Update: February 2019
Follicular sore throat is purulent inflammation of the follicles
tonsils (lymphoid formations of the pharynx), in which pus
located in the form of individual point foci. May be amazed
palatal, tube, pharyngeal and lingual tonsils. Disease
accompanied by an increase and inflammation of the cervical regional
lymph nodes, in which lymph flows from the foci of inflammation.
- Most often, adults and children fall ill during initial contact with
streptococcus or staphylococcus
- As well as carriers of microbes in the cold season
- Or at local overcooling of a throat (ice water, ice cream)
and reduced immunity.
Streptococcal sore throats account for about 90% of cases.
diseases. Primary streptococcal tonsillitis caused by
beta hemolytic streptokkokk, in combination with skin
An allergic reaction in the form of a rash is called scarlet fever.
Отличие лакунарной ангины и фолликулярной ангин заключается в
the location of purulent foci and the depth of their occurrence. Follicles over
smaller and superficial formations than lacunae filled
Symptoms of follicular angina
- Лихорадка, температура может быть до 39 — 40
degrees, and it can be a long time, hard to stray
antipyretic agents, especially for sore throat in children.
- First dry mouth, then tickling, coughing and aggravating
- Gradually swelling of the tonsils, redness of the almond
- There are pustules in the form of yellow and white bumps.
- General weakness, symptoms of severe intoxication, chills,
- Children may have diarrhea, vomiting, lack of appetite due to
severe sore throat.
- In adults, stool retention and constipation may occur.
- Pain in the muscles and joints, in adults there may be pain in the heart,
- Lymph nodes are enlarged, painful on palpation, right up
it’s painful to turn your head to
The clinic of such a sore throat begins with pain when swallowing, sometimes
radiating to the ear. With acutely flowing follicular tonsillitis
changes in blood composition are observed: increase in leukocytes (above
9g / l), leukocyte shift to the left with increasing
stab and segmented leukocytes, ingda eosinophilia,
increased ESR (sometimes significant).
Very often at an early stage of the disease, follicular symptoms
sore throats are very similar to infectious mononucleosis, aggravation
chronic tonsillitis, herpetic sore throat, cavity candidiasis
mouth Secondary angina with mononucleosis is very similar to
follicular, although it can occur and the type of lacunar:
- It starts from the first day of illness or joins 5-6
- In addition to the heat that flows in waves,
lymph nodes grow and become painful. But at the same time
not only cervical, but axillary, and occipital, and
subclavian, and inguinal groups of nodes.
- Also very typical are abdominal pain and enlargement of the liver and
spleen, which is not present in the primary follicular angina.
- Mononucleosis differs in blood tests (lymphocytosis,
detection of mononuclear leukocytes).
- The diagnosis is confirmed immunologically (detection of antibodies and
determination of their titers) and serological reactions of the blood.
It is especially important to distinguish infectious mononucleosis from
follicular sore throat, the treatment of these two diseases dramatically
is different. With mononucleosis in no case be taken
antibiotics, and a purulent follicular tonsillitis is treated only by them.
How to treat follicular sore throat with antibiotics
On the first day of the development of follicular angina in a patient
swabs of pharynx and nose should be taken on Lefler’s wand
(causative agent of diphtheria), with which it is necessary to differentiate
sore throat После этого начинается лечение diseases. Main
лечение – назначение антибиотиков. First
turn they must suppress the bacterial flora and in case
streptococcal sore throats to ensure the prevention of such terrible
complications like rheumatism:
- If acute rheumatic fever only causes fever
intoxication and provokes inflammation of the joints, lesions of the nervous
heart systems and valves
- That chronic rheumatic disease is a heavy valve.
heart defects with progressive heart failure and
disability of patients. Also for angina streptococcal genesis, we
afraid of secondary glomerulonephritis, leading to chronic
Therefore, always in the absence of allergy to this type
- Penicillins are first-line drugs.
