This is an automatically translated article.
Sore throat is a common manifestation in many diseases, however, for that reason, many people are subjective and wait until they have to go to the hospital in an emergency because of complications of pharyngitis.Pharyngitis is a common disease caused by bacteria, viruses, fungi... Usually, sore throat symptoms (sore throat) will go away within 3-5 days after being treated or the body adjusts itself. Okay.
However, in some special cases such as high bacterial toxins, reduced body resistance, throat infections spreading to the entire neck area, causing diffuse inflammation in the neck and chest area, in some cases spread to the mediastinum. Or severe infections can cause toxicity. Some complications of pharyngitis infection such as: tonsillitis leading to tonsil abscess, from infectious foci of pharynx, inflammatory process invades lymph node group in the posterior pharynx, causing abscess in the posterior wall of the pharynx. , abscess on the side of the throat... This is also an emergency in the ENT. It was found that the presence of pathogenic bacteria in these cases were staphylococci, streptococci, spirochetes, anaerobic and aerobic bacteria, including group A beta-hemolytic streptococci.
Inflammation picture. dangerous throat due to group A hemolytic streptococcus.
Recognizing complicated pharyngitis
When pharyngitis causes complications: the patient's expression of sore throat is increasing, opening the mouth is difficult, gradually leading to a tight jaw. Continuous sore throat while still on antibiotics, the pain level in the throat decreases in the first 1-2 days then increases again and gets worse. The characteristic of sore throat in peritonsillar abscess is pain spreading to the ear when swallowing, pain in the corner of the jaw. Patients feel difficulty swallowing, saliva flow a lot, dirty, bad breath, rotten. When the infection spreads, the patient's voice changes, the voice is like a grain of rice, full of difficulty hearing due to the narrow throat. In the late stage when the abscess spreads to the bite muscle area, it will cause a tight jaw. Shortness of breath occurs when an abscess fills the oropharynx and spreads down the larynx. Shortness of breath is often shallow, rapid, small pulse, difficult to catch. The whole body shows severe infection or infection with intoxication: High fever 39-40oC, chills, gray-blue skin. Examination of the throat, the mucosa is congested red, many pseudo-mucous membranes are dirty yellow-green. The anterior part of the tonsils is swollen, the lower part may contain pus. Succulent tongue, poor mobility. Tonsillitis is usually unilateral. The lymph nodes on the same side are also swollen and painful due to the inflammatory reaction spreading to the lymph nodes.
Required tests for correct diagnosis and treatment
Blood tests show that polymorphonuclear leukocytes in the blood are elevated, especially neutrophils (over 80%). A lateral neck X-ray may show water and vapor levels on film (a manifestation of an abscess). A computed tomography scan of the neck can be performed if the patient's condition allows and at the facility's conditions to accurately assess the location, size, and severity of the widespread infection. Take pus for culture to find the most appropriate bacteria and antibiotic, helping to treat effectively. Inflammation in the neck, if not detected and treated promptly, can spread to the posterior visceral space, the abscess spreads to the mediastinum and lungs. Sepsis... even death, so it's very dangerous.
Internal medicine combined with surgery (wide incision to drain pus). Medical treatment with antibiotics combined according to the antibiotic map, against both aerobic and anaerobic bacteria by parenteral route, antipyretic, analgesic, anti-inflammatory. Duration of treatment lasts at least 10 days. The patient is indicated for tonsillectomy, curettage of V.A. after the signs of local and systemic inflammation are gone for about a month.
Group A hemolytic streptococci
Prevention of dangerous complications of pharyngitis
When a patient has a sore throat, a patient needs to go to the doctor for examination and treatment as directed by an ENT specialist. Do not arbitrarily buy medicine to use or use the wrong medicine, not the right way to use as well as the time to take it as prescribed by the doctor. If the patient detects that the intermediate stage between acute tonsillitis and peritonsillar abscess is inflammation around the tonsils, it is very important, to avoid the patient having to have surgical intervention, and the treatment time. treatment is shortened. In the stage of inflammation around the tonsils, it is usually only necessary to use antibiotics, high-dose anti-inflammatory drugs orally or by injection, and at the same time to reduce fever and relieve pain well for the patient in about a week. Keep your throat clean regularly by gargling daily with mild alkaline drugs (diluted saline), eating hygienically...
Dr. Pham Bich Dao
