Herpes sore throat in children and adults

The tongue in the throat is a small process that in its natural state is not felt at all. The situation when the tongue in the throat is swollen takes on completely different symptoms. The person feels discomfort and severe pain.

Swelling of the tongue in the throat (pathology uvulitis) is a clear symptom of infectious diseases, burns, injuries and even oncological processes in the body. It is very important to determine the cause of uvulitis as soon as possible. Delay stimulates the development of severe complications that pose a serious danger to human life.

Causes of herpangina

Herpangina can be caused by about 70 serotypes of enteroviruses. Most often these are Coxsackie B, Coxsackie A17 viruses and enterovirus 711.

Since the only carrier of enteroviruses is humans, you can become infected through contact with a sick person or with a virus carrier who has no symptoms of the disease1. According to the literature, the number of virus carriers can be up to 46% of people2.

The virus is released into the external environment with feces and droplets of saliva. It is also contained in bubbles that appear in the patient’s throat. Enterovirus infections most often affect children, although the disease also occurs in adults5.

The patient or virus carrier excretes viruses from the upper respiratory tract within 3 weeks after infection, and with feces - up to 8 weeks. In the first two weeks, herpetic sore throat is most contagious1.

You can become infected in the following ways:

through dirty hands, objects and food if they are exposed to the virus;
drinking contaminated water from a reservoir;
upon contact with a patient or virus carrier.

The herpangina virus is also transmitted transplacentally - from mother to fetus3.

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The essence of pathology

The uvula is a part of the soft palate, a conical process that performs the following functions:
– protects the mucous membranes of the pharynx from exposure to cold air;
– prevents the penetration of pathogenic bacteria;
– when the need arises, pressing on the palatal tongue provokes a gag reflex;
– takes over and distributes air and food flows.

Under the influence of external irritating factors (allergens, bacteria, mechanical and thermal damage), the body reacts when this organ increases to such a size that a person’s life is threatened. The process when the uvula becomes inflamed is diagnosed as the development of the disease uvulitis.

Swelling of the uvula contributes to the development of severe complications associated with the functions of breathing, swallowing, and speaking.

Symptoms

Signs that the tongue in the throat has enlarged are pronounced, manifested in the form of:
– active secretion of saliva;
– wheezing and hoarseness;
– pain (increases during swallowing and talking).

Swelling of the tongue in the throat, provoked by an allergic reaction, manifests itself in the form of:
– debilitating cough or sneezing;
– tearing;
– sensations of constant tickling of the root of the tongue;
– a rash may appear on the mucous membranes of the mouth.
When your throat hurts and your tongue is swollen due to an infection, the pathology manifests itself with the following symptoms:
– feeling of weakness;
– chills or fever;
– discomfort and pain when swallowing and speaking;
– sensations of dry mucous membranes of the throat;
– possible purulent lesions of the oral mucosa.

Causes of pathology

The causes of swelling of the uvula are varied.
Inflammation can be caused by:
– diseases of an inflammatory nature (the process is activated when the human immune system is unable to fight a large number of bacteria in the growth cavity);
– chemical, mechanical and thermal damage to mucous membranes;
– uvulitis as a reaction to contact with an allergen;
- formations localized in the nasopharynx.

Allergic uvulitis

Prolonged contact with household, chemical, and food allergens is one of the causes of a swollen tongue in the throat. Most often, edema is diagnosed in severe allergic reactions: Quincke's edema or urticaria.

Important: when the first symptoms of an allergy appear, the patient must be immediately taken to a doctor.

Allergies can also cause swelling of the uvula in the throat in asthmatics. Long-term use of medications may cause allergic swelling of the tongue in the throat. Swelling caused by an allergy to medications develops immediately after injections or use of the medicine.

The cause of uvulitis can be an allergy to certain foods: honey, chocolate, citrus fruits. Important: before taking any action to eliminate the swelling of the tongue in the throat, it is important to establish why it is swollen and what (what allergen) causes the disease.

Getting burned

One of the reasons why a small tongue in the throat may swell is a burn. A person swallows large pieces of hot food or suddenly drinks hot liquid, as a result of which blood actively rushes to the tongue and swelling develops. The patient feels very unpleasant pain.

