Angina, streptococcal angina J03.0

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

Angina; angina catarrhalis; angina lacunaris; angina lateral strand angina; angina lingualis; angina retronasalis; Streptococcus angina; Tongue base angina

Definition
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Inflammation, redness and swelling of the throat, especially of the tonsils.

Pathogen
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Mostly Streptococcus pyogenes, rarely Streptococcus pneumoniae or Staphylococcus aureus.

Clinical features
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Severe pain, especially when swallowing, foetor ex ore, fever, headache, swelling of the jaw angle lymph nodes. A distinction is made:
  • A. catarrhalis: Redness and swelling of the palatal tonsils.
  • A. lacunaris (tonsillitis, angina follicularis): formation of purulent spots and plugs in the crypts of the tonsils.
  • A. lingualis (base of the tongue angina): Serous to purulent inflammation of the base tonsils of the tongue.
  • A. retronasalis: Inflammation of the vengeance tonsils, swelling of the cervical lymph nodes.
  • Lateral gangina: inflammation of the lateral strands.

Differential diagnosis
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Complication(s)
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Peritonsillar abscess, tonsillogenic sepsis, streptococcal secondary diseases ( rheumatic fever, post-streptococcal glomerulonephritis).

General therapy
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Bed rest, always detect streptococci in children first (throat swab).

External therapy
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Antiseptic mouth rinses e.g. chlorhexidine gargle solution ( R045, chlorhexidine digluconate solution), tormentil astringent R255, dexpanthenol solution (Bepanthen Roche solution, R066 ).

Internal therapy
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  • Penicillin V: adults 3 times 600,000 IU or 2 times/day 1 million IU p.o. over 10 days. Children: 50.000-100.000 IU/kg bw/day p.o.
  • Alternative: In case of penicillin allergy erythromycin (e.g. paediathrocin) 3-4 times 250-500 mg/day p.o. or i.v., children 20-50 mg/kg bw/day divided into 2-4 doses, clarithromycin (e.g. Klacid) 2 times 250-500 mg/day p.o., children 15 mg/kg bw/day divided into 2 doses p.o.
  • Alternatively cephalosporins like cefpodoxime (orelox). In case of recurrence cephalosporin or clindamycin (e.g. sobelin) 3-4 times/day 300 mg p.o. p.o., children 8-25 mg/kg bw/day p.o. divided into 4 ED.
  • Analgesics like paracetamol (e.g. ben-u-ron Supp.) for children or acetylsalicylic acid (e.g. ASS) for adults.

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 29.10.2020