What is catarrhal tonsillitis, its photos and symptoms

Bilateral lacunar tonsillitis

Acute tonsillitis

(from the Latin tonsillae - tonsils), in everyday life -
(from the Latin ango - “I squeeze, squeeze, soul”), an infectious disease with local manifestations in the form of acute inflammation of the components of the lymphatic pharyngeal ring, most often the palatine tonsils, caused by streptococci or staphylococci, less often other microorganisms, viruses and fungi (see Etiology for more details [⇨]) [3]. Sore throat is also called an exacerbation of chronic tonsillitis.

Classification[edit | edit code]

The most common vulgar (ordinary, banal) sore throats are: catarrhal, lacunar, follicular, fibrinous, phlegmonous, herpetic and ulcerative membranous.

Catarrhal[edit | edit code]

Catarrhal tonsillitis develops acutely, the patient complains of a burning sensation in the throat, dryness, soreness, and then there is slight pain when swallowing. A clinical picture of astheno-vegetative syndrome is observed. The temperature is usually low-grade. Upon examination, the tonsils are hyperemic, somewhat enlarged in size, and in some places may be covered with a thin film of mucopurulent exudate. The tongue is dry and coated. There is a slight increase in regional lymph nodes. Typically, clinical manifestations disappear within 3-5 days.

Follicular[edit | edit code]

Follicular tonsillitis debuts with an increase in body temperature to 38-39 °C. The clinic begins with severe pain in the throat when swallowing, often radiating to the ear. Depending on the severity of intoxication, headache, lower back pain, fever, chills, and general weakness occur. A general blood test revealed neutrophilic leukocytosis, eosinophilia, and elevated ESR. Most often, regional lymph nodes are enlarged, their palpation is painful, in some cases there is an enlargement of the spleen. Children may have vomiting, meningism, confusion, and diarrhea. There is hyperemia of the soft palate and tonsils, on the surface of which numerous round, somewhat raised yellowish or yellowish-white dots are visible. The duration of the disease is 5-7 days.

Lacunar[edit | edit code]

Lacunar tonsillitis occurs with symptoms similar to follicular tonsillitis, but more severe. With it, yellowish-white plaques appear against the background of the hyperemic surface of the enlarged tonsils. The duration of the disease is 5-7 days. In some cases, follicular or lacunar angina can develop according to the type of fibrinous angina, when the basis for the formation of the film is bursting suppurating follicles, or in lacunar angina the fibrinous film spreads from the area of ​​necrotization of the epithelium at the mouths of the lacunae.

Fibrinous[edit | edit code]

Fibrinous tonsillitis is characterized by the formation of a single continuous plaque of a whitish-yellow color, which can extend beyond the tonsils. This type of sore throat can develop from lacunar or proceed independently with the presence of a continuous film already in the first hours of the disease. In the latter case, an acute onset is characteristic with high fever, chills, severe symptoms of general intoxication, sometimes with signs of brain damage.

Phlegmonous (intratonsillar abscess)[edit | edit code]

Phlegmonous tonsillitis is relatively rare. Its development is associated with purulent melting of the tonsil area. The defeat is usually unilateral. The tonsil is enlarged, hyperemic, its surface is tense, and painful on palpation. On examination, a forced position of the head and enlarged regional lymph nodes, painful on palpation, are characteristic. Complaints of sore throat when swallowing, talking; headache, increased body temperature to 39-40 °C, symptoms of general intoxication. Pharyngoscopy: the tonsil is enlarged, hyperemic, its surface is tense, and painful on palpation. Characterized by trismus of the masticatory muscles, asymmetrical pharynx due to displacement of the uvula and tonsil to the healthy side. The mobility of the soft palate is limited.

Herpetic[edit | edit code]

Herpetic sore throat often develops in childhood. Its causative agent is the Coxsackie A virus. The disease is highly contagious and is transmitted by airborne droplets and rarely by the fecal-oral route. Herpetic sore throat debuts acutely, fever appears, the temperature rises to 38-40 ° C, sore throat occurs when swallowing, headache, muscle pain in the abdomen; There may be vomiting and diarrhea. In the area of ​​the soft palate, uvula, on the palatine arches, on the tonsils and the back wall of the pharynx, small reddish bubbles are visible. After 3-4 days, the blisters burst or resolve, and the mucous membrane takes on a normal appearance.

