Treatment of angina, causes, types of the disease, features of the clinic and complaints

Sore throat is one of the most common reasons for parents to consult a pediatrician. However, not every case requires treatment with antibiotics. In most children, throat inflammation is caused by viruses, but sometimes the cause of the illness is a bacterium - beta-hemolytic streptococcus group A. 

Streptococcal tonsillopharyngitis requires timely diagnosis and correct treatment. This helps to alleviate symptoms faster, reduce the risk of spreading the infection to others, and prevent the development of potential complications. 

What is streptococcal tonsillopharyngitis? 

It is an acute bacterial infection that affects the palatine tonsils and the mucous membrane of the throat. It most commonly occurs in children aged 5 to 15 years, especially during the autumn-winter and early spring periods. 

The infection is transmitted from person to person via small droplets of saliva and nasal secretions during coughing, sneezing, talking, or close contact. 

What symptoms may indicate a streptococcal infection? 

A child may experience: 

• sudden intense sore throat;  
• fever;  
• redness and swelling of the tonsils;  
• white patches or pus on the tonsils;  
• enlarged and painful neck lymph nodes;  
• headache;  
• abdominal pain;  
• nausea or vomiting;  
• decreased appetite due to pain while swallowing.  

At the same time, it is important to remember: no individual symptom allows for a diagnosis to be made independently. The presence of cough, runny nose, hoarseness, or conjunctivitis more often suggests a viral nature of the disease. 

How is the diagnosis confirmed? 

Clinical manifestations alone do not always distinguish streptococcal infection from viral infection. Therefore, a doctor may recommend additional testing. 

The most commonly used tests include: 

• rapid streptococcal test (strep test) – results can be obtained within minutes;  
• bacteriological examination of a throat swab – may be recommended in some cases, for example, after a negative rapid test if the clinical picture raises doubts.  
• It is not recommended to start taking antibiotics on your own without a confirmed diagnosis. 

How is streptococcal tonsillopharyngitis treated? 

If a streptococcal infection is confirmed, the doctor may prescribe antibacterial treatment. It is very important to follow recommendations regarding the duration of medication and not to stop treatment on your own after feeling better. 

Usually, the first signs of improvement appear within 48–72 hours from the start of therapy. If this does not happen or the child's condition worsens, it is necessary to consult a doctor again. 

Supportive treatment also helps the child cope with the illness more easily. Helpful measures may include: 

• sufficient fluid intake to prevent dehydration;  
• soft foods that do not irritate the throat;  
• cool drinks or ice cream if they provide relief to the child;  
• fever-reducing and pain-relieving medications in age-appropriate doses as recommended by a doctor.  

When can a child return to a group setting? 

After starting antibiotic therapy, the child usually stops being contagious after 24 hours. If there is an improvement in well-being and no fever, they may return to kindergarten or school. 

If antibiotics were not prescribed, the timing of returning to a group should be discussed with the doctor individually. 

When should a doctor be consulted immediately? 

A follow-up examination is necessary if the child: 

• has a fever lasting more than 48–72 hours after starting treatment;  
• has developed a rash;  
• experiences difficulty breathing;  
• has trouble swallowing liquids or food;  
• has severe drooling due to inability to swallow;  
• cannot open their mouth wide;  
• experiences significantly worsened throat pain;  
• has swelling or redness of the neck;  
• has bleeding from the mouth.  

It is also advisable to consult a doctor if the child experiences swelling or changes in urine color within 1–3 weeks after the infection.

How to reduce the risk of spreading the infection? 

Preventing the transmission of streptococcus can be aided by simple rules: 

• regular handwashing with soap;  
• using individual dishes and hygiene items;  
• not sharing food and drinks;  
• covering the mouth and nose while coughing or sneezing;  
• teaching the child not to touch their face with dirty hands.  

Currently, there is no vaccine to prevent streptococcal tonsillopharyngitis.