Purulent plugs in the throat appear as a result of the development and progression of a chronic purulent-inflammatory process.
Purulent plugs in the throat appear as a result of the development and progression of a chronic purulent-inflammatory process.They have different densities and are found during examination of the oropharynx in different quantities. Sometimes the patient himself notices them on the surface of the tonsils - anxiety about the presence of plugs is in this case one of the dominant complaints.
Tonsil plugs
If during an independent examination of the oropharynx or a consultation in the doctor's office, purulent formations in the throat are detected, most likely, we are talking about traffic jams. Why do they arise and what are they formed from? Should you be afraid to find white plaques on the tonsils? These questions are certainly important for every patient. And if in the second case they are asked directly to a specialist, then in the first one, before examining a therapist or ENT doctor, you can get an idea of what a purulent plug is on your own.
Plugs, sometimes also described by patients as white globules, are accumulations of exfoliated epithelium, necrotic tissue fibers, leukocytes, and microorganisms in the lacunae of the tonsils. Lacunas are the depressions with which the surface of the amygdala is dotted; their standard size ranges from 1 to 4 mm. In a healthy person, gaps do not contain either pus or dense purulent-caseous plugs. In very rare cases, in the absence of an inflammatory process, there are single cork-like inclusions that resemble a spot on the surface of the mucous membrane.
Ulcers on the tonsils are primarily a sign of chronic tonsillitis.
A purulent inflammatory process can occur in different forms of tonsillitis - in particular, in the acute course of a banal (typical) follicular and catarrhal sore throat. However, at the same time, purulent plugs in the lacunae of the tonsils have a loose structure, within a short time (on average, from 2 to 4 days from the onset of symptoms) they are transformed into ulceration. In general, they are not classic plugs, they are not always present, combined with a purulent bloom.
For the chronic course of tonsillitis, purulent plugs are characteristic, which in density can resemble stones in the tonsils - this is due to the inclusion of mineral deposits (for example, calcium salts) in the composition.
Clinical signs
How do purulent plugs in the tonsils manifest themselves? This question is extremely important for diagnostic search, since pathological deposits are not always the first to be found. There are variants of the course in which the patient has no complaints at all, and pustules become an accidental find. In addition, the patient himself cannot always see them, even if he examines the throat with additional lighting. Therefore, all characteristics of the clinical picture should be taken into account.
What should be the symptoms if there are purulent plugs in the throat? It depends on the form of the disease - and if we are talking about chronic tonsillitis, also on the stage of the course (remission, exacerbation). It should be said right away that an exacerbation or relapse of chronic inflammation of the tonsils proceeds in the form of a classic acute tonsillitis. One of the diagnostic criteria in this case is the frequency of recurrence of the manifestations of angina over a certain period of time.
In acute tonsillitis and exacerbation of chronic inflammation, the patient is worried about:
- Pain when swallowing.
- Perspiration, sensation of dryness in the throat.
- Weakness, headache, loss of appetite.
- Increased body temperature.
The above symptoms characterize a simple or initial form of chronic tonsillitis. If a patient develops a toxic-allergic form, additional manifestations are added - not only from the oropharynx and tonsils, but also from the whole organism. Patients may emphasize that "the plugs are as dense as a stone, and the lacunar pus that is released when pressure is applied to the tonsil is very smelly."
Another common symptom of chronic tonsillitis is bad breath.
White lumps with an unpleasant odor can be present both during an exacerbation and after the elimination of vivid manifestations of the inflammatory process. Sometimes they are excreted along with scanty phlegm. It is worth remembering that a pungent unpleasant odor also requires the elimination of pathology of the teeth and the digestive system.
Another classic manifestation of the chronic course of tonsillitis is recurrent pain in the ears and cervical lymph nodes. If such a complaint occurs against the background of frequent sore throats, you should consult an otolaryngologist. Those patients who have found fetid pus and other changes inherent in the disease need compulsory treatment.
In a patient suffering from a toxic-allergic form of chronic tonsillitis, purulent plugs in the tonsils are found during examination as a permanent manifestation. Their presence is accompanied, in addition to the previously mentioned signs:
- unmotivated weakness;
- periodic increase in body temperature to subfebrile numbers;
- recurrent joint pain;
- decreased appetite, sleep disturbance;
loss of body weight;- decreased exercise tolerance;
- decreased ability to concentrate, etc.
loss of body weight;During the period of exacerbation of chronic tonsillitis, the symptoms are supplemented by pain in the region of the heart. With a prolonged course of the disease, the absence of treatment or under the influence of factors that worsen the patient's condition, there are changes in the cardiovascular, urinary, and musculoskeletal systems. White plugs on the tonsils require clarification of the diagnosis, since the risk of complications in tonsillitis of any form is very high.
