Inflammation of the tonsils: tonsillitis or sore throat?

Tonsillitis is a well-studied and extremely common disease from the category of infectious lesions of the upper respiratory tract. According to WHO, 15% of the world's population suffers from chronic tonsillitis, in Ukraine - 12.6% of people. After caries, chronic tonsillitis is the second most "popular" disease...

The tonsils are one of the human lymphoid organs and take the most active part in the development of immunity. In the tonsils, due to the accumulation of lymphoid tissue and lymphoid nodules, which are located in the mucous membrane of the pharynx, the formation of lymphocytes occurs. Some of them are released from the tonsils into the lymph flow, and the remaining lymphocytes are a defensive post on the path of inhaled microbes and viruses.

And as soon as the enemy begins an attack, that is, an airborne infection tries to penetrate our body, the tonsils “enter the battle”.

This "battle" can be won or lost. In the latter case, tonsillitis occurs.

In the pharynx, which connects the nasal cavity, oral cavity, larynx and esophagus, there are six tonsils. A pair of palatine tonsils are located on both sides of the pharynx. Two tubular tonsils are located deeper - in the area of the pharyngeal opening. In the upper part of the pharynx, a single pharyngeal tonsil - adenoids (from the Greek "gland") - serves to protect the body from infection. And the last tonsil - the lingual - "lurks in ambush" under the root of the tongue.

Most often, the palatine tonsils have to fight infection. In everyday life, they are also called glands (from the Latin glandem ulam - "small acorn"). So someone saw in them an external resemblance to an almond nut, and someone - to an ordinary acorn. And according to the Latin terminology accepted in medicine, the palatine tonsils are called tonsillae. Therefore, the answer to the question of what is the name of the inflammation of the tonsils, is simple - tonsillitis.

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Causes of tonsillitis

The cause of inflammation of the tonsils is usually an acute respiratory infection in the form of streptococci, staphylococci and pneumococci. The seasonality of the disease is clearly visible: in most cases, people complain about the throat in the cold season - when overcooled. Moreover, children and adolescents get sick much more often, since their immune system is weaker than that of adults.

When microbes and viruses enter the mucous membrane, the tonsils try to neutralize them. A strong immune system copes with this, but if the immune system is weakened, the tonsils cannot fight the infection, and acute inflammation of the palatine tonsils begins.

By the way, ENT doctors divide tonsillitis into forms: acute and chronic. Acute tonsillitis, that is, acute inflammation of the palatine tonsils, is angina (from the Latin "angere" - to squeeze). With angina, the tonsils are affected mainly by beta-hemolytic streptococcus, much less often - by Staphylococcus aureus and streptococcus. Acute inflammation can also affect other tonsils - pharyngeal or lingual, and sometimes the back wall of the pharynx becomes inflamed.

Acute inflammation of the tonsils (tonsillitis) can also be provoked by nearby infectious and inflammatory foci - chronic or untreated rhinitis, inflammation of the paranasal sinuses (sinusitis), and caries. In addition, the development of inflammation of the tonsils is facilitated by difficult nasal breathing, in which a person breathes through the mouth and cold air (along with microbes) gets directly on the mucous membrane of the throat.

If a person's body is weakened and sore throats happen to him often, this results in the formation of a permanent source of infection and chronic inflammation of the tonsils - tonsillitis, in which periodic exacerbations are observed.

It should be noted that the toxins released during angina and chronic tonsillitis enter the blood and lymph and are carried throughout the body. Therefore, these diseases often cause complications in the form of rheumatism, infectious polyarthritis, nephritis and even sepsis.

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Symptoms of tonsillitis

The first sign of acute tonsillitis is a sore throat. Then the sore throat turns into a sore throat (especially when swallowing), and the tonsils turn red and increase in size. Sometimes even breathing becomes painful. General malaise may be accompanied by chills and a feeling of heat, body aches and headache. And the temperature may jump to +38-39°C.

When examining the tonsils, a yellowish-white purulent coating is found on them. The submandibular lymph nodes (and sometimes the nodes in the neck) are enlarged and painful when pressed. They may remain swollen even after all other symptoms of tonsillitis have disappeared.

Another sign of this disease is a hoarse voice and its temporary loss: when the tonsils become inflamed, they swell, which prevents the vocal cords from closing. If you do not take up intensive treatment for tonsillitis, you can get acute laryngitis, which is accompanied by bouts of severe coughing.

