Differential diagnosis of angina pectoris

Acute tonsillitis (lat. acute tonsillitis) can be caused by a wide range of agents. It occurs most often in children and young adults.

The etiology is mainly determined by the intensity, extent, involvement of the neck, soft palate, and the presence of exudation, blisters, petechiae or enanthema. Among the bacteria, the most common causative agent is Streptococcus pyogenes. In children under three years of age, it is usually of viral origin.

Clinical picture
Locally, with tonsillitis, the tonsils become red and swollen, they may be covered with coatings - studs. A sore throat accompanied by difficulty in swallowing (odynophagia) develops quickly. The submandibular nodes are swollen and painful. In addition to the local manifestations, a general feeling of illness is added - malaise, fatigue, fever, malaise.

It is usually not possible to determine the causative agent from the clinical picture.

Plaut-Vincent's angina

 * Rare, caused by a mixed flora of anaerobes and spirochetes;
 * The disability is one-sided - typical is the disgusting feator ex ore;
 * Lemierre's disease/Lemierre syndrome – rare but fatal, infection fusobacterium necrophorum spreads to the 	 mediastinum.

Infectious mononucleosis

 * Considerable swelling of the tonsils, humming;
 * Holtzel's sign – small petechiae on the soft palate;
 * Bass's sign - swelling of the eyelids.

Herpangina

 * Coxsackie viruses, mostly in children,
 * Fever, headache,
 * Redness of the oropharynx with small blisters (2–10), they do not merge,
 * On arches, pain when swallowing,
 * Within 2-4 days the fever subsides and the boils heal,
 * Diff.dg. – herpetic stomatitis – ulcers in the front of the oral cavity.
 * Other forms
 * Less common;
 * Gonococcal pharyngitis, secondary syphilis.
 * Diagnosis
 * From the clinical picture;
 * Laboratory examination – viral – normal sedimentation, rather leukopenia, predominance of mononuclear cells;
 * IM – atypical lymphocytes.
 * Therapy
 * Viral - only symptomatically;
 * Streptococcal – penicillin (erythromycin), cephalosporins I.g., abscess – lincosamides;
 * Gonococcus, lues – also penicillin;
 * Ccorynebacterium diphtheriae – also penicillin;
 * On the contrary, aminopenicillins are completely unsuitable for MI!