A burn to the mucous membrane and swelling of the tongue in the throat can cause solutions of alkalis or acids to enter the oral cavity. For example, swelling can be caused by rinsing with a strong soda solution or accidentally swallowing vinegar.

Complication of sore throat

Inflammation of the small uvula in the throat as a complication of sore throat is a dangerous condition. Swelling causes the following symptoms:

- cardiopalmus;
– difficulty breathing, swallowing and speaking;
– pain in the throat and ears;
– wheezing, cough;
– blue discoloration of the skin (a sign of lack of oxygen).

Ignoring these signs or delaying medical care can cause asphyxia. It is necessary to eliminate swelling in severe sore throat as quickly as possible.

Infectious lesion

Penetration of pathogenic bacteria and viruses into the nasopharynx area can provoke inflammation of the uvula in the throat.

The most common cause of swelling of the tongue in the throat is infection:

Staphylococcus aureus. Provokes a severe inflammatory process of purulent uvulitis. It is difficult to treat with antiseptics and antibiotics.
Streptococcus. Provokes the development of a mild, sluggish form of uvulitis.
Herpes virus. Affects the entire body with pathogenic elements. Inflammation of the uvula in the throat is most often provoked by Epstein-Barr infections and cytomegalovirus.
Chlamydia, gonococci and other pathogenic structures. It provokes uvulitis if there has been sexual intercourse in the recent past.
Human papillomavirus. More than 500 strains of this virus are known, most of which provoke not just swelling of inflammation, but malignant formations.

Most often, swelling of the uvula is a consequence of damage to the body by infectious diseases, a signal of weakened immunity. As soon as the body's defenses weaken, infections affect the oral cavity, throat (palatal tongue), and provoke an inflammatory process.

Excessive alcohol consumption and frequent smoking

The palatine tongue is covered with multiple small blood vessels, which, irritated by tobacco smoke during active smoking and alcohol due to excessive consumption of alcohol, become inflamed.

Also, abuse of alcoholic beverages and tobacco products reduces the body's resistance to pathogenic bacteria and can cause burns.

What is the danger?

The uvula protects the respiratory organs from food particles entering them, distributes warm air, activates processes provoked by the gag or cough reflex, and participates in spoken speech.

Acute processes of inflammation of the uvula affect the surrounding soft tissues of the oral cavity, which is not just accompanied by unpleasant sensations, but sharply worsens the general physical condition of the patient and provokes breath holding.

Ignoring the pronounced symptoms of the disease can cause asphyxia.

Swelling of the throat and tongue can provoke a number of negative changes in the body:
– difficulties in speaking;
– clogging of the respiratory system with food particles (this case requires an immediate response and can lead to respiratory arrest);
– damage by infections and bacteria to the mucous membranes of the nasopharynx;
– constant unpleasant feeling of nausea, gag reflex;
- inflammation of both tonsils.
Important: swelling of the nasopharynx and palatal tongue is life-threatening and therefore requires prompt medical attention.

Diagnostics

An ENT specialist conducts diagnostics and determines treatment options (and, if necessary, surgery).
During the appointment, the ENT doctor:

Examines the oral cavity for the presence of pathological structure and the presence of foreign objects.
Collects the patient's medical history.
Clarifies the location of the pain, the intensity and nature of the pain, the severity of the symptoms.

The doctor can confirm the suspected diagnosis based on the results of the following studies:

Laboratory blood test.
Bacterial blood test.
Immunogram (helps determine the presence of allergies).
Histological examination of the mucous membranes and tissues of the uvula (recommended if cancer is suspected).

Drug treatment

Only an ENT doctor can determine how to treat pathological processes in the throat. This is due to the high risk of side effects on the respiratory system when taking incorrectly selected medications.

Antihistamines

Treatment of uvulitis caused by an allergic reaction involves eliminating contact with the allergen and taking certain medicinal antihistamines. Most often, the doctor prescribes the following medications: Claritin, Diazolin, Fexofenadine, Suprastin.

The tongue in the throat can swell under the influence of various allergens, therefore only after the type of allergen has been determined can one decide what to do next.
Important: in case of severe allergic reactions (for example, angioedema), the doctor may decide to perform a tracheotomy procedure.

