Risk of infection
Acute tonsillitis is known to be a highly contagious, common disease. Chronic tonsillitis must also be said to be contagious. The infection occurs mainly through droplet infection.
When sneezing or coughing, the pathogens pass from person to person in tiny water droplets via the air inhaled by other people. However, the probability of infection is not as high as in acute tonsillitis, since the pathogens are located deep in the crypts of the tonsils and are thus more difficult to cough up, and a smaller number are located in the throat. If an acute inflammation breaks out in the course of chronic tonsillitis, the patient is highly contagious again and should avoid crowds.
In the case of acute purulent tonsillitis, the rule is that the inflammation is no longer contagious approximately one day after starting antibiotic therapy. This does not generally apply to chronic tonsillitis, as the pathogens are located deep in the indentations of the tonsils within food remains and dead cells and partially evade the effect. The disease is still contagious.
The doctor will first ask about the symptoms as part of an anamnesis. This is followed by a physical examination. Special attention is paid to palpation of the cervical lymph nodes and examination of the palate region.
The palatal tonsils usually appear reduced in size and scarred (atrophic). Only rarely are they enlarged and swollen (hypertrophic). The surface often appears very fissured due to the crater-shaped crypts.
When pressure is applied to the tonsils, crumbly detritus and pus can be squeezed out. The tonsils are hardened by the scarring and are difficult to move with a spatula through the examiner. The palatal arches are usually reddened.
The jaw angle lymph nodes are usually permanently enlarged, but do not hurt when palpated. Carcinoma of the tonsils: A malignant tumour originating from the palatal tonsil is rare. However, it is important to remember that if only one side is affected, the tumour also spreads to areas outside the tonsil and looks irregular.
If the tonsils are only scarred but do not cause any discomfort, the ENT physician must take a sample and examine it under a microscope; if the tonsils are scarred but do not cause any discomfort, a therapy with disinfectant brushes is initiated. Often herbal or homeopathic remedies that strengthen the immune system are also administered. In case of repeated tonsillitis, antibiotics are prescribed each time.
However, if more than three bacterial tonsillitis cases occur per year, accompanied by fever and requiring antibiotic therapy, a tonsillectomy (removal of the palatine tonsils) should be performed. The ENT physician will also perform a tonsillectomy in cases of chronic tonsillitis associated with symptoms such as bad breath or difficulty swallowing. There are a number of known home remedies to treat tonsillitis.
Commonly used, for example, is tea made from sage or chamomile extract, which can be used to gargle against pain and inflammation. In addition, one covers the increased water requirement with inflammations so. Also known as home remedies are warming neck compresses, which may be wrapped around the neck together with various preparations made from healing earth or curd cheese.
However, the use of household remedies for chronic tonsillitis is generally not very promising: The chronic inflammation persists. The effects of the above-mentioned or similar home remedies are soothing and supportive of healing, so that they can be useful if the condition worsens again towards acute tonsillitis. If, on the other hand, you have been suffering from chronic tonsillitis for months, which causes significant discomfort and becomes acute again and again, consulting a doctor is usually the best course of action.
The danger of dangerous complications of chronic tonsillitis, such as kidney or heart damage and rheumatic fever, should not be underestimated. Therefore, home remedies do not make surgery to remove the tonsils (tonsillectomy) unnecessary. In the treatment of chronic tonsillitis, antibiotics play a role if the symptoms worsen.
Antibiotics are substances that intervene in the metabolism of bacteria at many different points, thus inhibiting their growth or killing them. For example, they are the drug of choice for infectious diseases such as acute tonsillitis. However, antibiotics are not effective against viruses.
Antibiotics are also used to treat chronic tonsillitis. They are used when the chronic, symptom-free inflammation develops into acute tonsillitis with pain and difficulty swallowing. Penicillin preparations are then used or, if these are not sufficient, erythromycin or clarithromycin.
Care must be taken to keep taking the product for as long as the doctor prescribes, even after the symptoms have subsided. However, antibiotics are not sufficient as a therapy for the actual chronic tonsillitis. The inflammation remains symptom-free and plagues the patient at regular intervals.
In this case, surgical removal of the tonsils should be recommended. One of the treatment options for some patients is the use of homeopathy. If there are doubts about antibiotics, surgery, or if the patient is convinced of the superiority of homeopathic remedies, this alternative is sometimes used first.
Homeopathy is considered to have fewer side effects. One of the preparations used for chronic tonsillitis is potassium sulfuricum (potassium sulfate), which is also prescribed for menstrual problems or depressive moods. The proven diluting potencies are D6 to D12.
It is said to help against inflammation in late stages such as chronic tonsillitis. From the field of homeopathy, various medicinal herbal preparations containing extracts of thyme, arnica or sage are also used. These plants have been proven to have anti-inflammatory effects.
