Symptoms of chronic tonsillitis

Chronic tonsillitis in adults: forms, causes, symptoms and treatment

Unpleasant, but with a rather beautiful name, chronic tonsillitis is familiar to very many people these days. Having fallen ill once a person, often, for years can not get rid of this disease and becomes a frequent guest at the ENT doctor.

Tonsillitis is called inflammation, localized in the so-called glands, and in anatomical terms, in the region of the tonsils. This disease occurs in two main variants: acute and chronic. The first in the common people is called angina. It was the first one. That is, angina and chronic tonsillitis are not the same thing.

Chronic tonsillitis, as a rule, proceeds much milder in comparison with the bright manifestations of the acute form of the disease. He can remind of himself only a few times a year, and even less often.

Symptoms with exacerbation of the chronic process are usually poorly expressed, for example, it may slightly hurt and sore throat, but there should be no temperature.

Many patients do not even try to identify the cause in such cases, believing that everything will end by itself. However, after a month, the condition can only worsen and you have to go to a specialist who diagnoses chronic tonsillitis in adults, well, or in children, and begins a long treatment.

Chronic compensated and decompensated tonsillitis

About the chronic form of tonsillitis it usually comes up in cases where the tonsils are constantly in a state of inflammation.

In this case, two possible scenarios are possible. In one case, the disease as it completely disappears, but immediately returns at the slightest supercooling. At the second variant the inflammation leaves, and only calms down, causing satisfactory state of health in the patient.

Clinically, two forms of chronic tonsillitis are distinguished: one is called compensated, the other is called decompensated. Regardless of which form of the described disease has developed in the patient, it is necessary to take all measures in order to achieve a stable remission.

If only the symptoms of a local nature develop in the form of a slight inflammation of the tonsils and pain in the throat without changes in the general condition, then there is a compensated chronic tonsillitis. In other words, the tonsils generally cope with their functions and compensate for the inflammatory response.

If frequent inflammatory processes in the glands are accompanied by acute paratonzillitis (inflammation of the tissues surrounding the tonsils), and also diseases of other organs that seemingly have nothing to do with them, then this is without a doubt the decompensated form of the described ailment.

Causes of inflammation of chronic tonsillitis

It is not difficult to guess that, as with the acute form, the causes of chronic tonsillitis in adults and children are microbes.

Among ENT doctors, it is widely believed that the disease described affects 100% of the population. In a sense, it's true. A lot of microorganisms live on the human tonsils. Healthy tonsils cope with the disease-causing effect of certain of them, but the sick forces do not have enough for such a struggle.

There are several reasons for the transition of the disease to a chronic stage. The main one is untreated tonsillitis. The remaining causes of chronic tonsillitis are less important causes.

Most often it happens this way: immediately, as soon as the throat pain subsides and the temperature normalizes, the patient stops taking antibiotics and goes to work, believing that the illness has passed. However, it only retreated and in order to defeat it it is absolutely necessary to bring to completion the appointed course of antibiotic therapy and rinses, take vitamins and take up strengthening of immunity. Otherwise, chronic tonsillitis, the video about which is located below, is provided:

The second reason is frequent pharyngitis, to which patients, and some doctors do not pay due attention. In many cases, even a sick leave is not necessary: ​​in a few days the illness passes without treatment. However, in time, the uncontrolled pathological process will certainly make itself felt. The slightest fatigue or weakening of immunity will lead to an increase in the multiplication of bacteria. Therefore, pharyngitis should be cured to the end. This is much better than to suffer later from the effects of this inflammation - chronic tonsillitis.

If a person periodically excruciates chronic rhinitis or rhinitis of an allergic nature, this too can lead to chronic damage to the tonsils.

In addition, it is necessary to observe the hygiene of the teeth and monitor the condition of periodontal disease. Originating in the teeth, the infection tends to wade farther and touch the throat.

Characteristic signs of chronic tonsillitis

If we talk about the symptoms accompanying chronic tonsillitis and treatment in adults, we can note one important feature: the chronic tonsillitis itself does not manifest itself in any way. You can find out about the presence of this disease during the period of its exacerbation, but during this period the most obvious diagnosis will be acute angina, the consequence of not treatment or improper treatment of which often becomes the chronic inflammatory process. Nevertheless, a thorough examination will certainly help the specialist to find out the true nature of the ailment.