Diuretics

Taking diuretics (water medications) helps relieve swelling of the small tongue in the throat. The patient is prescribed: Veroshpiron, Chlorthalidone, Furosemide.

Glucocorticosteroid drugs

Taking glucocorticosteroid drugs: Betamethasone, Hydrocortisone will help prevent the development of breathing and swallowing complications with an enlarged tongue in the throat. These medications contain an anti-inflammatory component, which reduces capillary permeability and stops the development of edema.

Taking antibiotics

The situation when the tongue in the throat has enlarged due to bacterial infection requires taking antibacterial agents: Azithromycin, Timentin, Vilprafen.

Important: antibacterial drugs are used strictly as prescribed by a doctor. Only a specialist can determine exactly the type of causative agent of the inflammatory process and prescribe an antibiotic that is sensitive to this bacterium.

Therapy using traditional recipes

The use of traditional medicine in combination with traditional medications helps speed up the healing process if the tongue in the throat is swollen.

Important: traditional medicine must be taken strictly in combination with the dosage calculated by the doctor.

Herbal decoctions

To quickly relieve inflammation of the tongue in the throat at home, gargling with medicinal herbs will help reduce pain:

Raspberry decoction. For a liter of water you need two tablespoons of dry raspberry leaves. The raw materials are steamed and left to simmer on the stove for twenty minutes. The prepared broth is cooled, filtered and used as directed at least three times a day.
Chamomile and sage decoction. To prepare a decoction, you need to take one tablespoon of dry herbs per liter of water. The broth is brewed and left to brew for at least fifteen minutes. After the broth has cooled, filter it and gargle at least three times a day.
Viburnum decoction. A spoonful of dry berries is poured with boiling water (one liter) and simmered over low heat for half an hour. Afterwards, gargle with a lukewarm decoction. This remedy is good for removing ulcers on the tongue.

Important: before using medicinal plants, you should consult your doctor about possible allergic reactions.

Inhalations

Carrying out the inhalation procedure will speed up the treatment of laryngeal edema, swollen tongue in the throat, and inflamed tonsils.
Recipe for decoction for medicinal inhalations:

Mix two tablespoons of pine buds with water. Boil the mixture for half an hour. Separately, boil the dry thyme leaves. Mix the resulting decoctions in a bowl and add a few drops of eucalyptus oil.

Medicinal tinctures

Medicinal tinctures will help to quickly cleanse the mucous membranes of the mouth from pathogenic microorganisms and relieve swelling of the tongue in the throat. Also, taking tinctures is indicated for the purpose of quickly removing toxins from the body and improving the general condition of the patient.

Recipes for the most effective medicinal tinctures:

Rosehip tincture. Place a few tablespoons of dried rose hips in a thermos and pour half a liter of boiling water. The thermos is tightly closed and left to infuse for at least twelve hours. The tincture is drunk in small sips throughout the day.
Anise tincture. In a bowl, combine half a glass of crushed anise and water. The mixture is heated and boiled for several minutes. Then add two tablespoons of honey and the same amount of cognac. Infuse the resulting product for twenty-four hours. Afterwards, the tincture is taken one tablespoon, several times a day, before meals.

In combination with traditional drug therapy, taking herbal tinctures can speed up the process of treating an inflamed tongue in the throat.

Preventive recommendations

The following preventive measures will help prevent inflammation of the tongue in the throat:
– timely diagnosis and high-quality treatment of ENT pathologies and infections of the mucous membranes of the growth cavity;
– careful and regular oral hygiene;
– health control and prevention of injury to the mucous membranes of the growth cavity;
– giving up bad habits: alcohol and smoking.

Important: if symptoms of uvulitis appear, it is strictly forbidden to self-medicate. Errors in treatment actions taken can aggravate the course of the pathological process and provoke complications.

Symptoms of herpetic sore throat

The disease begins acutely. From the moment of infection to the first symptoms, it takes from 2 to 14 days3. The temperature rises to 38-39°C. The patient feels weakness, headache, chills, less often nausea, possible vomiting and enlargement of the submandibular lymph nodes, 1,2,3.

