What Is a Tonsillolith?

Tonsillitis can be divided into acute tonsillitis and chronic tonsillitis. After suffering from acute infectious diseases (such as scarlet fever, measles, influenza, diphtheria, etc.), it can cause chronic tonsillitis, and sinus infection in the nasal cavity can also accompany the disease. The most common pathogenic bacteria are streptococcus and staphylococcus. Clinical manifestations are often symptoms of pharyngeal discomfort, foreign body sensation, dryness, itching, irritating cough, and bad breath.

Basic Information

English name: tonsillitis
Visiting department: Infectious Diseases
Common causes: Often caused by the accumulation of streptococcal or staphylococcal secretions in the tonsil fossa

Common symptoms: Pharyngeal discomfort, foreign body sensation, dryness, itching, irritating cough, etc.
Contagious: no

Causes of tonsillitis

1. Caused by the accumulation of bacteria and secretions in the tonsil fossa. The pathogenic bacteria are mainly streptococci or staphylococci.

2. Secondary to certain acute infectious diseases such as scarlet fever, diphtheria, influenza, measles, etc.

Clinical manifestations of tonsillitis

Acute phase

(1) Systemic symptoms are acute, chills, and high fever can reach 39 ~ 40 ° C, especially young children can convulse, vomit or lethargy, loss of appetite, constipation, and general laziness due to high fever.

(2) Local symptoms are obvious sore throat, especially when swallowing. Those with severe pain can radiate to the ears. Young children often cry because they cannot swallow. Children who suffer from tonsil hypertrophy can prevent their sleep when breathing, and often wake up at night.

Chronic phase

(1) Repeated episodes of sore throat Every time a cold, cold, tired, poor sleep, or tobacco and alcohol irritation occurs, there is a feeling of discomfort and blockage in the throat.

(2) Halitosis Due to the multiplication of bacteria in the tonsils and the purulent emboli remaining in the tonsils, it can often cause bad breath.

(3) Swollen and tonsil tonsils can make swallowing difficult, can't speak clearly, can't breathe, or snoring during sleep.

(4) The whole body shows bacteria in the tonsils, and pus plugs often enter the digestive tract with swallowing, which causes indigestion. If bacterial toxins enter the body, there may be headaches, limb weakness, fatigue or low fever.

Tonsillitis examination

Acute phase

The oropharyngeal mucosa is obviously hyperemic and can be diffuse. Congestion was more pronounced in the tonsils, pharyngeal arch, and lingual arch. The total number of white blood cells increased significantly during bacterial infection, and the neutrophil classification increased significantly.

Chronic phase

Examination showed chronic congestion of the tonsils, uneven tonsil surface, scars, and involvement with surrounding tissues. Occasionally, the crypt mouth was closed with small yellow-white dots covered with phenanthrene thin mucosa or adhesions. There may be purulent secretions or casein-like secretions at the opening of the crypt, and the secretions overflow when squeezed. Congestion of the lingual arch and pharyngeal arch. Mandibular lymphadenopathy. In addition, the tonsil challenge test, the dynamic observation of serum anti-streptolysin "O", anti-streptokinase and anti-hyaluronidase titers have certain reference significance for diagnosis.

Diagnosis of tonsillitis

It should be comprehensively analyzed based on medical history, local and systemic examinations, mutual evidence, and sometimes combined with the situation after tonsillectomy.

Tonsillitis Treatment

General treatment

(1) Keep your mouth clean, brush your teeth before bedtime, and rinse your mouth after meals to reduce the chance of bacterial infections in your mouth.

(2) You can use iodine tablets for gargle method, 1-2 tablets each time, 3 to 4 times daily. Rinse with fresh salt water is simple and convenient. Take a cup of warm water after meals and before going to bed, add a little salt, and taste salty. Repeat the mouthwash for about 5 minutes each time.

(3) Drugs use immune-enhancing drugs; if they are streptococcal infections, they can be treated with long-acting penicillin; strengthen physical exercise to enhance physical fitness and disease resistance. Surgical treatment should be used when conservative treatment is ineffective.

2. Principles of surgical treatment

(1) Excessive hypertrophy of the tonsils, which prevents breathing and swallowing.

(2) Repeated acute attacks, more than 4 to 5 times per year, with a history of abscesses around the tonsils.

(3) Those with long-term low fever and no pathological changes except tonsillitis.

(4) Nephritis, rheumatism and other diseases caused by tonsillitis should be selectively operated under the guidance of a doctor.

3. Not suitable for surgery

(1) Acute inflammation and the period of suffering from acute diseases, upper respiratory infections and epidemics.

(2) Patients with hematopoietic diseases, hypocoagulation, hypertension, heart disease, tuberculosis, etc. are not suitable for surgery.

(3) Women do not undergo surgery during the menstrual period and 3 to 5 days before menstruation. Otherwise, the symptoms of pharyngeal inflammation will increase.

(4) Patients with chronic pharyngitis may not be operated if it is not necessary, otherwise, the symptoms of pharyngeal inflammation will increase after operation. As for the specific surgery time for patients with chronic tonsillitis, it is best to ask a doctor to help decide.

Prognosis of tonsillitis

The prognosis of timely treatment in the acute phase is good. Chronic tonsillitis is often associated with chronic diseases such as chronic pharyngitis, acute laryngitis, and chronic otitis media. It can even induce serious diseases such as rheumatoid arthritis, rheumatic valve heart disease, endocarditis, myocarditis, and acute nephritis.

Tonsillitis prevention

1. Patients with chronic tonsillitis should develop good living habits, ensure adequate sleep time, and increase or decrease clothes in time as the weather changes. Persist in exercising and improve the body's ability to resist disease.

2. Suffering from acute inflammation of tonsil should be completely cured to avoid becoming chronic inflammation.

3. Prevention and treatment of various infectious diseases.