Tonsillitis or angina – colloquially known as tonsillitis – (synonyms: Angina; Angina catarrhalis; Angina Plaut-Vincentii; Angina tonsillaris; Pharyngotonsillitis; Streptococcal angina; Streptococcal tonsillitis; Tonsillopharyngitis; ICD-10 J35.0: Chronic tonsillitis; J03.-: Acute tonsillitis) generally refers to inflammation of the palatine tonsils. The pharyngeal tonsils (tonsilla pharyngea; synonyms: tonsilla pharyngealis, tonsilla pharyngica, adenoid vegetations – colloquially called polyps) and the lingual tonsil (tonsilla lingualis) of the lymphatic pharyngeal ring may also be affected. According to the acute S2k guideline, only one of the following three diagnoses should be given in patients with sore throat with or without difficulty swallowing:
- “acute tonsillitis” (tonsillitis).
- “acute pharyngitis” (pharyngitis).
- “acute tonsillopharyngitis” (inflammation of the tonsils and pharyngeal mucosa).
Acute tonsillitis is caused mainly by viral, rarely by bacterial pathogens. Pathogens see under “Causes”. Pathogen reservoir is the human being. The contagiousness of the pathogen is high. The disease occurs more frequently in the cold and humid seasons. Transmission of the pathogen (infection route) is aerogenic: droplet infection in the air. Human-to-human transmission: Yes
Incubation period (time from infection to onset of disease) is usually 1-3 days. The duration of illness is usually 7-14 days. Tonsillitis can be classified by location into:
- Unilateral (one-sided) tonsillitis.
- Bilateral (bilateral) tonsillitis
Furthermore, a classification according to the clinical aspect is common:
- Catarrhal angina – redness and swelling of the tonsils.
- Follicular angina – stipple-like fibrinous coatings on the crypts of the tonsils
- Lacunar angina: redness and confluent (flowing into each other) fibrinous coatings.
The time course also allows a classification:
- Acute (tonsillitis acuta)
- Recurrent (acute) tonsillitis (RAT) – repeated occurrence of acute tonsillitis with symptom-free or symptom-free intervals.
The severity also allows a classification:
- Simple tonsillitis
- Purulent tonsillitis
- Necrotizing (associated with scarring of the affected tissue) tonsillitis.
Frequency peak: children are more often affected because they are more easily infected, for example, in school and kindergarten. Tonsillitis is a very common disease. In the context of infection by ß-hemolytic streptococci of Lancefield group A, tonsillitis is no longer infectious 24 hours after the start of antibiotic therapy. The disease does not lead to immunity. Course and prognosis: The disease can occur in both acute and recurrent (acute) forms. Angina catarrhalis, the inflammation associated with a virus-related cold, is treated without antibiotics. Penicillin is the drug of choice for all other, purulent forms of tonsillitis. The prognosis for acute tonsillitis is good. In recurrent (acute) tonsillitis, the palatine tonsils are permanently inflamed by bacteria and secondary diseases may occur. If tonsillitis is caused by ß-hemolytic streptococci, acute rheumatic fever, glomerulonephritis (inflammatory kidney disease that occurs on both sides of the glomeruli (kidney corpuscles) and can lead to permanent kidney damage), or endo-, myo-, and/or pericarditis (endocarditis; inflammation of the heart muscle; pericarditis) may occur. The affected person may even suffer permanent damage such as a heart valve defect (HKF). Usually, chronic tonsillitis requires tonsillectomy (removal of the affected tonsils). Other indications (a compelling medical reason) for tonsillectomy include recurrent (recurring) acute tonsillitis, peritonsillar abscess (abscess formation (encapsulated cavity filled with pus) in the loose connective tissue surrounding the palatine tonsil), and severely enlarged palatine tonsils in children.