Inflammation of the pharynx of bacterial etiology, which experts define as bacterial pharyngitis, is most often acute. Infection occurs by airborne droplets or by contact; the likelihood of activation of infectious agents constantly living in the pharyngeal cavity cannot be ruled out - this occurs in conditions of hypothermia, trauma to the mucous membrane. A variety of bacteria become the causative agents of the disease, and symptoms can appear in both an adult and a child. In order to properly provide assistance to the patient, you need to make sure of the diagnosis and imagine what treatment methods can be useful for bacterial pharyngitis.
Causes and classification
Bacterial inflammation of the pharynx can occur at any age, therefore, if one of the family members or closely communicating people in the team has an infection, the risk of infection of contact persons is very high. Contributing factors are immunodeficiency of various etiologies, hypothermia, injury to the mucous membrane of the pharynx or its dryness, leading to a decrease in the amount of mucus, its inherent protective properties. In this case, the causative agent of scarlet fever can be transmitted even through indirect contact - that is, upon contact with a person who was next to the patient and thus became a carrier of the infection.
Scarlet fever is referred to as a type of bacterial pharyngitis for good reason. By itself, bacterial inflammation of the pharynx is a general definition, the meaning of which is to indicate the presence of an inflammatory process caused by a bacterium in a specific anatomical region. Therefore, the designation "pharyngitis of bacterial etiology" is valid for all diseases that are characterized by an inflammatory lesion of the pharynx, which means a pathological syndrome, that is, a complex of symptoms. However, depending on the pathogen, the diagnosis may sound different, therefore pharyngitis of a bacterial nature can occur when:
- streptococcal, staphylococcal infections;
- varieties of streptococcal infection - scarlet fever;
- infection with corynebacterium diphtheria - diphtheria;
- infection with bacteria of the Neisseria, Yersinia group;
- typhoid fever, tularemia as a secondary infectious and inflammatory process.
The most common streptococcal pharyngitis provoked by group A beta-hemolytic streptococcus.This pathogen is dangerous because, in the absence of treatment, and, accordingly, high-quality elimination (removal from the body), it can provoke not only a pronounced intoxication syndrome, but also severe complications - kidney damage, joints, heart.
Pharyngitis of bacterial etiology is often considered synonymous with purulent inflammation, although in fact it is not always accompanied by the release of pus.
Bacteria can indeed be the cause of purulent pharyngitis, but a course in which there is no purulent exudate and infiltration is also likely. Thus, pharyngitis is divided as:
- catarrhal;
- purulent.
Catarrhal inflammation can only be the initial stage preceding the appearance of pus.
Patient complaints
Manifestations that bother the patient are important information for the doctor that allows him to outline the boundaries of the diagnostic search and already at the patient's stage to understand what pathology can be discussed. Therefore, you should know what complaints are characteristic when pharyngitis of bacterial etiology occurs:
- Rawness and dryness in the throat.
- Unpleasant sensations, discomfort, irritation of the mucous membrane.
- Periodic obsessive coughing.
- Sore throat of varying severity.
- An increase in body temperature to subfebrile and febrile levels.
- Weakness, headache, impaired appetite during fever.
Patients may indicate irradiation, that is, the return of pain to the ears. Fever with bacterial inflammation is often febrile, the degree of intoxication can be different - weakness and headache increase during fever and persist during a period of persistent temperature rise, its sharp rise and fall. Unlike SARS (acute respiratory viral infection), sore throat is not always combined with inflammation of the nasal mucosa (rhinitis). In this case, very often there is a simultaneous defeat of the pharynx and palatine tonsils - tonsillopharyngitis.
For bacterial pharyngitis, severe sore throat is characteristic - up to refusal of food for fear of worsening the condition.
However, this symptom is not always present - for example, with diphtheria of the oropharynx, pain is usually of moderate intensity. At the same time, raids, allowing to suspect a diphtheria infection, do not appear immediately, but after two to three days. This slows down the diagnosis. In vaccinated persons, the course of diphtheria can be atypical, erased, in a mild form without plaque.
Objective symptoms
Objective symptoms are understood as a description of the picture of changes in the pharynx, which can only be assessed by means of a special examination (pharyngoscopy). Pharyngoscopy is no less important than a correctly conducted survey - it allows you to confirm or, conversely, exclude a number of diagnoses. What can be seen in the pharynx with bacterial pharyngitis? Among the characteristic features are:
- redness (hyperemia);
- swelling (including the uvula);
- raids (mucopurulent, yellowish, whitish);
- increase, redness of individual follicles on the back of the pharynx;
- white bloom on the surface of the follicles.