Herpangina goes through several stages2:

The day before the rash appears in the throat, the patient feels a mild pain. On examination, you may notice redness of the palatine arches and the back wall of the pharynx.
Then, rashes appear on the mucous membrane of the soft palate, palatine arches, tonsils and uvula - small papules (nodules) up to 5 mm in diameter with a red rim.
The nodules turn into vesicles, which open after 1-2 days.
In their place, painful erosions with a gray-white coating form.

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Not really heroic snoring

Finally, the working day is over, and you, having had dinner, watched TV, got to bed, there is very little left to feel almost happy. And then suddenly a whole cascade of sounds comes at you, made by your already safely asleep partner... Snoring, or rhonchopathy, is a sound phenomenon whose source is the vibrating soft palate and small uvula. Most often, it is perceived as an unpleasant, but confirming good health phenomenon, and a clear illustration of the stability of this popular opinion is the expression “heroic snoring.” In fact, everything is exactly the opposite. Snoring is a harbinger and one of the main symptoms of a serious disease - obstructive sleep apnea syndrome or, in human terms, sleep apnea disease. In nightly serenades there are sudden dead pauses, which end with a strong snore, followed by the continuation of the concert. These pauses are moments of complete cessation of breathing.

Herpetic sore throat in children

Children usually become infected at school or kindergartens2,3. Due to pain and fever, they are restless, tearful, and often refuse to eat and drink because food irritates erosions on the mucous membrane and causes discomfort. But due to refusal to drink water or juices, children often develop dehydration. At the same time, the child’s tongue becomes dry, and the elasticity of the skin decreases1. Convulsions may occur due to high temperature1.

Blistering rashes in children can appear not only on the mucous membrane of the throat, but also on the hands and feet, and even on the buttocks and forearms. This manifestation of enterovirus infection is called viral pemphigus of the oral cavity and extremities or mouth-hand-foot syndrome. The disease is contagious in 100% of cases, is often mild, and can affect nails3.

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Swollen tongue in the throat: causes and treatment. How to relieve inflammation?

This condition may be accompanied by increased pain in the larynx, if you move the tongue and breathing is disturbed, it becomes difficult and confused.
In the list of diseases, this pathology is called uvulitis and means acute inflammation of the tongue.
In this case, the tongue changes color from soft pink to intense purple, covered with a thin whitish film-like coating, and becomes noticeably larger (may hang down to the root of the tongue).

Sometimes it becomes so deformed that it interrupts the pronunciation of certain sounds and causes vomiting. The causes of this pathology are different, and all of them must be eliminated immediately.

The palatal tongue is the removed tongue, which is located in the mouth, on the edge of the soft part of the palate, just above the tongue, is in good condition, small in size and color, and is identical to the mucous membrane of the mouth.

Performs important functions for the body:

protects the nasopharynx from the penetration of food during swallowing;
separates air flows and heats them;
is a barrier against infections;
prevents accidental regurgitation of food;
causes spasm of the larynx, preventing a person from suffocating;
participates in the production of some sounds;
if necessary, induces vomiting.

Why the tongue in the throat swells: reasons

When the soft palate is clear and the tongue is inflamed, the red doctor diagnoses uvulitis. Basically, it is an acute disease characterized by suddenness - pain and swelling occur while eating or even at night while sleeping. The reasons for this are, among others:

Inflammatory pathologies - ENT infections, angina pectoris, advanced dental diseases, abscesses, diphtheria, tuberculosis, sexually transmitted diseases, HIV;
chemical or thermal damage to the mucous membrane as a result of exposure of tissue to aggressive compounds (caustic or acid burns) and consumption of hot food and alcohol;
allergies - if allergic products are contained in food, inhalation of allergens (chemicals, natural irritants), taking medications;

allergies and sore throat - polyps, cysts. In addition to the immediate causes, there are associated factors that influence the expansion of the tongue in the throat. These:
a stuck bone in the throat, injuring the mucous membrane;
consumption of low-temperature drinks and food;
consequences of instrumental manipulations during respiratory and gastrointestinal examinations and dental operations;

swelling of the tongue can occur after vomiting, especially after prolonged and repeated bouts, after snoring and in people who smoke a lot.