Acute inflammation of the palatine tonsils (tonsillitis) can be catarrhal, follicular, lacunar or phlegmonous. In the mildest - catarrhal - tonsillitis, the body temperature is subfebrile, the tonsils are hyperemic, but the pain in the throat is not severe. Follicular tonsillitis is accompanied by a high temperature, sharp pain in the throat (radiating to the ears), and the tonsils are covered with purulent follicles - yellowish-white dots the size of a buckwheat grain.

Lacunar tonsillitis, with all the symptoms common to acute inflammation of the palatine tonsils, is distinguished by the fact that the purulent plaque is concentrated in the lacunae of the tonsils. And with phlegmonous inflammation of the tonsils, an abscess is formed (usually on one side), and the temperature can rise to +40°C.

Inflammation of the lingual tonsil is a rather rare disease. Among the common symptoms of angina, it differs in the location of the inflammation and the nature of the pain that occurs when moving and sticking out the tongue. Chewing, swallowing and clearly pronouncing sounds are also difficult. And since the location of the lingual tonsil is on the back surface of the back of the tongue, many patients call this disease - inflammation of the sublingual tonsil.

Inflammation of the pharyngeal tonsil (adenoids) - adenoiditis - occurs both in isolation and in parallel with inflammation of the palatine tonsils. Adenoiditis can also be acute and chronic. The causes of acute inflammation of the pharyngeal tonsil are different: from viruses that have penetrated the tonsil and began to actively develop when overcooled, to other infectious diseases, when adenoiditis manifests itself as a complication of them.

In addition, otolaryngologists note that acute inflammation of the pharyngeal tonsil most often affects enlarged adenoids.

Obvious signs of this disease, in addition to fever, are difficulty breathing through the nose and mucopurulent discharge in the nasopharynx. If the inflammation affects the nearby auditory (Eustachian) tube, then ear pain appears and hearing is reduced.

In the chronic form of inflammation of the pharyngeal tonsil, which appears as a consequence of acute adenoiditis, the temperature rises slightly, but patients feel general weakness and frequent headaches, get tired quickly, sleep poorly and lose their appetite. And at night they are tormented by coughing fits due to the fact that purulent contents flow out of the inflamed tonsil and irritate the back wall of the pharynx.

Diagnosis of tonsillitis

Diagnosis of tonsillitis is usually not difficult. An otolaryngologist makes a diagnosis of tonsillitis based on a standard examination of the patient's throat and a list of his complaints. However, in cases of purulent forms of tonsillitis and frequent relapses of chronic tonsillitis (tonsillitis), fraught with complications, a blood test may be required. This is a blood test for the presence of bacteria in it (test for C-reactive protein), for the presence of antibodies in the blood resistant to the antigen of beta-hemolytic streptococcus group A (anti-O-streptolysin), as well as for the detection of antibodies to immunoglobulins of class G (rheumatoid factor, RF).

Also, in the diagnosis of inflammation of the tonsils, they resort to taking samples (smears) of the mucus or pus that forms on them - to determine the type of pathogenic bacteria and their sensitivity and resistance to antimicrobial drugs (antibiotics).

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How to treat tonsillitis?

All diseases caused by infection have a two-pronged treatment. On the one hand, it is necessary to remove the symptoms of the disease, on the other hand, to eliminate the cause of the inflammation and rid the body of the infection. This is exactly how the treatment of tonsillitis should be.

Drug treatment of tonsillitis includes the use of antibacterial disinfectants for gargling, fever-reducing and pain-relieving agents, as well as antibiotics (mandatory for purulent tonsillitis).

Gargling plays an important role in the treatment of tonsillitis, as

Mechanically, we reduce the number of pathogenic bacteria in the larynx and suppress their activity. For this purpose, boric acid solutions (one teaspoon per glass of water), 1% hydrogen peroxide solution, rivanol solution (a teaspoon per 200 ml of warm water), furacilin solution (1 tablet per 100 ml of water) have been used for decades. You can use ready-made antimicrobial solutions - iodinol, dioxidine or chlorophyllipt.

To get rid of a sore throat, various lozenges and pastilles with antiseptic and local anti-inflammatory action are successfully used. For example, lozenges "Sage P", which are recommended to be kept in the mouth until completely dissolved: adults - no more than 6 pieces per day, and children under 5 years old - no more than two lozenges. This remedy is recommended for the treatment of tonsillitis during pregnancy.

