Effective treatment of chronic tonsillitis

Author:

• Elena Vitalievna Naumova, otolaryngologist, leading doctor of the clinic

2.82 (Votes: 11)

Acute tonsillitis with purulent exudate is considered the most common infection.

The disease occurs in both adults and children due to the entry of pathogenic microbes and bacteria into the oral cavity. It is not difficult to get a purulent sore throat even in the absence of direct contact with a sick person. Bacteria are spread through contact and airborne transmission, such as by sneezing or coughing in a public place or sharing household items.

Forms of purulent sore throat

There are two varieties:

• Purulent sore throat, affecting the lacunae of the tonsils. The infection is localized in the upper part of the throat and does not penetrate deeper. Purulent deposits are easily separated with a spatula.
• Purulent tonsillitis affecting the lymph nodes. The infection penetrates deeper and affects the lymphoid apparatus. Purulent exudate cannot be separated manually. The condition is extremely serious and threatens the formation of a peritonsillar abscess. Urgent medical attention and hospitalization are required.

Causes of sore throat (acute tonsillitis)

The accumulation of purulent “sacs” in the tonsils occurs for various reasons. The main causative agents of tonsillitis are streptococci, but viral and fungal pathogens, staphylococci and pneumococci are also found. If the body is healthy, then the infection will not develop, but the following factors can aggravate the condition:

• Injuries to the tonsils and nasopharynx.
• Weak immunity.
• Chronic diseases of the ear, nose and throat, for example, stomatitis, caries, rhinitis, etc. foci of infection increase the proliferation of pathogens.
• Local and general hypothermia, for example, eating ice cream or drinking cold water.
• Autumn-spring vitamin deficiency.

The pathogenic factor penetrates deep into the tissues of the tonsils, forming a focus of infection.

Treatment of chronic tonsillitis

Chronic tonsillitis is treated using both conservative and surgical methods.

Conservative methods are:

• antibiotics that are prescribed both locally (gargling) and systemically (tablet or injection forms);
• direct washing of lacunae and introduction of antibacterial and anti-inflammatory drugs into them;
• physiotherapeutic procedures (hallotherapy, magnetic laser treatment of lymph nodes, phonophoresis and ultraviolet irradiation of the palatine tonsils).

Surgical treatment methods:

• Tonsillectomy – removal of the tonsils along with the capsule (instrumental and bloodless technique).
• Destruction of lymphoid tissue in the tonsil (radio wave ablation, cryodestruction).
• Cryptolysis (“soldering” of palatal lacunae).

Clinical picture

Once a pathogen enters the body, two hours are enough for it to spread. Streptococci settle on the tonsils, weakening local immunity. The incubation period varies from several hours to 5 days.

The main differences between purulent tonsillitis are symptoms:

• A sharp pain in the throat occurs, which causes discomfort even at rest. The next day she becomes unbearable when talking or eating.
• Within a few hours, the body temperature rises to 39-40°C. Against the background of high temperature, it throws you either hot or cold, sweating increases and chills are present.
• Swallowing saliva causes severe, sharp pain.
• There is not enough air when breathing due to swelling of the tonsils.
• When examined with the naked eye, swollen tonsils and severe hyperemia of the back wall of the throat are visible. The next day the tongue and palate swell.
• There is a sensation of a foreign body in the nasopharynx, which intensifies when saliva is swabbed.
• Due to the fact that the tonsils are well supplied with blood, a yellowish-white dot appears on them, the boundaries of which quickly expand. The next day, the throat may become covered with many white purulent dots, which gradually merge into large ulcers.

Purulent tonsillitis in children occurs in a more severe form. Due to the excessive pressure of the swollen lymphoid tissue of the adenoids on the Eustachian tubes, the ears become blocked and there is tinnitus. If treatment is not attempted, the infection can spread to the ears, complicated by otitis media.

Usually the acute period lasts no more than one week if treatment is prescribed on time.

Important to know and remember! Purulent tonsillitis is a dangerous infectious disease, so the patient should be immediately isolated from household members.

Complications of sore throat

During the disease, the infection can spread to neighboring organs, causing otitis media, lymphadenitis, sinusitis, and peritonsillitis. Among the local purulent complications of tonsillitis, one can note the formation of an abscess or phlegmon in the inflamed tissues. Their occurrence is accompanied by a new wave of fever, increasing sore throat, problems with swallowing and breathing. In the case where the pathology is caused by streptococcus, 3-4 weeks after clinical recovery, glomerulonephritis, reactive arthritis or rheumatic carditis may develop due to subsequent autoimmune processes.

