Inflammation of the tonsils, or another pathological process occurring in them, leads to a malfunction of the immune system of the whole organism. In this regard, inflamed tonsils are a reason to visit an otolaryngologist in order to study the cause of this phenomenon, to carry out anti-inflammatory actions.
Of greatest importance are the palatine tonsils, often called glands, paired formations that are located symmetrically in the pharynx. Inflammation of the glands is called tonsillitis (tonsil in Latin - tonsillae). This process is due to the impact of pathogenic microorganisms, viruses, bacteria, specific pathogens, and can develop as a result of immune disorders occurring in the body.
Symptomatic tonsillitis
The defeat of the tonsils can be isolated or be caused by a systemic process in the body. In this case, inflammation of the glands is one of the symptoms of the pathological process. Often, acute tonsillitis is a sign of systemic damage to the body by various infections, such as
- Infectious mononucleosis;
- scarlet fever;
- measles;
- diphtheria;
- typhoid fever;
- tularemia;
- herpes and adenovirus infection;
- syphilis.
The nature of the defeat of the tonsils in these pathological conditions is not specific.
In this regard, additional signs and laboratory diagnostics play an important role in clarifying the diagnosis.
The development of acute tonsillitis in infectious mononucleosis is caused by the Epstein-Barr virus. Just like sore throat, the disease is characterized by the fact that the throat hurts, the tonsils are swollen, and the body temperature rises. Unlike other bacterial tonsillitis, with infectious mononucleosis, there is an increase not only in regional, but also in all groups of lymph nodes.
Enlargement of the liver and spleen is also characteristic. In this case, there may be sensitivity to palpation of these organs. A significant proportion of patients have a rash. Infectious mononucleosis is characterized by a long course of the disease.
The patient may be sick for several months, noting malaise, discomfort in the throat, and an increase in body temperature.
In this case, it will not be possible to clarify the diagnosis based on the pharyngoscopic picture, since the inflammation of the glands in infectious mononucleosis is not characterized by special signs. The presence of additional signs, as well as laboratory diagnostics, which allows detecting atypical mononuclear cells or pronounced lymphocytosis in the general blood test, helps to clarify the diagnosis.
A severe course, when the glands are sharply swollen, is characterized by a process caused by the influence of a diphtheria bacillus. The infection develops sharply from the phenomena of intoxication. The disease may have the character of a local lesion or widespread, when the nose, larynx, trachea, bronchi are involved in the process. Oropharyngeal diphtheria is the most common form of the disease. With this disease, there is moderate hyperemia and edema of the tonsils, palatine arches. The degree of pain in the throat corresponds to the nature of the changes in the tonsils.
A characteristic sign that allows one to suspect diphtheria is the detection of a typical diphtheria film covering the tonsils.
At first it looks like a jelly-like mass, but after 1-2 days it becomes gray, dense. When trying to scrape it off, a bleeding erosive surface is formed. Another sign that characterizes diphtheria is that the removed film, when placed in water, does not sink and does not disintegrate into separate fragments.
The duration of the temperature period in diphtheria depends on the degree of damage, its prevalence. On average, hyperthermia persists for 5-7 days. At the same time, temperature indicators vary from 37.5 to 39-40 degrees. The disease is characterized by a fairly long-term presence of changes in the tonsils, which persists even after the temperature has returned to normal and the pain syndrome has decreased. The presence of a fibrinous film can be noted within a week after the regression of the remaining symptoms of the disease.
This course of diphtheria usually has a benign course, resembling streptococcal sore throat. Often, it becomes possible to clarify the diagnosis only on the basis of the epidemiological situation, the results of laboratory examination. However, in rare cases, the disease can transform into a more severe form, leading to the development of laryngeal edema and laryngospasm.
The tonsils can also become inflamed and swollen with other infectious processes occurring in the body. Adenovirus, herpes infection, measles, scarlet fever, as well as other infections transmitted by airborne droplets, usually occur with the defeat of lymphoid formations. In this case, hyperemia of the hard and soft palate, posterior pharyngeal wall, palatine arches is found.
The tonsils can also become inflamed. They increase in size, acquire a bright pink color. Since changes in the throat cavity are not specific, additional symptoms and data on the epidemiological situation contribute to clarifying the diagnosis. In the case of childhood infections, the presence of a rash, characteristic of each disease, is of significant help in diagnosis.
