Synonyms
Chronic tonsillitis
Definition
Chronic tonsillitis is present when the inflammation of the palatine tonsils lasts longer than three months. Chronic tonsillitis can progress very variably, sometimes unnoticed, sometimes with severe symptoms of recurrent acute tonsillitis. The complication, rheumatic fever, is a rare but very threatening complication.
The therapy for chronic tonsillitis is the surgical tonsillectomy. On the one hand, a protracted inflammation after acute tonsillitis can be the cause. This is favoured if the immune system is poor or if a prescribed antibiotic is discontinued prematurely.
A previous tonsillotomy (partial removal of the palatal tonsils) also increases the risk of chronic tonsillitis. On the other hand, a smouldering inflammation can develop in the depths of the palatine tonsils, the so-called crypts. These crypts contain detritus, a mushy, crumbly mass of dead cells, food remains and white blood cells.
The detritus can no longer flow off sufficiently and clogs the crypts. The problem is that detritus is an optimal breeding ground for germs. The bacteria multiply and repeatedly lead to acute inflammations.
The symptoms of chronic tonsillitis also differ from the acute form. Patients mainly complain of sore throats, severe difficulty swallowing and sometimes high fever. The symptoms of chronic tonsillitis are less obvious.
Tonsillitis is considered chronic if it does not heal for at least three months or recurs several times a year. The symptoms vary greatly from patient to patient. Some do not notice their chronic tonsillitis at all, others suffer from recurrent acute tonsillitis.
In most cases the symptoms are very discreet, as the inflammation is persistent but rather mild. Although slight difficulty in swallowing is experienced, this is often dismissed as an atypical scratching of the throat or a feeling of dryness. In addition, a subjectively bad taste is often felt in the mouth, which does not improve with brushing.
In addition, there is also an unpleasant bad breath perceived by other people. This is due to the fact that in chronic tonsillitis, bacteria that are permanently fed by food residues sit in the small niches of the tonsils and their metabolic products are perceived as having a bad smell. This explains another symptom of chronic tonsillitis, described as white patches (not pus), which are the visible correlate of inflamed tissue, pathogens, food remnants and partially dead tissue.
In addition to these symptoms, which are limited to the neck area, very unspecific symptoms affecting the body and the overall well-being are often described. These include general reduced performance and sleepiness. Concentration disorders can also occur.
These symptoms are an expression of the non-healing, latent inflammation of the tonsils. In addition, an enlargement of the lymph nodes in the neck can be observed in chronic tonsillitis. They appear as slight lumps below the lower jaw, which are painless in most cases.
In addition, the main symptom of this disease is that the chronic inflammation repeatedly develops into acute recurrences with the typical symptoms of acute tonsillitis. At this point at the latest, or even after attentive observation of the above symptoms, the diagnosis of chronic tonsillitis can be made. Only few patients with chronic tonsillitis consult a doctor at all.
and pus on the tonsilsFatigue is one of the main symptoms of chronic tonsillitis, along with fatigue and reduced ability to concentrate. In chronic tonsillitis, the bacteria have manifested themselves in the throat and pharynx for at least 3 months. While the throat was the sole source of infection in the first few weeks, over time they have usually spread to other parts of the body.
This happens relatively easily via the blood and lymph channels, which transport body fluids to even the “remotest corners” of the body. The most common bacterial pathogens are beta-haemolytic streptococci or Streptococcus pyogenes. In addition to tonsillitis, scarlet fever and erysipelas, i.e. sharply defined, painful reddening of the skin, are also part of its disease pattern.
This is intended to illustrate that the body has to deal with all the more “construction sites” after a longer period of infection. The more the immune system has to do, the more energy it needs for its work and the more exhausted and tired we feel. The fatigue is therefore a result of the body’s constant defence against antibodies.
In the same way, fatigue and lack of concentration occur. These symptoms are therefore frequent side effects of chronic tonsillitis. A typical appearance in the context of chronic tonsillitis is swollen lymph nodes in the neck.
They are noticeable as palpable nodules under the skin and express the inflammation. In most cases, the lymph nodes in chronic tonsillitis are not painful. The swelling is a natural reaction to substances and cells that have been transferred to the lymph fluid by the inflammatory process. Conspicuous lymph nodes due to chronic tonsillitis are therefore harmless and sometimes the only perceived symptom.