Treatment of purulent sore throat

Purulent tonsillitis threatens serious complications from the heart, kidneys, joints and soft tissues of the neck if therapy is chosen incorrectly or treatment is started late. It is for this reason that it is important to immediately consult a doctor when the first signs of a sore throat appear.

The basic treatment regimen for acute tonsillitis with purulent exudate:

• Taking antibiotics of the penicillin group or the macrolide group. You can't do without them. General and local remedies are prescribed. Antibiotics kill pathogenic microflora and after a few days the production of pus stops, blood circulation in the tonsils is restored.
• Taking anti-inflammatory lozenges, lozenges, lozenges.
• Gargling and irrigating the throat with different solutions every hour.
• Use of local antiseptics in the form of a spray.
• Taking antipyretic drugs.
• Vitamin therapy and taking immunomodulators.

The principle of treatment of acute tonsillitis in children is similar, the only differences are in the dosage of medications. The patient needs to observe strict bed rest, talk less and gargle more often.

If the prescribed drug therapy does not have positive dynamics within several days, the patient continues treatment in the hospital.

Due to the presence of purulent plaque on the palatine tonsils, eating is difficult or completely impossible, so you can eat only pureed and liquid food, and also drink a lot of warm water to relieve symptoms of intoxication.

Main groups of drugs

Sore throat is provoked by different types of opportunistic microorganisms and treatment depends on the specific causative agent of the disease. First of all, the ENT doctor will give a referral for a blood test and bacterial culture from the tonsils to detect antibiotic resistance.

Most often, purulent tonsillitis is treated with systemic antibiotics:

• Penicillin series. They have fewer contraindications, so they are often prescribed to children and adults with intolerance to other groups of antibiotics. Penicillins are effective only at the initial stage, when ulcers have not formed. It is worth noting that they are not prescribed if the patient has a history of bronchial asthma or urticaria. During pregnancy, they are prescribed only when absolutely necessary in the early stages.
• Cephalosporins. They are beneficial in severe cases of the disease. They are low toxic and effective from the first day of use. Can be prescribed to pregnant women.
• Macrolides. Prescribed if there is no effect from taking medications of the first two groups. Macrolides have an extended list of contraindications and are taken in a short course. It is worth noting that they are prohibited during pregnancy and breastfeeding.
• Lincosamides. Used for frequent exacerbations of purulent tonsillitis.

General therapy should be comprehensive, i.e. It is possible to speed up recovery and remove the pathogen with oral antibiotics and local treatment. Local antibiotics for purulent sore throat are prescribed to young children and pregnant women.

Prohibited methods of treatment for purulent sore throat

Unfortunately, patients often make independent treatment attempts, which only worsen the clinical picture. The following actions are prohibited:

• Pierce the ulcers with sharp objects.
• Push out, tear off or squeeze out ulcers.
• Treat tonsils with hydrogen peroxide, Lugol's solution, iodine.
• Warm your throat and gargle with hot water.
• Rinse with vinegar and concentrated alcohol solution.
• Apply compresses of vodka and alcohol to the throat.

Important to remember! It is very dangerous to try to remove purulent deposits on your own.

At the ENT CLINIC in Chertanovo, otolaryngologists immediately help patients. They carry out non-contact removal of purulent plaque using ultrasound on the CAVITAR device (USOL therapy). Pharyngoscopy and smear analysis are performed to determine sensitivity to antibiotics in order to prescribe an effective medicine. Specialists use modern drugs of the latest generation to improve the patient’s condition. Based on the severity of the disease, individual characteristics, and age of the patient, the clinic’s ENT doctor prescribes medications and gives recommendations for treating purulent tonsillitis at home.

Release form

Depending on the stage of development of the disease, the ENT doctor prescribes different types of antibiotics:

• Tablets and syrups. Used as the disease progresses. Usually the drug effect is noticeable 2-4 days after the start of administration.
• Local medications (sprays, lozenges). They are used as an addition to the main therapy, since they only relieve acute pain when swallowing saliva, and do not kill completely pathogenic bacteria.
• Injections for intramuscular and intravenous administration are prescribed for advanced stages of angina, when the patient cannot swallow a tablet. Basically, antibiotics of the bicillin group are used as active substances once. The effectiveness of injections is much higher, since the active substance is evenly distributed throughout the tissues. A high concentration of the drug lasts longer, so the result is visible faster.

Important to remember! The earlier the diagnosis is made and rational therapy for acute purulent tonsillitis is prescribed, the greater the chances of curing the disease without developing serious complications. At the first manifestations of purulent tonsillitis, do not waste precious time self-medicating, consult a doctor! This will save you and your loved ones from serious consequences!