Symptoms of sore throat

Streptococcal tonsillitis begins acutely with a rise in body temperature to 38-39 °C, chills, headache and pain when swallowing. Clinical symptoms reach their maximum severity already in the first day from the onset of the disease. Patients complain of general weakness, loss of appetite, sore throat, sometimes radiating to the ear and lateral parts of the neck. In more severe cases, repeated vomiting, delirium, agitation, convulsions are possible. The patient's appearance is characteristic: dry skin, hyperemic face, blush on the cheeks, bright, red, dry lips, cracks in the corners of the mouth.

Changes in the oropharynx usually include bright diffuse hyperemia, involving the soft and hard palate, tonsils, posterior pharyngeal wall, but sometimes limited hyperemia of the tonsils and palatine arches is observed. The tonsils are enlarged mainly as a result of infiltration and edema.

• In lacunar tonsillitis, the deposits are located in the lacunae. Sometimes the deposits strictly repeat the tortuous lacunae, but they are often mosaic - located not only in the lacunae, but also have the appearance of islands or completely cover part of the tonsil. Usually these deposits are yellowish-white, easily removed with a spatula and ground between slides, i.e. they consist of pus and detritus.
• In follicular tonsillitis, whitish follicles 2-3 mm in diameter appear on the tonsils, slightly elevated above the surface of the tonsils. They are not removed with a swab or spatula, as they are subepithelial purulent masses formed as a result of the destruction of the lymphoid follicles of the tonsils. Microabscesses usually mature and open, which is accompanied by a new rise in body temperature and the appearance of superficially located purulent island deposits on the tonsils.
• In necrotic tonsillitis, the affected areas of the tonsil tissue are covered with a coating with an uneven, pitted, dull surface of a greenish-yellow or gray color, going deep into the mucous membrane. They are often soaked with fibrin and become dense. When trying to remove them, a bleeding surface remains. After the rejection of the deposits, a tissue defect is formed that has a whitish color, an irregular shape, an uneven, bumpy bottom. Necrosis in streptococcal infection can spread beyond the tonsils - to the arches, uvula, the back wall of the pharynx.

In addition to the characteristic changes in the oropharynx, all patients with streptococcal tonsillitis have enlarged regional lymph nodes. They are painful and dense upon palpation. The involvement of the lymph nodes in the process is proportional to the severity of the changes in the oropharynx.

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