Ulcerative-membranous[edit | edit code]

The cause of ulcerative membranous sore throat is considered to be a symbiosis of a spindle-shaped rod and an oral spirochete, which often live in the oral cavity of healthy people. Morphological changes are characterized by necrosis of the pharynx surface of one tonsil with the formation of an ulcer. The patient complains of a feeling of awkwardness and a foreign body when swallowing, putrid odor from the mouth, and increased salivation. Body temperature, as a rule, is not elevated. There is moderate leukocytosis in the blood. Regional lymph nodes are enlarged on the affected side. The duration of the disease is from 1 to 3 weeks, sometimes lasting several months.

Catarrhal tonsillitis: photos of tonsils, symptoms and treatment

Catarrhal tonsillitis is the simplest form of inflammation of the tonsils. But the relatively mild symptoms do not mean that treatment can be carried out independently.

What kind of disease is this?

Catarrhal tonsillitis, or acute catarrhal tonsillitis, or tonsillopharyngitis, is an infectious inflammation of the pharyngeal tonsils. Accompanied by damage to the surface of the mucous membrane of the oropharynx and lymphoid formations.

It is a mild form of bacterial sore throat. The development of the disease is such that there are no ulcers and a thick white coating in the tonsil area. And this distinguishes tonsillopharyngitis from other - more severe - forms of the disease.

Reasons for development

The main causative agent of catarrhal tonsillitis is beta-hemolytic streptococcus. Less commonly - staphylococcus, pneumococcus. Sometimes the disease can be caused by yeast-like fungi.

Most of the pathogenic microorganisms that cause inflammation live permanently on the tonsils. But they do not lead to an acute form of the disease.


The active proliferation of bacteria that are in the oropharynx in a latent state can be provoked by:

  • hypothermia;
  • avitaminosis;
  • exacerbation of chronic diseases;
  • viral infections;
  • immunodeficiency;
  • overwork, sleep disturbance, stress;
  • improper use of medications.

Catarrhal sore throat can be infected. Ways of infection entering the body:

  • airborne (coughing, sneezing, communicating with an infected person) - when coughing and sneezing, bacteria located on the mucous membranes easily spread over a distance of 1-1.5 meters and are able to penetrate the body of a healthy person;
  • contact-household (direct contact with a patient, use of contaminated household items) - bacteria remain on dishes and household items, which, when they get on the mucous membranes, can cause an infectious disease.

But due to the fact that the causative agents of acute tonsillitis are constantly present in the body, infection occurs mainly against the background of the same additional factors - weakened immunity, stress, ARVI, etc. That is why catarrhal tonsillitis occurs less frequently in adults than in children.


The infection is localized to the palatine tonsils. Their defeat is the first signs of the disease.

Then the inflammation moves to the pharyngeal surface. On the second day, the lymph nodes enlarge.

With catarrhal tonsillitis, the tonsils are inflamed, enlarged and covered with clear mucus without plaque. You can see what inflamed tonsils look like in the photo.

Appearance of tonsils in acute catarrhal tonsillitis

The first days of illness are important for starting treatment. Since the infection can further spread throughout the body, complications arise (diseases of the kidneys, heart, meninges).

Infection with catarrhal tonsillitis occurs very quickly - after 3-4 hours the first symptoms appear:

  • headache;
  • lack of appetite;
  • pain when swallowing;
  • elevated temperature (37 – 37.8 C);
  • joint pain;
  • weakness.

The course of the disease, especially in adults, is relatively mild. Fever and acute sore throat last for about three days.


Catarrhal sore throat is often confused with viral pharyngitis. They look at the tonsils in the mirror and see that they are inflamed. They diagnose themselves with “acute bacterial tonsillitis” and start taking antibiotics. There is more harm from such treatment than benefit.

Therefore, correct diagnosis of the disease is important, which includes the following steps.

Visual inspection. Performed by a doctor. Notes:

  • degree of enlargement and redness of the tonsils:
  • the presence or absence of plaque and/or colorless mucus;
  • swollen lymph nodes;
  • absence or presence of a runny nose:
  • degree of increase in body temperature.

