Chronic tonsillitis

  • Jun 22, 2018
Chronic tonsillitis

The cause of tonsillitis in chronic form lies in the constant presence of bacterial infection. Microbes affect the body, which is responsible for the protective function - the tonsils, and thereby reduce the resistance of the whole organism, constantly suppressing the local immune response. The diagnosis is made after relapsing angina, which should be treated with strong antibiotics.

What is chronic tonsillitis

The inflammation of the tonsils is associated with the constant activity of bacteria that are in the tissues. The causative agents of the infection are streptococci and staphylococci. Immune cells do not manage to cope with a persistent infection that turns into a chronic infection because of the bacteria's resistance to certain groups of antibiotics and the effects of unfavorable environmental factors on the weakened organism.

Symptoms of

Symptoms of tonsillitis in adults are similar to those in a similar diagnosis in children. The patient feels:

  • sore throat( varies from ba
    rely noticeable to strong, depending on the activity of bacterial infections);
  • mucositis, edema of the palatine arch;
  • elevated body temperature;
  • bad breath;
  • painful, slightly enlarged lymph nodes( cervical, submandibular).

Only the doctor can make the correct diagnosis. The described symptoms of chronic tonsillitis can correspond to other diseases of the throat and respiratory tract. Inflammation of the tonsils in adult patients is less pronounced than in children. Therefore, the correct diagnosis of this disease includes a laboratory study - bacterial culture from the mouth to identify the pathogen. A laboratory test is also necessary to select antibiotic therapy.


Exposure to foreign agents that cause inflammation, our body meets with an increase in temperature. This means that the immune system is fighting the disease. However, doctors are increasingly encountering the phenomenon of chronic inflammation without fever or with a constant low-grade fever( 37 ° -38 °).Subfebrile or normal body temperature in tonsillitis testifies to a weakened immune system. This can carry the risk of:

  • intoxication of the body;
  • intoxication of the tissues of the cardiovascular system;
  • lesions of the kidney tissue.

Tonsils for chronic tonsillitis

An important barrier organ is the tonsils, which take on the impact of tonsillitis. In the chronic course of the disease, pathogenic bacteria actively multiply in tissues and are exposed to immune cells. If the immune system is still able to cope with bacteria, the pharynx and tonsils can look only inflamed, without visible plaque. However, the following changes are more likely to indicate infection:

  • redness;
  • increase in size;
  • fabric is loose;
  • plaque white or yellowish;
  • purulent tubes.

Symptoms of exacerbation of

Symptoms of exacerbation are similar to those of acute tonsillitis. Promotes the emergence of this state of weakening of the immune system. Exacerbation occurs with more severe symptoms than chronic inflammation. Tonsillitis in acute form is called angina, with the disease appear:

  • sharp pain in the throat;
  • pain in the joints, lower back;
  • headache;
  • increase and soreness of lymph nodes;
  • complicated swallowing;
  • high body temperature;
  • general weakness.

Classification of

More common with angina are only the symptoms described above. If the standard symptoms are associated with violations from the internal organs, persistent cervical or submandibular lymphadenitis, then such an angina is toxic-allergic and there is a risk of serious complications. Chronic disease is classified according to the stages of development:

  1. Compensated - the stage of tonsillitis is a condition when local immunity still copes with pathogenic bacteria, but in the tonsils there is already a dormant foci of infection. Often there are no recurrent inflammatory diseases of the throat.
  2. Decompensated - at this stage, there are angina, there may be complications in the form of an abscess, manifestations of lesions of internal organs( kidneys, heart).Decompensated stage can diagnose several infectious foci in addition to the throat - diseases of the nose, ears.

Depending on the localization of inflammation and its characteristic signs, tonsillitis is classified:

  • lacunar - localized on lacunae( physiological indentations in tissues) of tonsils;
  • sclerotic - there is abundant growth of the affected tissue;
    lacunar-parenchymal - develops in lacunae and lymphadenoid tissue;
  • phlegmonous - localized in the lymphadenoid tissue.

