Acute and chronic tonsilitis
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Transcript of Acute and chronic tonsilitis
- 1.Acute Tonsilitis
- Pathogen: -Hemolytical Streptococci*.
- Virus:adenovirus, rhinovirus, enterovirus**
- Causes: cold, fatigue, decreasing of the resistance to diseases, smoke and drink to excess, stimulated by harmful gas ,etc.
3. In Clinics
- 1. Acute Catarrhal Tonsilitis
- caused by virus, the symptom is light, inflammation located on mucosa
- 2. Acute Purulent Tonsilitis
- caused by bacteria, the symptoms is severe, inflammation develop in deep layer, purulent discharge from tonsil crypt
4. Clinical Appearances
- General : rise of temperature, chills, malaise, headache , a general feeling of illness, and appetite decrease, etc.
- Local: pain, pain felt only on swallowing, or swallowing is extremly painful, and dysphagia.
5. Clinical Appearances
- pharyngeal mucosal diffuse congestion, the mucosal membrane of the fauces is bright red, uvula edema, the crypt filled with debris, desquamated epithelium and pus.
- lymph nodes: below the jaw draining the tonsillar area are frequently enlarged and tender
6. Diagnosis and Differential Diagnosis
- Vincents angina:infected with spirillum in symbiosis with a fusiform bacillus, poor dental hyigene,a bleeding ulcerative gums are covered with a membrane which spread to the tonsils. Diagnosis is bacteriological.*
- pharyngeal diphtheria:infected withCorynebacterium diphtheriae, most commonly affect fauces, may be relatively mild or very severe, a swab should be taken and do bacteriological comfirmation.
- the others:
- LocalComplications: peritonsillar abscess (most common seen), retropharyngeal abscess (seldom seen), acute sinusitis, acute otitis media, and acute laryngitis, etc.
- General Complications: rheumatic fever, acute glomerulo-nephritis, acute arthritis, myocarditis, type allergic reaction, and bacterial toxin.
- 1.General therapy:in bed, diet should be light but nourishing, encourage to intake fluid,
- 2. Antibiotics therapy: Penicillin should be given, or erythromycin if the patient is allergic
- 3. Local treatment: soothing the affected membrane and clearing the secretion, inhalation,etc.
- 4. Chinese Medicines
- 5. Surgery: recurrence and relapse, particularly with complications.
- Chronic Tonsilitis
10. 11. Chronic Tonsilitis 12. Chronic Tonsilitis
- Caused by repeated attacks of acute tonsilitis or influent drainage of the crypt.
- Pathogen: bacteria infection, secondary to the acute infectious diseases or nasosinus infections.
- Pathogenesis unknown, autoallergic reaction
- Proliferation repeated stimulation tissue proliferation, gland hypertrophy, soft.
- Fibrous degeneration, atrophy, gland is small and stiff
- Crypt the crypt filled with debris, desquamated epithelium and pus or adhesion by scar.
14. Clinical Appearances
- Local symptoms:simple sore throat, dry,itchy,, a pricking or irritation as of a foreign body, fetor oris, and cough
- Pharyngeal obstructive symptoms in children snoring disturbance of respiratory, swallowing and speech resonance
- General symptoms dyspepsia, headache, tired, low fever,etc.
- Chronic congestion of tonsils and palatoglossal arches.
- Tonsil sizes are different (fairly prominent, small, or even difficult to see.), caseation, scar, adhestion,etc.
- Submandibular lymph node enlargement.
16. Diagnosis and Differential Diagnosis
- Diagnosis:caused by repeated attacks of acute tonsilitis*, simple sore throat, dry,itchy, a pricking or irritation as of a foreign body, fetor oris, and cough, caseation,scar, adhestion, and
- submandibular lymph nodes enlargement.
17. Diagnosis and Differential Diagnosis
- Differential Diagnosis:
- Tonsil Physiological Hypertrophy
- Tonsil keratosis
- Tonsil Tumor ( biopsy )
- General : rheumatic arthritis, rheumatic fever, heart diseases, nephritis, etc.
- Tonsilitis of focal infection:
- 1. History: acute tonsilitis
- 2. Examinations: erythrocyte sedimentation rate (ESR), anti- o, serium mucus protein, ECG (electrocardiogram)
- Non-surgical therapy:medicine management, local treatment, build up patients health
- Surgical therapy: tonsilectomy.
20. Indications for Tonsillectomy
- Repeated attacks of tonsillitis*
- P eri-tonsillar abscess (quinsy), abscess of thelateral or retropharyngeal spaces initiated by an episode of tonsillitis.
- Tonsils excessive hypertrophy: interfere swallowing, respiration, or phonation.
- Focal infection tonsils.
- Diphtheria carrier, conservative therapy is ineffective.
- Tonsil tumor.