(semi-synthetic or inhibitory). This drugs
broad-spectrum, effective against staphylococci and
streptococci. The course of penicillins should be 10 days. it
Амоксициллин (Флемоксин солютаб), при резистентности
Amoxicillin with clavulanic acid Augmentin
(140 -250 rubles), Amoxiclav (120-300 rubles), Ecoclav (170-280
- The second row of antibiotics is macrolides. Azithromycin (Sumamed,
Azitrox, Hemomycin), clarithromycin (Klacid), josamycin. Their
course admission may be limited 5 days, as drugs
accumulate in the blood, and this course will give ten days of exposure to
The effectiveness of antibiotic therapy evaluated within 72
hours to reduce the temperature and improve overall health. For
This patient is visited by a doctor during the first three days. With
the inefficiency of the antibiotic is replaced with a drug from another
With таком серьезном заболевании как фолликулярная ангина,
antibiotic treatment should not be stopped after
it will be easier. With досрочном окончании курса возможно возникновение
resistance of bacteria to this antibiotic and
the occurrence of recurrent angina, he will be powerless, and
the development of serious complications.
Read also on the topic:
- Antibiotics for angina in adults
- Lugol with angina
- Iodinol in sore throat, how to gargle with iodinol
- How and what to gargle with sore throat
- Sumamed with angina
- 11 rules – How to take antibiotics correctly
- Throat sprays
The patient should comply with bed rest, weakened
the patient should not go outside, as this may lead to
- Antipyretic and antihistamines
To reduce the symptoms of angina, use nonsteroidal
anti-inflammatory drugs that reduce pain and temperature
(nurofen, paracetamol, ibuklin). Also to reduce allergic
component of inflammation resort to antihistamines (see
list of drugs for allergies, Loratadine, Claritin, Clarisense,
- Drinking mode
To avoid severe dehydration of the body from fever and
severe intoxication, for the rapid elimination of toxins, it is shown
обильное теплое питье, лучше всего это теплое молоко с содой
or mineral water without gases, also herbal teas help well – with
pharmaceutical chamomile, sage, dogrose. Fluid temperature should
to be optimally comfortable, not hot and not cold, so as not to
cause unnecessary injury to the inflamed mucosa.
Nutrition должно быть максимально однородным, так как при глотании
solid food brings a significant increase in pain when swallowing,
The diet should consist of liquid cereals, soups, broths. Important
also often air the room and clean every
- Local procedures
In addition to the antibiotic, the treatment must be supplemented with local
procedures. The process of developing this disease is first
in the formation of a purulent follicle, then its maturation, growth in
size, and finally, the process of opening the follicle. It is for the reason
constant finding of purulent discharge in the oral cavity
the most important condition for proper treatment of follicular tonsillitis
considered frequent gargling.
Gargle with sore throat should be as often as possible up to 6-10 times a
day. Special antiseptic can be used during the procedure.
agents such as Yodinol, Dolphin, Lugol, Chlorophyllipt,
Miramistin, furatsilin (2 tablets. Per glass of water), herbal infusions,
soda solution and salt. Pharmaceutical industry offers
also a great many different aerosols that are convenient
enjoy – Ingalipt, Tantum Verde, Hexoral. You can also
soothe sore throats and swelling with absorbable pills and
lollipops – Faringosept, Geksoral tabs, etc. In addition to disinfecting
action, gargling helps to wash away purulent secretions,
which are formed after opening the follicles.
There is one available folk treatment for follicular disease.
sore throats – gargling with this solution: take 1 beetroot, grate
it on a fine grater, at the rate of 1 cup of the rubbed mass – 1 dining room
spoon 6% apple cider vinegar, better homemade, combine vinegar with
beet mass, put the mixture in a dark place for 4 hours, squeeze
juice through a thick cloth, so juice gargle every 3 hours.
Beetroot juice with vinegar have antibacterial properties.
Follicular tonsillitis – complications
If a patient has 6 days after the start of treatment
following symptoms, it indicates deterioration and
- aggravated sore throat
- elevated body temperature
- difficulty swallowing
- external tumor in the area of the inflamed tonsils around the neck
- lymph nodes pain
If you have a follicular sore throat whose treatment is started late,
and also, if the antibiotic for sore throat is chosen incorrectly and when
weakened immunity of the patient, the appearance of serious
- parathinsillar abscess comes first
- Lemierre Syndrome
- infectious toxic shock
- streptococcal meningitis
If not treated with antibiotic, ignore rinsing
throat, a complication may occur if a festering tear
follicle does not occur in the oral cavity, and in the near-indiginal
tissue. Then it can lead to severe consequences – infection.