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Inflammation of the tonsils: tonsillitis or tonsillitis?
Last reviewed: 23.04.2024
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Inflammation of the tonsils is a well-studied and extremely common disease from the discharge of infectious lesions of the upper respiratory tract. According to WHO, 15% of the world's population suffers from chronic tonsil inflammation, while in Ukraine it is 12.6% of people. After caries, chronic inflammation of the tonsils is in second place in terms of “popularity”...
Tonsils are one of the human lymphoid organs and take an active part in the development of immunity. In the tonsils, due to the accumulation of lymphoid tissue and lymphoid nodules that are in the mucous membrane of the pharynx, lymphocyte formation occurs. Some of them from the tonsils are secreted into the lymph flow, and the remaining lymphocytes are a defensive post in the path of inhaled microbes and viruses.
And as soon as the enemy begins to attack, that is, the infection is airborne trying to penetrate into our body, the tonsils "come into battle."
This “battle” can not only win, but also lose. In the latter case, and there is inflammation of the tonsils.
In the area of the pharynx, which connects the nasal cavity, mouth, parts of the larynx and esophagus, there are six tonsils. A pair of palatine tonsils is located on both sides of the pharynx. Two tubal tonsils settled deeper - in the area of the pharyngeal opening. In the upper part of the pharynx, a single pharyngeal tonsil, the adenoids (from the Greek “iron”), serves to protect the body against infection. And the last amygdala - the lingual - “hid in ambush” at the root of the tongue.
Most often to fight the infection accounts for palatine tonsils. In everyday life, they are also called glands (from the Latin glandem ulam - “little acorn”). So someone saw in them a resemblance with an almond, and someone with an ordinary acorn. According to the Latin terminology used in medicine, the tonsils are called tonsillae. Therefore, the question of what is called inflammation of the tonsils, the answer is simple - tonsillitis.
Causes of tonsil inflammation
The cause of tonsilitis is usually acute respiratory infection in the form of streptococci, staphylococci and pneumococci. The seasonality of morbidity is clearly traced: in most cases, people complain of a sore throat during the cold season - during hypothermia. Moreover, children and adolescents are much more likely to get sick, since their immune systems are weaker than those of adults.
When microbes and viruses hit the mucous membrane of the tonsils, they try to neutralize them. A strong immune system copes with this, and if the immune system is weakened, the tonsils cannot overcome the infection, and acute inflammation of the tonsils begins.
By the way, ENT doctors divide tonsillitis into forms: acute and chronic. Acute tonsillitis, that is, acute inflammation of the tonsils is a sore throat (from the Latin "angere" - compress). In tonsillitis, tonsils are affected mainly with beta-hemolytic streptococcus, much less often with Staphylococcus aureus and Streptococcus. Acute inflammation can affect other tonsils - pharyngeal or lingual, and sometimes the back wall of the pharynx is inflamed.
Acute inflammation of the tonsils (sore throat) can also be caused by nearby infectious-inflammatory foci - chronic or under-treated rhinitis, inflammation of the paranasal sinuses (sinusitis), and caries. In addition, the development of inflammation of the tonsils contributes to difficulty in nasal breathing, in which a person breathes through his mouth and cold air (along with microbes) falls directly on the throat mucosa.
If the human body is weakened, and sore throats occur with it often, then this results in the formation of a permanent focus of infection and chronic inflammation of the tonsils - tonsillitis, in which periodic exacerbations are observed.
It should be noted that toxins excreted in tonsillitis and chronic tonsillitis enter the blood and lymph and are spread throughout the body. Therefore, these diseases often give complications in the form of rheumatism, infectious polyarthritis, nephritis and even sepsis.
Symptoms of tonsil inflammation
The first sign of an acute inflammation of the tonsils is “tearing” in the throat. Then the tickling turns into a sore throat (especially when swallowing), and the palatine tonsils redden and increase in size. Sometimes even breathing becomes painful. General malaise may be accompanied by chills and a feeling of heat, body aches and headaches. And the temperature can jump to + 38-39 ° C.
On examination of the tonsils, a purulent, yellowish-white color appears. Submandibular lymph nodes (and sometimes nodes in the neck) are enlarged and painful with pressure. They may remain swollen even after all other symptoms of tonsil inflammation disappear.
