Symptoms of viral sore throat in children, photos of the throat and comprehensive treatment. Viral sore throat in a child Enteroviral sore throat in children is the most contagious

The most common reasons for children and their parents visiting their local pediatrician are severe sore throat, cough and runny nose. During seasonal epidemics of influenza and acute respiratory viral infections, viral tonsillitis in children is diagnosed in 50% of cases of calls for sore throat. Antibiotics will not help get rid of the virus quickly. Doctors recommend leaving the child at home to prevent the spread of infection, provide symptomatic therapy and prevent complications.

If a child has rhinitis, conjunctivitis, hoarseness, sore throat and cough, then he is unlikely to have bacterial infection. It is necessary to distinguish the symptoms and treatment of viral tonsillitis in children from acute streptococcal tonsillitis. In the first case, as a rule, the use of antibiotics is not required. Viral infection also causes pharyngitis or acute inflammation mucous membrane of the pharynx. If the inflammatory process covers the oropharynx, tonsillopharyngitis develops.

The palatine tonsils are two small lymphoid formations located in the recess between soft palate and tongue. They filter bacteria and viruses that enter the body through the mouth and nose in order to neutralize them and prevent them from entering the deeper parts of the body. respiratory system. However, the tonsils can be so overloaded with infectious agents that they become inflamed. Other common causes acute pharyngitis and tonsillitis - rhinoviruses, coronaviruses, adenoviruses, influenza A and B, influenza and parainfluenza.

Inflammation of the tonsils viral etiology in adults it occurs 2–4 times during the year, in children up to school age over the same period they get sick 6 to 10 times.

Symptoms of viral sore throat in children:

enlargement of the cervical lymph nodes, their soreness;
pain in the neck and throat when swallowing, which radiates to the ears;
fever, body temperature 38.1–39.5°C;
red swollen tonsils;
decreased appetite;
hoarse voice;
headache;
runny nose;
weakness;
cough.

A sore throat of viral etiology begins with an increase in temperature to 38.3°C or higher, chills, and body aches. The mucous membrane of the pharynx and nasal passages becomes inflamed, the throat begins to hurt, the eyes become red and watery. It can be difficult to recognize a viral sore throat based on a medical examination alone. Doctors also take into account accompanying circumstances. So, The peak of viral infections in children aged 5 to 15 years is confined to the season from November to April.

Enteroviral sore throat in children is the most contagious

Enterovirus affects the intestines, oropharynx and eye mucosa. The incubation period of a viral infection varies from several days to four weeks. Children usually become infected during the warm season. The disease begins acutely, with an inflammatory process in the oropharynx, and later a papular rash appears on the mucous membrane. Doctors call this condition “enteroviral vesicular pharyngitis”; the word “herpangina” has become popular in common parlance.

After primary infection with enterovirus, immunity is formed, which remains long time.

The mucous membrane of the pharyngeal ring and palatine tonsils is covered with reddish papules, reaching 1–3 mm in diameter. Then vesicles are formed - bubbles filled with light liquid, with a red halo around them. The mucous membrane of the oropharynx becomes inflamed with enteroviral sore throat, which causes pain to the child, which intensifies over 2–4 days. During this time, the bubbles open, the contents flow out of them, and the surface becomes covered with crusts.

For initial stage Viral sore throat in children is characterized by a sharp increase in temperature to 39–41 ° C, weakness, stabbing pain in the throat, nasal congestion and runny nose. Simultaneously begin digestive disorders due to damage to the intestinal walls by enteroviruses. Laboratory tests will help distinguish bacterial sore throat from enteroviral pharyngitis - linked immunosorbent assay, polymerase chain reaction and other virological diagnostic methods.

Generally recognized and effective drug There is no way to eliminate the herpangina pathogen. Doctors prescribe antiviral drugs, symptomatic treatment, as in the case of viral tonsillitis.

The child’s immune system copes with the pathogen during the acute period. In total, 8–14 days pass from the onset of the first symptoms to recovery. This type of infection is severe in young children with weakened immune defenses. Encephalitis and meningitis and other serious complications may develop.

Etiotropic treatment of viral sore throat

Antiviral drugs for sore throat, it is prescribed by a doctor for children to prevent serious complications. Moreover, there should be no doubt about the nature of the disease - enteroviral, adenoviral, herpetic. Characteristic features occur in the first days, namely conjunctivitis, runny nose, cough, severe redness and swelling of the tonsils, lack of plaque in the oropharynx.

Before treating a viral sore throat in a child, you should always consult a doctor. If you suspect herpes infection a specialist may prescribe the drugs "Acyclovir" or "Famciclovir". Viral tonsillitis is treated with antiviral medications ( "Viferon", "Arbidol", "Grippferon" and others). Children under one year of age are prescribed drugs with an immunostimulating effect in the form rectal suppositories.

Doctor Komarovsky: what not to do with a viral type of sore throat

Symptomatic treatment of viral tonsillitis in children

Patients should stay at home while elevated temperature- maintain bed rest. At the appointment, the pediatrician can recommend remedies that alleviate the condition of young patients. For viral sore throat, gargle with warm salt water and give herbal tea with honey. Anti-inflammatory and painkillers based on ibuprofen and paracetamol are sold in pharmacies without a prescription in the form of suspensions, tablets and suppositories.

Viral sore throat usually goes away without specific treatment after 4–10 days. Treatment for bacterial sore throat includes taking antibiotics.

How to treat viral sore throat in children - symptomatic therapy:

Drink plenty of fluids.
Antipyretics “Paracetamol”, “Nurofen”, “Efferalgan”.
Pain relievers for the throat “Tantum-Verde”, “Hexoral Tabs”, “Teraflu LAR”.
Antihistamines “Desloratadine”, “Fenistil”, “Suprastin”.
Gargling saline solutions and infusions of calendula, chamomile, and sage.

Weak solutions of potassium permanganate, baking soda and salt (sea or table) are used. The gargle should be warm, but not hot. The procedure is performed 2–3 times a day. An herbal infusion is prepared from one or two tablespoons of raw materials and 250 ml of boiling water. Irrigation of the pharynx and tonsils brings pain relief and eliminates other discomfort, weakens the inflammatory process.

How to recognize and treat viral sore throat in your child updated: August 18, 2016 by: admin

You can get a sore throat at any age. This disease is most severe in children. Quite often, sore throat occurs against the background of a viral infection.

