Lacunar tonsillitis in adults and children: symptoms,treatment

Update: November 2018

Among other children’s diseases, tonsillitis, as well as her
type – lacunar tonsillitis, occupy not the last place.
The disease is accompanied by inflammation and an increase in lymph nodes.

When lacunar tonsillitis affects the pharyngeal, palatine, lingual,
tubal tonsils, unlike follicular (when formed
small purulent formations), the lacunae are completely filled with pus.
The main causative agent is streptococcus (90%), staphylococcus, less often
adenoviruses. Most often such a sore throat is in children (75%),
occurs when:

  • primary contact with staphylococcus, streptococcus
  • hypothermia throat – ice food and drink
  • reducing local immunity
  • in the cold season in chronic carriers of microbes

Streptococcal sore throat, which occurred in a child for the first time,
caused by beta-hemolytic streptococcus, with
characteristic rash called scarlet fever (see signs of scarlet fever in
children). Purulent tonsillitis is considered a contagious disease transmitted by
with airborne droplets, and when talking loudly, sneezing, coughing
patches of saliva pathogens can get into
the organism, among children, the contact path of transmission is also not excluded,
when communicating with other sick children, through their toys or other
infected items.

There are cases of the disease and after various manipulations and
surgical interventions in the nasopharynx. Increases risk
diseases of angina, dental diseases, in particular caries. To development
заболеванию предрасполагают и прочие  факторы: переохлаждение
body fatigue, air temperature drops, dampness,
total air pollution – dust, gas, production

Symptoms of lacunar tonsillitis

Angina in children usually begins rather sharply than younger
the child, the higher the temperature and the stronger the reaction of the body. At first
only symptoms of general intoxication and soreness appear
throat, and then there are other signs:

  • High body temperature, usually 39–40 ° C, chills, weakness,
    the child becomes whiny, capricious, sluggish, refuses to eat
    and drinking
  • Pain and sore throat, pain when swallowing
  • Swollen lymph nodes
  • Children often have indigestion, diarrhea, vomiting,
    cramping in the intestines, pain in the stomach.
  • Specific symptoms are purulent plaque on the tonsils.
  • In the early stages of the disease, foci with
    yellowish-whitish bloom, which gradually turn into purulent
    raid, in children it can manifest itself as individual foci, and
    continuous purulent film, which is quite easily removed, with
    this surface does not bleed.

The child’s body is much weaker than the adult’s
so for babies, this disease is a serious
danger. This is due primarily to severe intoxication,
high fever (possibly with febrile convulsions in children) and
serious complications.

Timely treatment to the pediatrician, competent diagnosis and
квалифицированное treatment — главные условия выздоровления ребенка,
не стоит рисковать и заниматься самоtreatmentм, использовать в
therapy only folk remedies, sore throat is treated with antibiotics in
for 10 days.

Treatment of lacunar tonsillitis

If we talk about treatment, it is a mandatory and integral part
is bed rest for the patient and whenever possible
isolation from other family members and children.


Of the main drugs are antibacterial
broad-spectrum drugs. They are prescribed only by a doctor in
dosage and course according to the patient’s age and severity
inflammatory process. При ангине treatment антибиотиками просто
necessary, among the most effective against streptococcus and
Staphylococcus is a penicillin antibiotics, if they
no allergic reactions.

  • The first-line drugs are semi-synthetic or
    inhibitor penicillins. This is Amoxicillin (Flemoxin
    солютаб), при  резистентности возбудителя назначают
    Amoxicillin with clavulanic acid Amoxiclav (120-300 rubles),
    Augmentin (140 -250 rubles), Ecoclav (170-280 rubles). Course of treatment 10
  • Второй ряд –  макролиды. Azithromycin treatment course
    (Sumamed, Azitroks, Hemomitsin, Zitrolid), limited to 5 days,
    due to its prolonged action, it also applies
    clarithromycin (Klacid), josamycin, midecamycin – Macropene

Within 3 days, the effectiveness of antibacterial
therapies – lowering fever, pain, and general improvement
the patient. Therefore, it is mandatory that the patient visits the first 3 days.
doctor. In the absence of an antibiotic effect, it is replaced.
drug from another group.

