Angina, streptococcal anginaJ03.0
Synonym(s)
Angina; angina catarrhalis; angina lacunaris; angina lateral strand angina; angina lingualis; angina retronasalis; Streptococcus angina; Tongue base angina
DefinitionThis section has been translated automatically.
Inflammation, redness and swelling of the throat, especially of the tonsils.
PathogenThis section has been translated automatically.
Mostly Streptococcus pyogenes, rarely Streptococcus pneumoniae or Staphylococcus aureus.
Clinical featuresThis section has been translated automatically.
Severe pain, especially when swallowing, foetor ex ore, fever, headache, swelling of the mandibular angle lymph nodes. Distinguish:
- A. catarrhalis: redness and swelling of the palatine tonsils.
- A. lacunaris (tonsillitis, angina follicularis): Formation of purulent stipples and patches in the crypts of the tonsils.
- A. lingualis (tongue base angina): Serous to purulent inflammation of the tongue base tonsils.
- A. retronasalis: inflammation of the pharyngeal tonsil, swelling of the nuchal lymph nodes.
- Lateral trangangina: inflammation of the lateral cords.
Differential diagnosisThis section has been translated automatically.
Angina Plaut-Vincenti, angina agranulocytotica, specific angina, angina in tuberculosis, angina diphtherica, herpangina, infectious mononucleosis, candidiasis, tonsil carcinoma.
Complication(s)This section has been translated automatically.
Peritonsillar abscess, tonsillogenic sepsis, streptococcal secondary diseases ( rheumatic fever, post-streptococcal glomerulonephritis).
General therapyThis section has been translated automatically.
Bed rest, always detect streptococci in children first (throat swab).
External therapyThis section has been translated automatically.
Internal therapyThis section has been translated automatically.
- 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.