Causes

Viruses are the second most common culprits in the development of sore throats in childhood after bacteria. Most often, the development of acute tonsillitis is caused by infection with adenovirus infection, influenza and parainfluenza, as well as herpes.

The peak incidence of such forms of tonsillitis occurs between the ages of 3-7 years.

Children who attend educational institutions. In crowded, organized groups, viral infections usually spread at a faster rate.

Viral tonsillitis is characterized by systemic manifestations. Catarrhal symptoms also appear: runny nose and cough. For bacterial tonsillitis, such manifestations, as a rule, are not typical and practically do not occur.

Viral forms of the disease usually progress within 5-7 days and end with complete recovery.

How can you get infected?

You can get a sore throat after any contact with a sick and contagious person. The most common type of infection is airborne.

Tiny viral particles get into the mouth when talking or sneezing. environment. They can stay there for quite a long time and not lose their viability. Subsequently getting on the mucous membranes of another child, the viruses begin to multiply quickly and provoke the development of an inflammatory process.

Another, also quite common method of infection is the contact-household variant.

It is possible during joint games with the same toys or when using common utensils. Similar cases of infection are observed within the family or in kindergarten. Violation of personal hygiene rules also leads to possible infection.

Symptoms

The first clinical manifestations of the disease appear after the incubation period. For viral sore throats, it usually lasts about 1-3 days.

For some forms of infection, the incubation period can even last up to a week. At this time, as a rule, the child does not have any adverse symptoms of the disease, and nothing bothers him.

The main manifestations of viral sore throat in childhood are:

Increased body temperature. Usually it rises to 38-39 degrees during the first day of illness and persists for a couple of days. Against the background of high body temperature, fever and intense heat appear, as well as increased sweating.
Sore throat when swallowing. Any food, especially with solid particles, can cause increased pain.
Redness of the throat and enlarged tonsils. They turn bright red. Various rashes appear on the tonsils, as well as whitish or gray plaque. Viral sore throats are not characterized by purulent crusts. This symptom occurs only when infected with a bacterial infection.
Enlarged peripheral lymph nodes. The occipital and submandibular areas are most often affected. They become quite dense and painful when touched.
Severe headache, loss of appetite, change general condition child. The baby becomes more capricious, refuses to eat, and tries to spend more time in the crib. At high temperatures, symptoms of thirst and dry mouth increase.

What does it look like?

With a viral sore throat, the tonsils become enlarged and bright red. The entire pharynx and oropharynx are also scarlet. Various rashes appear on the tonsils.

With adenoviral variants of the disease, they look like white millet grains, which are located at some distance from each other.

Usually on the 4-5th day of illness they open and the fluid flows out.

In place of the former blisters, areas with erosions and ulcers remain. The surface of the tonsils becomes loose and bleeds easily when touched.

A week after the onset of herpes sore throat, the tonsils become clean and have no traces of blisters and ulcers.

Diagnostics

After the first signs of illness appear, you should definitely show your baby to the pediatrician. The doctor will examine the child's throat and be able to make the correct diagnosis.

To clarify the pathogen, sometimes it is necessary to carry out additional tests and examinations.

For all children with tonsillitis, a smear is taken from the surface of the tonsils. It allows you to accurately identify the causative agent of the disease, as well as exclude such dangerous childhood infections as scarlet fever and diphtheria.

General analysis blood tests are performed on all children with acute tonsillitis.

An increase in the number of lymphocytes against the general background of a high content of leukocytes indicates the presence of a viral infection in the body. Also, similar variants of acute tonsillitis occur with a strong acceleration of ESR.

Treatment

You can treat a sore throat at home. Such treatment should be carried out under the mandatory supervision of the attending physician. The doctor will be able to detect the development of complications in a timely manner, and will also make the necessary adjustments to therapy if necessary.

For the treatment of viral sore throat use:

Antiviral agents. They help effectively cope with viruses, and also contribute to quick recovery. The most commonly used drugs are: Acyclovir, Remantadine, Viferon, Groprinosin, Isoprinosine. They have a pronounced viral toxic effect. Antiviral drugs are usually prescribed in the form of tablets, and in severe situations - in injections and injections.

Immunostimulating drugs. Significantly enhance the effect of antiviral agents. They can be prescribed in the form of drops, tablets, and suppositories. In pediatric practice, the most frequently used are: Interferon, Immunal and others. They are prescribed for 7-10 days. Strengthen the immune system and promote good work immune system.
Antipyretic. Use only when body temperature rises above 38 degrees. To improve your well-being, medications based on paracetamol or ibuprofen are ideal. Such products are approved for use in pediatric practice.
Antihistamines. Used to eliminate swelling of the tonsils and reduce symptoms of intoxication. Prescribed for 5 days, usually 1-2 times a day. Some drugs can cause increased drowsiness, so they are usually recommended for use in the first half of the day. Suitable antihistamines include: Claritin, Suprastin, Loratadine and others.

Warm, plenty of drink. Helps eliminate viral toxins from the body. This simple measure helps prevent the development of dangerous complications that manifest themselves as inflammation in the kidneys or heart. Suitable drinks include compotes or fruit drinks made from berries and fruits.
Bed rest for the entire period of high temperature. Staying in bed will contribute to a quick recovery and improved well-being in a short time. Usually, with viral tonsillitis, doctors recommend that children remain in bed for 2-3 days.
Gentle nutrition. All prepared dishes must be at a comfortable temperature, no higher than 50 degrees. Extremely cold foods can cause increased pain when swallowing. It is better to choose dishes with a thinner consistency that are not capable of injuring the tonsils.
Rinse. They help wash the tonsils and remove plaque from their surfaces. They are usually carried out 3-4 times a day for 5-7 days. Decoctions of chamomile, calendula or sage, as well as a solution of diluted hydrogen peroxide and soda, are well suited for rinsing.
Pain-relieving lozenges or lozenges. Eliminate pain syndrome in the throat and help reduce inflammation of the tonsils. Faringosept, Strepsils, Septolete help cope with pain when swallowing. Prescribed 3 times a day for a week. Longer use of pain-relieving lozenges is discussed with your doctor.

Multivitamin complexes including selenium. The microelements contained in such preparations are needed for rapid recovery from illness, as well as to improve the functioning of the immune system. Selenium helps the body cope with viruses faster and activates the immune system.

Creating a comfortable indoor microclimate. Excessively dry air in a child's room leads to difficulty breathing during a viral infection. The use of special humidifier devices helps to cope with this problem. They create optimal humidity in the children's room, which is necessary for good breathing.