You can not independently stop the course of treatment with antimicrobial
broad-spectrum drugs, since later in
re-inflammation bacteria produce resistance to this
antibiotic, and it becomes powerless, which complicates the prognosis
diseases (see how to drink antibiotics).


At high temperatures should be shot down fever
antipyretic drugs – Nurofen, Paracetamol tablets,
suspension or in the form of suppositories. Do not bring the temperature down
more than 3 days, with effective antimicrobial therapy, it is by day 3
will decrease and the need for antipyretic disappears.


Antihistamines are also recommended – Suprastin,
Tsetrin, etc., they help reduce the swelling of the tonsil, improving
thus breathing and soothing pain when swallowing.


Gargling and spraying

It is very important, especially in the first 2 days of the disease hourly
gargling with antiseptic solutions – Miramistin,
Chlorophyllipt, Iodinol, furatsilinom (2 tab. Per glass of water),
a weak solution of potassium permanganate, decoction of oak bark or chamomile. For
local treatment can use a variety of sprays – Ingalipt,
Hexoral, Tantum Verde.

Gargling in sore throat is the most important stages in
treatment, other than antibiotics, since purulent plaque follows both
You can often remove and rinse out of the mouth. For более
older children and adults in pharmacies have lots of lollipops and
absorbable tablets for the throat with disinfectant properties.


Due to sore throat, high fever, general
intoxication, the patient refuse to eat. Therefore, if
the child does not want, you should not insist, do not force him,
so requires his body. During the illness, the load on the organs
digestion, liver and kidneys are very high, therefore refusal to take
food is dictated not by a whim, but by a physiological state.

Fresh milk should be excluded from the diet, since dairy
bacteria linger on the mucous membrane and promote
reproduction of pathogens in the oral cavity, if
the child loves milk and does not want to give it up, then
then after the milk should be thoroughly rinsed several times

Because solid food increases pain when swallowing, food should
be as homogeneous as possible – broth, cream soup, porridge. As with
обычной ангине рекомендуется принимать много жидкости  — слабо
brewed tea, it is possible with the addition of raspberry, honey, lemon, very
well helps fortified dogrose infusions, warm
mineral water without gases.

Probiotics and stuff

It is also important to pass after the end of the acute period of the disease.
a course of vitamin therapy and a course of probiotic preparations, because
purulent processes, prolonged intoxication weakens the immune
систему, а treatment антибиотиками нарушает микрофлору кишечника (см.
analogs of Linex, a list of all possible probiotics).

It is very important what the air in the apartment of the patient, with diseases
airways it is desirable that the air in the room was humid
warm and clean. Daily wet cleaning should be carried out.
the patient’s room is best, if there is a cleaner and
humidifier, it will create the best conditions for speedy
recovery of a child or adult.

Lacunar tonsillitis in adults and in children is usually treated for
10 days, with severe symptoms and complications for two weeks or more.
Again, whether the disease has subsided or not should be determined by a specialist.
because the absence of external signs does not mean complete


Read also on the topic:

  • Фолликулярная ангина: симптомы, treatment
  • Antibiotics при ангине у взрослых
  • Lugol with angina
  • Iodinol in sore throat
  • Than gargling with sore throat
  • Sumamed with angina
  • Ангина у ребенка: treatment
  • Throat sprays

With a severe course of the disease may be early complications:

  • ларингит (treatment у ребенка), острый отит
  • lymphadenitis of regional lymph nodes with abscess or phlegmon
  • with infection in the blood – sepsis, meningitis
  • вовtreatment в воспалительный процесс органов средостения

Late complications:

  • Cardiac pathology: myocarditis, pancarditis, pericarditis
  • Acute rheumatic fever with chronic
    rheumatism (hereinafter heart defects and the development of heart
  • Acute pyelonephritis, glomerulonephritis
  • Rheumatic CNS-encephalitis
  • Hemorrhagic vasculitis
  • Thrombocytopenic purpura

Во избежание нежелательных последствий исключите самоtreatment и
time, contact the experts.

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