Ulcerous necrotic tonsillitis, or ulcerative-film angina of Simanovsky-Plaut-Vincent is a non-infectious disease of the larynx caused by pathogenic microorganisms. The microorganisms that provoke it - the spirochaete and the spindle-shaped rod - often are constant companions of even a healthy person and live on the mucous membranes of the lips, cheeks and throat, showing no existence. But under certain circumstances they are activated, the form of their vital activity changes, and as a result, necrotic tonsillitis occurs. The reasons for such negative changes, the first signs of the disease, its symptoms and methods of treatment, we'll talk about in this article.

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  • 1 How does the disease go?
  • 2 Reasons for the appearance of
  • 3 Treatment
    • 3.1 Regimen and diet

How does the disease go?

The name of ulcerative-necrotic tonsillitis is derived

from the word "necrosis"( necrosis).This means that the advanced stage of the disease is characterized by the necrosis of tonsil tissue, and in especially severe cases - the walls of the larynx, tongue, palate and periosteum.

necrotic angina

The symptoms by which the disease can be determined differ from the signs of acute bacterial or viral tonsillitis: the body temperature remains within normal limits, and if it increases, it is insignificant( up to 37-37.5 ºC).The patient is troubled:

  • has a slight pain when swallowing, which can worsen if a streptococcal or staphylococcal infection is attached to the disease;
  • enlargement of lymph nodes;ulcerative necrosis
  • discomfort in the throat, reminiscent of the presence in it of a foreign body, which can not be swallowed or cough;
  • increased salivation;
  • intoxication and dehydration.

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Necrotic angina is often accompanied by an unpleasant smell of rot from the mouth and stomatitis. Upon examination, the otolaryngologist discovers an enlarged, loose, amygdala, covered with a white coating with a greyish or yellowish hue. If you touch it with a spatula, it easily separates from the tissue of the tonsils, leaving behind a slight bleeding and a groove with uneven edges. A laboratory assessment of plaque( seeding on a nutrient medium, antigenic test, polymer chain reaction analysis) and a discrepancy between general and local symptoms, namely the able-bodied state of the patient with severe tissue damage, helps to render the final verdict to the doctor. The general analysis of the blood shows an increased content of leukocytes and an increase in ESR.

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The disease most often affects one amygdala, but in rare cases can be bilateral. The initial task of the doctor in diagnosis is to exclude a malignant tumor, tuberculosis, diphtheria, syphilis, lacunar angina.

In the photo - ulcerative necrotizing sore throat:

necrotic angina

If the body temperature rises above 37.5 ºC, this indicates the attachment of a viral infection( staphylococcal or streptococcal) and requires appropriate treatment correction.

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Reasons for the appearance of

Tonsillitis Simanovsky is an infectious malaise, which can result from the following factors:

  • prolonged infectious diseases;
  • dental problems( tooth decay, stomatitis);caries or stomatitis that leads to angina
  • general exhaustion due to various ailments, immunodeficiency;
  • deficiency of vitamins, especially groups C and B;
  • suppuration in the nasopharynx;
  • non-compliance with oral hygiene. non-compliance with oral hygiene., which leads to angina

In addition, atypical angina can occur as a complication of more serious diseases: leukemia and other blood diseases, diphtheria( especially in children), scarlet fever, tularemia.

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Despite the fact that ulcerative necrotic angina is an individual disease, it can be epidemic in an unfortunate social setting. It is known that its outbreaks were noted during the First and Second World Wars, for which it was called "Trench Trash".


Like any respiratory disease, ulcerative necrotic angina of Simanovsky is treated by therapeutic and physiotherapy methods. Antibiotic therapy is prescribed by the results of tests. Penicillin antibiotics( Amoxicillin, Phenoxymethylpenicillin, Benzylpenicillin), cephalosporin( Cephaloridine, Cefalixin, Cefazolin) series and macrolides give good results( Meidekamycin, Azithromycin, Erythromycin, Clarithromycin).

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Clarithromycin antibiotic against purulent sore throat

The latest version of antibiotics is most preferred because it spares the gastrointestinal tract and is low in toxicity, while also having a powerful bacteriostatic effect. The drugs are administered intramuscularly in doses corresponding to the age and weight of the patient.

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Local therapy includes a number of measures aimed at the phased cleaning of damaged tissues from purulent and mucous plaque, their healing and recovery.

Among the complex measures must be present:

  1. treatment of ulcers with hydrogen peroxide;Treatment of larynx ulcers with hydrogen peroxide
  2. rinsing of the throat with a solution of potassium permanganate and potassium chloride, furacilin, silver nitrate;Rinsing of the throat with a solution of potassium permanganate and potassium chloride
  3. irrigation with antiseptics;
  4. lubrication of the surface of the tonsils with iodine, novarsenol, neo-salvar;
  5. , sometimes doctors prescribe the shedding of affected surfaces with sugar or their treatment with sugar syrup - it is believed that this contributes to a change in the acidic background, making it unsuccessful for the growth of pathogens.

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Regimen and diet

Depending on the stage of tonsillitis, the patient may be offered to be treated on an outpatient basis in compliance with all preventive precautions( separate dishes, maximum isolation from others, adherence to bed rest) or in an infectious hospital. a diet with angina

A lot of attention will have to be given to the diet.

It should completely eliminate food that can cause irritation of the mucous membranes: too hot or cold, and too hard. The patient is recommended to abandon the sharp, salty, spicy dishes, replacing them with soft, frayed.

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The diet must be saturated with animal protein:

  • with poultry meat( chicken, turkey, rabbit, veal, beef);
  • kefir, yoghurt, cottage cheese and dishes from it;
  • liver and other by-products;
  • with hard cheese;
  • eggs( except cooked soft-boiled - they may contain pathogenic bacteria).

We should not forget about the drinking regime. Benefit to the patient will bring a rich drink, consisting of saturated with vitamins B and C compotes and fruit drinks, broth of rose hips, freshly squeezed juices, tea with lemon. Fruit and vegetable purees, citrus fruits( especially oranges and grapefruits) are perfect for replenishing vitamin stores of the body.

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Provided all the prescriptions of the doctor are fulfilled, the forecast is favorable. The disease can be defeated within 7-20 days, and until necrosis the case usually does not reach. For the prevention of ulcerative necrotic tonsillitis, it is necessary to adhere to proper nutrition at the stage of recovery after viral infectious diseases, if necessary, take fortifying and immunostimulating drugs, and timely sanitize the oral cavity.