Below you can watch Dr. Komarovsky’s video about sore throat in children.

Babies are susceptible to various infectious diseases, and almost every parent has heard the diagnosis of “angina.” A special place among throat diseases is occupied by viral sore throat in children, because the nature of this disease differs from the usual bacterial tonsillitis. The causative agents of viral sore throat are viruses that specifically act on the child’s body.

Pediatrician, neonatologist

The treatment of viral tonsillitis in children also differs from the usual scheme, so it is important to recognize the disease correctly and in a timely manner. But how to identify a viral disease in children and distinguish it from bacterial tonsillitis? We’ll talk about what parents should know and what they should pay special attention to when treating the disease in this article.

What is viral sore throat?

Viral tonsillitis is an infectious disease caused by viruses, which manifests itself by damage to the mucous membrane of the oropharynx, intestines and others. internal organs.

Causes of viral sore throat in children

Adenoviruses and can cause sore throat. Particular importance is attached to the most common form, herpangina, which is caused by enteroviruses.

Herpetic sore throat got its name due to the similarity of the lesions of the mucous membrane with the rash of herpes. The blistering rash can spread to the area around the mouth and lips, which causes many errors in diagnosing the disease. A more accurate name for the disease is enteroviral vesicular pharyngitis or stomatitis.

Enteroviral sore throat is most often caused by Coxsackie viruses of group A, less often viruses of group B are isolated, in 25% of cases another type of virus is found - ECHO. All these pathogens are highly contagious (infectious).

the danger of contracting a virus is due to the ability of the infectious agent to infect nervous system, internal organs of the child;
The favorite habitat of the pathogen is a humid environment, open water bodies, soil, and sewage drains. It is possible that there is a virus on food products, household items;
The pathogen is highly resistant and can remain viable for several years under the influence of low temperatures. Alcohol, antibiotics, and Lysol cannot get rid of the virus;
the pathogen is sensitive to action high temperatures, and when boiled it dies instantly. Among antiseptics, solutions containing formaldehyde or chloramine are suitable for combating the virus;
Not all people get sick when exposed to the virus. People with weakened immune systems are most susceptible to developing infection;
most cases of virus infection result in complete recovery and do not have negative health consequences;

Development is very dangerous viral disease for pregnant. The virus often leads to fetal damage and even intrauterine death. The disease is also unsafe for people with weakened immune systems, in whom the disease occurs in a severe form with the development of complications.

The incubation period for viral infection ranges from 2 to 10 days.

A less common cause of viral sore throat is adenovirus. Causes not only damage to the tonsils, but also conjunctivitis, runny nose, cough,. Adenoviral sore throat is characterized by filmy deposits, which are removed during processing.

Routes of entry of the virus

nutritional;

When consuming contaminated food or drinks, the pathogen may enter the gastrointestinal tract.

airborne;

The virus enters the environment when the carrier of the infection sneezes or coughs, after which the pathogen enters the mucous membrane of a healthy child.

contact and household;

In close contact with a carrier of the infection, especially in the first 5 days from the onset of the disease, the virus is easily transmitted through household items, toys, and dishes. Kissing and contact with saliva or secretions from the mouth and pharynx are especially dangerous.

water.

Often outbreaks of the disease occur in children visiting the same pool. Often the disease overtakes children on vacation near bodies of water.

Distribution mechanism

The virus enters the child’s body through the mucous membrane of the nasopharynx or oral cavity. With the flow of lymph, the infectious agent penetrates into the lymph nodes, where it actively multiplies and circulatory system spreads throughout the body. Concentrated on the mucous membrane of the oropharynx, in vesicles and plaque a large number of viruses. If the process is widespread, bubbles can also form on internal organs.

In severe cases, a specific rash can affect internal organs - the gastrointestinal tract, kidneys, heart, nervous system. The child develops digestive disorders and heart pain.

The disease appears more often in childhood. This is due to the large number of contacts between children, visits to childcare facilities, and non-compliance with preventive measures. Children from 3 to 10 years old are most susceptible to the disease. Newborns and infants, subject to natural feeding, are reliably protected from the disease by maternal antibodies.

In adults, viral tonsillitis is rare, and its manifestations are subtle. The disease affects people with weakened immunity, systemic diseases, who have not previously suffered from sore throat.

After a person has suffered from an illness, a strong immunity to the viruses that caused the disease is formed. The disease cannot recur again over time and does not become chronic.

Seasonality of the disease

In most cases, viral tonsillitis makes itself felt in the warm season (enteroviruses) and in the off-season (typical of adenovirus). Outbreaks of the disease often occur in summer and autumn, when the pathogen is especially active.

Source of infection

The disease is very common among children attending child care institutions. A sick child quickly infects those around him, because there are several ways of contracting the infection. In addition, the source of infection may be a baby who has had the disease. Isolation of the pathogen when the virus is carried persists for a month.

Although the disease is mainly transmitted from person to person, cases of infection from pigs have been recorded.

Factors in the development of infection

Although the disease is very common and highly contagious, not all people exposed to the virus become ill. The disease can occur due to a combination of various factors.

decreased immunity;

The inability of the immune system to give an appropriate response when an infection penetrates, low immunoreactivity is the main factor in the development of the disease.

stress;

Stressful situations significantly reduce the child’s body’s defenses. Stress can include unfavorable relationships in the family, the child’s adaptation to a new team, kindergarten or school.

overwork;

Excessive workload at school, physical and mental fatigue increase the risk of developing the disease.

background diseases;

Children with chronic diseases, metabolic disorders, adenoid vegetations, having suffered infectious diseases, are more likely to get a viral sore throat.

congenital pathologies of immunity.

For immunodeficiencies, oncological diseases the child is susceptible to developing infectious diseases.

Signs of viral sore throat in children

The first signs of the disease may appear in different time, it all depends on the baby’s body’s resistance to infection. Typically, the first manifestations occur 3 to 14 days after the child comes into contact with the source of the disease. The incubation period passes without visible changes in the baby’s condition, nothing indicates the development of the disease.

After the end of the latent period, the first manifestations of the disease appear, the severity of which also varies from person to person. Some children tolerate the disease well and easily, while others feel a significant deterioration in their general condition from the first day of the disease.

Symptoms of viral sore throat in children include a number of manifestations.

