Chronic tonsillitis

Chronic tonsillitis is one of the most common diseases of adulthood.
 * This is a chronic focal inflammation affecting the tonsil parenchyma (both in the vicinity of the lacunae and in the fibrous stroma).
 * In adults, the palatine tonsils are mainly affected, in children also the nasopharyngeal tonsils.
 * It occurs most often after recurrent angina, but it can also occur after one severe angina (e.g. diphtheria angina, angina in infectious mononucleosis).

Etiopathogenesis

 * Mostly it is a mixed bacterial infection involving β-hemolytic streptococci and other bacteria that persist in the lacunae for a 'long-term time.

Symptoms

 * subfebrile (most often in the morning)
 * fatigue
 * paresthesia and sensations of a foreign body in the throat (paresthesia is more pronounced when swallowing empty)
 * irritation to cough
 * bad breath (caused by decomposition of the contents of tonsillar crypts)

Finding

 * Tonsils can be hypertrophic, atrophic, oozing, pale or reddened.
 * As a rule, the surface of the tonsils is scarred, the scarred mouth of the lacunae does not allow the emptying of the contents by physiological massage during swallowing, the secretion in the tonsil stagnates and forms studs (yellow color, characteristic lumps of a gooey consistency). 'Studs are necrotic, sequestered portions of tonsils infiltrated by immune cells and pathogens.
 * Tonsils can be asymmetric - tiny inflammatory foci remain unhealed in the tonsil causing chronic inflammation.
 * The tonsil case is usually thickened, adhesions are often found in the paratonsillar space.

Treatment

 * Conservative therapy - after cultivation ATB according to sensitivity (systemically), antibiotics and antiseptics (locally), mechanical cleaning and washing of tonsils.
 * In case of failure of surgical therapy - tonsillectomy, or adenotomy.

Related articles

 * Angina
 * Differential diagnostics of pseudomembranous angina