Purulent complications of sore throats

Local purulent complications of angina and nearby - acute otitis media, acute laryngitis, laryngeal edema, phlegmon of the neck, parapharyngeal abscess, acute cervical lymphadenitis, lesions of the salivary glands (sialoadenitis). Complications at a distance include arthritis and arthrosis, orchitis, cholecystitis, meningitis, etc.

Common purulent complications of angina apparently include general toxic syndrome with disruption of the central nervous system and cardiovascular system, as well as postanginal septicemia. Frequently recurring angina contribute to sensitization of the body, against the background of which the general resistance of the body to other infectious diseases decreases.

Postanginal septicemia is a severe purulent complication of tonsillitis and is currently extremely rare. Most often, it occurs in people who have had tonsillitis between the ages of 16 and 35. In severe cases, this complication can be fatal. Postanginal septicemia is divided into primary and secondary. As a rule, primary septicemia occurs after a common tonsillitis and is classified as a monobacillary complication: anaerobes, saprophytes of the oral cavity (B. funduliformis, a gram-negative bacterium very sensitive to penicillin, B. fragilis, B. ramosus, etc.). Secondary septicemia occurs as a complication of ulcerative necrotic tonsillitis, for example, with agranulocytosis or leukemia. They are much more severe than primary ones and are classified as polybacterial complications of tonsillitis. The entry gate for microorganisms is the internal jugular vein or cavernous sinus, into which the infection penetrates due to a violation of the barrier function of the vascular wall in follicular and lacunar tonsillitis or peritonsillar phlegmon. An infected thrombus that occurs in the vein is a source of septicemia, and in some cases, when purulent emboli break away, it is also a source of pyemia. In the latter case, metastatic abscesses occur at a distance (in the lungs, joints, liver, etc.).

The latent period of postanginal septicemia is from 1 to 15 days. The clinical course is characterized by a sharp rise in body temperature, severe chills, accompanied by "cold" sweat, weakness of cardiovascular activity (frequent threadlike pulse, sharp decrease in blood pressure, hypoxia), which occurred suddenly either during the recovery period or some time after it in complete health. The patient's face becomes gray with an icteric tint. With high body temperature and a severe clinical course, the patient periodically falls into an unconscious state, delirium. Stupor and coma are harbingers of a fatal outcome, which in an extremely severe course can occur within 3 days. In the acute course of postanginal septicemia, death can occur in 5-10 days from the onset of the disease. Purulent complications of subacute tonsillitis are cured by prescribing large doses of penicillin.

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