The choice of the treatment strategy for the patients presenting with chronic tonsillitis of streptococcal etiology and subfebrility of long duration

Yanov, Yu. K.; Mal’tseva, G. S.; Drozdova, M. V.; Zakharova, G. P.; Гринчук, О. Н.

doi:10.17116/otorino20198401164

Cited by 3 publications

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“…Диагностика ХТ в большинстве случаев трудностей не представляет и включает в себя определенные жалобы больного, фарингоскопические признаки, а также анамнестические данные, из которых наиболее информативным является наличие перенесенных ангин [17][18][19].…”

Section: Introductionunclassified

Comparative characteristics of the options for conservative therapy of chronic tonsillitis of toxic-allergic form I

et al. 2021

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Introduction. The high incidence of chronic tonsillitis (CT), as well as the high risk of complications, make research in this area very relevant. The ambiguity of approaches to conservative therapy determines the need to search for new, reasonably effective, chemotherapy regimens.Objective. To carry out a comparative characteristic of various options for conservative therapy of chronic tonsillitis of toxicallergic form (TAF) I degree (CT TAF I).Materials and methods. The study included patients with CT TAF I according to the classification of B.S. Preobrazhensky and V.T. Palchun. The patients were divided into three clinical groups, depending on the therapy. Patients of the first group underwent a course of washing the lacunae of the tonsils with 1% dioxidine solution. Patients of the second group were prescribed antibiotic therapy with a retard form of clarithromycin. Patients of the third group underwent complex treatment – washing the lacunae of the palatine tonsils and simultaneously taking antibiotic therapy. The effectiveness of treatment was assessed by comparing the dynamics of changes in complaints, pharyngoscopic symptoms of CT, regional lymph nodes, and laboratory parameters.Results. Complex conservative therapy of CT TAF I provides early relief of patients’ complaints (in 93.2% of patients on the 7th day from the start of treatment), the maximum decrease in the severity of local CT symptoms (up to 1 point on the VAS at the end of treatment, with the exception of the Zak sign — 1.4 points) and the greatest positive dynamics of laboratory parameters.Conclusions. The analysis showed that for patients with CT TAF I, complex therapy, including a course of washing the lacunae of the palatine tonsils with 1% dioxidine solution and simultaneous administration of antibacterial therapy with a retard form of clarithromycin, is the most optimal therapeutic tactic that allows to achieve an earlier and stable reduction in the severity of symptoms HT, patient complaints, as well as the normalization of laboratory parameters.

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Section: Introductionunclassified

Comparative characteristics of the options for conservative therapy of chronic tonsillitis of toxic-allergic form I

et al. 2021

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Differential diagnosis of chronic tonsillitis in frequently ill children

2020

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Chronic tonsillitis is one of the most common pathologies of the lymphoepithelial pharyngeal ring. The main pathogen in chronic tonsillitis and its complications is group a β-hemolytic Streptococcus A (BGSA). This pathogen is detected in 30–60% of patients. At the present stage, the role of latent viral infections (Epstein – Barr virus (EBV), cytomegalovirus (CMV)) in the formation of chronic tonsillitis in children has been proven. Treatment of frequently ill children with pathology of the pharyngeal lymphoid ring remains an urgent and widely discussed issue. Depending on the etiology and clinical form of chronic tonsillitis (simple, toxicallergic form (TAF I or II), the choice is between conservative methods and radical surgical treatment. Surgical treatment of chronic tonsillitis in children is recommended only if there are absolute indications. To standard methods of conservative treatment, such as sanation of lacunae of the tonsils with antiseptic solutions, the appointment of physiotherapy, funds for the correction of systemic and local immunity are actively used. In Pediatrics, the safe and optimal complex of effects of the herbal medicinal product Tonsilgon N is widely used. Based on the analysis of clinical observations of frequently ill children with chronic tonsillitis, the effectiveness of the herbal medicine Tonsilgon H (in monotherapy mode) was revealed. As a result, the expediency of using the drug Tonsilgon H in the treatment of compensated forms of chronic tonsillitis in frequently and long-term ill children was established. There was a significant decrease in the frequency of acute respiratory infections and, consequently, the risk of transition to a decompensated form of chronic tonsillitis.

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Etiological aspects of chronic pathology of the lymphepithelial pharyngeal ring in children at the present stage

2021

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The lymphoepithelial pharyngeal ring is located in the entrance gate and is constantly exposed to infectious agents. Currently, chronic pathology of the lymphoepithelial pharyngeal ring remains one of the most common problems in the practice of a pediatric doctor. Hypertrophy of the pharyngeal tonsil, chronic adenoiditis, which occurs in 35.3% of children under the age of 7 years, and chronic tonsillitis, which occurs in 15-63% of cases, are among the most common diseases of childhood. Taking into account the wide range of infectious microbiota that contributes to the development of chronic pathology of the lymphoepithelial pharyngeal ring, the issue of differential diagnosis of the etiology of the disease and the selection of adequate treatment regimens remains relevant. In most cases, at the present stage, the approach to the treatment of patients with chronic inflammation of the lymphoid ring of the pharynx in children is reduced to replacing the surgical method with a conservative one with the appointment of immunocorrective and immunomodulatory drugs. The lack of a positive effect of the ongoing conservative treatment, clinical and laboratory signs of persistent streptococcal infection say us about the need for surgical treatment. At the same time, a group of frequently ill children requires special attention with the development of new regimens of the immunocorrecting and immunomodulating drugs usage.

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The choice of the treatment strategy for the patients presenting with chronic tonsillitis of streptococcal etiology and subfebrility of long duration

Cited by 3 publications

References 1 publication

Comparative characteristics of the options for conservative therapy of chronic tonsillitis of toxic-allergic form I

Comparative characteristics of the options for conservative therapy of chronic tonsillitis of toxic-allergic form I

Differential diagnosis of chronic tonsillitis in frequently ill children

Etiological aspects of chronic pathology of the lymphepithelial pharyngeal ring in children at the present stage

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