Another of the signs of this disease is a hoarse voice and its temporary loss: when the tonsils are inflamed, their edema occurs, which interferes with the closing of the vocal cords. If you do not take up intensive treatment of angina, then you can get acute laryngitis, which is accompanied by attacks of strong cough.
Acute inflammation of the tonsils (sore throat) is catarrhal, follicular, lacunar, or phlegmonous. At the lightest - catarrhal - sore throat, body temperature is low-grade, tonsils are hyperemic, but the sore throat is not severe. Follicular sore throat is accompanied by high fever, a sharp pain in the throat (extending to the ears), and the palatine tonsils are covered with purulent follicles — yellowish-white dots the size of a buckwheat grain.
Lacunar angina, with all symptoms common for acute inflammation of the tonsils, is characterized by the fact that purulent plaque is concentrated in the gaps of the tonsils. And with phlegmonous inflammation of the tonsils, an abscess is formed (usually on the one hand), and the temperature can rise to + 40 ° C.
Inflammation of the lingual tonsil is a rather rare disease. Among the common symptoms for tonsillitis, there is a different place for inflammation and the nature of pain that occurs when moving and sticking out the tongue. Chewing, swallowing and pronounced pronunciation of sounds are also difficult. And since the location of the lingual tonsil is located on the dorsum of the back of the tongue, many patients call this disease inflammation of the hypoglossal tonsil.
Inflammation of the pharyngeal tonsil (adenoid) - adenoiditis - occurs both in isolation and in parallel with the inflammation of the tonsils. Adenoiditis is also acute and chronic. The causes of the acute form of inflammation of the pharyngeal tonsil are different: from viruses that have penetrated to the amygdala and with hypothermia began to actively develop, to other infectious diseases, when adenoiditis manifests as their complication.
In addition, otolaryngologists note that acute inflammation of the pharyngeal tonsil most often affects enlarged adenoids.
Obvious signs of this disease, in addition to an increase in temperature, are difficulty in nasal breathing and mucopurulent discharge in the nasopharynx. If inflammation affects the adjacent auditory (Eustachian) tube, earache pains and hearing are reduced.
In chronic form of inflammation of the pharyngeal tonsil, which appears as a result 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 because the purulent contents flow out of the inflamed tonsil and irritate the back of the throat.
Where does it hurt?
Diagnosis of tonsil inflammation
Diagnosis of inflammation of the tonsils, as a rule, does not cause difficulties. The diagnosis of inflammation of the tonsils otolaryngologist puts on the basis of the standard examination of the patient's pharynx and the list of his complaints. However, with purulent tonsillitis and frequent recurrences of chronic inflammation of the tonsils (tonsillitis), which are fraught with complications, a blood test may be necessary. This is a blood test for the presence of bacteria in it (analysis for C-reactive protein), for the presence in the blood of antibodies resistant to the antigen of beta-hemolytic streptococcus group A (anti-O-streptolysin), and also for the detection of antibodies to immunoglobulins of class G ( rheumatoid factor, RF).
Also in the diagnosis of inflammation of the tonsils resort to taking samples (smear) of mucus or pus formed 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 inflammation of the tonsils?
In all diseases caused by infection, treatment is bilateral. On the one hand, it is necessary to remove the symptoms of the disease, on the other - to eliminate the cause of inflammation and rid the body of infection. This is what treatment of tonsil inflammation should be.
Drug treatment of tonsil inflammation includes the use of antibacterial disinfectant compositions for gargling, means to reduce the temperature and pain, as well as antibiotics (mandatory for purulent inflammation of the tonsils).
Gargling in the treatment of tonsil inflammation plays an important role, since
Mechanically, we reduce the number of pathogenic bacteria in the larynx and suppress their activity. For this purpose, solutions of boric acid (one teaspoon for a glass of water), 1% hydrogen peroxide solution, rivanol solution (a teaspoon per 200 ml of warm water), furatsilin solution (1 tablet per 100 ml of water) have been used for decades. You can use ready-made antimicrobial solutions - iodinol, dioxidine or chlorophilipt.
To get rid of the sore throat, various pills and lozenges with antiseptic and local anti-inflammatory action are successfully used. For example, “Sage P” pills, which is recommended to keep them in the mouth until they are completely absorbed: for adults - no more than 6 pieces per day, and for children under 5 years old - no more than two pills. This remedy is recommended for treating tonsil inflammation during pregnancy.
