Xp tonsillitis code according to microbial code 10. Code microbial chronic tonsillitis

Laser therapy is aimed at increasing the energy rating of the body, eliminating immunological abnormalities at the systemic and regional levels, reducing inflammation in the tonsils, followed by the elimination of metabolic and hemodynamic disorders. The list of measures to solve these problems includes percutaneous irradiation of the tonsils, direct irradiation of the throat area (preferably with red spectrum laser light or associative IR and red spectrum). The effectiveness of treatment is significantly increased with simultaneous irradiation of the above-mentioned zones with light of the red and IR spectrum according to the following method: direct irradiation of the tonsils is carried out with light of the red spectrum, their percutaneous irradiation with light of the IR spectrum.

Rice. 67. Impact on the projection zones of the tonsils on the anterior-lateral surface of the neck.

When choosing LILI modes at the initial stages of the course treatment, percutaneous irradiation of the projection zones of the tonsils with IR spectrum light is performed at a frequency of 1500 Hz, and at the final stages, as the positive effects of the course therapy are obtained, the frequency decreases to 600 Hz, and then, at the final stage of the course treatment - up to 80 Hz.

Additionally performed: NLBI of the ulnar vessels, contact to the area of ​​the jugular fossa, the zone of segmental innervation of the tonsils in the projection of the paravertebral zones at the C3 level, the impact on regional lymph nodes (irradiation is performed only in the absence of lymphadenitis!).

Rice. 68. Zones of general influence in the treatment of patients with chronic tonsillitis. Symbols: pos. "1" - projection of the ulnar vessels, pos. "2" - jugular fossa, pos. "3" - zone of the 3rd cervical vertebra.

Rice. 69. Projection zone of the submandibular lymph nodes.

Also, to potentiate the effects of the regional level, distant irradiation with a defocused beam of receptor zones located in the anterior cervical region, on the scalp, in the anterior parietal, occipital, temporal zones, on the outer surface of the lower leg and forearm and in the rear of the foot is performed.

Modes of irradiation of medical zones in the treatment of tonsillitis

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Chronic diseases of the tonsils and adenoids (J35)

In Russia, the International Classification of Diseases of the 10th revision (ICD-10) is adopted as a single regulatory document for accounting for morbidity, reasons for the population to apply to medical institutions of all departments, and causes of death.

ICD-10 was introduced into healthcare practice throughout the Russian Federation in 1999 by order of the Russian Ministry of Health dated May 27, 1997. №170

The publication of a new revision (ICD-11) is planned by WHO in 2017 2018.

With amendments and additions by WHO.

Processing and translation of changes © mkb-10.com

Chronic tonsillitis code mkb

Chronic Tonsillitis - Overview of Information

Chronic tonsillitis is an active, with periodic exacerbations, chronic inflammatory focus of infection in the palatine tonsils with a general infectious-allergic reaction. The infectious-allergic reaction is caused by constant intoxication from the tonsillar focus of infection, which increases with the exacerbation of the process. It disrupts the normal functioning of the whole organism and aggravates the course of general diseases, often itself becomes the cause of many common diseases, such as rheumatism, diseases of the joints, kidneys, etc.

Chronic tonsillitis with good reason can be called a "disease of the 20th century", which "successfully" crossed the threshold of the 21st century. and still constituting one of the main problems not only of otorhinolaryngology, but also of many other clinical disciplines, in the pathogenesis of which allergies, focal infection and deficient states of local and systemic immunity play the main role. However, the basic factor of particular importance in the occurrence of this disease, according to many authors, is the genetic regulation of the immune response of the palatine tonsils to the effects of specific antigens. On average, according to a survey of different groups of the population, in the USSR in the second quarter of the 20th century. the incidence of chronic tonsillitis fluctuated within 4-10%, and already in the third quarter of this century, from the message of I.B. -31.1%. According to V.R. Hoffman et al. (1984), 5-6% of adults and 10-12% of children suffer from chronic tonsillitis.

ICD-10 code

J35.0 Chronic tonsillitis.

ICD-10 code J35.0 Chronic tonsillitis

Epidemiology of chronic tonsillitis

According to domestic and foreign authors, the prevalence of chronic tonsillitis among the population varies widely: in adults it ranges from 5-6 to 37%, in children - from 15 to 63%. It must be borne in mind that between exacerbations, as well as in the nonanginal form of chronic tonsillitis, the symptoms of the disease are largely habitual and have little or no concern for the patient, which significantly underestimates the actual prevalence of the disease. Often, chronic tonsillitis is detected only in connection with the examination of the patient for some other disease, in the development of which chronic tonsillitis plays a large role. In many cases, chronic tonsillitis, remaining unrecognized, has all the negative factors of a focal tonsillar infection, weakens a person's health, and worsens the quality of life.

Causes of chronic tonsillitis

The cause of chronic tonsillitis is a pathological transformation (the development of chronic inflammation) of the physiological process of the formation of immunity in the tissue of the palatine tonsils, where the normally limited inflammation process stimulates the production of antibodies.