Clinical blood test . Next, a blood test is prescribed. With catarrhal tonsillitis, changes in ESR indicators are insignificant. Bacterial culture. To carry out this analysis, a smear is taken from the surface of the tonsil. Today, smear analysis is often performed using the PCR method. This allows you to accurately determine the type of pathogenic bacteria and select effective medications. Analysis of urine . With a severe bacterial infection, protein and red blood cells increase in the urine.

How to treat catarrhal sore throat?

To relieve symptoms and reduce the duration of the disease, it is recommended:

  • exclude spicy and solid foods;
  • drink more fluids;
  • quit smoking and alcohol;
  • maintain bed rest;
  • take all prescribed medications.

Drug treatment

To avoid complications and stop the spread of infection, antibiotics are prescribed. Usually this:

  • Amoxicillin;
  • Sumamed (Azithromycin);
  • Cefatoxime.

The course of treatment is 10 days. For Azithromycin and Sumamed – 5 days.

The dosage is determined by the doctor based on the patient’s age, weight, course of the disease and individual characteristics of the body.

If the doctor has not done a bacterial culture and cannot be completely sure that you have catarrhal bacterial tonsillitis and not a viral form of the disease or a common ARVI, you do not need to take antibiotics.

To reduce fever, reduce joint pain and headaches, use:

  • Ibuprofen;
  • Paracetamol;
  • Ibuklin.

You can use antipyretic drugs for no more than 5 days.

It is recommended to alternate drugs with paracetamol and ibuprofen every 4-6 hours.

Antihistamines relieve swelling in the oropharynx. This:

  • Suprastin;
  • Zyrtec;
  • Claritin;
  • Zodak.

Local antiseptics reduce sore throat and have an antibacterial effect: Use:

  • Septolete;
  • Hexoral;
  • Inhalipt;
  • Bioparox.

You should carefully read the instructions for use of the drugs to avoid side effects. Some products are contraindicated for children under 14 years of age and pregnant women.

Gargling also has an antibacterial effect. For this procedure use:

  • Miramistin;
  • Chlorhexidine;
  • Furacilin.

It is recommended to gargle 4-6 times a day with a warm solution prepared as indicated in the instructions for the drug.

Are inhalations necessary?

Therapy for catarrhal tonsillitis may include inhalations. The procedure helps to reduce sore throat, shorten the duration of the acute phase of the disease, prevent complications in the oropharynx, reduce inflammation of the tonsils, and relieve swelling.

To avoid harm during inhalation, contraindications for the procedure should be taken into account. This:

  • heat;
  • the presence of ulcers on the tonsils;
  • the patient's tendency to nosebleeds;
  • diseases of the ENT organs (benign or malignant tumor);
  • high blood pressure;
  • heart diseases;
  • bronchial asthma;
  • pregnancy;
  • children's age up to 7 years.

Decoctions and infusions of herbs are used as a solution for inhalation.

  1. Add 1 liter of water to the dry mixture of chamomile, mint and sage, bring to a boil, wait until the solution cools slightly and breathe over the steam for 5-7 minutes.
  2. Pour 2 tablespoons of St. John's wort and chamomile into a liter of boiling water, breathe over the steam for 5-7 minutes, covering your head with a towel.

To avoid getting burned during inhalation, monitor the temperature of the decoction and take precautions.

It's good to use a nebulizer.

Carry out the procedure an hour before meals or an hour after.

The following is used as a solution for inhalation using a nebulizer:

  • Furacilin;
  • Miramistin;
  • Chlorophyllipt;
  • Cromohexal;
  • saline;
  • mineral water "Essentuki", "Narzan".

Folk remedies

Another option for treating catarrhal tonsillitis is herbal remedies. Or, as they say, “traditional medicine”.

  1. Pour chamomile, St. John's wort and eucalyptus in equal proportions (1 tablespoon) with a liter of boiling water, let it brew and rinse with warm infusion several times a day.
  2. Pour 2 tablespoons of oak bark into half a liter of water, boil for 5 minutes, cool and gargle 3 times a day.
  3. Dissolve 1-2 teaspoons of baking soda in a glass of warm water and gargle 3-4 times a day.

Features of treatment during pregnancy

The body of a pregnant woman is extremely vulnerable to pathogens of various diseases, including tonsillopharyngitis. And any infection can harm an actively developing fetus.

