Tonsillitis
As tonsillitis or tonsillitis refers to a painful inflammation of the tonsils. In practice, the term is reserved for the inflammation of the tonsils ( palatine tonsil ). The disease is contagious and can be transmitted by droplet infection. Acute streptococcal tonsillitis is no longer contagious 24 hours after the start of antibiotic therapy. The incubation period is 1-3 days. Tonsillitis is one of the 20 most common consultation events in general practices.
Classification
After Timeline:
- Acute ( tonsillitis acuta)
- Chronic ( chronic tonsillitis )
- Recurrent
After localization:
- One-sided (unilateral ) Tonsillitis
- Both sides (bilateral ) Tonsillitis
After clinical aspect:
- Catarrhal angina: redness and swelling of the tonsils
- Follicular angina: stippled fibrinous deposits on the crypts of the tonsils
- Lacunar angina: redness and confluent fibrinous coverings
Etiology ( causes)
Tonsillitis usually is less frequently caused by bacteria, viruses. The typical pathogens are beta-hemolytic streptococci of Lancefield group A ( Streptococcus pyogenes )
Besides playing
- Pneumococcal
- Staphylococci
- Haemophilus influenzae
- Branhamella catarrhalis and
- Neisseria gonorrhoeae
A role.
Many of these bacteria belong to the resident oral flora. The infection is, however, usually caused by new serotypes of the pathogens against which there is no immunity. As additional factors, a weakened general condition or an immune deficiency could join.
Of the viral tonsillitis the Monocytic caused by the Epstein -Barr virus, in contrast to most viral tonsillitis distinct surfaces.
In chronic tonsillitis usually there is a mixed infection with anaerobic and aerobic pathogens.
Symptoms
- Difficulty swallowing (narrowing of the isthmus of the fauces )
- Kloßige language
- Swollen, red tonsils (angina catarrhalis )
- Fibrin, initially stipple (angina follicularis ), then larger spots (angina lacunaris )
- Mucosal
- Halitosis (bad breath )
- Lymphadenopathy ( esp. the angle of the jaw lymph nodes)
- Scarlatiniformes rash (rash in scarlet fever, angina )
- General symptoms (fever, headache, fatigue )
- Bitter taste after eating and drinking
In chronic tonsillitis also:
- Detritus
Diagnostics
The diagnosis is usually made of the typical clinical picture ( inspection). To confirm the diagnosis, if appropriate, additionally:
- Streptococcus rapid test
- Bacterial culture from throat swab
- Antibody detection ( antistreptolysin AK; Attention: increase after weeks )
Therapy
The treatment depends on the cause and the course of tonsillitis. In general, a combination of local and general treatment is applied.
In acute tonsillitis:
- In bacterial- purulent tonsillitis: Antibiotic; Penicillin- V for at least 7, usually 10 to 14 days; penicillin intolerance 2nd generation cephalosporins or a macrolide antibiotic such as clarithromycin are given for 5 days.
- Analgesics
- Throat washes and gargling with disinfectants
- Pinselungen with almond 's solution (iodine - potassium iodide - glycerol)
- Schleimhautanästhetika
- Neck wrap
- Oral care, if the action can not be performed by the person concerned
In chronic tonsillitis:
- Antibiotics
- Tonsillectomy
Differential diagnosis
- Plaut -Vincent Angina (one-sided, necrotizing tonsillitis )
- Glandular fever ( infectious mononucleosis )
- Diphtheria
- Scarlet
- Syphilitic chancre
- Herpangina
- Agranulocytosis
- Tonsillenkarzinom
- Tuberculosis
Complications
- Peritonsillar
- Retropharyngeal
- Jugular vein thrombosis
- Halsphlegmone
- Sepsis
- Rheumatic fever
- Endocarditis, myocarditis, pericarditis
- Post -infectious glomerulonephritis