The palatine tonsils are part of the immune system, which consists of three barriers: lympho-blood (bone marrow), lympho-interstitial (lymph nodes) and lympho-elitelial (lymphoid accumulations, including tonsils, in the mucous membrane of various organs: pharynx, larynx, trachea and bronchi, intestines). The mass of palatine tonsils is an insignificant part (about 0.01) of the lymphoid apparatus of the immune system.

Symptoms of chronic tonsillitis

One of the most reliable signs of chronic tonsillitis is the presence of a history of tonsillitis. In this case, the patient must definitely find out what kind of increase in body temperature is accompanied by pain in the throat and for what period of time. Angina in chronic tonsillitis can be pronounced (severe sore throat when swallowing, significant hyperemia of the pharyngeal mucosa, with purulent attributes on the palatine tonsils, according to the forms, febrile body temperature, etc.), but adults often do not have such classic symptoms of angina. In such cases, exacerbations of chronic tonsillitis occur without a pronounced severity of all symptoms: the temperature corresponds to low subfebrile values ​​​​(37.2-37.4 C), sore throat when swallowing is insignificant, a moderate deterioration in general well-being is observed. The duration of the disease is usually 3-4 days.

Where does it hurt?

Screening

It is necessary to screen for chronic tonsillitis in patients with rheumatism, cardiovascular diseases, diseases of the joints, kidneys, it is also advisable to keep in mind that with common chronic diseases, the presence of chronic tonsillitis to one degree or another can activate these diseases as a chronic focal infection, therefore, in In these cases, examination for chronic tonsillitis is also necessary.\

Diagnosis of chronic tonsillitis

The diagnosis of chronic tonsillitis is established on the basis of subjective and objective signs of the disease.

The toxic-allergic form is always accompanied by regional lymphadenitis - an increase in lymph nodes at the corners of the lower jaw and in front of the sternocleidomastoid muscle. Along with the definition of an increase in lymph nodes, it is necessary to note their soreness on palpation, the presence of which indicates their involvement in the toxic-allergic process. Of course, for clinical assessment, it is necessary to exclude other foci of infection in this region (teeth, gums, nasal sinuses, etc.).

What needs to be examined?

What tests are needed?

Who to contact?

Treatment of chronic tonsillitis

With a simple form of the disease, conservative treatment is carried out and for 1-2 years, 10-day courses. In cases where, according to local symptoms, the effectiveness is insufficient or an exacerbation (tonsillitis) has occurred, a decision may be made to repeat the course of treatment. However, the absence of convincing signs of improvement, and even more so the occurrence of repeated tonsillitis, is considered an indication for the removal of the palatine tonsils.

With the toxic-allergic form of the first degree, it is still possible to carry out conservative treatment of chronic tonsillitis, however, the activity of the chronic tonsillar focus of infection is already obvious, and general severe complications are likely at any time. In this regard, conservative treatment for this form of chronic tonsillitis should not be delayed unless a significant improvement is observed. The toxic-allergic form of the II degree of chronic tonsillitis is dangerous with rapid progression and irreversible consequences.

More about treatment

Acute tonsillitis (tonsillitis) and acute pharyngitis in children

Acute tonsillitis (tonsillitis), tonsillopharyngitis and acute pharyngitis in children are characterized by inflammation of one or more components of the lymphoid pharyngeal ring. For acute tonsillitis (tonsillitis), acute inflammation of the lymphoid tissue, mainly of the palatine tonsils, is typical. Tonsillopharyngitis is characterized by a combination of inflammation in the lymphoid pharyngeal ring and the mucous membrane of the pharynx, and acute pharyngitis is characterized by acute inflammation of the mucous membrane and lymphoid elements of the posterior pharyngeal wall. In children, tonsillopharyngitis is more often noted.

ICD-10 code

• J02 Acute pharyngitis.
• J02.0 Streptococcal pharyngitis.
• J02.8 Acute pharyngitis due to other specified pathogens J03 Acute tonsillitis.
• J03.0 Streptococcal tonsillitis.
• J03.8 Acute tonsillitis due to other specified pathogens
• J03.9 Acute tonsillitis, unspecified

ICD-10 code J02 Acute pharyngitis J03 Acute tonsillitis J03.8 Acute tonsillitis due to other specified pathogens J03.9 Acute tonsillitis, unspecified J02.8 Acute pharyngitis due to other specified pathogens J02.9 Acute pharyngitis, unspecified

Epidemiology of angina and acute pharyngitis in children

Acute tonsillitis, tonsillopharyngitis and acute pharyngitis develop in children mainly after the age of 1.5 years, due to the development of the lymphoid tissue of the pharyngeal ring by this age. In the structure of acute respiratory infections, they account for at least 5-15% of all acute respiratory diseases of the upper respiratory tract.