In the first trimester, the disease can lead to oxygen starvation, improper formation of vital organs, and even miscarriage.


  • avoid crowded places;
  • do not contact people who are already sick;
  • take vitamins;
  • Healthy food;
  • maintain a sleep and rest schedule;
  • regularly carry out wet cleaning;
  • ventilate the premises.

But if infection has already occurred, treatment of catarrhal tonsillitis during pregnancy should be provided only by a doctor. Self-activity is unacceptable.

Pregnant women are prescribed gentle antibacterial agents of the latest generation, which practically do not harm the child.

If the disease was detected in the early phases, only local antiseptic drugs and traditional medicine are prescribed.

Features of symptoms and treatment in children

Catarrhal tonsillitis in children usually occurs in a more acute form with vivid symptoms. Body temperature can rise to 39C and last up to 5 days.

Against the background of elevated temperature, convulsions and vomiting, sleep disturbances, loss of appetite, weakness and lethargy may begin.

Treatment is carried out with antibiotics, local antiseptics, antihistamines (to relieve swelling in the oropharynx), non-steroidal anti-inflammatory drugs to reduce pain and fever.

If the disease was diagnosed quickly, it is possible to limit the use of antibiotics to drugs from the macrolide group, which have the least toxicity among all antibacterial agents. An example of such a medicine is Sumamed.

Immediately after the first symptoms of the disease appear, you must contact a pediatrician who will conduct an examination, refer you for the necessary tests, and prescribe effective treatment. And will give recommendations on nutrition and daily routine during the child’s illness.


If treated incorrectly and untimely, catarrhal tonsillitis can lead to complications: Possible:

  • development of more severe forms of angina (lacunary, follicular);
  • otitis, laryngitis;
  • heart damage;
  • acute rheumatism, which subsequently becomes chronic;
  • renal failure;
  • blood poisoning (sepsis);
  • meningitis.

Source: https://gorlolor.ru/ru/tonzillit/kataralnyiy/

Etiology[edit | edit code]

In more than 50%[4] of cases of angina, the main etiological role belongs to group A β-hemolytic streptococcus.

  • Bacteria - most often β-hemolytic streptococcus of group A, less often staphylococcus or a combination of both.
  • Viruses - most often adenoviruses (types 1–9), Coxsackie enterovirus, herpes virus.
  • Spirochete Vincent in symbiosis with a spindle-shaped rod (ulcerative membranous tonsillitis).
  • Fungi of the genus Candida in symbiosis with pathological cocci.

Predisposing factors: local and general hypothermia of the body, decreased local and general immunity, trauma to the tonsils, the state of the central and autonomic nervous system, impaired nasal breathing, chronic inflammatory processes in the oral cavity, nose and paranasal sinuses[4].

Catarrhal tonsillitis: symptoms and treatment of the disease - Website about

Catarrhal tonsillitis is the simplest form of inflammation of the tonsils. But the relatively mild symptoms do not mean that treatment can be carried out independently.

Catarrhal sore throat in adults: symptoms and treatment

Catarrhal tonsillitis is a disease spread by airborne droplets through contact with a patient. The disease is characterized by an inflammatory process in the palatine tonsils; it affects the oral mucosa without penetrating deep into the body.

Sore throats in children are most common during spring-autumn temperature fluctuations. To recognize the disease in the early stages of development and begin effective treatment, you should know the primary symptoms of the inflammatory process.

Causes of catarrhal tonsillitis

Catarrhal tonsillitis is a form of tonsillitis caused by simple streptococcus, rhino or adenovirus, staphylococcus or yeast-like fungus. A distinctive feature of inflammation is its mild course, without the appearance of purulent follicles and whitish plaque.

With catarrhal tonsillitis in adults, redness of the tonsils and arches near the root of the tongue is observed. The latter increase in diameter, there is redness, and they are partially covered with a cloudy mucous membrane.