Hyperthermia

The disease usually occurs with a high febrile temperature, up to 40 ºС. The temperature rises quickly and is difficult to control with conventional anti-inflammatory drugs. There are typically 2 peaks in temperature rise - on the first and third days, with high numbers remaining on the remaining days. The symptom persists for about 4 - 5 days, then gradually decreases with treatment.

Rash on the palate and tonsils

2-3 days after the temperature rises, a characteristic rash appears in the mouth. The rash appears as small reddish papules. The nodules are located on the mucous membrane of the tongue, pharynx, tonsils and palate in the amount of 3 - 7 pieces. In severe cases of infection, the disease begins with a profuse rash containing more than 20 papules.

It happens that papules appear in small numbers and are difficult to notice, which leads to diagnostic errors.

Gradually, the papules increase in size and turn into vesicles (vesicles with serous contents). After 24 - 48 hours, the bubbles open, and a gray-white color appears on the mucous membrane, surrounded by a red crown. If the sores are located close to each other, they can merge and form a larger defect.

The resulting ulcers cause significant pain to the child. Regular eating or drinking becomes a real test for the baby. The child cries, complains of a sore throat, and often feels a “coma” and burning sensation.

With adenoviral sore throat, the rash looks like white millet grains or filmy translucent plaques located on the tonsils.

Lymphadenopathy

Since the spread of the virus plays a significant role lymphatic system, enlarged lymph nodes are very characteristic of the manifestation of infection. The most susceptible to changes are the cervical The lymph nodes, they become dense, swollen, painful when touched.

General symptoms

The child’s well-being is disrupted, the baby becomes lethargic, capricious, and irritable. Sleep and appetite are significantly impaired, and symptoms of intoxication appear. Muscle pain may occur, especially in the neck area. Children often complain about headache, malaise, catarrhal symptoms appear - runny nose, cough.

The development of intoxication and dyspeptic disorders is more typical for children; in adults, the disease most often resolves without complications.

Indigestion

Problems with the gastrointestinal tract are associated both with general intoxication and with the effect of enterovirus or adenovirus on the intestinal mucosa. Nausea, vomiting, loss of appetite, and possible development of diarrhea often occur.

Rashes in the oral cavity last on average 3-5 days, healing of ulcerated areas begins on the 6th-7th day of illness. But there are cases of a wave-like course of the disease, when the appearance of the rash repeats every 2 to 3 days. This course is typical for weakened children with somatic diseases. In cases of severe disease, a vesicular rash appears on the torso, hands and feet.

Rash on the body

In some children, the rash is not limited to the oropharynx; elements can be found on the skin of the hands and feet. The rashes are most often localized on the palms of the hands and soles of the feet and appear as small blisters with a rim of redness along the periphery. Usually the rash lasts from 5 days to a week and disappears without a trace, leaving no scars.

Diagnosis and differential diagnosis

The disease is determined by a pediatrician or otolaryngologist; for an experienced specialist, diagnosing the disease is not difficult and includes the following methods.

taking anamnesis;

The doctor pays attention to the age of the baby, visits to the children's group and the possibility of contact with sick children. Chronic somatic diseases and disturbances in the functioning of the immune system also indicate the possibility of developing a sore throat.

inspection;

To make a diagnosis, a specialist carefully examines the baby’s oropharynx (throat), paying attention to the presence of a specific blistering rash or plaque. If there are rashes not only on the mucous membrane of the oropharynx, but also on the body, it is worth differentiating the disease with the “hand-foot-mouth” syndrome.

The course of the disease is sometimes similar to the “hand-foot-mouth” syndrome, also caused by enteroviruses. But, unlike the syndrome, the rash does not spread to the tonsils.

Viral sore throat must be distinguished from other pathologies, for example, with thrush, a whitish coating is noticeable on the tongue, palate, and inner surface of the cheeks; blisters do not appear with thrush.

Viral sore throat is easily confused with herpetic, the rash of which also consists of blisters, and the disease goes away with an increase in temperature. But with stomatitis, the rash is located mainly on the tongue and gums and never spreads to the tonsils.

Bursted blisters with serous contents and plaque when adenovirus infection can be confused with purulent discharge from bacterial tonsillitis. Diseases can be distinguished by paying attention to the localization of the rash; with tonsillitis, the discharge does not extend beyond the tonsils. In addition, viral tonsillitis is characterized by the presence of a runny nose, which may not be present with bacterial tonsillitis.

laboratory diagnostics:
- Clinical blood test will show an increase in leukocytes;
- inoculating smears from the oropharynx will help exclude other microflora;
- Enzyme immunoassay blood test - helps determine the presence of specific antibodies that were formed in response to the penetration of the virus. If antibodies increase by 4 times, one can confidently make a diagnosis of “viral tonsillitis”;
- polymerase chain reaction (PCR) - needed to identify the virus itself in swabs from the patient’s throat. This method helps determine the DNA of the virus for accurate diagnosis;
- spinal puncture - performed to examine the cerebrospinal fluid. Diagnosis is prescribed only to children with signs of damage to the nervous system.
specialist consultations.

In case of severe disease and suspected damage to internal organs, consultation with a neurologist, urologist, nephrologist, or cardiologist is required.

How to treat viral sore throat in a child?

According to Dr. Komarovsky, treatment of viral tonsillitis in children should be aimed at eliminating the symptoms of the disease and preventing dehydration. The use of antibiotics does not reduce the risk of complications of a viral infection, but treatment herpetic sore throat in children, Acyclovir is unjustified, since the drug does not act on the virus.

bed rest;

A simple but important way to speed up recovery and prevent the development of complications.

fight against hyperthermia;

Anti-inflammatory drugs based on paracetamol and ibuprofen are suitable to reduce body temperature and relieve pain.

gargling;

To prevent the addition of a secondary infection, it is recommended to rinse the oropharynx with gargling solutions and antiseptics, for example, Miramistin, Agisept, Biocide. If a viral sore throat develops in a child under one year old, the oropharynx should be irrigated using a syringe without a needle. Possible rinsing with decoctions medicinal herbs– chamomile, calendula.

local anesthesia;

To remove pain and inflammation in the throat, aerosols are suitable: Ingalipt, Hexoral, Tantum-Verde or lidocaine solution.

antiallergic drugs;

Drugs such as Cetrin, Fenkarol, Claritin will prevent the development allergic reactions and will have an anti-edematous effect.

physiotherapy.

UV irradiation of the oropharynx can accelerate the healing of ulcers and shorten recovery time.