There are age differences in the etiology of the disease. In the first 4-5 years of life, acute tonsillitis / tonsillopharyngitis and pharyngitis are mainly of a viral nature and are most often caused by adenoviruses, in addition, acute tonsillitis / tonsillopharyngitis and acute pharyngitis can be caused by herpes simplex viruses and Coxsackie enteroviruses. Starting from the age of 5, B-hemolytic streptococcus group A (S. pyogenes) becomes of great importance in the occurrence of acute tonsillitis, which becomes the leading cause of acute tonsillitis / tonsillopharyngitis (up to 75% of cases) at the age of 5-18 years. Along with these causes of acute tonsillitis / tonsillopharyngitis and pharyngitis, group C and G streptococci, M. pneumoniae, Ch. pneumoniae and Ch. psittaci, influenza viruses.

Causes of angina and acute pharyngitis in children

Acute tonsillitis / tonsillopharyngitis and acute pharyngitis are characterized by an acute onset, usually accompanied by a rise in body temperature and deterioration, the appearance of a sore throat, refusal of small children to eat, malaise, lethargy, and other signs of intoxication. On examination, redness and swelling of the tonsils and the mucous membrane of the posterior pharyngeal wall, its "granularity" and infiltration, the appearance of purulent exudation and raids, mainly on the tonsils, an increase and soreness of the regional anterior cervical lymph nodes, are revealed.

Symptoms of angina and acute pharyngitis in children

Where does it hurt?

What worries?

Classification of angina and acute pharyngitis in children

Primary tonsillitis / tonsillopharyngitis and pharyngitis and secondary ones can be distinguished, which develop in infectious diseases such as diphtheria, scarlet fever, tularemia, infectious mononucleosis, typhoid fever, human immunodeficiency virus (HIV). In addition, there is a mild form of acute tonsillitis, tonsillopharyngitis and acute pharyngitis and severe, uncomplicated and complicated.

Diagnosis is based on a visual assessment of clinical manifestations, including a mandatory examination by an otolaryngologist.

In severe cases of acute tonsillitis / tonsillopharyngitis and acute pharyngitis and in cases of hospitalization, a peripheral blood test is performed, which in uncomplicated cases reveals leukocytosis, neutrophilia and a shift of the formula to the left with a streptococcal etiology of the process and normal leukocytosis or a tendency to leukopenia and lymphocytosis with a viral etiology of the disease.

Diagnosis of angina and acute pharyngitis in children

What needs to be examined?

How to investigate?

What tests are needed?

Who to contact?

Treatment varies depending on the etiology of acute tonsillitis and acute pharyngitis. With streptococcal tonsillopharyngitis, antibiotics are indicated, with viral they are not indicated, with mycoplasmal and chlamydial - antibiotics are indicated only in cases where the process is not limited to tonsillitis or pharyngitis, but descends into the bronchi and lungs.

The patient is shown bed rest in the acute period of the disease for an average of 5-7 days. The diet is normal. Gargling with 1-2% Lugol's solution is shown. 1-2% solution of hexetidium (hexoral) and other warm drinks (milk with Borjomi, milk with soda - 1/2 teaspoon of soda per 1 glass of milk, milk with boiled figs, etc.).

Treatment of angina and acute pharyngitis in children

More about treatment

Angina (acute tonsillitis) - Overview of information

Angina (acute tonsillitis) is an acute infectious disease caused by streptococci or staphylococci, less often by other microorganisms, characterized by inflammatory changes in the lymphadenoid tissue of the pharynx, more often in the palatine tonsils, manifested by sore throat and moderate general intoxication.

What is angina, or acute tonsillitis?

Inflammatory diseases of the pharynx have been known since ancient times. They received the common name "angina". In essence, according to B.S. Preobrazhensky (1956), the name "throat angina" combines a group of heterogeneous diseases of the pharynx and not only inflammation of the lymphadenoid formations proper, but also tissues, the clinical manifestations of which are characterized, along with signs of acute inflammation, by the syndrome of compression of the pharyngeal space.

Judging by the fact that Hippocrates (5th-4th centuries BC) repeatedly cited information related to a disease of the pharynx, very similar to a sore throat, we can assume that this disease was the subject of close attention of ancient doctors. The removal of the tonsils in connection with their disease was described by Celsus. The introduction of the bacteriological method into medicine gave reason to classify the disease according to the type of pathogen (streptococcal, staphylococcal, pneumococcal). The discovery of Corynebacterium diphtheria made it possible to differentiate banal sore throat from a sore throat-like disease - diphtheria of the throat, and scarlet fever manifestations in the pharynx, due to the presence of a rash characteristic of scarlet fever, were isolated as an independent symptom characteristic of this disease even earlier, in the 17th century.

At the end of the XIX century. a special form of ulcerative-necrotic angina is described, the occurrence of which is due to the Plaut-Vincent fusospirochete symbiosis, and when hematological studies were introduced into clinical practice, special forms of pharyngeal lesions were identified, called agranulocytic and monocytic angina. Somewhat later, a special form of the disease was described that occurs with alimentary-toxic aleukia, similar in its manifestations to agranulocytic angina.