The main component of the Faringosept lozenges is the substance ambazone monohydrate with a strong local bacteriostatic effect against streptococci, staphylococci and pneumococci. For children over seven years old and adults, the permissible daily dose is 3-5 tablets, which should be kept in the mouth until completely dissolved. This drug contains sucrose, so it is better not to use them in diabetes. But in the treatment of inflammation of the tonsils during pregnancy and lactation, Faringosept can be taken.

Antiseptic preparation for local use - lozenges and pastilles Strepsils - contain amylmetacresol (antibiotic for local use) and lidocaine hydrochloride (local anesthetic drug). Adults and children over 12 years old are prescribed to use it one tablet no more than 5 times during the day and no longer than three days.

Dr. Theiss Angi Sept lozenges (with various flavors) contain anethole, dichlorobenzyl alcohol, menthol and peppermint oil. The aromatic ether anethole is used as a fragrance for cosmetics. But dichlorobenzyl alcohol, which contains chlorine, is an organohalogen compound that can accumulate and decompose when it gets into tissues, causing changes in the protein structure... These tablets have an antiseptic effect. It is recommended to dissolve one tablet every 2-3 hours. Contraindications - childhood (up to 5 years), and during pregnancy and breastfeeding, they should be taken only after consulting a doctor.

Septolete lozenges (as well as Septolete D and Septolete Neo) in addition to menthol, thymol, essential oils of mint and eucalyptus contain benzalkonium chloride - a powerful antiseptic agent active against staphylococci, streptococci, Escherichia coli and Pseudomonas aeruginosa, anaerobic bacteria, fungi and molds. It is even used to disinfect premises and medical devices. Septolete is not recommended for children under 4 years of age, and for the treatment of tonsillitis during pregnancy and lactation, this drug can be taken only on the recommendation of the attending physician.

Treatment of tonsillitis with antibiotics

Despite the fact that antibiotics, in addition to their beneficial effects, have a lot of side effects, they are usually the only ones that can cope with the microbes that cause inflammation of the tonsils. Seeing purulent plaque or follicles on your tonsils, the doctor will certainly prescribe at least a 5-day course of treatment for inflammation of the tonsils with antibiotics using one of the drugs listed below.

Amoxicillin is a semi-synthetic penicillin with a broad spectrum of bactericidal action. Among its contraindications are hypersensitivity to other penicillins, colitis, renal failure, pregnancy and lactation. And the list of side effects begins with "harmless" dysbacteriosis and ends with tachycardia, confusion, behavioral changes and depression. Amoxicillin tablets of 0.5 g are prescribed to adults and children over 10 years old 3 times a day, and in severe cases of the disease - up to 1 g three times a day (before or after meals). The course of treatment is from 5 to 12 days with monitoring of the functions of the hematopoietic organs, liver and kidneys.

Amoxiclav is a broad-spectrum antibiotic containing amoxicillin (see above) and the b-lactamase inhibitor clavulanic acid. Adults and children over 12 years of age are prescribed 1 tablet of 375 mg every 8 hours, in case of severe tonsillitis - 1 tablet of 625 mg three times a day. The course of treatment is 5-14 days - with mandatory monitoring of the liver, kidneys and hematopoietic function.

Analogues of these two drugs are Augmentin, Amosin, Flemoxin Solutab. In combination with antibiotics, doctors prescribe drugs to maintain intestinal microflora: Linex, Acipol, Bifidumbacterin, Bifform, etc.

Vilprafen (and its analogue Vilprafen Solutab) is an antibiotic of the macrolide group, the active substance of the drug is josamycin, active against gram-positive and gram-negative bacteria, especially concentrated in the lungs and tonsils. Vilprafen is available in the form of tablets of 100 and 500 mg. For an adult, the daily dose is 1-2 g (in 3 doses, washed down with a full glass of water), for children the dosage is calculated depending on their body weight - 40-50 mg per kilogram of weight per day.

Side effects of the drug may include: stomach discomfort, nausea, vomiting, diarrhea, constipation, stomatitis, loss of appetite, urticaria, dermatitis, Quincke's edema, jaundice. It is contraindicated to use vilprafen for the treatment of children weighing up to 10 kg, with severe liver dysfunction and with hypersensitivity to the components of the drug. It is allowed to use it for the treatment of tonsillitis during pregnancy after a doctor's assessment of the benefits for the mother and the possible risk to the fetus.

