chronic tonsillitis
Introduction
Introduction to chronic tonsillitis Chronic tonsillitis (chronictonsillitis) is often converted from chronic tonsillitis to chronic, after acute infectious diseases (such as scarlet fever, measles, flu, diphtheria, etc.), can also cause chronic tonsillitis, nasal sinus infection can also be associated with this Disease, pathogens such as streptococcus and staphylococcus are the most common. basic knowledge The proportion of illness: 0.07% Susceptible people: no special people Mode of infection: contagious Complications: otitis media, sinusitis, bronchitis, acute nephritis
Cause
Causes of chronic tonsillitis
Cause
In chronic tonsillitis, epithelial necrosis in the crypt, bacterial and inflammatory exudate accumulate, crypt can produce small ulcers and scar formation and poor drainage, suitable for bacterial growth and reproduction, so infection is not easy to eliminate, repeated acute Tonsillitis, which reduces the body's resistance or incomplete treatment, is more likely to turn chronic. The mechanism of this disease is still unclear. However, in recent years, based on the immunological point of view, it is considered that its own allergic reaction is an important mechanism for causing chronic tonsils.
Prevention
Chronic tonsillitis prevention
1. Patients with chronic tonsillitis should develop good living habits, ensure adequate sleep time, increase or decrease clothes in time with the weather, and remove indoor humid air. It is important for sick children to develop no picky eaters, no Good habit of partial eclipse.
2. Insist on exercising and improve the body's ability to resist disease. If you are tired, you should adjust your rest and quit smoking and alcohol. It is an important point to prevent chronic tonsillitis.
3. Acute inflammation of the tonsils should be completely cured to avoid leaving behind.
4. Prevent all kinds of infectious diseases, epidemics, liquid food or semi-liquid food, and use high-alcoholic baths to help cool down.
5. Active treatment of acute tonsillitis can prevent this disease.
Complication
Chronic tonsillitis complications Complications otitis sinusitis bronchitis acute nephritis
Chronic tonsillitis, not only due to the spread of inflammation can cause infection of adjacent organs, such as otitis media, sinusitis, larynx, trachea, bronchitis, etc., more importantly, one of the common infections of the human body, with acute nephritis, rheumatoid arthritis , rheumatic fever, heart disease, long-term low fever and other diseases are closely related, how to diagnose the disease of tonsillitis, there is still no specific examination method, clinically, the human body is affected by the bacteria and toxins in the tonsil crypt, allergic reactions occur and produce various Complications; such complications occur more than 1 to 3 months after the onset of tonsillitis. The evolution or deterioration of the disease is often associated with the onset of tonsillitis; the focal tonsils are mostly fibrous lesions, often with crypt endocrine Retention and submandibular lymphadenopathy, etc., should be based on medical history, local and systemic examination and other data, comprehensive analysis, mutual identification, sometimes combined with the situation after tonsillectomy, in addition, tonsil stimulation test, serum anti-streptolysin" O", dynamic observation of anti-streptokinase and anti-hyaluronidase titer, etc., have certain parameters for diagnosis Meaning.
Symptom
Chronic tonsillitis symptoms Common symptoms Indigestion sore throat tonsil congestion hypothermia powerless appetite, tonsils become small and tough, uvula, drooping, fatigue, tonsil, gray membrane
According to the medical history, combined with the above symptoms and signs for diagnosis, and should not be based on the size of simple tonsils, because with the increase of age, tonsils are shrinking, chronic tonsillitis is divided into three types, namely proliferative, fibrous And crypt type, so the size of the tonsils does not indicate the degree of inflammation, so it cannot be diagnosed.
According to its pathological changes, it can be divided into three types.
1. Proliferative type is more common in children, tonsil lymphoid tissue hyperplasia, increased lymphoid follicles, increased connective tissue, chronic congestion of tonsils, hypertrophy.
2. Fibrous type is more common in adults, atrophy of tonsil lymphoid tissue, hyperplasia of fibrous scar tissue in interstitial, obstruction of crypt, and tonsil becomes small and tough.