Source: https://nyaganngp1.ru/preparaty/kataralnaya-angina-simptomy-i-lechenie-bolezni.html

Clinical manifestations[edit | edit code]

In acute primary tonsillitis, the clinical picture is manifested by symptoms of damage to the tonsils - varying degrees of pain in the throat when swallowing, signs of general intoxication, hyperemia, swelling of the tonsils (catarrhal tonsillitis), fibrinous-purulent plaque at the mouths of the lacunae (lacunar tonsillitis), a picture of the “starry sky” (follicular tonsillitis), a removable grayish-yellow coating, under which superficial, painless ulcers are found (ulcerative membranous tonsillitis), regional lymphadenitis.

A sore throat begins with a sore throat and a sharp increase in body temperature to 39–40 °C (sometimes up to 41 °C). Sore throat is usually severe and sharp, but can also be mild. Lymph nodes enlarge. They can be easily felt under the lower jaw and cause pain. Sore throat can also occur at lower body temperatures - from 37 to 38 ° C, but with greater damage to the throat.

Chronic diseases of the tonsils and adenoids ICD code J35

Chronic diseases of the tonsils and adenoids develop in the case of persistent colds, which are accompanied by sore throat.

An infectious-allergic disease, which manifests itself as persistent inflammation of the tonsils and is characterized by a chronic course, develops after infectious diseases or as a manifestation of allergies.

It occurs with enlargement and loosening of the tonsils, some of their parts are covered with purulent plaque. Antibacterial therapy and local sanitizing agents are used.

J35.1 Hypertrophy of the tonsils.

It is more often noted in children as a general lymphatic constitution. In hypertrophied tonsils, most often, inflammatory processes do not occur. Enlarged tonsils make it difficult to breathe and swallow food. The patient's speech is unintelligible and his breathing is noisy. Local astringents and cauterizing substances are used for therapy.

J35.2 Adenoid hypertrophy.

Pathological proliferation of the nasopharyngeal tonsils, which occurs due to hyperplasia of lymphoid tissues. The disease is often diagnosed in young children.

If there is no proper treatment, the adenoids quickly enlarge and make nasal breathing difficult. This condition causes associated diseases of the throat, ear, or nose. Treatment can be conservative using inhalations, hormones and homeopathic remedies, or surgical.

J35.3 Hypertrophy of the tonsils with hypertrophy of the adenoids.

Cases of simultaneous enlargement of the tonsils and adenoids in children are common, especially if there is a frequent history of infectious diseases. Comprehensive treatment is used, which contains topical preparations and medications to maintain immunity.

J35.8 Other chronic diseases of the tonsils and adenoids.

They arise due to frequent colds, which are accompanied by sore throats. The main treatment is aimed at restoring the immune system, using sanitizing drugs.

J35.9 Chronic disease of the tonsils and adenoids, unspecified.

Caused by pathogenic microorganisms that cause frequent sore throats presented in ICD 10, with the slightest cooling, and general intoxication of the body. Treatment boils down to washing the tonsils and using physiotherapeutic procedures. Therapy is carried out in courses at least twice a year.

All throat diseases that are accompanied by tonsillitis or other changes according to ICD 10 must be treated only under the supervision of a doctor. This will prevent possible complications and speed up the healing process.

Sore throat is one of the most common symptoms.

Let's consider a disease for which this symptom is very pronounced - lacunar tonsillitis (ICD code 10 J03).

Complications[edit | edit code]

Of the complications of angina, the most common are acute otitis media, sinusitis, arthritis, acute laryngitis, laryngeal edema, neck phlegmon, peripharyngeal abscess, acute cervical lymphadenitis.

The most dangerous complications of angina:

  • in the early stages - pharyngeal abscesses (formation of large cavities filled with pus), spread of infection into the chest along the fascial spaces of the neck with the formation of mediastinitis, into the cranial cavity with the development of inflammation of the meninges (meningitis), infectious-toxic shock (poisoning of the body with waste products of microbes and breakdown of body tissues), sepsis (“blood poisoning”, that is, the penetration of infection into the blood and its spread throughout the body);
  • in the later stages (after 2-4 weeks) - acute rheumatic fever [5], glomerulonephritis (inflammation of the kidneys of non-infectious origin, leading to severe health problems, including kidney failure).

Treatment[edit | edit code]

Basic recommendations: taking antibiotics, bed rest in the first days of the disease, a non-irritating, soft and nutritious diet, vitamins, drinking plenty of fluids[4].