Symptoms of chronic tonsillitis in adults should be considered based on its basic clinical forms. Above we have already mentioned the compensated and decompensated inflammation of the tonsils. However, in addition to classification of the disease can be identified two more options: a simple tonsillitis of a chronic nature and a toxic-allergic form of the disease. The difference between these forms is both in the mechanisms of the formation of the disease, and in clinical manifestations in the period of exacerbation.

Symptoms of chronic tonsillitis of simple form do not differ from manifestations of ordinary sore throat. To suspect the chronic course of the inflammatory process in the powers of only an attentive specialist.

Most often the simple form is characterized by local signs: pus, purulent plugs, swollen arch, enlarged lymph nodes. When swallowing, discomfort appears, there is a foreign body sensation, dryness is felt in the mouth. During the remission, there are no manifestations, and with exacerbations (up to 3 times per year), angina develops with an increase in temperature, weakness, general malaise, and headache, characterized by a long period of recovery.

With the diagnosis of toxic-allergic chronic tonsillitis symptoms and treatment in adults are somewhat different. This form is characterized by a heavier current. For convenience, it distinguishes two degrees of severity.

The first degree of toxic-allergic tonsillitis in addition to local inflammatory reactions includes general intoxication symptoms and manifestations of allergization. This includes fever, pain in the joints and heart, increased fatigue. A person who falls ill with such a form of tonsillitis, is more difficult to cope with the flu and orgi. The period of recovery after illness is prolonged.

Symptoms of chronic tonsillitis in adults with a second degree of toxic-allergic variant of the disease are characterized by the presence of concomitant diseases. Often they have an autoimmune component, or they are associated with streptococcus - the most common cause of tonsillitis, both acute and chronic.

With this form of the disease, the amygdala becomes a permanent source of infection. The risk of spreading it through the body becomes high. Possible violations in the work of the heart, joints, liver, kidneys.

How much does subfebrile temperature with chronic tonsillitis

The temperature in chronic tonsillitis rises on the same principle and the same reasons as in other infectious diseases.

The human immune system triggers hyperthermia as a response to the activity of pathogenic bacteria or viruses that are the causative agents of infection. Thus, conditions are created in which microbes feel uncomfortable and begin to die.

The temperature for the described disease, as a rule, rises during the period of exacerbation. Conditions for favorable spread disappear, and the propagation of the pathogen is suspended.

Subfebrile temperature in chronic tonsillitis is more common than high. Substances that give a signal to the immune system in case of infection in the body are called pyrogens. The latter include both the microorganisms themselves and their toxins. Plus, pyrogens can also be created inside the body.

Regulates the temperature of the special area of ​​the brain - the hypothalamus. He commands the blood to move from the skin to the internal organs. As a result of this process, heat loss decreases and the human body begins to "warm up".

On the question of how much the temperature keeps in chronic tonsillitis, it is difficult to give an unambiguous answer. The naturally healed blood, getting back to the hypothalamus, informs him that the temperature has reached the desired level. At this level, it will persist until the eradication of the infection is over.

Diagnosis of chronic tonsillitis

Before talking about whether it is possible to cure chronic tonsillitis should pay attention to its diagnosis. The doctor must determine the described disease. In the diagnosis, he will be guided by a characteristic history, objective examination, as well as the results of additional studies.

As already mentioned above, the accompanying chronic tonsillitis symptoms, the photos of which are located below, most clearly manifest themselves during periods of exacerbation of the disease. Therefore, it is easier to diagnose an illness in this period.

In addition to the complaints of the patient himself, when examining the throat, one can notice hyperemia, the palatine arch will be swollen and with thickened margins. You can even find the fusion of palatine arches with glands and triangular fold.

Often there is a loosening of the tonsils (especially if the disease has developed in the child). Often there is an increase in regional lymph nodes.

As can be seen in the photo of chronic tonsillitis in adults, purulent plaque can be detected on the tonsils.

In the case of a toxic-allergic form of the ailment under consideration, a comprehensive examination of the patient should be carried out. The purpose of such a survey is to identify the associated diseases and assess the severity of the pathology.

