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Quinsy

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Quinsy
Diagnosis

Quinsy — the infectious disease caused by various activators is characterized by fever, the phenomena of the general intoxication and the expressed inflammatory changes in an adenoid tissue of a throat and regional lymph nodes.

Etiology. Most often quinsy is caused by a beta and hemolitic streptococcus of group A, is more rare — staphylococcus, the green streptococcus, a pneumococcus, mushrooms, spirochetes, viruses.

Epidemiology. An infection source — the patient. Infectivity is high. The way of transfer — airborne, is more rare alimentary. Quinsy forms are known catarral, follicular, lacunary, phlegmonous and ulcer and necrotic (gangrenous).

Pathogeny. Infection atriums — a mucous membrane of a free surface of almonds. Also hematogenous genesis of quinsies is possible. From the developed septic center the infection can extend on all organism, leading to various complications. At recurrent quinsies an undoubted role is played by an allergic factor.

Clinic. The disease begins sharply. There is a fever, temperature increases, when swallowing — pain, there are painful regional lymph nodes. Tachycardia, fever duration — is noted 4 — 5 days. At catarral quinsy puffiness and a hyperemia of almonds are observed, it is frequent — palatal handles, a soft palate. Temperature, intoxication phenomena, increase and morbidity of regional lymph nodes are unsharply expressed.

The angina follicularis is shown by suppurations of lymphatic follicles of almonds. The subepithelial abscesses, yellow-white about a pin head, which are translucent through a mucous membrane and slightly acting over a surface of almonds are visible. When opening these abscesses melkoochagovy plaques which can merge are visible. The same process can arise in lacunas where there is an accumulation of purulent exudate leading to development of follicular and lacunary quinsy. Lacunary quinsy meets considerably more often than follicular. Inflammatory process begins in lacunas, leads to accumulation in them suppurating that is perceived as purulent traffic jams or plaques in mouths of lacunas.

At phlegmonous quinsy inflammatory process happens in the thickness of an almond (intratonzillit) or is more often in a peritonsillar fat (peritonsillitis). Suppuration leads to formation of intratonzillyarny or paratonsillar abscess, as a rule, on the one hand. Together with temperature increase and the general intoxication the throbbing pain in a throat irradiating in an ear accrues, the patient hardly opens a mouth, the voice becomes nasal, regional lymph nodes increase, the movements of the head and a neck are painful. Survey of a pharynx is complicated. The sharp redness and puffiness of fabrics of oral part of a throat are observed. The almond is increased and is considerably evaginated in this connection the front palatal handle is maleficiated. The uvula is displaced to the opposite side. Forming of abscess can be determined by protrusion of a yellowish site of a mucous membrane or a softening and fluctuation at palpation by fingers. At Simonovsky's quinsy Vensana changes are observed usually on the one hand. The necrosis leads to formation of deckle-edged quite deep ulcer which bottom is covered with a dirty greenish-gray plaque. Easily deleted film quickly "is recovered". Process can take all almond and even to go beyond its limits. In typical cases the general state and subjective feelings of the patient correspond to rough morphological changes a little.



 
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