Course of herpetic sore throat

The diagnosis of herpetic sore throat can be made by an otolaryngologist, therapist or pediatrician after examining the patient and clarifying his complaints. To monitor changes characteristic of a viral infection, the doctor may prescribe a general blood test, and to confirm enteroviral sore throat, a specialist may prescribe a pharyngeal smear and a blood test for specific antibodies. The pathogen can also be detected in stool or inflammatory fluid that is released from vesicles1,4.

Manifestations of herpetic sore throat can go away on their own in less than 10 days. But in any case, at the first symptoms of the disease, you should definitely consult a doctor. You cannot self-medicate2,3.

In some cases, herpetic sore throat can cause complications from the nervous system. In this case, 1 appears:

severe spasm of the neck muscles, due to which the child cannot bend his head;
weakness of the muscles of the limbs;
disturbance of consciousness.

A severe complication of herpetic sore throat is damage to the soft membranes of the brain, brain and spinal cord1,3.

Newborns are at highest risk of developing complications, so they need careful treatment and care3. It is important to maintain hydration and give your child enough fluids1.

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1.General information

In order not to be interrupted by terminological references in the future, we will stipulate the following as a kind of preamble.

Opportunistic is an infection that occurs, literally, “at an opportunity,” “if possible,” i.e. under a certain combination of conditions favorable for the opportunistic microorganism. In turn, conditional pathogenicity implies asymptomatic parasitism or commensalism (harmless coexistence) of any microculture in the host’s body - as long as the host is healthy and immunocompetent - and the ability of this culture to undergo rapid pathogenic activation with a weakening of the immune defense, a significant change in the structure of the microbiome and some other circumstances.

Mycosis is a systemic infection by fungal cultures. Candidiasis is an extremely widespread (in fact, the most common) variant of mycosis, caused by yeast-like opportunistic fungi of the numerous genus Candida, most often Candida ablicans (the causative agent, in particular, of urogenital “thrush”).

Thus, pharyngeal candidiasis is an opportunistic mycosis caused by the activation of Candida and predominantly localized in one of the ENT organs.

A must read! Help with treatment and hospitalization!

Treatment of herpetic sore throat

Patients with complications require hospitalization in an infectious diseases hospital and treatment under the supervision of specialized specialists - a neurologist and a cardiologist. If the doctor has recommended treatment at home, it is necessary to closely monitor the patient's condition2.

The sick person should be isolated and stay in a clean, well-ventilated area so as not to infect other family members. Quarantine must be observed until symptoms subside1.

For herpangina you should 1,3,4:

Wash your hands as often as possible, including after feeding and changing a sick child’s diaper.
Disinfect surfaces and objects with which the patient has been in contact.
Drink enough fluids to avoid dehydration. At the same time, pay attention to the temperature of the drink: hot, warm drinks irritate the mucous membranes and cause additional discomfort. You can drink cool drinks.
Consume food in liquid or mushy form. Spicy, salty, sour foods, including fresh fruits even in the form of puree, are not suitable for a patient with herpetic sore throat.
Rinse your mouth with a saline solution after every meal to maintain oral hygiene and prevent bacterial infections from erosions.
Use a soft toothbrush to reduce trauma to the mucous membrane.

Currently, there is no proven antiviral drug to treat herpangina by acting on its causative agent. Sometimes a doctor may prescribe medications that support local immunity of the pharyngeal mucosa1. Antibiotics are not prescribed for herpangina6.

The goal of treatment for herpangina is to relieve the symptoms of the disease4.

If the body temperature is above 38.5°C, physical methods such as cold compresses and ice packs may be used. Your doctor may also recommend anti-inflammatory and antipyretic medications1. Local treatment includes agents with anti-inflammatory, analgesic, enveloping and antiseptic effects1.

For the symptomatic treatment of herpetic sore throat, the doctor may prescribe the drugs HEXORAL®7,8,9,10,11. It is convenient to use HEXORAL® spray to irrigate the pharyngeal mucosa. The active substance of the spray is hexethidine. It acts against the main bacteria found in the oral cavity and pharyngeal mucosa8. The drug is also active against some viruses and fungi of the genus Candida8. Thanks to the local anesthetic effect of hexethidine, HEXORAL ® spray helps reduce pain8. HEXORAL®7 solution is suitable for rinsing. The use of HEXORAL ® spray and solution is allowed in children over 3 years of age7,8.