Tablets for resorption "Faringosept" as the main component has a substance amazona monohydrate with a strong local bacteriostatic action against streptococci, staphylococci and pneumococci. For children over seven years old and adults, the permissible daily dose is 3-5 tablets, which must be kept in the mouth until completely dissolved. The composition of this drug is sucrose, so that they are best not to use in diabetes. But in the treatment of inflammation of the tonsils during pregnancy and lactation, Faringosept can be taken.
Antiseptic preparation for local use - Strepsils lozenges and lozenges - contain amylmetacresol (an antibiotic for topical administration) and lidocaine hydrochloride (local anesthetic drug). Adults and children over 12 years old are instructed to take it one tablet at a time, not more than 5 times a day, and not more than three days.
Anatol, dichlorobenzyl alcohol, menthol and peppermint oil are included in the composition of Dr. Tiss Angi Sept resorption tablets (with different flavors). Aromatic ether anethole is used as a fragrance for cosmetics. But dichlorobenzyl alcohol containing chlorine refers to organohalogen compounds, which, if they enter the tissue, can accumulate and decompose, which causes changes in protein structure... These tablets have an antiseptic effect. It is recommended to dissolve one tablet every 2-3 hours. Contraindications - children's age (up to 5 years), and during pregnancy and lactation they should be taken only after consulting a doctor.
Pastilles "Septolete" (and also "Septolete D" and "Septolete Neo") other than menthol, thymol and essential mint and eucalyptus oils contain benzalkonium chloride - strong antiseptic agent active against staphylococci, streptococci, Escherichia coli and Pseudomonas rods, anaerobic bacteria, fungi and molds. It is even used for disinfecting premises and medical products. "Septolet" is not recommended for children under 4 years old, and for the treatment of inflammation of the tonsils during pregnancy and lactation, you can take this drug only on the recommendation of your doctor.
Treatment of inflammation of the tonsils with antibiotics
Despite the fact that antibiotics, in addition to the beneficial effects, have a mass of side effects, the microbes that cause inflammation of the tonsils are often only able to cope with them. Seeing purulent plaque or follicles on your glands, the doctor will certainly prescribe at least a 5-day course of treatment of inflammation of the tonsils with antibiotics with one of the following drugs.
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. A list of side effects begins with a "harmless" dysbiosis and ends with tachycardia, confusion, behavior change and depression. Amoxicillin 0.5 g tablets are prescribed for adults and children over 10 years old, 3 times a day, and in severe cases, up to 1 g three times a day (before or after meals). The course of treatment is from 5 to 12 days under the control of the functions of the blood-forming organs, liver and kidneys.
Amoxiclav is a broad-spectrum antibiotic containing amoxicillin (see above) and b-lactamase inhibitor clavulanic acid. Adults and children over 12 years old are prescribed 1 tablet of 375 mg every 8 hours, in the case of severe tonsil inflammation, 1 tablet of 625 mg three times a day. The course of treatment - 5-14 days - with the obligatory control of the liver, kidneys and hematopoietic function.
Analogs of these two drugs - augmentin, amosin, flemoxin solyutab. In combination with antibiotics, doctors prescribe drugs to maintain intestinal microflora: Linex, Acipol, Bifidumbacterin, Bifform, etc.
Vilprafen (and its analogue vilprafen soljutab) is an antibiotic of the macrolide group, the active ingredient 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, a daily dose of 1-2 g (in 3 doses, with a full glass of water), for children, the dosage is calculated depending on the weight of their body - 40-50 mg per kilogram of body weight per day.
Side effects of the drug can be expressed in the form of: discomfort in the stomach, nausea, vomiting, diarrhea, constipation, stomatitis, loss of appetite, urticaria, dermatitis, angioedema, jaundice. It is contraindicated to use vilprafen for the treatment of children weighing up to 10 kg, with severe impaired liver function and with hypersensitivity to the drug. Allowed to use for the treatment of tonsil inflammation in pregnancy after medical evaluation of benefits to the mother and the possible risk to the fetus.
For the local treatment of inflammation of the tonsils with antibiotics, drugs are produced in the form of a spray: Bioparox, Hexasprey, Tantum Verde. Aerosol products without antibiotics have also proven themselves: Ingalipt, Kameton and Anti-Angin Formula. Kametone contains antiseptic chlorobutanol, camphor and levomenthol. In Anti-angina, the bactericidal substance chlorhexidine, while Ingalipt’s antimicrobial action is provided by its soluble sulfanilamides.