It is possible to damage not only the palatine, but also the lingual, pharyngeal, laryngeal tonsils. However, most often the inflammatory process is localized in the palatine tonsils, therefore it is customary under the name "angina" to mean acute inflammation of the palatine tonsils. This is an independent nosological form, but in the modern sense, it is essentially not one, but a whole group of diseases, different in etiology and pathogenesis.

ICD-10 code

J03 Acute tonsillitis (tonsillitis).

In everyday medical practice, a combination of tonsillitis and pharyngitis is often observed, especially in children. Therefore, the unifying term “tonsillopharyngitis” is quite widely used in the literature, however, tonsillitis and pharyngitis are included separately in ICD-10. Given the exceptional importance of streptococcal etiology of the disease, streptococcal tonsillitis J03.0), as well as acute tonsillitis caused by other specified pathogens (J03.8), are distinguished. If necessary, an additional code (B95-B97) is used to identify the infectious agent.

ICD-10 code J03 Acute tonsillitis J03.8 Acute tonsillitis due to other specified pathogens J03.9 Acute tonsillitis, unspecified

Epidemiology of angina

In terms of the number of days of disability, angina ranks third after influenza and acute respiratory infections. More often children and persons of younger age get sick. The frequency of visits to the doctor per year is cases per 1000 population. The incidence depends on population density, household, sanitary and hygienic, geographical and climatic conditions. It should be noted that the disease is more common among the urban population than among the rural population. According to the literature, 3% of those who have been ill develop rheumatism, and in patients with rheumatism after the disease, in 20-30% of cases, a heart disease is formed. In patients with chronic tonsillitis, angina is observed and 10 times more often than in practically healthy people. It should be noted that approximately every fifth person who has had a sore throat subsequently suffers from chronic tonsillitis.

Causes of angina

The anatomical position of the pharynx, which determines the wide access to it for pathogenic environmental factors, as well as the abundance of vascular plexuses and lymphadenoid tissue, turn it into a wide entrance gate for various pathogenic microorganisms. The elements that primarily respond to microorganisms are solitary accumulations of lymphadenoid tissue: palatine tonsils, pharyngeal tonsils, lingual tonsils, tubal tonsils, lateral ridges, as well as numerous follicles scattered in the region of the posterior pharyngeal wall.

The main cause of angina is due to an epidemic factor - infection from a patient. The greatest danger of infection exists in the first days of the disease, however, a person who has had an illness is a source of infection (albeit to a lesser extent) during the first 10 days after a sore throat, and sometimes longer.

In 30-40% of cases in the autumn-winter period, pathogens are represented by viruses (types 1-9 adenoviruses, coronaviruses, rhinovirus, influenza and parainfluenza viruses, respiratory syncytial virus, etc.). The virus can not only play the role of an independent pathogen, but can also provoke the activity of the bacterial flora.

Symptoms of angina

Symptoms of angina are typical - a sharp sore throat, fever. Among the various clinical forms, banal sore throats are more common than others, and among them are catarrhal, follicular, lacunar. The division of these forms is purely conditional, in essence it is a single pathological process that can progress rapidly or stop at one of the stages of its development. Sometimes catarrhal angina is the first stage of the process, followed by a more severe form or another disease occurs.

Where does it hurt?

Classification of angina

During the foreseeable historical period, numerous attempts were made to create a somewhat scientific classification of throat sore throats, however, each proposal in this direction was fraught with certain shortcomings and not through the “fault” of the authors, but due to the fact that the creation of such a classification for a number of objective reasons is practically impossible. These reasons, in particular, include the similarity of clinical manifestations not only with different banal microbiota, but also with some specific angina, the similarity of some common manifestations with different etiological factors, frequent discrepancies between bacteriological data and the clinical picture, etc., therefore, most authors, guided by practical needs in diagnostics and treatment, they often simplified their proposed classifications, which, at times, were reduced to classical concepts.

These classifications were and still are of a pronounced clinical content and, of course, are of great practical importance, however, these classifications do not reach a truly scientific level due to the extreme multifactorial nature of etiology, clinical forms and complications. Therefore, from a practical point of view, it is advisable to subdivide angina into non-specific acute and chronic and specific acute and chronic.

Classification presents certain difficulties due to the variety of types of the disease. The classifications of V.Y. Voyachek, A.Kh. Minkovsky, V.F. Undritsa and S.Z. Romma, L.A. Lukozsky, I.B. Soldatov et al. lies one of the criteria: clinical, morphological, pathophysiological, etiological. As a result, none of them fully reflects the polymorphism of this disease.