Causes of

Tonsillitis develops after the infectious diseases of the throat and nose have been transferred, more often after the incorrectly treated angina. The immune function of the tonsils is suppressed by the human herpesvirus type 4, which interferes with the work of the entire immune system. The cause of tonsillitis and its development into a chronic form can be in other infectious diseases of the nasopharynx. For example, the disease often develops due to pharyngitis, sinusitis.

Treatment of chronic tonsillitis

Complex treatment of infection is necessary. It is necessary to get rid of the hearth and unpleasant symptoms and to identify the cause of the disease. To treat tonsillitis should be under the supervision of a doctor, since a specialist after a correct diagnosis of the stage of the disease will be able to tell what to do in case of chronic tonsillitis, prescribe a complex therapy. For correct diagnosis, not only local symptoms are studied. It is necessary to pass the following tests:

  • general clinical blood test;
  • urine analysis( for revealing kidney pathologies);
  • bacterial culture from the oral cavity, nose( to identify the causative agent of the disease and the selection of correct antibacterial therapy).

Drug treatment

In the chronic course of the disease at the compensated stage, conservative therapy is possible. Complex treatment in this case is the appointment of a number of drugs necessary for the effective treatment of inflammation of the tonsils. Among the list of medications are often:

  1. Antibiotics( required).Prescribe drugs based on the results of the tests. For each group of pathogens, selected antibacterial agents are selected.
  2. Penicillins are prescribed for the control of certain streptococci. The drugs of this group include Amoxiclav, Amoxicillin, more resistant - Augmentin, Flemoclav( with the addition of clavulanic acid), the combined preparation Ampimox.
  3. Macrolides - Larithromycin, Josamycin, Azithromycin( Azitralum, Sumamed).
  4. Cephalosporins - Cefurocovsim, Ceftriaxone, Cefoperazone, Ceftibuten, Cefepime.
  5. If a staphylococcus aureus is identified, Aminoglycosides of the third generation are prescribed, as the risk of kidney side effects( Amikacin) is reduced.
  6. Fluoroquinolones: ofloxacin, moxifloxacin, norfloxacin, lomefloxacin, lefloxacin, ciprofloxacin, sparfloxacin, levofloxacin, gatifloxacin.
  7. Anesthetics for the relief of severe pain in the throat with tonsillitis - Stopangin, Pharyngocept, Falimint, etc. Anesthetic tablets, rinsing solutions and sprays in their composition have analgesic and anti-inflammatory components and antiseptics.
  8. Antihistamines are used for allergic reactions to prevent complications. Effective drugs Suprastin, Loratadin - they quickly and gently remove the symptoms of intoxication, contribute to improving well-being.
  9. Soothing agents for the throat help to treat irritated mucous, remove irritation, redness and pain( Tonzilotren, Falimint, Tantum Verde).
  10. Immunostimulating drugs increase local immunity, help to cope faster with the disease and reduce the risk of complications. Such immunostimulating drugs include Imudon( children from 3 years old), IRS-19 - an immunostimulant of bacterial origin, can be prescribed to children from 3 months.
  11. Probiotics are prescribed as a concomitant medication to restore intestinal microflora, which is disrupted by the administration of antibacterial drugs. Probiotics are microorganisms useful for the intestine. Assign Bifiform, Linex, Enterol, etc.

Local treatment

Complex therapy is performed using local treatment methods, selected by the doctor separately in each case. An important role in the treatment of exacerbation of tonsillitis is played by the following methods of local treatment:

  • lavage lacuna;
  • gargling;
  • lubrication of the tonsil surface with medicinal solutions;
  • suction of pathological contents from lacunae.

