Symptoms of angina

Streptococcal angina begins acutely with an increase in body temperature to 38-39 ° C, chills, headache and pain when swallowing. Clinical symptomatology reaches its maximum severity in the first day after the onset of the disease. Patients complain of general weakness, decreased appetite, sore throat, sometimes with irradiation in the ear and lateral sections of the neck. In more severe cases, repeated vomiting, nausea, agitation, convulsions are possible. Characterized by the appearance of the patient: the skin is dry, the face is flushed, the cheeks are flushed, the lips are bright, red, dry, in the corners of the mouth seized.

Changes in the oropharynx usually include bright diffuse hyperemia, exciting soft and hard palate, tonsils, posterior pharynx wall, but sometimes observe delimited hyperemia of the tonsils and palatine arch. Tonsils are enlarged mainly as a result of infiltration and puffiness.

• With lacunar angina, the overlays are located in lacunae. Sometimes overlays strictly repeat tortuous lacunae, but often are mosaic - they are located not only in lacunae, but also have the appearance of islets or completely cover part of the amygdala. Usually these overlays are yellowish-white, easily removed with a spatula and rubbed between the object glasses, i.e. Consist of pus and detritus.
• With follicular tonsillitis on the tonsils appear whitish follicles 2-3 mm in diameter, somewhat rising above the surface of the tonsils. They are not removed with a tampon or spatula, since they represent subepithelial located purulent masses formed as a result of destruction of the lymphoid follicles of the tonsils. Usually, microabscesses ripen and open, which is accompanied by a new rise in body temperature and the appearance on the tonsils of superficially located purulent island overlays.
• With necrotic angina, the affected areas of the tonsil tissue are covered with a plaque with an uneven, dingy, dull surface of greenish-yellow or gray color that extends into the mucous membrane. Often they are impregnated with fibrin and become dense. When you try to remove them, there is a bleeding surface. After the rejection of overlaps, a tissue defect is formed, which has a whitish color, irregular shape, uneven, and a hilly bottom. Necrosis with streptococcal infection can spread beyond the tonsils - on the arch, tongue, back of the pharynx.

In addition to the characteristic changes in the oropharynx, all patients with streptococcal angina have an increase in regional lymph nodes. With palpation, they are painful and dense. The involvement of lymph nodes in the process is proportional to the intensity of changes in the oropharynx.

[1], [2], [3], [4], [5], [6], [7]