The classification of the disease developed by B.S. Preobrazhensky and subsequently supplemented by V.T. Palchun. This classification is based on pharyngoscopic signs, supplemented by data obtained from laboratory studies, sometimes information of an etiological or pathogenetic nature. By origin, the following main forms are distinguished (according to Preobrazhensky Palchun):

• episodic form associated with autoinfection, which is also activated under adverse environmental conditions, most often after local or general cooling;
• an epidemic form that occurs as a result of infection from a patient with a sore throat or a bacillus carrier of a virulent infection; usually the infection is transmitted by contact or airborne droplets;
• tonsillitis as another exacerbation of chronic tonsillitis, in this case, a violation of local and general immune responses results in chronic inflammation and tonsils.

The classification includes the following forms.

• Banal:
  • catarrhal;
  • follicular;
  • lacunar;
  • mixed;
  • phlegmonous (intratonsillar abscess).
• Special forms (atypical):
  • ulcerative necrotic (Simanovsky-Plaut-Vincent);
  • viral;
  • fungal.
• For infectious diseases:
  • with diphtheria of the pharynx;
  • with scarlet fever;
  • measles;
  • syphilitic;
  • with HIV infection;
  • damage to the pharynx with typhoid fever;
  • with tularemia.
• For blood diseases:
  • monocytic;
  • with leukemia:
  • agranulocytic.
• Some forms according to localization:
  • tray tonsil (adenoiditis);
  • lingual tonsil;
  • guttural;
  • lateral ridges of the pharynx;
  • tubal tonsil.

Under "tonsillitis" is understood a group of inflammatory diseases of the pharynx and their complications, which are based on the defeat of the anatomical formations of the pharynx and adjacent structures.

J. Portman simplified the classification of angina and presented it in the following form:

1. Catarrhal (banal) non-specific (catarrhal, follicular), which, after localization of inflammation, are defined as palatine and lingual amygdalitis, retronasal (adenoiditis), uvulitis. These inflammatory processes in the pharynx are called "red sore throats."
2. Membranous (diphtheria, pseudomembranous non-diphtheria). These inflammatory processes are called "white tonsillitis". To clarify the diagnosis, it is necessary to conduct a bacteriological study.
3. Angina, accompanied by a loss of structure (ulcerative necrotic): herpetic, including with Herpes zoster, aphthous, ulcerative Vincent, with scurvy and impetigo, post-traumatic, toxic, gangrenous, etc.

Screening

When identifying the disease, they are guided by complaints of sore throat, as well as characteristic local and general symptoms. It should be borne in mind that in the first days of the disease, with many common and infectious diseases, there may be similar changes in the oropharynx. To clarify the diagnosis, dynamic observation of the patient and sometimes laboratory tests (bacteriological, virological, serological, cytological, etc.) are necessary.

Diagnosis of angina

The anamnesis should be collected with the utmost care. Great importance is attached to the study of the general condition of the patient and some "pharyngeal" symptoms: body temperature, pulse rate, dysphagia, pain syndrome (unilateral, bilateral, with or without irradiation to the ear, the so-called pharyngeal cough, feeling of dryness, perspiration, burning, hypersalivation - sialorrhea, etc.).

Endoscopy of the pharynx in most inflammatory diseases makes it possible to establish an accurate diagnosis, however, the unusual clinical course and endoscopic picture make it necessary to resort to additional methods of laboratory, bacteriological and, if indicated, histological examination.

To clarify the diagnosis, it is necessary to conduct laboratory tests: bacteriological, virological, serological, cytological, etc.

In particular, the microbiological diagnosis of streptococcal angina, which includes a bacteriological examination of a smear from the surface of the tonsil or posterior pharyngeal wall, is important. The results of sowing largely depend on the quality of the material obtained. The smear is taken with a sterile swab; the material is delivered to the laboratory within 1 hour (for longer periods it is necessary to use special media). Before taking the material, you should not rinse your mouth or use deodorants for at least 6 hours. With the right technique for taking the material, the sensitivity of the method reaches 90%, the specificity is %.

What needs to be examined?

How to investigate?

What tests are needed?

Who to contact?

Treatment of angina

The basis of drug treatment of angina is systemic antibiotic therapy. On an outpatient basis, the appointment of an antibiotic is usually carried out empirically, therefore, information about the most common pathogens and their sensitivity to antibiotics is taken into account.

Preference is given to drugs of the penicillin series, since beta-hemolytic streptococcus is most sensitive to penicillins. On an outpatient basis, oral medications should be prescribed.

More about treatment

Prevention of angina

Measures for the prevention of the disease are based on the principles that have been developed for infections transmitted by airborne or alimentary routes, since tonsillitis is an infectious disease.

Preventive measures should be aimed at improving the external environment, eliminating factors that reduce the protective properties of the body in relation to pathogens (dustiness, smoke, excessive crowding, etc.). Among the measures of individual prevention are hardening of the body, physical education, the establishment of a reasonable regime of work and rest, exposure to fresh air, food with a sufficient content of vitamins, etc. The most important are therapeutic and preventive measures, such as sanitation of the oral cavity, timely treatment (if necessary, surgical) of chronic tonsillitis, restoration of normal nasal breathing (if necessary, adenotomy, treatment of diseases of the paranasal sinuses, septoplasty, etc.).