Chronic tonsillitis (tonsillitis) in pregnancy

Many women preparing to become a mother even before conception can face the manifestations of a disease. However, not all are being treated. Often it seems to future mothers that once the symptoms are not critical, then the disease is not serious. That is why chronic tonsillitis in pregnancy occurs quite often.

Pregnancy is a very important and responsible period. From the very beginning it is necessary to take care of the safety of the baby. Including you need to pay attention to chronic diseases of the mother, because any malfunction in the mother's organism will inevitably affect the child.

Chronic tonsillitis can seriously affect a baby's health. Affected with this disease, tonsils - a kind of barrier for various infections. As a result of inflammation, this barrier is broken, creating the risk of penetration of pathogenic microbes into the bloodstream through which they can reach the fetus.

If during pregnancy a woman has symptoms characterizing chronic tonsillitis symptoms, then you should immediately consult a doctor, because among the dangers that this disease contains in itself lies the threat of miscarriage, toxicosis in later periods and premature birth.

Is it possible to cure chronic tonsillitis forever and how to do it with antibiotics?

There are many ways to combat the described disease. But only after an accurate diagnosis of the extent and form of the disease can you understand how to cure chronic tonsillitis forever.

One of the most common methods is drug therapy, in which the decisive role is given to treatment with antibacterial agents. Preparations of this group are prescribed during periods of exacerbation of the disease and are the best answer to the question of how to get rid of chronic tonsillitis. Prescribe them should be based on the results of the tank-sowing. The use of an antibiotic blindly may not give the desired effect.

Antibiotics for chronic tonsillitis can be prescribed by a short course using light and relatively safe means, and can be prescribed for a long time using aggressive drugs that require simultaneous reception of probiotics.

With latent flow of tonsillitis, antibiotic therapy is usually not performed, this additionally disrupts the microflora of the mouth and the gastrointestinal tract, plus immunity to all.

Than to treat chronic tonsillitis in adults: medicamentous agents

Treatment of chronic tonsillitis in adults also includes the use of painkillers (for example, Nurofen). These medications are used as symptomatic therapy mainly in severe pain syndrome. With minor pain, their use does not make sense.

To reduce the edema of the mucous throat and tonsils, antihistamines are necessary. The most good at the same time means the latest generation, such as Zirtek, Telfast, etc. They are stronger and safer, and also have a longer action and do not produce a sedative effect.

In the diagnosis of chronic tonsillitis treatment must necessarily be supplemented with local antiseptic drugs. They are released in the form of sprays, tablets for resorption or solutions. Of the first, Miramistin can be used very efficiently, which has a rather extensive spectrum of action. Among the tablets for resorption is quite popular Pharyngocept. Of the solutions that are used to rinse the throat, you can give an example of Hexoral.

How to get rid of chronic tonsillitis and how to gargle

When deciding what to gargle with chronic tonsillitis, do not forget about sea salt. It is sold in any store and very inexpensive. Gives a good result, and besides does not irritate the mucous membrane.

For rinses, essential oils can also be used. For example, lavender, cedar, eucalyptus or tea tree. With the described disease they have a positive effect. And some of these oils are part of the pharmacy medicine for angina.

It is worth noting that when diagnosing chronic tonsillitis it is up to the doctor to rinse the throat. He will choose the most suitable drug for a particular case, which will allow for a speedy recovery.

To stimulate local immunity in chronic tonsillitis, you can use a drug called Imudon. For the same purpose, natural products are also good: chamomile, ginseng, propolis, etc.

How to treat chronic tonsillitis at home: folk remedies

In case of development of the disease chronic tonsillitis treatment at home can be carried out through folk remedies. If you follow the recommendations of an experienced homeopath, you can significantly increase the remission of the disease.

For example, to rinse your throat, you can use a turn or sage. A good effect is given by chamomile and eucalyptus leaves. Not bad help with the described disease kidneys of pussy willow, aspen bark, as well as the roots of elecampane and ginger.

Talking about how to treat chronic tonsillitis in adults, you can not fail to mention the mitigants. The fact is that as a result of the processes of inflammation and taking certain medications, the patient may have dry mouth, a feeling of perspiration, or a feeling of sadness in the throat. In such cases, you should use apricot, peach or sea buckthorn oil by digging into the nose in the morning and evening a few drops.

