Sore Throat: Causes and Pathogenesis
Inflammation of the throat, or pharyngitis, developsdue to exposure to viruses of streptococcal infection. In the inflammatory process, the mucous membrane of the pharynx, soft palate, amygdala, as well as muscles and intraluminal lymph nodes are involved. Limited inflammation of the soft palate and tonsils of the pharyngeal lymphoid ring is called angina.
By the nature of the lesion, the inflammation of the throatclassified into: catarrhal, croupous, diphtheria, ulcerative, phlegmonous. By origin - to primary and secondary, and downstream - to acute and chronic. Primary acute pharyngitis occurs, mainly due to the general supercooling of the organism or local exposure to cold on the mucous membrane of the pharynx, more often in the autumn and in the spring, i.e. in periods of the year with large fluctuations in air temperature. Inflammation of the throat can also occur when inhaling poisonous gases, chemical irritants (acids, alkalis, aqueous ammonia, formalin). The etiology of pharyngitis is also associated with infectious and viral diseases. Inflammation of the throat develops and complicates such diseases as stomatitis, rhinitis, laryngitis, tracheitis.
The connection between pharyngitis and mucositisthe lining of the nose, larynx and trachea is so close that in most cases in diffuse processes it is impossible to set the primary affected organ. Therefore, in these cases, the diagnosis is limited to "upper respiratory tract catarrh". Pharyngitis as a nosological disease is diagnosed only when the clinical signs manifest mainly from the side of the pharynx.
In the throat, a lot of lymphoidformations. Tonsils (accumulation of lymphoid tissue in the mucous membrane of the pharynx) play an important role in protecting the body from pathogens. The tonsils of the pharyngeal ring "inform" the body's immune system about the nature of the antigen that enters the body with food, water and air. In addition, they antigen-dependent differentiation of lymphocytes into their effector cells, which cause immunity, so the lymphoid system of the pharynx plays a significant role in the pathogenesis of infectious diseases. This is due to the fact that the mucous membrane of the tonsils and the lymphoid pharyngeal ring has many depressions (crypts) and folds that contain saprophytic and opportunistic microflora: strepto- and staphylococci, sarcin, actinomycetes, pasteurellas, fungi, pseudomonas, E. coli and other bacteria. But the microflora in these areas does not multiply due to the impact on it of cellular and humoral factors of the body's immune system. At the same time, there is a balance between macro- and microorganisms. However, a decrease in the overall resistance of the body and the protective mechanisms of the pharynx under the influence of etiological factors creates conditions for the development of microflora and enhance its pathogenic action. Microorganisms and metabolites of their vital activity irritate the mucous membrane, penetrate the tonsils and cause inflammatory processes in them. Products of inflammation and toxins of microorganisms are absorbed into the blood and cause intoxication of the body, resulting in fever, general condition worsening, regional lymph nodes increase. Inflamed tonsils do not fully perform the protective function and can be a gateway for the penetration of microflora, which causes the development of the septic process in the body.
Streptococcal sore throat in childrenaccompanied by pain in the throat, hyperthermia, edema of the tonsils, an increase and soreness of the lymph nodes. The most susceptible are children 4-11 years of age. To confirm the diagnosis it is necessary to carry out a bacteriological study.
Patients with a diagnosis of "sore throat" treatment is prescribed with the use of antibacterial drugs, enveloping agents that soothe irritated throat and inflamed mucous membrane.</ p>>