Forecast

The prognosis is favorable if treatment is started in a timely manner and carried out in full. Otherwise, it is possible to develop local or general complications, the formation of chronic tonsillitis. The period of disability of the patient is on average equal days.

RCHD (Republican Center for Health Development of the Ministry of Health of the Republic of Kazakhstan)
Version: Clinical Protocols of the Ministry of Health of the Republic of Kazakhstan - 2016

Acute tonsillitis (J03), Chronic tonsillitis (J35.0)

Otorhinolaryngology

general information

Short description

Approved
Joint Commission on the quality of medical services
Ministry of Health and Social Development of the Republic of Kazakhstan
dated June 23, 2016
Protocol #5

Acute tonsillitis- a general acute infectious-allergic disease with local manifestations in the form of acute inflammation of one or more components of the lymphadenoid pharyngeal ring, most often the palatine tonsils.

Chronic tonsillitis- persistent chronic inflammation of the palatine tonsils with a general infectious-allergic reaction.

Correlation between ICD-10 and ICD-9 codes

Protocol Users: general practitioners, otorhinolaryngologists, infectious disease specialists, hematologists.

Level of evidence scale:

Classification

Classification(according to Soldatov I.B.)

I.Acute tonsillitis:

Primary angina:
· catarrhal;
· lacunar;
· follicular;
Ulcerative membranous.

Secondary angina:
in acute infectious diseases - diphtheria, scarlet fever, measles, tularemia, typhoid fever;
in diseases of the blood system - infectious mononucleosis, agranulocytosis, alimentary-toxic aleukia, leukemia.

II. Chronic tonsillitis:

Non-specific:
The compensated form
decompensated form.

Specific:
with infectious granulomas, tuberculosis, scleroma, syphilis, scleroma.

Diagnostics (outpatient clinic)

DIAGNOSTICS AT OUTPATIENT LEVEL**

Diagnostic criteria

Acute tonsillitis

Complaints about: sore throat, weakness, headache, fever, chills, loss of appetite.

Catarrhal angina: burning sensation, dryness, perspiration, moderate sore throat, aggravated by swallowing, subfebrile body temperature, malaise, fatigue, headache.

Follicular angina: severe sore throat, sharply aggravated when swallowing, with irradiation to the ear, fever up to 38-40 ° C, difficulty swallowing, symptoms of intoxication - headache, weakness, chills, sometimes pain in the lower back and joints.

Lacunar angina: as well as with follicular, but it is more severe.

Chronic tonsillitis

Complaints about: frequent sore throats, subfebrile temperature, pain in muscles, joints, weakness, lethargy, fatigue, sleep disturbance.

Anamnesis: transferred sore throats, especially without antibiotic treatment, impaired nasal breathing.

Physical examination:

Acute tonsillitis:
with pharyngoscopy:

Catarrhal angina: diffuse hyperemia and swelling of the palatine tonsils.

Follicular angina: diffuse hyperemia, infiltration and swelling of the palatine tonsils, the presence of yellowish-white purulent dots on the surface of the tonsils.

Lacunar angina: hyperemia and swelling of the palatine tonsils, the surface of the tonsils is covered with a purulent coating of various shapes.

On palpation: enlargement and soreness of regional lymph nodes.

Chronic tonsillitis:
with pharyngoscopy:
liquid pus or caseous-purulent plugs in gaps (may be with a smell);
Giza's sign - congestive hyperemia of the edges of the palatine arches;
Sign of Zach - swelling of the upper edges of the anterior palatine arches;
a sign of Preobrazhensky - a roller-like thickening of the edges of the anterior palatine arches;
adhesions and adhesions of the tonsils with arches and a triangular fold;
Tonsils are small with a smooth or loosened surface;
Enlargement of individual regional lymph nodes, sometimes painful.
On palpation: in the absence of other foci of infection in this region.

Laboratory research:
UAC;
· OAM;
throat swab BL.

Instrumental research:
pharyngoscopy;
EKG.

Diagnostic algorithm:(scheme)

Diagnostics (ambulance)

DIAGNOSTICS AND TREATMENT AT THE EMERGENCY STAGE**

Diagnostic measures:
Collection of complaints, anamnesis.

Medical treatment:
analgesics.

Diagnostics (hospital)

DIAGNOSTICS AT THE STATIONARY LEVEL**

Diagnostic criteria at the hospital level**:

Diagnostic algorithm: see ambulatory level.

List of main diagnostic measures:

For acute tonsillitis:
UAC;
· OAM;
feces on worm eggs;
blood on RW;
smear on BL.

For chronic tonsillitis:
histological examination of the surgical material (palatine tonsils).

List of additional diagnostic measures: no.