Pay attention to the child's drinking regime and encourage your child to choose the appropriate drink. Although your baby's appetite is reduced, make sure your baby gets enough food and drinks. Recommended foods include puree soups, jelly, and porridge. All products must be of liquid consistency so as not to further injure the delicate mucous membranes.

What not to do?

Treat the disease with antibiotics and anti-herpes virus agents, such as Acyclovir.
Treat the throat with Lugol's solution, which further injures the tissues and causes allergic reactions.
Carry out inhalations, apply compresses. Such treatment methods locally increase blood circulation, increase body temperature, and can provoke the spread of infection.

Complications

This infection is dangerous due to the ability of the virus to affect not only the mucous membrane of the baby’s oropharynx, but also nerve and muscle tissue. The most dangerous complication consider damage to the brain and its membranes in the form of meningitis and encephalitis.

In the generalized form of the disease, damage to internal organs is possible with the development of pyelonephritis, myocarditis, and hemorrhagic conjunctivitis. And the prolonged course of the disease creates the preconditions for an abnormal immune response and the development of the rheumatic process.

The virus significantly reduces the body's defenses and creates the ground for bacterial microflora to attach. Bacteria cause suppuration of the mucous membranes with the formation of abscesses and phlegmons.

Prevention

Since the likelihood of catching the virus from a sick child is very high, anti-epidemic measures become a method of prevention:

identification and isolation of a sick child;
introduction of quarantine for contact persons for at least 14 days;
a child who has had an infection can return to the team no earlier than a week after the manifestation of the disease;
administration of specific gamma globulins to children who have been in contact with an infected child;
disinfection of the epidemiological outbreak;
strengthening the body's defenses by rationalizing the work and rest regime, healthy eating, and hardening;
mandatory daily walks, wet cleaning of the premises;
the child observes the rules of personal hygiene, washing hands, using personal care items.

Enteroviruses and adenoviruses are very diverse, so specific vaccinations against them have not been developed, with the exception of vaccines against polio. But immunity from re-infectionafter an illness, it lasts for life.

Conclusion

Viral infections are common in children under 5 years of age. The development of viral sore throat in children is no exception.

The disease has characteristic features, and with a typical course, it is not at all difficult to suspect and identify the disease. Difficulties arise when there are a small number of elements of the rash or when the rash is localized in atypical places. In doubtful cases, they will help to recognize the disease laboratory methods diagnostics and consultation with an experienced specialist.

And ngina of a viral nature is a very common disease among children from 3 to 7 years old - it is children at this age who are at risk for the development of pathology.

Children of preschool and school age constantly stay in closed spaces and large groups (kindergartens and classes), where it is much easier for viral pathogens to spread and show signs of active life.

Symptoms of viral sore throat in children may differ depending on the type of pathogen, of which there are a large number.

True sore throat is caused by bacteria, while a viral disease is atypical and is provoked by the following microorganisms:

adenovirus;
cytomegalovirus;
rotavirus;
influenza viruses, of which there are about two thousand in nature;
Epstein-Barr virus, in which tonsillitis occurs against the background of infectious mononucleosis;
Coxsackie enteroviruses type A and B and ECHO viruses that cause herpetic sore throat.

Infection occurs after the introduction of a pathogenic pathogen into the cavity of the child’s oropharynx and the beginning of its active reproduction. The predominant form of transmission of viral agents is airborne.

Penetration into the body occurs through inhalation of pathogens spread by an already ill person with saliva and nasal mucus (when coughing, sneezing, talking).

The contact-household route of infection involves the use of shared utensils, personal hygiene products, toys, and the fecal-oral route involves consuming food in an inappropriate way, with unwashed hands.

The peak of infection occurs during periods when children experience vitamin deficiency and decreased immunity - winter (October to December) and spring (March-April).

The virus that causes tonsillitis penetrates the baby’s body, weakened by frequent colds and lack of vitamins. Cells deprived of protection are susceptible to easy penetration of the pathogen and react to its vital activity with signs of intoxication.

Thus, we can identify the main causes of viral tonsillitis in children:

weakened immune system;
recurrent pathologies of the respiratory system, nose and throat - sinusitis, sinusitis, tonsillitis, pharyngitis;
lack of vitamins;
local and systemic hypothermia;
close contact with already ill children in schools and kindergartens;
a tendency to stress and frustration are signs of an unstable nervous system.

Interesting:

In children with stomach diseases, symptoms of viral sore throat develop more often. The pathogen affects not only the respiratory system, but also the gastrointestinal tract, which is manifested by dyspeptic symptoms and stool disorders.

Characteristic symptoms depending on the type of pathogen

Tonsillitis of viral etiology in children is divided into three types:

adenoviral;
flu;
herpetic;

In the first two cases, a viral sore throat is diagnosed, except for herpetic - here the name of the disease is allocated to a special category. Although herpes tonsillitis is not caused by the herpes virus, and the scientific name of the disease is enteroviral vesicular stomatitis.

Herpes sore throat

Flu sore throat

A type of tonsillitis caused by influenza viruses of different strains (there are over two thousand in total). The peak incidence occurs in autumn and winter, when the child’s body is weakened and susceptible to the introduction of pathogens.

The development of pathology occurs rapidly, starting with an increase in temperature to 39-40°C.

sharp pain in the throat, accompanied by soreness and dryness of the mucous membranes;
nonproductive cough without sputum production;
nasal congestion and excessive snot;
increased sweating, weakness, drowsiness;
severe headaches, body aches, muscles and joints.

A distinctive feature of influenza sore throat is considered to be diffuse hyperemia of the throat, when the mucous membrane acquires a dark red, almost cherry tint.

Inflammation and swelling extend not only to the tonsil area, but also to the surface of the palatine arches. At the same time, the child complains of severe dry mouth, his lymph nodes are enlarged, skin becomes pale or bluish.

Differences between viral and bacterial tonsillitis

A distinctive feature of viral tonsillitis is its seasonal nature - the pathology spreads during periods of influenza and ARVI epidemics (winter and spring).

Also, a feature of the viral etiology of the disease is that it affects the entire surface of the larynx, and not just the tonsils, including the uvula, arches and root of the tongue.

Viral tonsillitis is characterized by an acute onset and rapid development; if there is an incubation period, the symptoms of the disease appear immediately after its completion. These are fever, inflammation of the larynx, runny nose, nasal congestion and cough.