Proper nutrition in the treatment of chronic tonsillitis in the home

In addition to treating chronic tonsillitis at home with medication, you need to think about the patient's diet. Diet therapy is an integral part of successful therapy.

Excessively chilled or heated food is not recommended for this disease. Hard, hard dishes are excluded. Limiting the reception of sharp, salty and smoked products, because they all significantly worsen the patient's condition.

Measures to prevent chronic tonsillitis in adults

Prevention of chronic tonsillitis in adults - an event no less important than the treatment of this disease.

To achieve the longest possible remission, it is necessary to eliminate stress and fully rest. It is extremely important to eat right, avoiding food, which can irritate the mucous membrane of the pharynx and tonsils.

In addition, the prophylaxis of the described ailment is closely associated with visiting seaside resorts.

NasmorkuNet.ru

Chronic tonsillitis - symptoms

As a rule, chronic diseases are characterized by prolonged sluggish inflammatory processes with recurrent relapses. This also applies to the chronic form of tonsillitis, in which inflammation of the pharyngeal and palatine tonsils is caused by various pathogens of the infection. Often, as pathogens of the disease are streptococci, staphylococcus, adenovirus, herpesvirus, fungi, etc. Chronic tonsillitis can develop both after the acute process in tonsils, and as an independent pathology against a weakened immune system.

Symptoms and signs of chronic tonsillitis in adults

One of the main symptoms in chronic tonsillitis is the presence in lacunae of tonsils of sealed purulent-caseous slugs, which consist of necrotic tissues, dead blood cells, accumulated infectious particles, toxins. The corks look like yellowish-white curdled clumps, with tubercles protruding on the surface of the tonsils. In some cases, their presence is accompanied by the accumulation of liquid pus. When the lacunae overflow with stoppers, they themselves go into the mouth.

Other manifestations of the disease are:

• unpleasant odor from the mouth;
• Discomfort, soreness in the throat when swallowing, especially in the morning;
• coughing;
• recurring headaches;
• increase, soreness of cervical and submandibular lymph nodes;
• yellowish white coating on the basis of the tongue;
• persistent redness, swelling, hyperplasia of the palatine arch;
• looseness or consolidation of the tonsils;
• the appearance of cicatricial adhesions between the palatine arches and tonsils;
• frequent feelings of general weakness, fatigue;
• subfebrile body temperature.

Symptoms of exacerbation of chronic tonsillitis

Chronic tonsillitis in very rare cases occurs without periodic exacerbations, more often in patients there are cases of exacerbation twice or thrice or more times a year. Relapses are provoked by hypothermia, viral respiratory infections, general weakening of the body's immune defense. The clinical picture becomes very pronounced, it includes such signs:

• intense sore throat, making it difficult to swallow, talk, open the mouth;
• severe puffiness, redness and enlargement of the tonsils;
• increase in body temperature, sometimes up to 39-40 ° C;
• feeling of general weakness, weakness;
• headache, muscle pain.

Symptoms of chronic compensated tonsillitis

With a compensated form of the disease, there are local symptoms of chronic inflammation of the tonsils, while their basic protective functions are still preserved. As a rule, exacerbations in this case do not happen often, and sometimes the clinical picture of this form of tonsillitis is quite worn out.

Symptoms of chronic decompensated tonsillitis

With the decompensated form of chronic tonsillitis, the tonsils can not cope with their functions due to irreversible changes that have occurred with their tissues. In this case, the tonsils are only the focus of infection, which extends to the surrounding tissues, and also easily penetrates the blood and lymph flow into others

organs - the heart, kidneys, pelvic organs, etc. In this case, exacerbations occur frequently, and there are not only local signs of chronic inflammation, but also the symptoms of significant general intoxication of the body and the manifestation of emerging complications depending on their location:

• pain in the heart and joints;
• shortness of breath, etc.

This form of tonsillitis is necessarily subject to surgical treatment.

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Symptoms of chronic tonsillitis in adults. Cause of the disease and treatment

Everyone knows what a sore throat is. During the development of the pathology, the patient has unpleasant symptoms, some of which even interfere with the habitual way of life. Often, throat diseases doctors call tonsillitis. It can flow in acute and chronic form. It is the last form of the disease that will be discussed later. From the article you will find out what can be the symptoms of chronic tonsillitis in adults. Also find out something about the methods of its treatment.

