Tonsillitis in adults

The lymphoid tissue of the palatine and other tonsils is designed to protect the upper and lower respiratory tract from the penetration of bacteria and viruses. If an infection penetrates into them, an inflammatory process occurs, which is aimed at suppressing activity and destroying the pathogen.

What is tonsillitis 

Tonsillitis is an infectious-allergic process that affects the lymphadenoid pharyngeal ring and, first of all, the tonsils.¹. 

The lymphoid tissue of the palatine and other tonsils is designed to protect the upper and lower respiratory tract from the penetration of pathogenic microorganisms. If an infection penetrates the tonsils, an inflammatory process occurs¹.

Useful information about tonsillitis

Causes of tonsillitis

The most common causative agent of tonsillitis is hemolytic streptococcus, less often – staphylococci and other bacteria, viruses or fungal infections. With a long and severe course of the disease or improper treatment, the tonsils themselves become a source of infection.².

In the lymphoid tissue of the tonsils there is a large number of lacunae – depressions into which particles of food fall. This food serves as a favorable environment for the reproduction of bacteria, forms plugs and becomes inflamed.

Risk factors contributing to the development and maintenance of inflammation in the tonsils²:

• deviated septum of the nose;
• adenoids;
• regular hypothermia;
• living in a region with polluted dusty air;
• sinusitis;
• caries.

Tonsillitis often occurs against the background of reduced immunity. A healthy body immediately eliminates pathogenic viruses and bacteria, and they do not have time to cause harm. With frequent colds and respiratory diseases, it is worth visiting a doctor to understand the reasons for the decrease in immunity.

Pathogens can get on the mucous membranes of the tonsils and provoke inflammation in several ways.³:

• airborne route. From sick people or carriers of infection who do not have symptoms, bacteria with droplets of mucus and saliva enter the air and spread within a meter when talking, coughing, sneezing.
• alimentary way, when the causative agent of tonsillitis enters the body with food or when sharing household items and hygiene items.
• endogenous distribution. Pathogens are carried by the blood or lymph flow from other places where there is an infection (for example, from the oral cavity).

Forms of tonsillitis

According to the course of the process, two forms of the disease are distinguished:

• Acute tonsillitis (second name – tonsillitis). It occurs when an infection enters the tonsils. Most often, one or both palatine tonsils are affected.
• Chronic tonsillitis. This is a long-term inflammatory process that occurs with improper treatment of acute processes or lack of treatment, weakening the body’s immune defenses. In the tissues of the tonsils, inflammation persists, bacteria linger. In the chronic course of the disease, periods of remission are replaced by exacerbation.

To date, the chronic process is not considered limited only to the tonsils. With it, a general damage to the body is possible, the development of autoimmune reactions, when the immune system attacks its own organs.

Symptoms of tonsillitis in adults

Acute tonsillitis or tonsillitis is an independent disease or exacerbation of chronic tonsillitis. Acute tonsillitis often occurs with overwork, decreased immunity or hypothermia.

Symptoms of acute tonsillitis or tonsillitis include:

• pain in the throat, especially during swallowing;
• increase in body temperature up to 39 ° C;
• redness, enlargement, swelling of the tonsils, redness of the palatine arches;
• the presence of purulent plugs on the tonsils;
• headache;
• enlargement and soreness of the cervical and submandibular lymph nodes;
• general weakness;
• nausea, loss of appetite, drowsiness.

Treatment of tonsillitis in adults

When the first signs of a sore throat appear or during an exacerbation of a chronic process, it is necessary to contact an ENT doctor and begin treatment under his guidance. Self-medication is unacceptable – it threatens with the development of dangerous complications, up to autoimmune organ damage⁴.

Diagnostics

To identify typical signs of inflammation of the tonsils, the doctor performs a pharyngoscopy – an examination of the pharynx and tonsils with a spatula and illumination. Using the device, the doctor detects typical signs of tonsillitis – enlargement, swelling of the tonsils, raids or purulent plugs. Also, the doctor can examine the tonsils with a spatula, magnifier, probe to determine the nature of the lesion in the gaps (recesses), remove plaques to assess the tissue of the tonsils under them. Discharge samples are taken for examination (smears for a rapid test for the presence of beta-hemolytic streptococcus, cultures for flora, counting of microbial bodies in a smear).