Viral tonsillitis in children is also accompanied by headaches, a feeling of weakness, children become capricious, sleep poorly and refuse to eat.

Under the influence of the virus, a large amount of mucus is formed in the nasopharynx, which flows down the posterior laryngeal wall and enters the upper sections of the bronchi, causing irritation - a dry or wet cough appears.

The virus that causes a sore throat provokes pronounced redness of the throat, while the tonsils are not covered with pus, and the entire surface of the larynx is covered with a whitish coating (with herpes tonsillitis, red blisters filled with liquid appear on the mucous membrane).

For bacterial tonsillitis, symptoms such as lacrimation, runny nose and cough are not typical. Initially, the patient complains of a sore throat; the temperature does not rise immediately, but as the infection progresses and signs of intoxication develop.

The manifestations of bacterial tonsillitis are clearly localized - the inflammatory process does not leave the borders of the tonsils, the tonsils become covered with purulent plaque, which also accumulates in the lacunae.

With bacterial sore throat, a cough does not occur, since the nasal cavity is not involved in the process of inflammation, and mucus is not secreted and does not flow into the upper respiratory tract.

Complaints boil down to a sore throat, the mucous membrane of the tonsils is inflamed, loose and swollen, covered with a white-yellow layer of plaque mixed with pus. Cough and runny nose may appear on the 3-4th day of illness in the form of complications and the development of a secondary infection.

What needs to be examined

Many parents, when their child develops a sore throat and fever, begin to treat viral sore throat with antibiotics, without consulting a doctor and without establishing the etiology of the disease.

This tactic is fundamentally wrong, since the treatment of bacterial and viral infections is very different - the use of antibiotics for the viral form of tonsillitis can only cause harm, causing the body to become resistant to the drugs.

Diagnostics includes the following activities:

performing pharyngoscopy - examining the larynx for redness, swelling and inflammation of the mucous membrane, the presence of rashes and the nature of plaque;
general blood test - it reveals an increased number of leukocytes;
biochemical blood test - necessary in case of illness in young children, in particular, adenoviral type of tonsillitis, which is often complicated by pneumonia. The development of pneumonia is indicated by an increase in the level of sialic acid and fibrinogen in the blood, positive result tests for C-reactive protein;
ELISA - study of epithelial cells to detect antigens to viruses in them;
immunofluorescence reactions are a highly accurate method that allows you to determine specific antibodies to the pathogen;
PCR diagnostics - they examine blood or a swab taken from the throat, detecting viral DNA there;
serological research methods - complement fixation reaction, PCR, ELISA, molecular hybridization method, immunoelectron microscopy.

In the event of complications developing, diagnosis is necessary with the participation of specialized specialists - a cardiologist, a neurologist and others as appropriate. Such cases occur in children with weakened immune systems and under the age of one year, with severe viral sore throat.

Treatment

Treatment of viral sore throat in children is necessary when signs of intoxication develop - headaches, fever, febrile syndrome.

Therapy involves getting rid of the causative agent of the disease (virus) and eliminating the severe symptoms of the pathology, since the child has a hard time tolerating the manifestations of tonsillitis. Treatment is divided into systemic and local.

Eliminating the pathogen

In case of viral etiology of sore throat, the child is given drugs that help reduce the activity of the pathogen by initial stage development of the disease and increasing the body's resistance to infection:

Antiviral– Acyclovir, Ganciclovir, Foscarnet, Penciclovir.
Immunomodulators– For children under one year of age, doctors recommend taking Immunoflazid syrup and Immunal drops. Good effect The use of drugs Bronchomunal, tincture of echinacea or eleutherococcus helps to increase the body's defenses. Older children are prescribed Genferon, Viferon (in the form of suppositories), Cycloferon in tablets. Influenza sore throat can be stopped at the initial stage by instilling the drug Interferon into the nose.
Vitamin complexes– Sana-Sol, Pikovit, Alphabet, Multitabs and others, depending on the age of the child to saturate the body with vitamins, beneficial macroelements and increase resistance to infections.

In case of herpangina infection, use antiviral drugs not always justified, since the body needs at least 7 days to cope with the pathogen on its own.

Only after this period has passed is immunity to Coxsackie viruses and echoviruses developed, which remains for the rest of life and prevents re-infection with herpetic tonsillitis.

Additional measures

Also, to speed up recovery and suppress the activity of viruses, a small patient needs to create comfortable conditions, including:

bed rest– suffering from a sore throat on the legs creates additional stress on the joints, which is fraught with the development of complications;
isolation from other family members– this point is especially important when a child suffers from herpes sore throat;
maintaining optimal levels of air humidity and temperature– in a hot and dry environment (or, conversely, dampness), the virus multiplies more actively, so you should not heat the room above 22°C, the recommended humidity is 50%;
fractional meals with semi-liquid food that does not irritate the throat– these are soups, broths, porridges, purees;
compliance with the drinking regime– to reduce signs of intoxication. Tea with raspberries, honey, lemon (they increase sweating and help reduce temperature), warm milk, pure water, fruit drinks from fresh and frozen berries, decoctions of chamomile, rowan fruits, viburnum and rose hips;
carrying out wet cleaning without the use of aggressive chemicals and ventilation of the room where the patient is.

These are measures that allow you to speed up the body’s fight against the causative agent of viral tonsillitis - by following simple rules, you can alleviate the child’s condition and cure a sore throat faster.

Taking immunostimulating and antiviral drugs prescribed by a doctor should be carried out taking into account dosages and frequency.

Symptomatic therapy

Taking systemic medications and local treatment of the throat are prerequisites for alleviating severe symptoms of a sore throat.

Tonsillitis manifests itself severe pain in the throat, which prevent the child from eating, drinking and sleeping normally, so you need to try to stop them. Also, signs of intoxication – headaches, fever, chills – cause discomfort to the little patient.

Symptomatic treatment of viral sore throat in children includes:

Taking NSAID drugs(anti-inflammatory non-steroids). They help reduce temperature, eliminate intoxication and normalize well-being. For children younger age Paracetamol and Panadol suppositories are recommended to reduce the effect on the liver. Starting from two years old, you can drink Nurofen and Ibuprofen syrups, and for children older than this, Ibuklin is suitable. Taking Aspirin is not recommended before reaching the age of 14, since viral sore throat increases the risk of toxic brain damage.
Irrigation of the throat with sprays with an anesthetic and antiseptic effect. The drugs Hexoral, Miramistin, Ingalipt and Lugolit help relieve pain in the inflamed surface of the larynx, giving children the opportunity to sleep and relax for several hours in a row. Also, these products cleanse the mucous epithelium from pathological plaque, accelerating recovery.
Gargling. For this purpose, Furacilin, Miramistin, Chlorophyllipt are used for children over 3 years of age. The easiest way to clean the throat mucosa is to prepare a solution of salt and baking soda - 0.5 tsp each. for 500 ml of water. Rinsing is carried out up to 4-5 times a day, after which topical sprays are used.