Acute form

Before you tell us what are the symptoms of chronic tonsillitis (in adults or children), it is worth paying a little attention to the acute form of the disease. It is with her often begins the development of the described pathology.

Acute tonsillitis, in fact, is an angina. The main symptoms of the disease are sore throat, fever, general malaise, an increase in lymph nodes and so on. The cause of this pathology is a bacterial infection. It is caused by staphylococci, streptococci and pneumococci. These bacteria affect the tonsils from the outside. They can enter the human body by direct contact with an infected or domestic route. The absence of timely and correct treatment of acute tonsillitis translates the disease into a chronic form.

What is chronic tonsillitis?

If during an acute form of the disease the infection affects the larynx from the outside, the chronic tonsillitis develops directly from the tonsils. Bacteria, which were described above, colonize the entire lymphoid tissue. And with the slightest decrease in immunity - are activated.

The exacerbation of chronic tonsillitis may be manifested by signs that characterize the common angina. Let's try to understand what are the symptoms of chronic tonsillitis. In adults, they are defined much more clearly than in children.

Patient's feelings: complaints

• In the chronic form of the disease in the stage of remission in humans, there is almost never a temperature increase. However, if you use a thermometer, you can see the values ​​on it up to 37.5 degrees.
• An unpleasant smell from the mouth is present in almost all people suffering from chronic tonsillitis. All because of the fact that there are bacteria in the tonsils.
• General malaise. Patients can complain of rapid fatigue, irritability, a feeling of dryness in the throat. They constantly want to moisten the larynx with water.

What does the doctor see?

If you come to the reception to a specialist, he will listen and write down all the complaints in the card. After that the otorhinolaryngologist will necessarily make an inspection. During the procedure, other symptoms of chronic tonsillitis can be determined.

In adults, the disease is characterized by swelling and looseness of the tonsils. Despite the stage of remission, the tonsils have a lot of depressions, in which there is a white accumulation of curd-like consistency. When the wells are cleaned, the surface of the mucous membrane remains red and inflamed.

If an adult has chronic tonsillitis, an increase in lymph nodes is an optional indicator. However, in most patients, small knobs are identified on the neck and occiput. Increased pharyngeal tonsils can also be probed through the skin under the jaw.

Symptoms of exacerbation of sore throat

Chronic tonsillitis in adults can be exacerbated with a certain periodicity. More often it happens in the cold season, when the patient lacks vitamins and there comes a decrease in immunity.

• During an exacerbation the body temperature rises. Its level reaches 39 degrees.
• The patient has a strong puffiness of the tonsils with the secretion of a viscous purulent secretion.
• There is a pain in the throat when swallowing, dryness, pershenia, cough.
• Often, exacerbation of chronic tonsillitis affects the nasopharyngeal tonsils - adenoids. There is a development of rhinitis.
• Lymph nodes, which could have been enlarged earlier, become more and more painful at this moment.
• The general intoxication of an organism against the background of infection spread is determined.

Why does the disease develop?

You already know that there are two main forms of tonsillitis. Chronic angina appears due to improper treatment of acute disease. Often the reason for the emergence of pathology is the uncontrolled use of antibiotics, antipyretics. As is known, during an increase in temperature, the body struggles with infection, the secretion of antibodies. Most microorganisms die at the moment when the level of your thermometer reaches the level of 38 degrees.

The cause of chronic tonsillitis can be diseases that occur in neighboring areas - dental caries, adenoiditis, sinusitis and so on. The aggravation of the disease develops due to low immunity, bad habits, malnutrition and lack of prevention of the disease.

Surgery: a controversial issue

Depending on what has chronic tonsillitis symptoms, and the treatment should be appropriate. If the bacteria in the tonsils are toxic to the body and greatly reduces the quality of life of the patient, surgical treatment is often suggested.

The procedure is under anesthesia. After it is carried out, the source of the disease disappears - the affected tonsils. However, doctors are dual to manipulation. After all, the lymphoid tissue is also the protector of the body. After its removal, the infection will go unhindered to the respiratory tract.

Antibiotics: is there a need?