For local treatment of tonsillitis with antibiotics, preparations are available in the form of a spray: Bioparox, Hexasprey, Tantum Verde. Aerosol products without antibiotics have also proven themselves well: Ingalipt, Kameton and Anti-angin formula. Kameton contains the antiseptic chlorobutanol, camphor and levomenthol. Anti-angin contains the bactericidal substance chlorhexidine, and the antimicrobial effect of Ingalipt is provided by the soluble sulfonamides included in its composition.

Treatment of tonsil inflammation with folk remedies

Gargling solutions of various compositions for treating tonsillitis help relieve pain and cleanse the mucous membrane of the tonsils from purulent plaque. The simplest and at the same time very effective treatment of tonsillitis with folk remedies is frequent gargling with a solution of salt and soda. For a glass of lukewarm water, take a teaspoon (without a stack) of both components and add 5 drops of iodine alcohol tincture to them.

Gargling with boiled water and fresh lemon juice (juice from half a lemon per glass of water) will help significantly reduce a sore throat. Decoctions and infusions of medicinal plants are excellent for treating various forms of tonsil inflammation in adults and children: St. John's wort, sage, chamomile, calendula, stinging nettle, orchis, yarrow, plantain, eucalyptus. They are prepared according to the same recipe: take a tablespoon of dry grass per glass of boiling water (you can use 2-3 types of plants at the same time), pour boiling water over it, bring to a boil and leave in a closed container to a comfortable temperature. The more you gargle, the better.

Traditional medicine has long known how to relieve inflammation of the tonsils. And here, honey and other bee products are in first place. In addition to the benefits of a spoonful of honey eaten at the first signs of a sore throat, it is very useful to add a little natural honey (incomplete teaspoon per 200 ml) to various herbal compositions for gargling with purulent inflammation of the tonsils. Propolis, which is not inferior to antibiotics in its bactericidal qualities, should be added to the same herbal decoctions - 20 drops of propolis alcohol tincture per 100 ml of gargling infusion. Three such rinses during the day are enough. Honeycombs together with cappings (comb caps) should be chewed during tonsil inflammation at least once a day - for 15 minutes. The powerful antibacterial properties of these bee products are especially effective in treating inflammation of the lingual tonsil, which is not always reached by gargling.

And for chronic inflammation of the tonsils in children (tonsillitis), a wonderful remedy for lubricating the glands is a mixture of 1 part aloe juice and 3 parts liquid (preferably flower) honey. The procedure should be carried out for two weeks - once a day.

Prevention of tonsillitis

The main task in preventing inflammation of the tonsils is to strengthen the immune system and maintain the body's defenses "in full combat readiness." What needs to be done for this is well known to everyone: adhere to a healthy lifestyle. That is, move more, be outdoors, harden yourself, eat a lot of fresh vegetables and fruits.

In addition, it is necessary to minimize provoking factors: do not overcool, do not drink cold drinks, quit smoking (nicotine reduces the intensity of blood circulation in the mucous tonsils and generally disrupts the normal functioning of the respiratory system). You should breathe exclusively through the nose: the mucous membrane of the nose cleans the inhaled air not only from dust, but also from microorganisms. In addition, passing through the nose, the air becomes warmer and more humid - just such that we do not have problems with the throat, trachea, bronchi and lungs. Everything that is a constant potential (and actual) source of inflammation should be cured: chronic rhinitis, sinusitis, dental caries. By the way, to prevent inflammation of the tonsils, it is very useful to do hardening rinses with herbal decoctions after daily brushing of teeth - with a gradual transition to a cooler solution. Sage (2 parts), St. John's wort (2 parts), coltsfoot leaves (2 parts), calendula flowers (1 part) and chamomile (1 part) are suitable for such procedures. Take a tablespoon of the mixture of these medicinal plants per glass of boiling water and let it boil. One glass is enough for two rinses - morning and evening.

As for the prognosis of tonsillitis, it should be noted that tonsillitis and chronic tonsillitis often lead to complications in the form of rheumatism, infectious polyarthritis, nephritis and even sepsis.

In all types of tonsil inflammation, streptococci multiply, releasing their waste products - toxins that enter the blood and lymph and spread throughout the body. If toxins and the microbes themselves penetrate the lymph nodes with the lymph flow, their inflammation begins - regional lymphadenitis.

When toxins enter the blood, they disrupt the functions of many body systems. For example, the streptococcal toxin streptolysin-O prevents the oxygen saturation of the heart muscle tissue and thus interferes with the conduction of cardiac impulses. And the proteinase enzyme secreted by streptococcus causes damage to the connective tissue of the heart structures. And medical science is inclined to conclude that this is what triggers pathological changes in a disease such as rheumatism.

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