  • In the treatment of bacterial sore throats, various types of antibiotics and antimicrobial drugs of synthetic origin are used (depending on the sensitivity of the microbe and the patient’s response to medications), various local antiseptics, which are available in the form of a spray or aerosol, as well as tablets, lozenges and lozenges.
  • In the treatment of fungal tonsillitis (this disease is provoked mainly by a fungus from the genus Candida), antifungal drugs are used. Fungal tonsillitis often occurs after long-term treatment with antibiotics.

At temperatures above 38 degrees, antipyretics may be prescribed. For bacterial etiology of sore throats, in many cases an antibiotic is prescribed that is active against coccal flora (streptococci and staphylococci), the course is carried out for at least 7 days. The goal of antibiotics for group A streptococcal infections is to avoid rheumatic fever as a possible complication[6].

Due to the lack of evidence, it can be argued that the widely advertised “immunomodulators” and “antivirals for all acute respiratory viral infections” do not work either against acute respiratory viral infections or against tonsillitis and pharyngitis caused by viruses.

Nuances of tonsillitis coding

The International Classification of Diseases, which is often referred to as the abbreviation ICD, is constantly updated. In the list of 10 revisions, tonsillitis is classified as acute respiratory diseases of the upper respiratory tract. This disease is assigned code J03.

The general symbol refers to several subtypes of sore throat according to ICD 10:

  • 0 is streptococcal acute tonsillitis. The causative agent from a number of cocci causes inflammation of the tonsils most often - it accounts for up to 70% of diagnoses. This includes primary catarrhal tonsillitis, which is considered the initial stage of the inflammatory process of the tonsils.
  • 8 - groups of acute types of tonsillitis, the causative agent of which has been identified. For clarification, there is an additional block with complete information under the letters B95-97. This point excludes viral herpes sore throat.
  • 9 - positioned as acute tonsillitis of unspecified etiology. The course of ailments from this group may be accompanied by high fever, severe pain, and difficulty breathing.

Follicular tonsillitis and lacunar purulent form do not have a separate coding. They are taken into account by the code according to ICD 10, subclause J03.9. This also includes gangrenous and ulcerative tonsillitis.

The classification considers the subtypes of the disease according to the pathogen. This helps, after diagnosis, to quickly determine the optimal set of medications for therapy.

Sore throat is an infectious disease that can affect patients of different age categories. Treatment involves neutralizing and destroying the pathogen and alleviating current symptoms.

Prevention[edit | edit code]

To prevent tonsillitis, timely sanitation of foci of chronic infection (carious teeth, chronic tonsillitis, purulent lesions of the paranasal sinuses, etc.) and elimination of the causes of impaired nasal breathing are necessary.

Sore throat can be contagious (especially with scarlet fever), so the patient should be placed in a separate room, often ventilated and wet cleaned, and children and the elderly should not be allowed near him. A special container is provided for the patient, which is boiled or doused with boiling water after each use.

Notes[edit | edit code]

  1. ↑ Disease Ontology release 2019-05-13 - 2019-05-13 - 2020.
  2. ↑ Monarch Disease Ontology release 2018-06-29sonu - 2018-06-29 - 2020.
  3. Preobrazhensky N.A., Kodolova I.M.
    Throat sore throat // Great Medical Encyclopedia: 30 volumes / chapter. ed. B.V. Petrovsky. — 3rd ed. - Moscow: Soviet Encyclopedia, 1974. - T. 1. A - Antibiosis. — 576 p. — 150,000 copies.
  4. 1 2 3 4 Kunelskaya N.L., Turovsky A.B., Kudryavtseva Yu.S.
    Sore throats: diagnosis and treatment // Russian Medical Journal: scientific article. - 2010. - T. 18, No. 7. - P. 438–440.
  5. Belov BS, Nasonova VA, Grishaeva TP, Sidorenko SV.
    // Antibiot Khimioter.. - 2000;45(4):22-7.. - PMID 10851646.
  6. Stanford T. Shulman, Alan L. Bisno, Herbert W. Clegg, Michael A. Gerber, Edward L. Kaplan.
    Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America // Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. — 2012-11-15. - T. 55, issue. 10. - pp. 1279–1282. — ISSN 1537-6591. - doi:10.1093/cid/cis847.
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