Among bacterial pathogens important role plays beta-hemolytic streptococcus group A, or pyogenic streptococcus. About 15% of cases of angina are associated with it. Streptococcus is transmitted by airborne droplets, contact and food.

Also, the disease can cause:

streptococci of groups C and G;
pneumococci;
anaerobes;
mycoplasmas;
chlamydia;
spirochetes;
gonococci.

The pathogen enters the mucous membrane of the tonsils exogenously with inhaled air or food, as well as endogenously - from chronic foci of infections or with an increase in the pathogenicity of saprophytic microflora against the background of a decrease in general or local immunity.

In conditions of local immunodeficiency, the causative agent can be yeast-like fungi of the genus Candida, which are part of the normal flora of the oropharynx.

The development of the inflammatory process is facilitated by:

trauma to the tonsils;
chronic inflammatory diseases of the oral cavity, nose and paranasal sinuses;
violation of nasal breathing;
concomitant somatic diseases various organs and systems that affect the overall reactivity of the organism.

Morphologically, with inflammation of the tonsils in the parenchyma, there is an expansion of the blood and lymphatic vessels, infiltration of the mucosa by leukocytes.

In the pathogenesis of chronic inflammation, the main role is played by the violation of the protective and adaptive mechanisms of the tonsils, the sensitization of the body. Available in lacunae pathogenic microflora with chronic angina, it can become a triggering factor in the development of autoimmune processes.

Classification

Tonsillitis code according to ICD-10 ( International classification diseases of the 10th revision):

J03.0 Streptococcal;
J03.8 - acute, caused by other specified pathogens;
J03.9 Acute, unspecified;
J35.0 - chronic.

Tonsillitis, depending on the course of inflammation, is divided into acute and chronic. Acute, in turn, can be primary or secondary.

Primary acute tonsillitis has the following forms:

catarrhal;
lacunar;
follicular;
ulcerative membranous, or necrotic.

Secondary acute tonsillitis may occur with acute infectious diseases, such as:

diphtheria;
scarlet fever;
tularemia;
typhoid fever;
Infectious mononucleosis.

Also, a secondary inflammatory process develops against the background of hematological diseases (with agranulocytosis, leukemia, alimentary-toxic aleukia).

Chronic tonsillitis is divided into nonspecific and specific. Nonspecific chronic tonsillitis has a compensated and decompensated form. specific inflammation tonsils develops with infectious granulomas - tuberculosis, syphilis, scleroma.

Also exists clinical classification forms of pathology:

catarrhal;
follicular;
lacunar;
necrotic;
phlegmonous;
fibrinous;
herpetic;
mixed.

Symptoms of tonsillitis

The main signs of tonsillitis are:

discomfort or pain in the throat, aggravated by swallowing, irradiation of pain in the ear is possible;
an increase in body temperature (tonsillitis can occur without fever);
putrid smell from the mouth;
dry cough;
feeling worse: general weakness, pain in muscles and joints, headaches, decreased performance.

With the lacunar form, there is an accumulation in the lacunae of serous-mucous and purulent discharge. Pus consists of leukocytes, lymphocytes, epithelium and fibrin. Wide drain raids may form.

If there is a strong swelling of the tonsils, there may be a feeling of tightness in the neck, difficulty breathing.

Diagnostics

In order to establish a diagnosis and conduct a differential diagnosis, it is necessary:

collection of complaints and anamnesis;
inspection;
instrumental examination, including pharyngoscopy;
microscopic, cytological, bacteriological examination of the discharge from the mucous membrane of the tonsils, oropharynx;
clinical blood test.

According to the photo of the throat taken during pharyngoscopy, changes in angina are clearly visible. There are several types of pharyngoscopy that allow you to visually examine the oropharynx and assess the condition of the mucous membrane.

In the catarrhal form, hyperemia of the tonsils is noted, they look swollen, the epithelium is loosened and saturated with a serous secretion. There are no purulent raids.

The follicular form is characterized by translucence of the follicles through the mucous membrane in the form of yellow dots.

With the lacunar form, there is an accumulation in the lacunae of serous-mucous and purulent discharge. Pus consists of leukocytes, lymphocytes, epithelium and fibrin. Wide drain raids may form.

The phlegmonous form is characterized by a violation of the drainage of lacunae, swelling of the parenchyma of the tonsils, necrotic changes in the follicles, which, merging, can form an abscess. Such an abscess is located close to the surface of the tonsil and is emptied into the oral cavity.

Candidal tonsillitis is characterized by moderate hyperemia of the tonsils, the presence of a curdled plaque of white or yellow color. As a rule, a fungal infection is preceded by long-term antibiotic therapy.

The disease is characterized by an increase, thickening and soreness of regional lymph nodes: submandibular, anterior and posterior cervical.

When examining the oral cavity or during pharyngoscopy, the doctor takes material from the surface of the tonsils, the posterior pharyngeal wall for bacteriological culture with subsequent determination of sensitivity to antibacterial drugs.

