Tonsillitis: symptoms, treatment
- Types of tonsillitis
- Symptoms of tonsillitis
- Diagnosis of tonsillitis
- Common complications of tonsillitis
- How is acute tonsillitis treated?
- Prophylaxis of tonsillitis
Tonsillitis in the people called angina. At the heart of the disease is an infectious-inflammatory process that affects mainly the palatine tonsils. When the disease progresses, the focus of inflammation can spread further, affecting surrounding soft tissues.
The basis of tonsillitis is a bacterial infection. Inflammation of the tonsils causes streptococci, fungi, staphylococci. There are several types of angina. It should be borne in mind that tonsillitis is dangerous for others, since a sick person is capable of secreting infectious pathogens along with saliva and mucous discharge from the nose.
Tonsillitis is chronic and acute. The disease leads to weakened immunity, can be complicated by abscesses, lymphadenitis, otitis, sinusitis, lead to the development of rheumatism, as well as heart disease. Tonsillitis often contributes to the spread of infection on the urine. The most dangerous is chronic recurrent angina , which most often gives formidable complications.
Types of tonsillitis
- primary tonsillitis: acute defeat of palatine tonsils against the background of general hypothermia of the body, decrease of immunity, due to thermal action on the throat tissue;
- secondary tonsillitis: develops due to other diseases ( diphtheria , leukemia, scarlet fever ), as a complication or concomitant symptom of an infectious disease;
- specific tonsillitis (caused exclusively by infectious agents).
Depending on the degree of the defeat of the throat and the complexity of the course of the disease, several types of tonsillitis are distinguished:
Most often there is a catarrhal angina, which is detected mainly in childhood. Symptoms of the disease last for a week.
The main signs of catarrhal angina:
- burning sensation, a feeling of tightness, dryness in the throat;
- pain during chewing, swallowing food;
- slight increase in body temperature;
- hyperemia of the tonsils;
- white coating on the tongue;
- increased submandibular lymph nodes.
With weak immunity and ineffective treatment, catarrhal angina can pass into the follicular. Also, the disease can develop independently. Follicular angina occurs with fever, expressed by hyperthermia, weakness, migraine headaches, severe chills. Regional lymph nodes are enlarged, palpation of them is accompanied by soreness. Pain when swallowed is strong, can give in the neck, ears. In childhood, follicular angina often occurs with vomiting, marked weakness, headache, diarrhea. Tonsils, soft sky are enlarged, bright red, and on their surface are visible foci, covered with a white and yellow coating.
Symptoms of lacunar angina are similar to manifestations of tonsillitis of the follicular form, but the patient feels much worse. In the fibrinous form of the disease, the hyperemia of the tonsils is covered with a continuous coating. Signs of intoxication of the body are expressed, the risk of damage to the kidneys and brain is great. The temperature is high, there are headaches, there is an ache in the body.
Phlegmonous tonsillitis is characterized by the formation of an abscess. The patient's condition is difficult. Inflammatory focus is located mainly on one side. The affected amygdala is enlarged, has a bright red color, sharply painful on palpation. Man due to the displacement of the tongue and the tonsil itself keeps the head all the time inclined, there is a spasm of chewing musculature. Soft palate edematous, practically not displaced aside, body temperature reaches 39-40 ° C, signs of general intoxication of the body are expressed.
The herpetic form of tonsillitis develops due to the ingress of the Coxsackie A virus into the body. It begins acutely, manifests itself:
- severe pain in the muscles, throat, abdomen;
- vomiting, diarrhea;
- swelling of palatine tonsils, soft tissues of the oral cavity;
- blisters located on the back of the pharynx, tonsils and palatal tongue.
Necrosis of the palatine tonsil appears due to the development of ulcerative-filmy angina (Simanovsky-Plaut-Vincent), which is based on the active reproduction of certain infectious agents (spirochaete, spindle-shaped rod). The disease is often found in people with severe caries, weak immune defense, against a background of chronic intoxication. Ulcerative-film angina can progress for 3-6 weeks. In this case, headaches, salivation, a lumpy sensation during swallowing, an increase in the amygdala on the side of the lesion, an unpleasant odor from the mouth are noted. Temperature, as a rule, is not increased. After the rejection of the necrotic area on the amygdala there is a ulcerative defect, but after a while the tissues are epithelialized.
Symptoms of tonsillitis
- signs of intoxication: pain in the muscles, joints, head;
- pain when swallowing;
- swelling of palatine tonsils, soft palate, tongue;
- presence of a plaque, sometimes there are ulcers;
- diarrhea, vomiting (most often these symptoms of angina occur in young children).
The incubation period for tonsillitis can last from 6-12 hours to 2-4 days. The deeper the tissues are affected, the more difficult the disease progresses, the infectious and inflammatory process progresses longer and the risk of complications increases. Children often encounter a catarrhal form of sore throat, which without effective therapeutic measures can go to the follicular stage or chronic tonsillitis. It is very important to conduct a survey in time to identify the causative agent of the disease and to select the appropriate treatment regimen.
