Acute nonspecific sore throats

Acute non-specific tonsillitis is a disease that affects preschool and school-age children and adults (less often) up to 35-40 years old. There are marked seasonal increases in the disease in the spring and autumn periods. Tonsillitis is 1.5-2 times more common in large cities with developed public transport than in small towns and rural areas.

According to B.S. Preobrazhensky (1956), acute non-specific tonsillitis is a very common disease, as evidenced by the average statistical rate of tonsillitis in the USSR in 1954 (39.17 cases per 1000 inhabitants). The increase in the incidence of tonsillitis is affected by the crowding of large groups (in kindergartens, schools, dormitories, army units), especially in newly created groups, when cross-infection of their members with the corresponding microorganisms occurs. Unfavorable environmental conditions and certain industrial hazards (atmospheric, radiation, etc.) also play a significant role in this.

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Epidemiology

Infection with pathogenic microorganisms in the case of angina occurs in two ways - exogenous and endogenous. The first way includes airborne and alimentary infection. In the case of airborne infection, the incidence of acute non-specific angina in large groups has the character of local "epidemics". The alimentary way is possible when consuming infected products, in particular milk from cows sick with streptococcal disease of the udder. This equally applies to infants whose nursing mothers suffer from mastitis.

Endogenous infection occurs when general and local immunity is weakened against the background of certain risk factors - local and general cooling, vitamin deficiency, protein deficiency in the diet (amino acid "starvation"), professional and household hazards, allergies. In this case, the individual's saprophytic microorganisms acquire pathogenic properties, causing an inflammatory process in the corresponding structures of the pharynx, which is of an infectious-allergic nature. Chronic tonsillitis is of great importance in the occurrence of endogenous infection. In this case, repeated or recurrent acute nonspecific tonsillitis usually occurs, characteristic of the decompensated form of this disease of the palatine tonsils. As B.S. Preobrazhensky (1954) notes, the frequency of sore throats in chronic tonsillitis is explained by the fact that in this disease there is usually up to 75% of cases of carriage of potentially virulent microbiota, especially hemolytic streptococcus, vegetating in the crypts of the palatine tonsils.

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What causes acute nonspecific tonsillitis?

In the most common forms of angina (catarrhal, follicular and lacunar), various pyogenic cocci (streptococcus, staphylococcus, pneumococcus) and yeast-like fungi of the genus Candida, etc., act as their causative agents. Anaerobic infection, adenoviruses, influenza viruses, as well as symbiosis with other pathogens can play a significant role in the development of acute non-specific angina. Purulent diseases of the nose and paranasal sinuses can be the source of infection.

Predisposing factors such as local and general hypothermia, overheating, harmful chemical and dust atmospheric agents, decreased reactivity of the body, hypo- and avitaminosis, and sometimes mechanical trauma (for example, a fish bone prick) of the palatine tonsil play a significant role in the pathogenesis of tonsillitis. Pathoanatomical changes are closely related to pathogenesis, the nature of which is determined by the clinical forms of tonsillitis. The most common are the so-called vulgar (common, banal) acute non-specific tonsillitis. As mentioned above, a distinction is also made between tonsillitis that occurs with acute infectious diseases (measles, scarlet fever, diphtheria, etc.), blood diseases (agranulocytosis, lymphocytic leukemia, etc.), and special forms of tonsillitis, such as Simanovsky-Plaut-Vincent angina. Each of these forms is characterized by its own pathological and anatomical picture.

Immunological characteristics

Vulgar angina does not create any stable immunity, more often the opposite (autoallergization and cross-sensitization): after the transferred angina there follows a series of angina, caused by other microorganisms. On the one hand, this is due to a decrease in immunity as a result of the transferred angina, on the other - the phenomenon of sensitization of local lymphadenoid formations of the pharynx to coccal antigens and the development of allergic readiness in the body to respond to both endogenous and exogenous microorganisms. In other words, acute non-specific angina opens wide gates for the introduction into the body and activation of pathogenic microorganisms, which in some cases cause not only the occurrence of local relapses, but also a general infectious-allergic status, manifested by pathological processes in the interstitial and connective tissue (rheumatoid arthritis, endo- and myocarditis, other forms of collagenoses).

Among the vulgar tonsillitis, there are catarrhal, follicular, lacunar and phlegmonous.