Sometimes the raids are tightly welded to the underlying mucous membrane, have a grayish, yellowish tint, and are difficult to remove; after removal, the mucous membrane bleeds, ulcerates. This is a sign of fibrinous inflammation, which causes corynebacterium diphtheria. If the plaque is also on the tonsils, then it spreads beyond the palatine arches (diphtheria of the tonsils).
With scarlet fever, the mucous membrane of the pharynx is bright red, the tongue is coated with a white bloom - later it acquires a crimson color, the plaque is "peeled off" within 3-4 days. The posterior wall of the pharynx is affected, as well as the palatine tonsils. In this case, one should pay attention to the patient's appearance: the blush on the cheeks creates a sharp contrast with the pale nasolabial triangle, a point rash appears on the skin.
If the inflammatory process is acute, but the patient already suffers from chronic pharyngitis, you can notice signs of chronic inflammation: dilated, translucent vessels, enlarged follicles, abundant mucous membranes, mucopurulent discharge, thickened or, conversely, dry and thinned, crusted mucous membrane.
Age features
With bacterial pharyngitis, age characteristics should be taken into account - belonging to a particular age group can significantly affect the course of the disease.
Younger children
In young children, the course of bacterial pharyngitis is more severe than in adults. The body temperature rises to high numbers, weakness, lethargy are expressed. Children suffer from severe sore throat, which radiates to the ears and nose (inflammation is most often in the nature of rhinopharyngitis, that is, a combined lesion of the nasal mucosa and pharynx), often refuse not only food, but even drink, since swallowing increases the pain syndrome ... The occurrence of vomiting and stool disorder increases the risk of dehydration - the less the child's body weight, the higher the likelihood of a sharp deterioration in the condition.
Elderly patients
In elderly patients, the disease can proceed in the classical, previously described form - but there are also cases of an erased course. Intoxication is mild, as is a sore throat. Fever is subfebrile or absent. Sometimes the patient may believe that the disorder is associated with fatigue; examination of the mucous membrane of the pharynx allows you to make sure that there are changes inherent in the infectious and inflammatory process.
Treatment
Treatment for bacterial pharyngitis is aimed at:
- to destroy the pathogen;
- to weaken the symptoms of the disease.
A patient who has a bacterial inflammation of the pharynx needs:
- breathe humidified, comfortable temperature air;
- exclude contact with dust, tobacco smoke and other irritants (thermal, mechanical);
- follow a diet (easily digestible mild food, plentiful warm drinks, refusal from alcohol);
- limit voice load;
- stay in bed during a fever.
In the fight against pain, in addition to special medicines, one must not forget about the connection between pain syndrome and dryness of the mucous membrane of the pharynx. To cleanse and moisturize it, you should drink enough - often, in small sips. Pure water, tea, compote, warm milk are suitable (if there are no contraindications).
Treatment of bacterial pharyngitis is not feasible without the use of antibiotic therapy.
Other remedies do not allow you to quickly eliminate symptoms and reduce the risk of complications. Antibacterial drugs are selected by the attending physician - they are used, according to the standards, for at least 7, 10 or 14 days - depending on the need in a particular case. The dosage is also determined individually. It is impossible to interrupt the course if there is no objective justification - this forms the resistance (resistance) of bacteria to drugs.
Also used are local antiseptics, analgesics and anti-inflammatory drugs (Strepsils, Anti-Angin, Heksetidine, Tantum Verde), local antibiotics (Bioparox), rinsing with herbal infusions (chamomile, calendula), saline.
Treatment for children includes antibiotic therapy, prescription of antiseptics, anesthetics and anti-inflammatory drugs, which are allowed according to age. If the child does not know how to gargle, frequent warm drinks can be used to moisturize the mucous membrane, discuss with the doctor the appropriate method of applying the medication. At the same time, it is important to understand that a small child should not be given large tablets for resorption - he may accidentally choke. Sprays should not be used to treat children under 5 years of age.
In the treatment of diphtheria, not only antibiotic therapy is used, but also a special drug - antitoxic antidiphtheria serum. This agent is designed to neutralize the toxin of the causative agent of diphtheria. The patient is hospitalized in a hospital, if necessary, detoxification, symptomatic therapy is carried out.
Antipyretic drugs (Paracetamol, Panadol, Nurofen, Ibuprofen) are indicated as symptomatic agents - if the body temperature reaches 38-38.5 ° C or more. They are used only for fever and are not used prophylactically, since in case of an overdose there is a high probability of drug intoxication, liver and kidney damage.