Treatment of tonsil inflammation with alternative means
Various compositions for gargling in the treatment of inflammation of the tonsils help relieve pain and clear the mucous membrane of the glands of purulent plaque. The simplest and at the same time very effective treatment of inflammation of the tonsils with alternative means is frequent gargling with a solution of salt and soda. For a glass of lukewarm water, you need to take a teaspoon (without a stack) of both components and add 5 drops of iodine spirit tincture to them.
Rinsing boiled water with fresh lemon juice (to a glass of water - the juice of half a fruit) will significantly reduce pain in the throat. In various forms of inflammation of the tonsils in adults and children, decoctions and infusions of medicinal plants perfectly help: St. John's wort, sage, chamomile, calendula, nettle, orchard, yarrow, plantain, eucalyptus. They are prepared according to one recipe: a tablespoon of dry grass is taken into a glass of boiling water (2-3 types of plants can be used at the same time), poured with boiling water, brought to a boil and infused in a sealed container to a comfortable temperature. Rinse the more - the better.
Alternative medicine has long been known how to relieve inflammation of the tonsils. And here in the first place - honey and other beekeeping products. In addition to the use of a spoon of honey eaten at the first sign of tickling and sore throat, it is very useful to add some natural honey (an incomplete teaspoon per 200 ml) to various herbal compositions for gargling with purulent inflammation of the tonsils. Propolis, which is not inferior to antibiotics for its bactericidal qualities, should be added to the same herbal decoctions - 20 drops of propolis spirit tincture per 100 ml of infusion for gargling. Three rinses during the day are enough. Honeycombs with zabrus (lids of honeycombs) should be chewed during the inflammation of the tonsils at least once a day - for 15 minutes. The powerful antibacterial properties of these bee products manifest themselves particularly well in the process of treating inflammation of the lingual tonsil, to which gargling does not always “reach”.
And with chronic inflammation of the tonsils in children (tonsillitis), an excellent means for lubricating the glands is a mixture of 1 part aloe juice and 3 parts liquid (preferably floral) honey. The procedure should be carried out within two weeks - once a day.
More information of the treatment
Prevention of tonsil inflammation
The main task in the prevention of tonsil inflammation is to strengthen the immune system and maintain the body's defenses “in full combat readiness”. What you need to do is well known to everyone: to adhere to a healthy lifestyle. That is to move more, to be in the open air, to become tempered, to eat a lot of fresh vegetables and fruits.
In addition, it is necessary to minimize the provoking factors: do not overcool, do not drink cold, stop smoking (nicotine reduces the blood circulation in the mucous tonsils and generally disrupts the normal functioning of the respiratory system). Breathing should be exclusively through the nose: the mucous membrane of the nose clears inhaled air not only from dust, but also from microorganisms. In addition, passing through the nose, the air becomes warmer and more humid - just so that we have no problems with the throat, trachea, bronchi and lungs. Everything that is a constant potential (and actual) source of inflammation should be cured: chronic runny nose, sinusitis, tooth decay. By the way, for the prevention of inflammation of the tonsils, it is very useful to do tempering rinsing with decoctions of herbs after daily brushing your teeth - with a gradual transition to a cooler solution. Sage (2 parts), St. John's wort (2 parts), mother and stepmother leaves (2 parts) and calendula flowers (1 part) and chamomile (1 part) are suitable for such procedures. On a glass of boiling water take a tablespoon of the mixture of these medicinal plants and allow to boil. One glass is enough just for two rinses - in the morning and in the evening.
As for the prognosis of inflammation of the tonsils, it should be noted that angina and chronic tonsillitis often result in complications such as rheumatism, infectious polyarthritis, nephritis, and even sepsis.
For all types of inflammation of the tonsils, streptococci multiply with the release of the products of their vital activity - toxins that enter the blood and lymph and are spread throughout the body. If the toxins and microbes themselves with lymph flow penetrate the lymph nodes, then their inflammation begins - regional lymphadenitis.
Getting into the blood, toxins lead to dysfunction of many body systems. For example, streptococcal toxin streptolysin-O prevents the cardiac muscle from being saturated with oxygen 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 prone to conclude that this is what triggers pathological changes in a disease like rheumatism.