Tonsillitis:

Definition: inflammation of the tonsils.

Types:

A) Acute tonsillitis
B) Chronic tonsillitis

Acute tonsillitis

Incidence: It is common in children

Etiology: mainly caused by hemolytic streptococci and usually

associated with regional cervical lymphadenopathy.

Types:

1- Acute catarrhal tonsillitis: tonsils are enlarged and red.

2- Acute follicular tonsillitis:

a) Acute suppurative inflammation occurs in lymphoid follicles, and

mouth of crypts which appear covered by pus.

b) The surface of tonsils show pus spots.

3- Membranous tonsillitis:
a) The exudate fuses forming a yellow membrane covering the
tonsillar surface.
b) It is symmetrical and limited to tonsillar boundaries
c) Non- adherent➔Easily removed without leaving a bleeding
surface.

Complications:

1- Spread:
a) Local spread of infection:
- nose rhinitis

- sinuses sinusitis

- nasopharynx nasopharyngitis

- tracheo- bronchial bronchopneumonia &lung abscess.

- peritonsillar space peritonsillar abscess

B) blood spread: septicem-ia or pyemia

C) lymphatic spread: cervical lymphadenopathy

2- Autoimmune disease: rheumatic fever ,ADPGN

 Chronic tonsillitis:

1- Chronic non specific tonsillitis: repeated unresolved acute attacks of

tonsillitis.
Types: either hypertrophic or Atrophic (small in size and fibrotic)
2- Chronic specific tonsillitis: T.B , syphilis,fungal.

Tuberculosis of the tonsils

A) Primary infection: more common in children and caused by drinking
infected milk .
Primary cervical complex develops and consists of:
1- A small tuberculous focus in the tonsil
2- Tuberculous lymphangitis
3- Tuberculous lymphadenitis of the cervical nodes which become
enlarged, soft and caseous.

The caseous nodes may open on the skin by sinuses

B) Secondary infection:
Caused by spread of infection from pulmonary lesions.
It manifests as an ulcer:
Shape: irregular
Edge: undermined edge
Base: soft
Floor: caseous