If purulent plugs are formed, the patient is assigned a procedure for rinsing lacunae or suctioning the contents. Purulent plugs look like white lumps and, unlike whitish plaque, are not removed when rinsing. Therefore, washing is recommended using solutions of antibiotics or antiseptics. Absorption of contents from lacunae is carried out simultaneously with washing. For this procedure, use a special vacuum cap. With a less severe form of the disease, rinsing with solutions is effective: furacillin, potassium permanganate, soda, hydrogen peroxide, propolis( several drops of alcohol solution per glass of water), sea salt.

Physiotherapeutic methods

With exacerbation of lacunar angina, tonsils become a source of repeated infection. In some cases it is necessary to resort to surgical treatment, but before deciding to remove the doctor appoints a course of physiotherapy, which can restore their function. The following methods are available:

  1. Warming, irradiating with UV rays that kill harmful bacteria that are in the tissues of the affected organ.
  2. Ultrasound or microwave therapy, electrophoresis - used to break down purulent mass in the tonsils, which contributes to its removal and purification of the tissues of the infected organ. These methods can be painful.
  3. Inhalation - warming up with wet steam, which helps to cleanse purulent contents.
  4. Laser Therapy. The laser has practically no contraindications. With its help, the throat is sanitized, the procedure is painless.

Surgical treatment of

If the complex treatment of tonsillitis for several years does not help, the periods of remission become shorter, the tonsils lose their protective functions or the disturbance of the work of other organs is observed, then doctors recommend to solve the problem surgically. Because of the infection, the heart and kidneys suffer, the tonsils become a hotbed of infection that spreads to the internal organs. The procedure for removing the removal of lymphoid tissue is called tonsillectomy. The operation is not considered difficult and is performed by several methods:

  • laser removal( radiofrequency, carbon laser);
  • excision with a scalpel;
  • electrocoagulation;
  • ultrasound scalpel.

The recovery period after laser surgery is faster( 3-4 days) than after the classical operation( a week or more).The laser closes the vessels, which significantly reduces blood loss. After the operation, regardless of the method of carrying out, in the early days you must adhere to the following rules:

  1. eat warm food;
  2. avoid products that scratch your throat( for example, cookies);
  3. the first three days it is better to eat soft food( food should not be salty, spices are forbidden);
  4. drink more fluids;
  5. try to talk less.

Folk methods

To fight with acute inflammation of the throat with tonsillitis can be folk methods. However, such treatment should be discussed with the attending physician. In folk medicine, common methods of treatment are rinsing broths of medicinal herbs:

  • chamomile;
  • calendula;
  • leaves and burdock roots;
  • of medicinal sage;
  • Oak bark.

Gargle with red beet juice( 1 glass of juice + 1 tsp apple cider vinegar), tincture of garlic( 2 cloves are poured into a glass of boiling water and insisted for about 40 minutes).It is useful to chew propolis and make lotions out of it, but with this method one needs to be especially careful, since individual intolerance, provoking the development of allergic reactions, can appear.

Consequences of

When tonsillitis changes into a chronic form, the body's immune response decreases, which can affect the functioning of internal organs. In severe cases, when symptoms of intoxication manifest themselves, some complications develop. Prolonged infections lead to complications related to cardiac dysfunction, kidney disease. Tonsillitis in neglected form is accompanied by rheumatism, tonsillocardial syndrome. Serious damage to health is caused by toxins, which are excreted in angina.


Dangerous lingering tonsillitis can not only be cured if you approach the problem in a comprehensive manner, but also prevent it. If the child is often sick, the problem lies in the weakened immunity. To avoid the disease, it is necessary: ​​

  1. to be hardened;
  2. eat right, so that the body gets all the necessary elements and vitamins;
  3. to abandon cold carbonated drinks( carbon dioxide in beverages irritates the throat);
  4. in time to treat infectious diseases of the nasopharynx, colds;
  5. sanitizing the oral cavity;
  6. follow the health of teeth and stomach.

Throat photo for chronic tonsillitis


Chronic tonsilitis