3. The main crypt-type lesions are deep in the tonsils, the lymphoid follicles are chronic inflammation, and the lymphoid tissues are scarred. Because the crypts are blocked by scar tissue, the crypts are obviously enlarged, or there are a large number of shed epithelia. Bacteria, lymphocytes and white blood cells aggregate to form a pus, which is complication due to the severity of the disease, also known as chronic septic tonsillitis.
[clinical manifestations]
Patients often have sore throat, easy cold and acute tonsillitis episodes, usually less symptoms, may have throat discomfort, foreign body sensation, irritating cough, bad breath or slight pain, children with tonsil hypertrophy, often have poor breathing, Buzzing, ambiguous language and slow eating, etc., because often swallowing inflammatory secretions, stimulating bacteria in the gastrointestinal tract or crypt, toxins are absorbed to cause systemic reactions, leading to indigestion, loss of appetite, fatigue, fatigue, fatigue, weight loss , headache, low fever and other symptoms.
Check the tongue and bowel and tonsil chronic congestion, the mucous membrane is dark red, the tonsils are more anterior and posterior arch inflammatory adhesions; the surface is flat or uneven, or lobulated, sometimes visible linear scars, enlarged crypts Opening and cheese-like plug or yellow-white spots under the mucosa, use the tongue depressor to squeeze the tonsils on the outside of the lingual arch, and the secretions may overflow from the crypt, and the swollen lymph nodes may often be touched under the mandibular angle.
Examine
Examination of chronic tonsillitis
Check the chronic hyperemia of the tonsils, the uneven surface of the tonsils, scars, and the surrounding tissues are involved, sometimes visible crypts closed, yellow-white dots, which are covered with a thin mucous membrane or adhesions, there may be purulent secretion in the crypt opening Or cheese-like secretions, secretions spilled when squeezed, tongue and bow and pharyngeal arch congestion, mandibular lymph nodes,
When chronic tonsillitis has caused systemic complications, the serum A, gamma globulin and mucin are abnormally increased, while the reactive protein test is mostly positive. The anti-streptolysin "O" has higher titer and more erythrocyte sedimentation rate. Accelerated, through immunohistochemical examination, amino acid quantification, high serum 2 protein, is important for focal tonsillitis, using electron microscopy and serum fluorescent antibody examination, in the tonsil tissue section, determine the quality of tonsil formation (IgG Predominant), if it can be determined that this change is mainly located in the crypt-lymphatic stroma (the latter does not normally have this function), there is sufficient evidence to suggest that there are potential or active lesions in the amygdala.
Diagnosis
Diagnosis and diagnosis of chronic tonsillitis
The disease should be differentiated from the following diseases.
1. Keratoosis of tonsil is a hyperkeratosis of the epithelial cells of the tonsil crypt. It is shaped like a yellow-white horn or a pointed sand-like keratin. It is hard to touch and has a firm root. It cannot be wiped off, but it is not obvious. Conscious symptoms, or anti-pharyngeal discomfort or foreign body sensation, can occur simultaneously in the posterior pharyngeal wall, pharyngeal tract and tongue root, etc., the disease course is longer, mostly occurs in young people before the age of 30, the cause is not clear, generally not needed Special treatment.
2. On the side of the tonsil tumor, the tonsils are rapidly enlarged or the tonsils are swollen and ulcerated. The possibility of tumors should be considered. For example, tonsil sarcoma can be confined to the submucosal mucosa in the early stage, and the surface is smooth. The main symptom is that the tonsil on one side increases rapidly. There are often cervical lymph node metastases, which are more common in young people, and biopsy can confirm the diagnosis.
3. Toxoplasmic symptomatic hypertrophy is a local manifestation of certain systemic diseases. In the case of leukemia, the tonsils may be symmetrically enlarged. Sometimes the pharyngeal symptoms may be their first symptoms, and the diagnosis is based on the surrounding blood and bone marrow.