Treatment of the disease often involves the use of antimicrobial agents. Doctors can recommend you such drugs as Amoxicillin, Flemoxin, Amoxiclav, Sumamed, Azithromycin, Biseptol, Suprax, Ceftriaxone and many others. In order to choose the right tool for you, you need to conduct research.

From the area of ​​the pharynx, the lab technician takes a smear. After that, the sensitivity of microorganisms to certain preparations is studied. Only effective means are assigned. After all, to many of the listed compounds the bacteria can have resistance.

Treatment of pharynx with antiseptics and antimicrobials

May have tonsillitis complications. These are kidney pathologies or cardiac dysfunction. Therefore, it is important to follow all the points described by the doctor. Often, doctors with angina design treatment of throat. However, patients are careless about this, believing that antibiotics will be enough.

To treat affected tonsils prescribed such means as "Lugol", "Chlorophyllipt", "Miramistin" and so on. At the same time, lozenges for resorption with antibacterial effect, for example, "Grammidine", can be administered.

Additional funds to help cure angina

Has chronic tonsillitis consequences in the form of reduced immunity. Therefore, immunomodulatory compositions are prescribed for therapy. It can be such drugs as "Anaferon", "Isoprinosine", "Likopid" and so on. They are taken only on the advice of a doctor.

Also, to restore a person need vitamin complexes. They can be purchased independently in each pharmacy network.

If it is found on tonsils, the plaque is removed. There is a manipulation in a hospital. The doctor uses a special tool to squeeze out a purulent secret from the depressions. After that, the tonsils are carefully treated with an antiseptic.

For the treatment of chronic tonsillitis in the acute stage, folk medicine is also used. This rinse with a decoction of chamomile and sage, hot drink, tea with honey and lemon, eating garlic and onions. The purpose of such events is to cleanse the tonsils and improve immunity. However, folk remedies are not always able to cope with the disease. In most situations, competent conservative therapy is necessary, in the absence of which complications and additional ailments develop.

A small conclusion: the outcome

You already know what chronic tonsillitis is. Symptoms and treatment of the disease are presented in your article. This pathology is very unpleasant and dangerous. Therefore, when the first symptoms of the disease should not engage in self-medication. As soon as possible, show your doctor and get qualified help. Always remember that the process can be complicated by diseases such as bronchitis, pneumonia. All the best to you, be healthy!

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Chronic tonsillitis - Classification

Currently, the classification adopted at the Seventh All-Union Congress of Otorhinolaryngologists (1975), proposed at this congress IB Soldatov, and also stated in his Methodological Recommendations (1979), according to which numerous pathoanatomical types of chronic tonsillitis are divided into two clinical forms - compensated and decompensated chronic tonsillitis. Of course, this classification has nothing to do with the principles of scientific classification of diseases of the pharynx and tonsils, but in general, including and acute tonsillitis, is only a list of long-known causes and types of pharyngeal diseases, and in particular palatine tonsils. Each classification should reveal the essential features of the classified object and contain information about internal processes (etiology and pathogenesis) and external signs (symptoms, dynamics of the clinical state) of one or another nosological form of the disease. On the way to developing such a classification for known reasons, there are great difficulties. Monomodal systems and phenomena delineated by a definite structural-functional complex are correctly classified. Such classifications can meet the truly scientific requirements of systematizing the quantitative and qualitative features of the phenomenon under study, consisting in fixing the regular links between the elements of the system to determine the location of each of them in the system being classified. In this sense, the classification, as a result of a whole layer of scientific research in the field of a specific medical problem, serves as a "bank" of identified information, and in the field of existing internal connections between the elements of the system - a means of searching for new patterns, phenomena and objects that develop this problem. Nevertheless, returning to the classification of IB Soldatov, one can not but note its practical importance, since it offers an alternative solution in choosing the method of treatment of chronic tonsillitis.

In 1978 VT Palchun "reanimated" the classification of chronic tonsillitis B.S. Preobrazhensky (1954), slightly changing it and adding. According to this classification, chronic tonsillitis is divided into a simple and toxic-allergic form.