Attention:

Steam inhalations and physiotherapy for viral sore throat are not recommended, as is applying warm compresses to the neck area. At elevated temperatures, such actions are contraindicated and will lead to activation of the viral pathogen in the tissues.

At the recovery stage, in order to heal the throat mucosa and increase local immunity, children are prescribed a course of ultraviolet irradiation of the larynx.

During development accompanying symptoms, such as cough and runny nose, medications are used to eliminate them.

To cleanse the nasal cavity from accumulation of mucus, use Aqua Maris and Marimer sprays, and rinse the nose with the Dolphin system.

At night, you can inject a small amount of Nazivin, Sanorin or Pinosol into the nostrils in a children's dosage. Syrups based on ivy and plantain, drugs Prospan, Gedelix, Travisil are good for dry cough.

Possible complications

One of the main complications of viral tonsillitis is the addition of a secondary bacterial infection. This happens when the child’s immunity is too weak and medical prescriptions are not followed.

The development of bacterial (including purulent) sore throat is fraught with the following complications for the child:

rheumatism of the heart - a consequence that develops with the active reproduction of pathogenic pathogens in the cells of internal organs with inadequate treatment of the disease, when Negative influence on connective tissues;
myocarditis – inflammation of the heart muscle;
rheumatism of the joints - the disease appears when suffering from a sore throat on the legs, is characterized by swelling of the joints and pain in them (however, it is quickly treated);
pyelonephritis and glomerulonephritis – inflammatory processes in the kidneys, developing as a complication of bacterial tonsillitis and when the drinking regime is not observed (when toxins cannot leave the body for a long time);
neuroinfections, such as meningitis;
chronic runny nose, otitis media, tonsillitis.

Such severe consequences develop mainly in children with recurrent colds that reduce immunity and chronic pathologies of the respiratory system.

To prevent such complications, you need to consult a doctor in time and follow all recommendations, as well as take measures to strengthen the body’s defenses.

Forecast

If a viral sore throat is diagnosed and treated in time, it will not cause serious complications. Recovery will occur after 7-10 days, after which the baby will need a short recovery period.

At this time it is necessary to limit physical exercise and contact with peers (for example, when a child has herpangina, he is contagious for another 3-5 days).

Activities to strengthen the immune system prescribed by the doctor can last up to a month.

The prognosis for viral tonsillitis will be favorable for those children whose parents teach them from an early age to wash their hands frequently, not to eat dirty fruits and vegetables, not to lick toys, and not to use other people’s dishes.

In contact with

Most often, angina develops against the background infectious infection. However, recently otolaryngologists have been talking about a disease that occurs with similar symptoms, but has completely different causes.

Today, viral tonsillitis in children is not a rare diagnosis. It leads to inflammation of the tonsils and lymphadenoid ring in the pharynx, as if bacteria are activated, but there is no purulent lesion of the oropharynx, which determines the specifics of the disease and its treatment.

According to the self-explanatory name, viral tonsillitis in a child develops against the background of the activation of numerous viruses. These can be Coxsackie, ECHO, enteroviruses, influenza strains, Epstein-Barr, herpes, adenoviruses. Routes of infection are airborne (conversation), household contact (kissing, toys, dishes), fecal-oral (food).

An infected child sheds viruses for about a month from the moment of infection. They usually affect the lymph nodes, multiply there and settle on the surface of the tonsils. Many factors contribute to infection.

Exogenous:

seasonal decrease in temperature;
poor (poor, unbalanced, monotonous) nutrition;
absence sanitary standards, failure to comply with hygiene rules;
hypothermia of the body: general (frozen on the street) and local (wet my feet, my ears got cold, I ate too much ice cream);
passive smoking;
poor environmental conditions;
climate change.

Endogenous:

weakened immune system;
infection after nasopharyngeal surgery;
advanced caries;
purulent diseases of the nasopharynx;
wounds, abrasions, scratches - any injuries to the tonsils;
their pathological structure or location;
complications after ARVI, influenza, diphtheria, scarlet fever;
a number of diseases: allergies, tuberculosis, lupus erythematosus;
stress.

Outbreaks of viral tonsillitis occur in October–December and March–April. In autumn, the body does not have time to adapt to cold weather, in spring it is weakened after winter. In adults, the disease is less common, since children come into contact with each other more often (at school, kindergarten) and have weak defensive reactions.

To recognize the enemy in time, you need to have a good understanding of clinical picture diseases.

Origin of terms. The word “virus” goes back to the Latin “virus”, which means “poison”; “angina” - from the same language, from “ango”, which means “to choke”.

Symptoms

The main symptoms of viral sore throat in children are very similar to the symptoms of the usual form of the disease. The main difference from a bacterial infection is the absence of plaque and purulent follicles on the tonsils. Depending on the state of immunity, the incubation period ranges from 2 days to 2 weeks.

Primary signs

Symptoms that appear immediately first:

elevated temperature (38-40°C);
body aches;
headache;
weakness;
decreased appetite;
severe sore throat;
profuse drooling;
enlarged lymph nodes.

Secondary signs

After some time (from 1 hour to 2 days) indicated symptoms viral sore throat in a child is accompanied by other signs that may be very similar to normal:

sore throat;
hoarseness of voice;
slight coughing;
runny nose;
in 50% of cases - nausea, diarrhea, vomiting;
swelling, inflammation, redness of the tonsils;
the main difference from a cold is the appearance of small, but not purulent papules on the tonsils;
when affected, on the 3rd day, vesicles (bubbles) with serous contents appear in place of the papules (rash), after which they open, forming ulcers merging with each other - at this stage of the disease, the pain in the throat intensifies, and appetite disappears.

With proper treatment of viral tonsillitis in children, the symptoms of the disease disappear after 5-7 days. With absence therapeutic measures Tonsillitis can be accompanied by a bacterial infection. This can lead to complications.