There is a rapid test to determine the presence of group A beta-hemolytic streptococcus in a scraping from the mucous membrane of the oropharynx. It is performed within 5–15 minutes and is an immunochromatographic method for express diagnostics of a qualitative assessment of the presence of group A beta-hemolytic streptococcus antigen. The analysis is performed by a doctor and does not require special laboratory. The sensitivity of the test is 97%.

By clinical analysis blood evaluate leukocyte shifts. In addition to general changes in the form of an increase in the number of leukocytes and an acceleration of ESR (erythrocyte sedimentation rate), with a bacteriological lesion, the number of neutrophils increases, a large number of stab (young) leukocytes appear. With viral damage, lymphocytes increase. Thus, the analysis helps in the diagnosis and differential diagnosis. For example, in infectious mononucleosis, the number of monocytes increases.

Differential Diagnosis

Follicular tonsillitis must be differentiated from oropharyngeal diphtheria. Both diseases are high temperature and intoxication, sore throat, hyperemia and enlargement of the tonsils, but there are distinctive signs that help the doctor make a correct diagnosis.

With follicular angina yellow plaque on the tonsils is easily removed, and bleeding is not observed. With diphtheria, islets of a shiny, dense fibrinous film are formed, which is removed with difficulty, after which a bleeding surface remains.

Also, with follicular angina, the relief of lacunae is clearly visible, swelling of the tonsils is not observed, regional lymph nodes are painful on palpation. With diphtheria of the oropharynx, the relief of the tonsils is smoothed, they are edematous, the regional lymph nodes are painless.

Candida tonsillitis is characterized by moderate hyperemia of the tonsils, the presence of a curdled plaque of white or yellow color. As a rule, a fungal infection is preceded by long-term antibiotic therapy.

With tuberculosis on the palatine arches, tonsils, ulcers of a pale pink color with jagged edges covered with purulent plaque. The correct diagnosis is established through microscopic and bacteriological analysis.

Under the guise of a sore throat, a tumor lesion of the tonsils and oropharynx can occur, which manifests itself in the form of tissue breakdown. The diagnosis is based on the results histological examination tonsil biopsy.

The development of secondary angina is possible with blood diseases, for example, with acute leukemia. Follicles can merge and disintegrate. The disease is characterized by the rapid spread of necrotic changes in the tonsils. In establishing the diagnosis, typical blood changes characteristic of leukemia play an important role.

Treatment

In case of bacterial infection, systemic antibiotic therapy is prescribed. Its purpose is to destroy the pathogen, limit the focus of infection, and prevent purulent and autoimmune complications. First, drugs of the penicillin group or third-generation cephalosporins are prescribed. The drug of choice for the treatment of acute streptococcal tonsillitis are phenoxymethylpenicillin, aminopenicillins. An antibiotic is prescribed for 10 days.

If there is allergic reactions macrolides are prescribed for penicillins (Amoxicillin) and cephalosporins (Cefixime). The duration of treatment with Azithromycin is 5 days.

In chronic angina, antibiotics are used during an exacerbation.

In the absence of positive dynamics (in the form of a decrease in body temperature and a decrease in the severity of sore throat within 72 hours from the start of therapy), the doctor may change the antibiotic.

You should not select or replace the drug on your own, as this can lead not only to complications, but also contribute to the formation of resistance of microorganisms to the antibiotic. When adverse reactions you must immediately consult a doctor.

In case of viral infection, prophylactic antibiotics are not recommended.

With the candidal form, systemic antifungal therapy is performed.

To reduce body temperature and reduce pain is indicated symptomatic treatment non-steroidal anti-inflammatory drugs (Paracetamol, Ibuprofen).

It is very important to carry out local treatment in the form of rinses, inhalations, the use of tablets and lozenges for resorption. This reduces the expression pain syndrome. It does not rule out systemic antibiotic therapy.

chlorhexidine;
iodine preparations;
sulfonamides;
biclotymol;
lysozyme.

The tonsils are lubricated with 1% Lugol's solution, 2% collargol solution, 40% propolis solution or interferon ointment.

In case of bacterial infection, systemic antibiotic therapy is prescribed. Its purpose is to destroy the pathogen, limit the focus of infection, and prevent purulent and autoimmune complications.

After washing, antiseptic pastes are injected intralacunarly: etonium, gramicidin. They have a wide range of effects, providing a bacteriostatic effect on pathogenic microflora.

According to the indications, general strengthening and immunostimulating agents are prescribed.

In chronic angina, physiotherapy is additionally carried out.

Prevention

Preventive measures to prevent the development of angina include:

compliance with the rules of personal hygiene;
taking complex vitamin preparations in the autumn and spring;
limiting contacts with patients with acute tonsillitis to prevent airborne transmission of infection;
treatment chronic infections upper respiratory tract.

Complications

How dangerous is the inflammatory process in the tonsils? Angina can cause severe complications lead to diseases of the cardiovascular system.

With untimely diagnosis or inadequate treatment, a transition is possible acute process into chronic.

Streptococcal angina can cause purulent complications:

otitis;
sinusitis;
mastoiditis;
paratonsillar abscess;
cervical lymphadenitis;
meningitis;
endocarditis;
pneumonia.

Late non-purulent consequences are also possible:

poststreptococcal glomerulonephritis;
toxic shock;
acute rheumatic fever.

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