The author describes the simple form of local signs of chronic tonsillitis and the presence of angina in the anamnesis in 96% of patients. The classification lists all known signs of chronic tonsillitis. With this form, there may be so-called concomitant diseases, which, according to VT Palchun, "do not have a single etiological bases with chronic tonsillitis; pathogenetic communication is effected through general and local resistance ". In the above definition of a simple form there is no key phrase, namely, that this form is characterized by the absence of metatonsillar complications. In the author's interpretation of the "simple form", "additives" such as a list of local signs of chronic tonsillitis and a reference to "accompanying" are identified with IB Soldatov's "compensated form" disease, "vaguely hinting at the possibility of potentiating chronic tonsillitis with appropriate risk factors, distances this part of VT Palchun's classification from the true purpose of this definition as an exhaustive classification definition and brings it closer to the scheme or list of local symptoms of chronic tonsillitis.

The toxic-allergic form of chronic tonsillitis in its descriptive part is even more reminiscent of the student's lecture made at the lecture on the clinical manifestations of chronic tonsillitis. In fact, she details the concept of "decompensated chronic tonsillitis", proposed by IB Soldatov in 1975 According to VT Palchun (1978), this form is divided into I and II degrees. Below are detailed information on tonsillar and general signs characteristic of these forms of chronic tonsillitis. Undoubtedly, the classification of chronic tonsillitis of B.S. Preobrazhensky and V.T. Palchun has a certain didactic meaning, contributing understanding of chronic tonsillitis as a systemic disease, detailing its clinical manifestations, but this form of information more suited to the concepts of the scheme or list of symptoms, rather than to the concept of classification of the pathological process as such.

Many other classifications proposed by different authors, repeat in different terms each other or make minor changes to existing ones, however all of them did not stand the test of time, and for today the classification of IB Soldatov remains the most acceptable classification for practical application.

Classification of diseases of palatine tonsils

Acute tonsillitis.

• Primary: catarrhal, lacunar. follicular, ulcerative-membranous angina.
• Secondary:
  • in acute infectious diseases - diphtheria, scarlet fever, tularemia, typhoid fever;
  • with diseases of the blood system - infectious mononucleosis, agranulocytosis, alimentary-toxic aleukia, leukemia.

Chronic tonsillitis.

• Nonspecific:
  • compensated form;
  • decompensated form.
• Specific: with infectious granulomas - tuberculosis, syphilis, sclera.

Concluding the "problem" of the classification of acad. IB Soldatov, one can not help noticing its brevity and, in contrast to the classification of Preobrazhensky-Palchun, a small amount of information.

According to VI Voyachek: "Chronic forms of amygdala diseases are divided into two main:

1. dystrophy, mainly of the hypertrophic type, and
2. associated with inflammatory and infectious processes. "

Even in this seemingly simple classification two fundamental concepts already appear: dystrophy and inflammatory-infectious process, "decoding" which in relation to chronic tonsillitis as a nosological form allows, if necessary, to create a harmonious classification of this disease, into which organically would include such obligate factors as etiology, pathogenesis, pathomorphology, clinical forms and "integral" - a method of treatment.

Continuing the analysis of V.Voyachek's classification, it is necessary to recall his conceptual approach to the isolated two forms of chronic tonsillitis. According to VI Voyachek, the first form is an expression of the so-called amygdala stereotype - biological necessity lymphadenoid tissue to functional (physiological) hypertrophy for certain, genetically determined functions. And although V.Voyachek does not speak about this, all subsequent researches in the field of the problem of chronic tonsillitis have shown that the physiological hypertrophy of palatine tonsils is reciprocal tissue immune response to external antigens, the underlying mechanisms of which are not limited to the replication of "killer" systems, but also the formation of so-called HLA markers with an immense number of their mutual combinations, connecting individual genetic features of a person with the nature of immune response and clinical polymorphism of diseases. The second form is a combination of productive and inflammatory processes that arise against the background of a gradual decompensation of the physiological form in connection with the growth of virulence of the microbiota and a decrease in the intensity of tissue and systemic immunity. Thus, although in other words, but corresponding to the above meaning, VI Voyachek, in fact, outlined the path, but which should go development of the theory of chronic tonsillitis and on which the modern concept (theory) of this disease was to be formed. How this concept evolved and forms - the subject of special discussions and publications not included in the task of this manual, we only note that some information on this issue the reader can find in the literature recommended by us, and in particular, in a very remarkable monograph by V.R. Gofman et al. (1998) "Clinical Immunology of Chronic Tonsillitis."

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