That is why a timely and correct diagnosis is so important. And for this you need as quickly as possible, at the first clinical signs, seek help from the hospital.

Through the pages of history. The works of Hippocrates, Avicenna and Celsus say that angina very often led to suffocation in those days, so intubation and tracheotomy were used to treat it.

Diagnostics

If a viral sore throat is suspected, doctors refer the child for a series of tests, visual inspection, collect data. Diagnostic techniques usually come down to the following activities:

Pharyngoscopy.
Analysis of complaints of a small patient.
Palpation of enlarged lymph nodes.
A blood test (general and RBC) will show leukocytosis, a band shift to the left, and an increased ESR.
A throat swab (PCR) will identify the pathogen.
Serological diagnostics (ELISA) will determine the absence or presence of antibodies.
An ECG is prescribed in rare, already advanced cases to determine toxic damage to the cardiovascular system as a complication: weakened tones, tachycardia, hypotension.

Data diagnostic studies allow you to most accurately differentiate viral tonsillitis from bacterial and from acute respiratory viral infections with influenza. This plays an important role when prescribing further treatment, because antibiotics are in this case useless.

About the diagnosis. Angina - spoken word used in everyday life. The child's diagnosis will most likely include tonsillitis. In ancient times, the disease was called angina pectoris. As for the specific viral form, it is often called vesicular tonsillitis or.

Treatment

Complex treatment of viral sore throat in children involves bed rest, a special diet, and medications, use of folk remedies (with the permission of a doctor).

Drug treatment

For viral sore throat, antibiotics are not prescribed, as they only worsen the situation, weakening the immune system and reducing the effectiveness of antiviral treatment.

Medications for oral use:

drugs that prevent the proliferation of viral infections: Tsitovir 3, Neovir, Cycloferon, Isoprinosine, Kagocel, Viferon, Ergoferon, Genferon Light, Anaferon, Grippferon - they can be in the form of suppositories, drops, tablets;
hyposensitizing and antihistamines: Diazolin, Erius, Tavegil, Zirtek, Zodak, Suprastin;
antipyretics at temperatures above 38°C: Nise, Nurofen, Paracetamol, Ibuklin, Tsefekon, Aspirin (from 12 years old) - it is better for children to put candles, and after 3 years you can give syrup;
immunomodulators: Likopid, Immunorix, Amiksin;
to prevent dehydration in extreme heat: Regidron;
vitamin therapy: especially vitamin C;
Antibiotics can only be prescribed in case of complications when viral infection the bacterial layer is layered (read about antibiotics for the treatment of childhood sore throat).

Local therapy:

resorption of antiseptic tablets: Faringosepat, Sebedina, Travisil, Immudon, Lizobact;
irrigation of the pharynx with anti-inflammatory sprays: Tantum Verde (after 3 years), Hexoral, Cameton, Interferon;
gargling with infusions of medicinal herbs (sage, calendula), Miramistin, solutions of Furacilin, potassium permanganate, salt and soda;
treatment of tonsils with Lugol, propolis tincture;
rinsing the nose with a solution of sea salt;
ultraviolet.

Folk remedies

With the permission of the doctor who is treating the child, viral sore throat can be defeated using folk remedies. Warm (not hot) gargling solutions help best. On the first day of illness, you can carry out this procedure up to 10 times, then gradually reduce their intensity. The following recipes can be used.

Mix chamomile and linden flowers equally, pour 300 ml of boiling water, wait 2 hours.
Slowly pour into 200 ml ordinary water 15 ml of golden root tincture.
Mix equally wormwood, calendula, plantain, sage; pour 200 ml of boiling water, wait an hour.
Mix linden flowers and oak bark 1 to 2, pour 200 ml of boiling water, wait an hour, then add 10 ml of honey.
Pour the grated beets with water 1 to 1, wait half an hour, strain, pour 15 ml of apple cider vinegar into 200 ml of the resulting infusion.
Pour 200 ml of boiling water over 3 chopped medium cloves of garlic, wait an hour, strain.
50 gr onion peel cook for 10 minutes in 500 ml of water, wait 3 hours, strain.
Pour 100 grams of blueberries (preferably dried) into 400 ml of water and keep on fire until the volume is reduced by half.

Patient care

To promote a speedy recovery of the child, the following patient care is recommended for viral sore throat.

Bed rest for the first 3-4 days of the disease, complete rest.
Isolation from others.
Diet: semi-liquid and liquid pureed dishes, no spicy, salty, pickled, smoked foods.
Drink plenty of water warm volume of about 2 liters per day.
Prohibition on warming compresses.
Gargling hourly folk remedies or medical solutions prescribed by a doctor.
At elevated temperatures, avoid walking. After it decreases, half-hour trips outside are possible.
Ventilate the room and maintain the required level of humidity.
A favorable psychological environment, moral support for the child, and positive emotions will speed up the healing process.

After making a diagnosis, the doctor will definitely tell you how to treat a viral sore throat in a child at home, if he was not left in the hospital. Competent care for the patient, the use of medications strictly as prescribed, the addition of basic therapy with folk remedies - all this in a single complex will give good results, and the baby will recover very soon, and without any complications. myalgia;

myocarditis.

The first two diagnoses are especially dangerous, as they are associated with brain damage. To prevent a viral sore throat from developing into something more, you need to try to identify and treat it in a timely manner. And even better - from birth to observe preventive measures. It's much easier and safer than releasing small organism from unwanted viruses.

Interesting fact. After a child has suffered a viral sore throat, he develops a strong immunity to the pathogen that caused the disease. But there are a huge number of strains, which is why this form can be diagnosed again and again.

Prevention

To protect a child from viral tonsillitis, from the first days of his life it is important to engage in disease prevention, which involves the following measures:

teach your child to wash their hands frequently: before eating, after using the toilet, walking, animals;
rinse the nasopharynx after contact with sick people;
put on cotton gauze bandages in public places during epidemics;
vitamin therapy courses twice a year;
hardening;
good nutrition;
strengthening the immune system;
constant ventilation of the room, if necessary - quartzing it;
timely treatment of all diseases.

If you think about prevention in a timely manner, the child will never know what a viral sore throat is and other diseases too. Strong immunity with a healthy lifestyle, it reduces the risk of infection with dangerous microorganisms and reduces it to almost zero. Parents are simply obliged to take appropriate measures for this.

Complications after the viral form of the disease are not as dangerous as after, but they can also lead to death due to meningitis - you need to know about this.