Tonsillitis and Its Pathophysiology

Tonsillitis is the inflammation which is associated with the inflammation of pharyngeal tonsils, which usually extend to other related regions like adenoid and lingual tonsils. Due to this spread and extension the term pharyngitis is used because it affects the whole pharynx area. Among various pathological and ethological factors one mostly affecting is group A beta-hemolytic Streptococcus pyogenes (GABHS). Celsius in around First century AD perfumed tonsillectomy. He used to perform it with sharp tool and used vinegar and other herbal product for rinsing after surgery. It was the Celsius contribution for physicians to consider this as medical condition.

Tonsillitis start to be considered as a medical fear in late 19^th century. After the death of American president George Washington’s due to suspected pharyngitis discussion started among the physicians. Kean,s books published in late 19^th century as Domestic medical literature further took the problem of tonsillitis and discussed it with broad explanation. It is still considered one of the burden on society and need a special concern to be tackled.

Various Disease of Mouth Including Tonsillitis

 Definition

Tonsillitis is inflammation of the pharyngeal tonsils. The inflammation generally spreads to the adenoid and the lingual tonsils; that’s is the reasons the terms pharyngitis is used. Here  for this article I am considering pharyngo-tonsillitis and adenotonsillitis equivalent. Lingual tonsillitis is the inflammation of tissues at the base of the tongue.

Tonsillitis become “Carrier state” when there is positive bacterial culture of group A beta hemolytic Streptococcus pyogenes as a contributing factor .

Causes of Tonsillitis

Pathophysiology and Etiology of Various Type Tonsillitis

Various causes are considered as contributing factors for this disease like some bacteria and viruses and some immunologic factors. Dense population, crowded residential and undernourishment also support tonsillitis. High number of episodes of acute pharyngitis and acute tonsillitis are affected by viruses like:

v Herpes simplex virus

v Epstein-Barr virus (EBV)

v Cytomegalovirus (CMV)

v Various other strains of  herpes viruses

v Adenovirus

v Measles virus

One Study has also shown EBV as a causative agents for 19 % of exudative tonsillitis in children without causing mononucleosis. Bacteria contribute for around 15-30% cases of pharyngotonsillitis. Anaerobes among the bacteria play notorious role in tonsillar disease. As previously mentioned the culprit which cause most cases of bacterial tonsillitis are group A beta hemolytic streptococcus (GABHS). These GABHS have special adherence capability by binding to specific receptors present on tonsillar epithelium. Other bacteria like Mycoplasma pneumoniae, Corynebacterium diphtheria, and Chlamydia pneumoniae occasionally cause acute pharyngitis. Neisseria gonorrhea may be a contributing factor for tonsillitis in sexually active people. Arcanobacteriumhaemolyticum is an significantsource of pharyngitis in Scandinavia people and the people of United Kingdom but is not recognized as such in Americans