Essential oils for inhalation soothe the throat and relieve symptoms. Overall, however, chronic tonsillitis must be seen as a disease which, if left untreated, can be accompanied by serious complications. Thus, the use of homeopathy to relieve symptoms and as a supplement is not harmful.
However, it does not replace the use of antibiotics or a removal of the tonsils, which in many cases is the only cure for chronic tonsillitis and certainly prevents dangerous secondary diseases. In the case of recurrent tonsillitis, surgical removal is indicated. In a study of the University Medical Center Hamburg-Eppendorf, a good third of the affected patients could be cured.
At least a slight improvement was achieved in 2/3. However, tonsillectomy is one of the most complicated operations with a 5 percent risk of bleeding on the first and 5 to 8 postoperative days. Many patients therefore wish to cure tonsillitis with natural remedies.
The naturopathic approach to this is, among other things, a change of diet and an intestinal rehabilitation, as the origin from a naturopathic point of view lies in a malnutrition. The aim is to strengthen the body’s defences and help the body to get rid of the pathogen by itself. In addition to proper nutrition, warm or cold compresses, camomile tea and sufficient physical protection can also contribute to healing.
Heart infection: The smouldering inflammation in chronic tonsillitis can have dangerous effects on the entire body. Starting from the depths of the tonsils, bacteria – especially streptococci – can spread to all organs of the body via the blood and lymphatic system. Since the tonsils act as a focus, this is called a focal infection.
The body forms antibodies against the pathogens. These antibodies clump together with bacterial components and clog the smallest vessels in distant organs. Mostly kidney, skin, joints or heart are affected.
This can lead to dangerous rheumatic fever. Joint inflammation, nephritis and inflammatory heart disease can be the result. In the worst case, heart valve defects or a rapid decline in kidney function can be the result.
For diagnosis, the doctor takes a smear of the tonsils to detect streptococci. Elevated inflammation values and antistreptolysin are found in the blood as a sign of antibody formation against streptococci. The only possible therapy is tonsillectomy to remove the focus.
Chronic tonsillitis is often accompanied by severe bad breath, much to the dismay of those affected. It is caused by the bacterial decomposition of food. Since in chronic tonsillitis there are always bacteria in the mouth and throat area, strong bad breath can hardly be avoided.
The bacteria produce hydrogen sulphide, amines and short-chain carboxylic acids during their metabolic processes. These produce a foul, very unpleasant halitosis. Unfortunately, this bad breath is very persistent and can only be covered up with difficulty.
Mouthwashes and tooth brushes are the means of choice. The tongue can also be scraped off to drive away the annoying smell. Hard-boiled coffee beans can also be chewed – this is to neutralize the acidic smell when burping.
Sugary pastilles are not recommended. These nourish the bacteria, and in the long run aggravate bad breath. The danger of chronic tonsillitis is the development of an inflammatory rheumatic systemic disease, rheumatic fever.
This disease is usually caused by an existing infection with the group A streptococcus pathogen. The reason for this is that the surfaces of the bacteria have certain abnormalities that our immune system recognises. This is important in order to ensure that our immune system is able to defend itself as effectively as possible.
However, the surface structure of certain cells in our body is similar to the surface characteristics of the streptococci, which means that when the immune system is activated, not only are the streptococci massively fought, but the immune system also attacks cells of our own body erroneously. This happens when bacteria not only cause problems on the tonsils, but in the case of chronic tonsillitis have now partially made it into the bloodstream. Cells that have these similar surface characteristics include those of the heart or pericardium.
The pericardium (medical term: pericardium) is virtually a sack that surrounds the heart. When the immune system fights the body’s own cells, an inflammation of the pericardium (endocarditis) occurs. However, heart muscle cells can also be affected, and this is known as myocarditis.
Children are more likely to develop endocarditis if rheumatic fever is present, whereas adults are more likely to suffer from arthritis associated with rheumatic fever. There are some unspecific symptoms that may indicate the presence of rheumatic fever or endocarditis. These include increased body temperature, joint pain and increased heart rate.
The development of rheumatic fever is dangerous because in many cases permanent damage can remain. Particularly acquired heart valve defects can often be associated with a previous infection with streptococci and an accompanying rheumatic fever. Damage to the heart muscle cells can also cause cardiac arrhythmias.
One therapy, and thus a reduction in the risk of permanent damage, is the administration of antibiotics to eliminate the streptococci underlying the disease. If the diagnosis of rheumatic fever with associated cardiac activity is present, anti-inflammatory substances such as glucocorticoids should also be taken. It is also important to prevent recurrent infection with streptococci.