Differential Diagnosis

For acute tonsillitis

For chronic tonsillitis

Treatment abroad

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Treatment

Drugs (active substances) used in the treatment

Treatment (ambulatory)

TREATMENT AT OUTPATIENT LEVEL

Treatment tactics**

Non-drug treatment:
bed rest;
sparing diet (milk-vegetable, fortified);
plentiful drink.

Drug treatment for acute tonsillitis:
Systemic antibiotic therapy
antipyretic and anti-inflammatory drugs
local rinsing and throat treatment with antiseptics.

Drug treatment for chronic tonsillitis:
Washing the lacunae of the tonsils according to N.V. Belogolov with antiseptic solutions or with the help of special devices
lubrication of the surface of the tonsils with a solution of iodine with glycerol for the treatment of tonsils

List of essential medicines:

Acute tonsillitis:

Other types of treatment:
Wave therapy
· ultrasound therapy;

UFO;
aerosols;
· laser therapy;

For acute tonsillitis:
- consultation of an infectious disease specialist - in case of suspected damage to the tonsils in infectious diseases;
- consultation of a hematologist - in case of suspected damage to the tonsils in blood diseases;

For chronic tonsillitis- to identify metatonsillar complications, a rheumatologist, cardiologist, nephrologist, neuropathologist.

Preventive actions:
Sanitation of the upper respiratory tract and dentoalveolar system;
strengthening of general and local immunity;
Timely and adequate therapy of acute tonsillitis.

Patient monitoring**: no.

For acute tonsillitis:
elimination of the local inflammatory process;
No signs of inflammation (pus) on the tonsils.

For chronic tonsillitis:
No recurrence of angina;
elimination of symptoms of intoxication and complications.

Treatment (hospital)

HOSPITAL TREATMENT**

Treatment tactics**: see ambulatory level.

Surgical intervention

Bilateral tonsillectomy:
Indications for 2-sided tonsillectomy:
Ineffectiveness of conservative treatment of chemotherapy;
Decompensated form of HT;
ChT complicated by paratonsillitis or paratonsillar abscess;
Tonsilogenic sepsis.

Other types of treatment:
Wave therapy
· ultrasound therapy;
UHF for regional lymph nodes;
UFO;
aerosols;
· laser therapy;
helium-neon laser radiation;
Washing of the tonsils according to N.V. Belogolov.

Indications for expert advice:
consultation of narrow specialists in the presence of concomitant pathology.

Indications for transfer to the intensive care unit and resuscitation:
Presence of complications after tonsillectomy (bleeding).

Treatment effectiveness indicators:
· after 2-sided tonsillectomy: no complaints of recurrence of angina.

Hospitalization

Indications for planned hospitalization:
Chronic tonsillitis:
· planned hospitalization surgical treatment - 2-sided tonsillectomy.

Indications for emergency hospitalization:
Acute tonsillitis:
emergency hospitalization in the infectious diseases department with severe intoxication;
With pain syndrome and hyperthermia.

Information

Sources and literature

1. Minutes of the meetings of the Joint Commission on the quality of medical services of the MHSD RK, 2016
   1. 1) Soldatov I.B. Lectures on otorhinolaryngology. - M.: Medicine.-1994.-288s. 2) Soldatov I.B. Guide to otorhinolaryngology. - M.: Medicine.-1997.- 608s. 3) PalchunV.T. Otorhinolaryngology. -Moscow "GEOTAR-Media". -2014.-654s. 4) Pluzhnikov M.S., Lavrenova G.V., et al. Chronic tonsillitis. - SPb.-20Yu.-224s. 5) Palchun V.T., Magomedov M.M., Luchikhin L.A. Otorhinolaryngology. -Moscow "GEOTAR-Media". -2008.-649s. 6) National Scientific Center for Expertise of Medicines and Medical Devices. http://www.dari.kz/category/search_prep 7) Kazakhstan national formulary. www.knf.kz 8) British National Formulary. www.bnf.com 9) Edited by prof. L.E. Ziganshina "Big reference book of medicines". Moscow. GEOTAR-Media. 2011. 10) Cochrane Library, www.cochrane.com 11) WHO Essential Medicines List. http://www.who.int/features/2015/essential_medicines_list/com