Diagnosis of tonsillitis
The main methods of examination in angina:
- pharyngoscopy (hyperemia, edema and tonsillitis, purulent films, suppurated follicles);
- laboratory diagnostics of blood (marked increase in ESR, leukocytosis with a shift to the left);
- PCR-study (the method allows to determine with high accuracy the varieties of pathogenic microorganisms that caused the development of infection and inflammation in the oropharynx);
- sowing fragments of mucus and plaque on nutrient media, which makes it possible to determine the type of microorganisms and determine the degree of their sensitivity to specific antibiotics.
Changes in blood tests for angina do not confirm the diagnosis. The main study for tonsillitis is pharyngoscopy. Catarrhal angina is determined by the hyperemia and swelling of the tonsils. On pharyngoscopy with follicular angina diffuse inflammatory process is noticeable, there are signs of infiltration, puffiness, suppuration of follicles of tonsils or already erupted erosions.
With lacunar angina, pharyngoscopic examination shows sections with a white-yellow coating that merge into films covering all the tonsils. During the diagnosis of tonsillitis Simanovsky-Plaut-Vincent, the doctor discovers a grayish-white coating on the tonsils, under which there is ulceration, resembling a crater in shape. Viral anginas during pharyngoscopy are diagnosed by characteristic hyperemic vesicles on the tonsils, posterior pharyngeal wall, arches and tongue, which burst after 2-3 days from the onset of the disease and heal quickly without scarring.
Common complications of tonsillitis
Early complications of tonsillitis:
- abscess of pharynx;
- laryngitis ;
- phlegmon neck;
- lymphadenitis ;
Later complications of angina are glomerulonephritis and rheumatic joint damage. When the first symptoms of tonsillitis occur, it is necessary to begin treatment. Timely treatment procedures will improve the patient's well-being, shorten the duration of the illness and minimize the risk of complications.
How is acute tonsillitis treated?
With angina shown bed rest. Prohibitions are walking, fatigue, food intake, which irritates the throat (sauces, smoked foods, seasonings, hot and cold dishes). Try as much as possible to drink, and the food should be caloric, restoring, but as sparing as possible. Recommended rubbed porridge, soups, meat, steamed, vegetable, fruit puree.
Treatment of acute tonsillitis is exclusively therapeutic. Medicines are selected individually, depending on the diagnostic results, the type of infectious agent and the severity of the disease. If the drug is administered improperly or in the wrong dosage, the effectiveness of treatment for tonsillitis is being questioned. Therefore, it is not recommended to experiment with your own organism. Angina is a disease of predominantly infectious nature, therefore treatment is in the competence of trained, experienced specialists.
With any form of angina, local antiseptics, anti-inflammatory and pain medications are prescribed. They are used to irrigate the inflamed mucous cavity of the mouth, which allows to reduce the number of colonies of microbes on the tonsils and adjacent tissues. To soften the throat appoint special pills and lozenges for resorption.
Bacterial tonsillitis is treated with antibiotics. Very dangerous tonsillitis, which is manifested by severe swelling and difficulty breathing. In this case, urgent medical manipulations may be required. Methods of traditional medicine for tonsillitis can be considered solely as an auxiliary method of treatment. Often, angina requires antifungal, antiviral, antibacterial agents. Decoctions and infusions of herbs can soften, help purify the throat, but they do not have the necessary healing properties.
Treatment of chronic tonsillitis
Chronic tonsillitis is formed as a result of frequent exacerbations of angina or existing infectious and inflammatory diseases accompanied by inflammation of throat (measles, scarlet fever), nasal mucosa (rhinitis, sinusitis ), gums and teeth ( caries , pulpitis ). Most often, patients with recurrent angina have streptococcal and staphylococcal infections.
In chronic tonsillitis, purulent plugs in lacunae, scar tissue changes, lymphadenitis and other complications that require well-chosen treatment, and sometimes surgical intervention, are detected. A radical method of controlling chronic tonsillitis is the removal of tonsils (partial or complete excision). The operation is indicated if the conservative therapy is ineffective, the lymphoid cells are replaced by a connective tissue. When a paratonsillar abscess is found, it is urgently performed by opening it.
Antibiotics are used according to the doctor's prescription. Local antiseptics in the form of aerosol, spray, and resorption tablets help to remove pain when swallowing and locally reduce inflammation. In chronic tonsillitis shows the use of immunostimulating agents, which activate the immune system and reduce the frequency of recurrence of angina.
The high efficiency of surgical treatment of tonsillitis is characterized by laser lacunotomy - an operation that involves "evaporating" the pathologically altered areas with a laser beam. This allows you to reduce the frequency of exacerbation of angina, reduce the palatine tonsils, eliminate bad breath. The remaining lymphoid tissue continues to perform its basic protective functions.
Prophylaxis of tonsillitis
To determine the list of preventive measures, it is necessary to understand that tonsillitis is an infectious disease that most often develops due to a decrease in the body's defenses, in the presence of foci of chronic infection (caries, sinusitis, otitis). If you are predisposed to the occurrence of angina, then trigger an exacerbation of the inflammation of the tonsils can hypothermia, the use of cold or too hot drinks, flu, ARVI.
For the prevention of tonsillitis it is recommended to strengthen immunity, use vitamins for courses, timely caries, otitis media, sinusitis, sinusitis and influenza. It is useful to use natural honey (if there is no allergy), since it is a natural biostimulator and helps to strengthen immunity.