In adult patients, if the tonsils are inflamed, it is also necessary to exclude sexually transmitted infections, syphilis, gonorrhea and others. Since clinical manifestations are scarce, anamnesis and laboratory diagnostics play an important role in the diagnosis of such conditions. It includes a study of the titer of antibodies to a specific pathogen in the blood, bacterial cultures of mucus from the oropharynx. A venereologist will help to determine the list of necessary examinations.
Streptococcal sore throat
Despite the fact that most often inflammation of the tonsils is caused by various viruses, the effect of hemolytic streptococcus occupies a special place among the causes of inflammation of the tonsils. The result of this infection is the development of tonsillitis. A special attitude to this pathology is due to the peculiarities of the disease, its course, and possible severe complications.
The main symptoms of the disease:
- sore throat, worse when swallowing;
- an increase in body temperature up to 39 degrees;
- severe malaise, weakness;
- soreness in the joints;
- headache;
- lack of appetite;
- swollen and painful regional lymph nodes.
In addition to severe clinical symptoms, angina is characterized by typical changes during pharyngoscopy. Depending on the nature of the lesion, the following forms are distinguished:
- catarrhal;
- purulent, which is divided into follicular and lacunar;
- necrotic.
Objective research with catarrhal form allows you to detect inflamed glands. They are red in color. Swelling of the tonsils is manifested by their "varnish", shiny appearance. There are no purulent foci. The inflammatory process can spread beyond the organs, spreading to the palatine arches, hard and soft palate.
Purulent inflammation of the tonsils in the throat is characterized by the presence of an off-white or yellow plaque covering the follicles or filling the lacunae. Purulent foci do not go beyond the tonsils.In this case, there is swelling and hyperemia of the tonsils. They are inflamed and severely painful.
A serious complication of the purulent process is the development of a phlegmonous form of angina, which can occur with the formation of an abscess. More often this is an asymmetrical process in which the amygdala is swollen on only one side. At the same time, the general condition of the patient deteriorates significantly. Intoxication phenomena are increasing. Temperature readings fluctuate within 40 degrees. Because of the pain, the patient has difficulty opening his mouth.
Pharyngoscopy reveals that the gland is significantly swollen on one side. The resulting tumor even leads to a displacement of the tongue in the opposite direction. Due to a sore throat, severe lymphadenopathy, with tonsil abscess, the patient's head is tilted towards the lesion. In most cases, despite the ongoing antibiotic therapy, such inflammation of the glands requires surgical treatment.
Chronic tonsillitis
Among the processes characterized by the defeat of the tonsils, chronic tonsillitis is widespread. The incidence is about 10% of the population. It is characterized by periods of exacerbation and remission.
The main signs of chronic tonsillitis are history data, which indicate frequent tonsillitis, as well as the presence of purulent contents in the crypts. It is a thick caseous content with an unpleasant fetid odor. Diagnosis of the disease must be carried out during the period of remission. With exacerbation of chronic tonsillitis, the pharyngoscopic picture corresponds to angina, which does not allow to reliably clarify the pathology.
An important sign confirming chronic tonsillitis is lymphadenopathy.
A swollen and painful lymph node near the corner of the mandible and along the sternocleidomastoid muscle suggests a chronic inflammatory process. However, lymphadenopathy can be of decisive importance in diagnosis only in the absence of acute inflammatory processes in the head, neck, and oral cavity.
Tonsillitis due to blood disorders
The cause of the development of tonsillitis can be hematological diseases, leukemia, agranulocytosis. Leukemia is caused by a violation of the maturation of blood cells, as a result of which immature cells accumulate in the bloodstream. This malignant process has an acute onset, manifested by a sharp malaise, an increase in temperature. Bleeding or hemorrhage may occur. Enlargement of the liver and spleen is characteristic. The defeat of the tonsils develops on the second or third day of the disease, proceeds first as a catarrhal sore throat, then transforms into a necrotic form.
Aganulocytosis is characterized by a sharp decrease in the amount of white blood elements, which play an important role in ensuring human immunity. The reason for its development is
- exposure to radioactive radiation;
- the use of antineoplastic agents, cytostatics;
- the use of drugs with appropriate side effects, analgin, butadione, etc.
Acute tonsillitis and stomatitis are the first signs of the disease. Agranulocytosis is characterized by a severe course, an increase in body temperature up to 40 degrees. The defeat of the oral mucosa and tonsils is necrotic.
Clarification of the diagnosis for hematological pathologies is possible after a blood test. In some cases, bone marrow examination is necessary. Such patients are treated in hematology departments.
Depending on the nature and course of the inflammatory process in the tonsils, therapeutic measures can differ significantly. In this regard, clarification of the diagnosis is a necessary part of effective treatment.