Blood and urine tests are important to confirm infection and rule out organ damage. In the blood test, leukocytes and ESR are usually elevated, there are changes in the leukocyte formula. Also, during the diagnosis, the level of antibodies to streptococcal antigens is determined.

Modern treatments

The main treatment for tonsillitis is topical therapy. With tonsillitis of bacterial origin, antibiotics are prescribed.

General prevention includes hardening, physiotherapy, outdoor exercise. However, these procedures cannot be performed during an exacerbation of the disease, but only during remission.

Treatment regimen for tonsillitis

In general, the treatment plan is developed by the doctor. It determines the duration of the course of antibacterial drugs and their type, as well as the frequency of treatment of the tonsils, the necessary solutions, additional methods of therapy.

In the treatment, anti-inflammatory, antiseptic and analgesic local drugs (Gexoral, Tantum Verde) are used.

At temperatures above 38,6 ° C, antipyretic drugs are used (Nurofen, Ibuklin, Paracetamol).

If the swelling of the tonsils is pronounced, antihistamines (Suprastin, Cetrin, Loratadin, Kestin) can be used.

What antibiotics can be used for tonsillitis

With tonsillitis, broad-spectrum antibiotics are used. The most effective in this case are amoxiclav (Augmentin), azithromycin (Sumamed), clarithromycin (Klacid). If standard therapy is not effective, the doctor changes antibiotics based on culture data.

How to gargle with tonsillitis

For gargling, antiseptic, anti-inflammatory and painkillers are used. These can be Chlorhexidine, Miramistin, Furacillin, OKI-solution, Chlorophyllipt. Gargling with saline solutions or a salt-soda mixture is also acceptable.

Do not routinely use local remedies in the form of “rubbing”, “lubricating” the tonsils, as well as mechanically removing raids for sore throats.

Surgical treatment of tonsillitis

With the ineffectiveness of therapy and the development of complications of tonsillitis, surgical treatment is resorted to.⁴. In most cases, the removal of the tonsils leads to an improvement in the general condition. But today, the radical removal of the tonsils is treated with extreme caution, these are important organs of the immune system, and their removal is used only in extreme cases.

Folk remedies for the treatment of tonsillitis

Tonsillitis is a serious disease. His treatment should be comprehensive. Folk remedies should be taken only in conjunction with drug therapy. In addition, before using any folk methods, you must first discuss their use with your doctor. No attempts at self-treatment are allowed.

Prevention of tonsillitis at home

In order to prevent the development of tonsillitis and prevent its transition into a chronic form, it is important to dress warmly in cold weather, not to overcool. It is necessary to strengthen the immune system, eat healthy, vitamin-rich foods, and treat colds in a timely manner.

Popular questions and answers

What are the complications of tonsillitis, how contagious is it and when is it necessary to see a doctor, answers otolaryngologist, PhD, Roman Order.

Sources of:

1. Angina: diagnosis and treatment. Kunelskaya N.L., Turovsky A.B., Kudryavtseva Yu.S. Medical business magazine, 2010. https://cyberleninka.ru/article/n/anginy-diagnostika-i-lechenie
2. Chronic tonsillitis – modern ideas. Turovsky A.B., Kolbanova I.G. Doktor.ru magazine, 2009. https://cyberleninka.ru/article/n/hronicheskiy-tonzillit-sovremennye-predstavleniya
3. Modern methods of treatment of chronic tonsillitis. Ryazantsev S.V., Eremina N.V., Shcherban K.Yu. Journal “Medical Council”, 2017. https://cyberleninka.ru/article/n/sovremennye-methody-lecheniya-hronicheskogo-tonzillita
4. Conservative treatment of various forms of chronic tonsillitis. Lukan N.V., Sambulov V.I., Filatova E.V. Journal “Almanac of Clinical Medicine”, 2010. https://cyberleninka.ru/article/n/konservativnoe-lechenie-razlichnyh-form-chronicheskogo-tonzillita