Nuances of diagnosis
Revealing even a single plug requires making sure whether the patient has a pathological process. To do this, it is worth, first of all, to answer the questions:
- Is there a general condition disorder (weakness, headache, fever)?
- Are there signs of local involvement (sore throat)?
- How often has the patient had episodes of acute tonsillitis over the past year?
As mentioned earlier, one cork can show up even in a healthy person. It becomes a residual phenomenon of an already stopped inflammatory process, a consequence of desquamation of the epithelium. Therefore, any measures to eliminate it cannot be started until complete confidence in the diagnosis. Also, it is not necessary to say only by the presence of a single inclusion in the amygdala that a person suffers from chronic tonsillitis. This disease is characterized by numerous abscesses on the tonsils, the accumulation of purulent exudate in the follicles, an increase in the size of the tonsils.
Pus on the tonsils is not a sign of a specific form of pathology, but of the presence of an infectious and inflammatory process, which, in turn, can be the basis of acute or chronic tonsillitis. If there are a lot of white, white-yellow or white-gray inclusions, you need to assume:
- acute banal sore throat;
- phlegmonous sore throat;
- diphtheria of the oropharynx and tonsils;
- chronic tonsillitis.
White dots in the throat are characteristic of acute follicular sore throat - their appearance is explained by the accumulation of purulent contents in the follicles of the tonsils.
In chronic tonsillitis, pus is released during pressure with a spatula on the anterior palatine arch.
If pus on the tonsils is located in the form of layers, spots, cork-like formations, but does not go beyond the tonsils, you can also think of acute tonsillitis. Chronic tonsillitis is suspected if:
- The patient often suffers sore throats, the symptoms are bilateral.
- Changes are observed on the surface of the amygdala - plugs or liquid purulent exudate.
- There is marked redness and swelling of the palatine arches.
- Stain, plaque on the tonsils is difficult to remove, the surface of the tonsils oozing pus.
In this case, the surface of the tonsils can be both smooth and loosened, bumpy. In the initial period of the disease, white lumps from the throat usually do not stand out, and the palatine tonsils are not enlarged, changes affect a limited area of the mucous membrane and underlying tissues. In the future, if there is a lot of purulent exudate, and the patient often coughs, individual fragments of cork-like deposits can be found in the sputum. However, this does not clear the tonsils, and white plugs in the throat can be seen with every re-examination.
"True" and "false" plugs
Purulent plugs in the throat are certainly a pathological sign. However, in this case, it is necessary to differentiate not only the main probable types of bacterial diseases described earlier, but also to exclude other pathologies. Corky deposits in the tonsils, which can be considered "true", contain pus and arise as a result of the vital activity of pathogenic bacteria and a violation of the outflow of exudate from the lacunae. "False" plugs often do not penetrate deep into the lacunae, appear during infection or non-infectious processes, among which are:
- candidiasis of the oropharynx and tonsils;
- diphtheria of the tonsils;
- leukoplakia of the tonsils.
It is necessary to differentiate "true" plugs from plaque, which may have the form of plaques raised above the surface of the mucous membrane of the layers. A curdled plaque, reminiscent of white ulcers in the throat, occurs with candidiasis of the oropharynx and tonsils. It is a fungal infection that develops in both children and adults. Differential diagnosis should be carried out by a doctor, since it is not always possible to distinguish the ananginous form of chronic tonsillitis from a fungal infection of the tonsils by objective signs.
It is also necessary to distinguish between plugs, which look like white lumps in the throat, and an insular form of diphtheria. The need for differential diagnosis arises mainly when the patient does not know about the presence of chronic tonsillitis. With diphtheria on the edematous surface of the tonsils, a whitish, white-gray plaque in the form of "islands" with irregular outlines is visible.
On examination, it can be mistaken for caseous plugs in the throat, since it has a dense consistency and is difficult to separate. The shiny surface is not always taken into account; in addition, diphtheria can begin as a banal tonsillitis, therefore, in some cases, it is mistakenly regarded as an acute course of primary tonsillitis or an exacerbation of chronic inflammation of the tonsils.
Leukoplakia is a process of keratinization of the epithelium of the mucous membrane. There are various types of leukoplakia; with a typical focal form, foci of white or whitish-gray color are observed, which are located superficially, and some of the scales that make up the focus of changes are easily removed with a spatula. With diffuse leukoplakia, the underlying tissue is loosened, and the lesions covered with scales bulge. Such "false" white plugs on the tonsils are not associated with purulent inflammation, but the altered tissues are easy to injure during meals, examination, which is associated with the risk of starting an infectious and inflammatory process.
The correct diagnosis can only be made by a doctor, so you should not resort to self-medication - this often becomes a direct or indirect cause of complications. To understand why traffic jams appeared, not only an objective examination is required, but also the use of laboratory and instrumental methods.
