Angina in children – 8 myths that can hinder treatment

Purulent angina , or bacterial tonsillitis, is a very common infection in children and adolescents. It is caused by bacteria from the group of streptococci Streptococcus pyogenes , i.e. group A streptococcus. That is why it is also sometimes called strep throat . Due to the fact that it is a common disease and can be difficult to treat, there are many myths associated with it. Here are a few of them.

MYTH 1. Angina does not need to be treated with antibiotics

Bacterial angina should be treated with antibiotics . Although the disease resolves spontaneously without treatment within a few days, the risk of complications without antibiotic treatment is higher. Antibiotics reduce the infection in the short term. Mainly penicillins are used. Note: even if the troublesome symptoms subsided quickly, you should take the medicine exactly as prescribed by your doctor. Premature discontinuation of antibiotics increases bacterial resistance to drugs and the risk of re-infection and complications (read: strep throat and kidney disease ).

MYTH 2. Very young children do not get strep throat Young children and infants can get strep throat, although this is rare. Symptoms of infection in children under 3 years of age can be unusual. It is worth being sensitive to them. The child may be irritable, tearful, refuse to eat – these are symptoms that indicate a sore throat in the child. In addition to this, there is a fever and sometimes a watery runny nose. Purulent angina, after all, most often affects children and adolescents aged 5-15 years. It is estimated that the disease accounts for up to 30% of acute throat infections in this group.

MYTH 3. White raids on the tonsils always mean angina White raids on the tonsils are a characteristic symptom of angina

, but they do not always appear with this infection! At the same time, they may indicate other diseases, e.g. infectious mononucleosis, i.e. a viral disease that is not treated with antibiotics. It is therefore not a conclusive symptom. However, if a child or teenager develops white raids on the tonsils, for this there is a severe sore throat, fever, weakness, then with a high degree of probability streptococci are to blame. It is worth confirming the assumptions with a test for the presence of Streptococcus pyogenes (group A streptococci) in the throat and tonsil swabs.

MYTH 4. A positive streptococcal test requires antibiotics According to some parents, a positive streptococcal test means that the child must take an antibiotic. This is not true. Many children are carriers of streptococcus and these children will test positive even in the absence of symptoms of the disease. If the symptoms indicate a cold, not strep throat, and the test result is positive, then there is also no need to prescribe an antibiotic to the child. The decision to administer it should always be made by the doctor on the basis of a detailed examination.

The most effective diagnostic test is culture, which involves taking bacteria and growing colonies in the laboratory. It also allows you to choose an antibiotic to which the bacterium is sensitive. However, this method requires time (up to 3 days), which is not there when it is necessary to implement treatment quickly.

MYTH 5. Unfortunately , there is no vaccine against type A streptococci responsible not only for strep throat, but also rheumatic fever, glomerulonephritis or scarlet fever. This is a neglected group of bacteria that vaccine manufacturers have not paid enough attention to. There is a vaccine for other types of streptococci (pneumococcal vaccine). It is mandatory for children.

MYTH 6. Angina is not affected in summer . Although most cases of angina occur from winter to spring, the infection can develop at any time of the year, including summer. Then it is favored by sudden changes in temperature. Cold drinks, especially carbonated drinks, ice cream, bathing in cold water or moving from an air-conditioned room to the outside when it is hot, cause that the local immunity in the throat decreases and angina may develop.

MYTH 7. With angina you can go outside And angina should not go outside until you feel better, and until the end of antibiotic therapy it is better to avoid groups of people (kindergartens, shops, playgrounds), because this is a time of slightly reduced immunity of the body and it is not difficult to catch another infection. A child during the treatment of angina should stay at home, rest and take plenty of fluids. You can go for a short walk when your child is no longer bothered by fever, weakness or chills. If it is cheerful, it is even worth doing, because the sun causes the release of vitamin D, which improves immunity.

MYTH 8. Improvement should occur after 1 dose of antibiotic Symptoms of angina do not disappear immediately after administration of the antibiotic. Often the inflammation is so great that sore throat and fever still bother. Therefore, in addition to the antibiotic, the patient is additionally given antipyretic, analgesic and anti-inflammatory drugs at this time. This does not mean that the antibiotic does not work. Its task is to reduce the amount of bacteria, not to alleviate symptoms such as fever.



4th Professional Medical Student. Karachi Medical and Dental College.

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