If herpangina causes severe pain and discomfort, adolescents over 12 years of age and adults can benefit from HEXORAL ® TABS EXTRA lozenges, which contain the anesthetic lidocaine10. For children over 4 years of age, HEXORAL ® TABS lozenges may be suitable. The anesthetic benzocaine in their composition helps reduce pain in the throat and mouth9.

All medications for herpetic sore throat should be used only after consultation with a doctor. In case of severe erosions, HEXORAL ® solution and spray are contraindicated7,8, and lozenges can only be prescribed by a specialist after examining the pharynx9,10.

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The information in this article is for reference only and does not replace professional advice from a doctor. To make a diagnosis and prescribe treatment, consult a qualified specialist.

Half the night without breathing

What happens is this: at the level of the pharynx, the airways are a tube of muscles that relax after falling asleep. If the pharynx is not wide, and this happens due to tonsils, obesity or an excessive soft palate, another inhalation leads to complete collapse of the airways and cessation of pulmonary ventilation. Negative information from various organs reaches the brain and causes its partial awakening. The brain regains control of the pharyngeal muscles and opens the airways. The man snores loudly and takes several deep breaths. The normal oxygen content in the body is restored, the brain calms down and falls asleep again... The cycle repeats again. Sometimes up to 400-500 breathing stops occur per night with a total duration of 3-4 hours. Snoring is a serious breathing disorder that leads to a sharp deterioration in sleep quality. Imagine - you have just fallen asleep, and suddenly someone starts pushing you, saying: “Breathe, breathe...”. This is approximately the situation in which the brain finds itself, which must be activated hundreds of times during the night to resume breathing. This leads to the loss of deep stages of sleep, severe daytime sleepiness develops and the nervous system is gradually exhausted, the oxygen content in the blood decreases, blood viscosity increases, vasospasm develops, arterial hypertension develops, the heart rhythm is disturbed, then you can choose from myocardial infarction, stroke or sudden death in a dream.

Sources

Corsino CB, Ali R, Linklater DR. Herpangina. 2021 Jun 23. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan–. PMID: 29939569. https://www.ncbi.nlm.nih.gov/books/NBK507792/
Ter-Baghdasaryan L.V., Ratnikova L.I., Stenko E.A. Clinical and epidemiological aspects of enterovirus infection // Infectious diseases: news, opinions, training. 2021. Vol. 9, No. 1. pp. 88-93. doi: 10.33029/2305-3496-2020-9-1-88-93 https://infect-dis-journal.ru/ru/jarticles_infection/672.html?SSr=2601343bdb01ffffffff27c__07e4040b011a36-9772
Alacheva Z. A., Rybalka O. B., Kulichenko T. V. Should everyone escape from Coxsackie?! Or fear has big eyes. Issues of modern pediatrics. 2017; 16 (4): 286–290. doi: 10.15690/vsp.v16i4.1774) https://vsp.spr-journal.ru/jour/article/viewFile/1787/713
Herpangina Brenda L. Tesini. University of Rochester School of Medicine and Dentistry // MSD Handbook - 2019 https://www.msdmanuals.com/ru/professional/infectious-diseases/enteroviruses/herpangina
Kozlovskaya O.V., Katanakhova L.L., Kamka N.N., Evseeva A.N. Epidemiological, clinical and diagnostic features of enterovirus infection in children and adults. Bulletin of Surgu State University. Medicine. 2018;(2):56-60. https://surgumed.elpub.ru/jour/article/view/140/141
Kuo KC, Yeh YC, Huang YH, Chen IL, Lee CH. Understanding physician antibiotic prescribing behavior for children with enterovirus infection. PLoS One. 2021 Sep 7;13(9):e0202316. doi: 10.1371/journal.pone.0202316. PMID: 30192893; PMCID: PMC6128467. https://pubmed.ncbi.nlm.nih.gov/30192893/
Instructions for use of the drug HEXORAL® SOLUTION:
Instructions for use of the drug HEXORAL® AEROSOL:
Instructions for use of the drug HEXORAL® TABS:
Instructions for use of the drug HEXORAL® TABS EXTRA:

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