How does the uvular reflex help with swallowing

Tonsillitis (tonsillitis)

Where are the almonds?

Pathogens can enter the body through the mouth and nose. They have to pass through the almonds. Their job is to protect the upper respiratory tract from bacteria and viruses. In childhood, the almonds support the maturation of the immune system.

The two tonsils are located on the right and left in the throat. They can be seen at least partially behind the lateral palatal arches. The pharynx is located on the upper palate. The tongue base almond is located in the posterior third of the tongue. The tonsils belong to a special defense tissue, the lymphatic throat ring.

Tonsillitis: contagion and causes

Various viruses or bacteria can multiply in the tissues of the lymphatic ring of the pharynx. The tissue swells, causing a sore throat and difficulty swallowing.

Acute tonsillitis is often caused by cold or flu viruses. But other viruses and bacteria such as streptococci, pneumococci or haemophilus influenzae can also be triggers. The tonsils also become inflamed as part of Pfeiffer's glandular fever. In this country, tonsillitis is a sign of diphtheria.

Anyone who has acute tonsillitis can pass the pathogen on when speaking, sneezing, coughing or kissing in the form of droplets of saliva (droplet infection) - even via commonly used, contaminated surfaces such as door handles.
In the first few days in particular, tonsillitis is usually very contagious. That is why children, for example, should stay at home for the time being and not go to kindergarten or school.

If tonsillitis is treated with an antibiotic (see section on therapy), the risk of infection drops significantly within one day of the start of therapy. If viruses are the trigger, the doctor will not prescribe antibiotics. Then the risk of infection often only decreases when the symptoms disappear - after about one to two weeks.

Anyone who has become infected may be able to spread the pathogen for a day or two before the first symptoms appear.

Some people carry potentially disease-causing bacteria in their throats for a long time without becoming sick themselves. You can - rarely - infect other people with it.

After tonsillitis you are not immune to it, so you can get sick again and again. A pet or a toothbrush, for example, can act as pathogen reservoirs and lead to reinfections.

Tonsillitis: symptoms

A tonsillitis can cause different symptoms - depending on the form, which bacteria or viruses caused the disease.

Common symptoms of acute bacterial tonsillitis:

  • Difficulty swallowing and a sore throat that may radiate into the ears and jaw
  • the tonsils are reddened, swollen and covered with yellowish-whitish pus spots (specks)
  • increased salivation, bad breath
  • fever
  • general malaise, headache, loss of appetite
  • the lymph nodes on the neck and jaw are swollen

In children, tonsillitis can also cause abdominal pain and vomiting.

If the tonsillitis occurs as part of a scarlet fever disease, the tongue often turns deep red. In addition, a typical rash usually shows up.

Plaut-Vincent angina, which is rather rare, usually affects only one tonsil, and the symptoms are unilateral. The almond is reddened and inflamed, and large, greasy, gray-whitish, smelly coatings are formed. There is pain in swallowing and swelling of the cervical lymph nodes. The general well-being is often little affected. The cause is an infection with two special bacteria.

Dirty-gray deposits on the swollen tonsils are typical of diphtheria, which has become rare but dangerous in this country. They smell noticeably sweet like acetone and bleed when touched. The patients usually feel very sick and have to go to an isolation ward immediately.

What are the signs of an abscess?

An accumulation of pus between the tonsil and the surrounding capsule (a peritonsillar abscess) often leads to severe swallowing difficulties. The voice may sound different. Affected people have increased salivation and can hardly open their mouth. Usually a rounded protrusion can be seen in the area of ​​an almond and the uvula deviates to the side. A tonsil abscess needs to be treated promptly.

Tonsillitis: this is how the doctor makes the diagnosis

The doctor asks about the symptoms and the history of the disease. A thorough examination of the mouth, throat, nose and ears is then carried out using special optical devices.

Doctors use scoring systems to better assess whether tonsillitis is caused by viruses or bacteria. The assessment includes, among other things, whether there is a fever and whether the cervical lymph nodes are enlarged.

A rapid strep test can provide additional information. To do this, the doctor rubs a cotton swab over various places in the throat (smear). The result is available after a few minutes. However, an inconspicuous test result does not rule out a streptococcal infection. In this case, the doctor can have a sample examined in the laboratory. The result is more accurate but takes a few days. Statutory health insurance companies only pay for the rapid test up to the age of 16.

Blood tests are only appropriate in some situations, for example if you suspect glandular fever.

In certain cases, an ultrasound examination of the soft tissues of the neck (e.g. to detect an abscess) or the removal of a tissue sample can be useful.

Therapy: How is tonsillitis treated?

Often the tonsils become inflamed as part of a cold. Then viruses are usually the trigger. An antibiotic won't help in such cases.

Purulent almonds, fever, but no cough - this combination indicates a bacterial infection of the tonsils. The doctor may then prescribe an antibiotic to reduce the risk of complications.

If bacterial tonsillitis is left untreated, the risk of developing an otitis media or an abscess in the area of ​​the tonsil increases. Inflammation of the kidneys or of the heart and joints (rheumatic fever) occurs less frequently.

An almond abscess usually requires immediate antibiotic therapy or even surgery.

If an antibiotic is necessary, the drug should be taken for the recommended duration of therapy. Otherwise secondary diseases cannot be reliably prevented. Side effects such as diarrhea occur. Patients should contact their doctor in such cases.

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Tonsillitis: which (home) remedies help against ailments?

  • Ibuprofen, for example, can help with fever and pain. Children should no Are taking acetylsalicylic acid
  • In the pharmacy there are many herbal active ingredients in different dosage forms that are supposed to have a soothing effect on sore throats. However, their effectiveness has not always been proven beyond doubt by scientific studies