Herpetic sore throat

Herpetic angina is an acute infectious disease that manifests itself with general (fever, general malaise, sometimes nausea and vomiting) and local symptoms (sharp pain in the throat when swallowing, enlarged pharyngeal tonsils). The pathognomonic sign of this type of angina is the appearance of vesicular formations on the back wall of the pharynx, which are subsequently subject to ulceration.

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Causes herpetic sore throat

Herpetic angina (herpes buccopharyngеalis) is caused by a filterable virus (herpes fever virus) of the same class as Herpes simplex and manifests itself in vesicular rashes on the mucous membrane of the oral cavity and pharynx. However, the toxin of this virus is many times more toxic than the herpes simplex virus. Thus, in special experiments it was found that if the contents of a vesicle with herpetic angina, taken from the pharynx, are introduced into the conjunctival sac of a rabbit, ulcerative keratitis develops and many animals die from viral encephalitis. Many researchers believe that the herpes fever virus is identical to the Economo lethargic encephalitis virus, the difference between them concerns only virulence and tropism to various substrates.

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Symptoms herpetic sore throat

The clinical picture of herpetic angina begins violently, especially in adults, with chills, a rise in body temperature to 40-41°C, as in lobar pneumonia, and sharp pains in the throat and dysphagia, which subside only on the 3rd day of the disease. At the onset of the disease, the mucous membrane of the pharynx is diffusely hyperemic, and clusters of small round white vesicles surrounded by a red halo appear on the arches and palatine tonsils. These vesicles merge, forming white spots, which somewhat later ulcerate and become covered with a pseudomembranous film surrounded by an uneven red border. The vesicles successively suppurate and ulcerate over 3 weeks. The appearance of herpetic eruptions on the mucous membranes of the cheeks, lips and even on the skin of the face facilitates the diagnosis of herpetic angina.

Sometimes herpetic blisters are found on the soft and hard palate, tongue and epiglottis. Often, general severe symptoms of intoxication disappear before the herpetic rash appears, while the body temperature gradually decreases by the 6th day of illness, and the patient recovers without complications.

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Diagnostics herpetic sore throat

The diagnosis of herpetic angina cannot always be established immediately, since many of its symptoms at the initial stage of the disease coincide with other forms of angina, both banal and in a number of infectious diseases. Only the appearance of characteristic herpetic vesicles on the tonsils and mucous membrane of the oral cavity allows one to lean towards the diagnosis of herpetic angina.

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Differential diagnosis

The initial appearance of herpes on the lips with the rapid development of a general severe condition is often mistaken for pneumonia of viral etiology, epidemic cerebrospinal meningitis, scarlet fever in the initial stage of pronounced enanthema; in the phase of polycyclic formation of pseudofilms, herpetic angina can simulate diphtheria. In the phase of the eruption of herpetic vesicles, herpetic angina must be differentiated from herpes zoster of the second branch of the trigeminal nerve, the nerve endings of which innervate the palatine arches and palate.

In differential diagnosis, one should also take into account the so-called recurrent herpes, which occurs in women during menstruation, as well as in smokers and people suffering from arthritis.

Treatment herpetic sore throat

Herpetic angina is treated symptomatically and specifically. The first includes gargling, drinking plenty of fluids, a balanced diet, multivitamins, and painkillers. Specific treatment involves prescribing modern antiviral drugs such as acyclovir. If bacterial complications occur, broad-spectrum antibiotics are prescribed.