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Acute tonsillitis (acute angina)

Acute tonsillitis (acute angina)

Question:

- 2 weeks ago my child completed an injection treatment with gentamicin and ampicillin. After I took him back to kindergarten, after about 2 and a half weeks he became ill again. Symptoms were: fever, tears in the eyes, productive cough. I was told by my family doctor that she had tonsillitis. I was given unasyn and ambroxol for administration. Although I started to give him the antibiotic, he has a feverish condition (38-39). I administered nurofen, but after 4-5 hours he has a fever again. Coughs further and drowns with mucus. I really don't know what else to do. Please can you help me with a tip?

Answer:

Acute tonsillitis (acute angina) is the inflammation of the palatal tonsils, which is often accompanied by inflammation of the pharynx, so the term acute pharyngitis is commonly used (which includes all the inflammations in the throat: pharyngitis, tonsillitis, pharyngeal tonsillitis). This condition is common in children after 1 year of age (it is unusual to appear under one year of age), with the maximum incidence between 4-7 years. It can be caused by viruses or bacteria.

When it is determined by viruses (respiratory viruses) in the neck, there is diffuse congestion (redness); there are fever, rhinorrhea (runny nose), cough, conjunctivitis (red eyes, tears); The lateral ganglions of the neck can be slightly enlarged, and the older children may experience muscle pain, fatigue and headache (headache).

The disease is favored by the cold season, polluted air, cold drinks; appears with a predilection in communities (kindergartens, nurseries, schools, etc.). It is contagious and affects all ages. The duration of the disease is 4-5 days but sometimes it can complicate with bacterial overinfection.

The angina caused by viruses does not require treatment with antibiotics, but only to combat the symptoms (fever, cough and agitation). So as local treatment: warm compresses around the neck, gargle with disinfectants or the administration of modern substances in the form of sprays or candies - in older children (Faringosept, Fenosept etc.). The general treatment is symptomatic: resting in the house during the fever and another 2 days after; during the fever, especially if it causes sore throat and refuses to eat, the main concern should be the proper hydration: hot and non-hot liquids will be given to the child in small and repeated quantities (herbal teas sweetened with sugar, compotes, water). simple, fruit juices, soups, soups, milk, yogurt); fever is fought with Paracetamol-based preparations, suppositories or syrup (eg Nurofen syrup).

Bacterial angina can be caused by many bacteria but most commonly it is caused by beta-hemolytic streptococcus. It is also contagious, but to a lesser extent than the viral one. The symptoms are similar to those of the previous form, but more pronounced: high fever (39-40 degrees Celsius), swallowing pain (younger children may refuse to eat), submaxillary lymph nodes are enlarged and painful.

The tonsils appear swollen, congested (red), with whitish deposits. The pharyngeal exudate can reveal the responsible microbial agent. The evolution of the disease is 7-10 days. The treatment should include in this case an anti-streptococcal antibiotic (Penicillin, Ampicillin or an equivalent product), to prevent its complications. If the disease does not develop favorably under treatment or the bacteriological examination detects a resistant germ (for example, staphylococcus), another antibiotic, preferably according to the antibiogram, can be used. Otherwise, the treatment is similar to that of the viral angina.

Therefore, in the case of your child, taking into account the treatment indicated by the doctor (which also includes an antibiotic) is probably a bacterial tonsillitis, the evolution of which, as mentioned above, is longer. You should continue to give the child the treatment indicated by the doctor and do not stop it sooner even if it seems that the symptoms have disappeared (Unasyn is an antibiotic preparation, Ambroxol is a mucolytic - it fluidises the secretions and eases the cough, and Nurofen fights fever); fever generally lasts 1-4 days, during which time you must maintain a good hydration of the child. However, if you feel that the general condition is still worsening, it is good to ask a doctor for a new consultation.

If these respiratory infections recur frequently (they are common at the entrance of the child into a community, then they begin to worsen once he or she gains immunity against a large number of germs, with which they come in contact). in view of increasing the resistance to infections; ask the doctor to prescribe an immunostimulatory preparation (Bronchovaxom, Rybomunil).

Alina Pop-Began
Resident physician
Anesthesia and intensive care

Tags Nurofen children