Information

Abbreviations used in the protocol

List of protocol developers:
1) Baymenov Amanzhol Zhumagaleevich - Candidate of Medical Sciences JSC "Astana Medical University", Associate Professor of the Department of Otorhinolaryngology and Eye Diseases, Chief Freelance Otorhinolaryngologist of the Ministry of Health and Social Development of the Republic of Kazakhstan.
2) Mukhamadieva Gulmira Aamantaevna - Doctor of Medical Sciences, Professor of the Department of Otorhinolaryngology and Eye Diseases of JSC "Astana Medical University", State Enterprise on the REM "City Hospital No. 1" of the Health Department of Astana City, Head of the Otorhinolaryngological Center No. 1.
3) Azhenov Talapbek Maratovich - Doctor of Medical Sciences, Republican State Enterprise on the REM "Hospital of the Medical Center Management of Presidential Affairs", head of the surgical department No. 1.
4) Gazizov Otegen Meerkhanovich - Doctor of Medical Sciences, Professor of the RSE on REM "Karaganda State Medical University", Head of the Department of Otorhinolaryngology and Neurosurgery.
5) Burkutbayeva Tatyana Nuridinovna - Doctor of Medical Sciences, Professor of JSC "Kazakh Medical University of Continuing Education", Professor of the Department of Otorhinolaryngology.
6) Satybaldina Gaukhar Kalievna - Candidate of Medical Sciences, JSC "Astana Medical University", assistant of the Department of Otorhinolaryngology and Eye Diseases.
7) Yersakhanov Bayan Kenzhekhanovna - JSC "Astana Medical University", assistant of the Department of Otorhinolaryngology and Eye Diseases.
8) Khudaibergenova Mahira Seidualievna - JSC "National Scientific Center of Oncology and Transplantation", clinical pharmacologist.

Conflict of interest: absent.

List of reviewers: Ismagulova Elnara Kireevna - Doctor of Medical Sciences, Professor of the RSE on REM "West Kazakhstan State Medical University named after Marat Ospanov", head of the course of otorhinolaryngology of the Department of Surgical Diseases No. 1.

Conditions for revision of the protocol: revision of the protocol 3 years after its publication and from the date of its entry into force or in the presence of new methods with a level of evidence.

Attached files

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This normative document promotes unity in the overall comparability of all medical materials.

What is the IBC used for?

The ICD is used to systematize analyzes and compare data on the levels of morbidity and mortality in the population, which were obtained in different countries and regions in different time periods.

The International Classification of Diseases is used to convert verbal formulations of diseases and other issues related to medicine into an alphanumeric code, which facilitates storage, retrieval and further analysis.

The International Classification of Diseases is a standard procedure, it helps to correctly analyze epidemiological risks and carry out the management process in medicine.

Classification allows you to analyze the general situation of the incidence of the population, calculate the spread of certain diseases and determine the relationship with various concomitant factors.

Acute tonsillitis ICD code J03

Throat diseases are common diseases in the population of different age groups. Let's consider the most common ones.

J03.0 Streptococcal tonsillitis.

The more common name is angina. It is called GABHS (group A beta-hemolytic streptococcus). It proceeds with elevated temperature and severe intoxication of the body.

The lymph nodes become enlarged and painful. The tonsils become loose and covered with a whitish coating partially or completely. For treatment, drugs of the penicillin group or macrolides are used.

J03.8 Acute tonsillitis.

Caused by other specified pathogens - caused by other pathogens, which include the herpes simplex virus. The disease proceeds according to the type of acute tonsillitis, the microbial code is 10. Treatment is selected based on the pathogen, which is determined in the laboratory.

J03.9 Acute tonsillitis, unspecified

May be follicular, gangrenous, infectious, or ulcerative. It proceeds as an acute illness with high fever, rashes on the tonsils and severe sore throat. Treatment is complex, antibiotics and local antiseptics are used.

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 tonsillitis.

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

It proceeds with an increase and loosening of the tonsils, some of their parts are covered with a purulent coating. 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 slurred, and breathing is noisy. For therapy, astringents and cauterizing substances of local action are used.

J35.2 Adenoid hypertrophy.

Pathological growth 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, then the adenoids quickly increase and make nasal breathing difficult. This condition causes concomitant diseases of the throat, ear, or nose. Treatment is conservative with the use of inhalations, hormones and homeopathic remedies, or surgical.

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

There are common cases of simultaneous enlargement of the tonsils and adenoids in children, especially if there is a frequent history of infectious diseases. A complex treatment is used, which contains topical preparations and drugs to maintain immunity.

J35.8 Other chronic diseases of the tonsils and adenoids

Arise due to frequent colds, which are accompanied by diseases of the throat. The main treatment is aimed at restoring the immune system, using sanitizing drugs.

J35.9 Chronic disease of tonsils and adenoids, unspecified

It is caused by pathogens that cause frequent sore throats presented in ICD 10, with the slightest cooling, and general intoxication of the body. Treatment is reduced to washing the tonsils and the use of physiotherapy. Therapy is carried out in courses, at least twice a year.

All diseases of the throat, which are accompanied by tonsillitis or other changes in microbial 10, should be treated only under the supervision of a physician. This will prevent possible complications and speed up the healing process.

Chronic diseases of the tonsils and adenoids (J35)

In Russia, the International Classification of Diseases of the 10th revision (ICD-10) is adopted as a single regulatory document for accounting for morbidity, reasons for the population to apply to medical institutions of all departments, and causes of death.

ICD-10 was introduced into healthcare practice throughout the Russian Federation in 1999 by order of the Russian Ministry of Health dated May 27, 1997. №170

The publication of a new revision (ICD-11) is planned by WHO in 2017 2018.

With amendments and additions by WHO.

Processing and translation of changes © mkb-10.com

Classification of acute tonsillitis according to microbial 10

Acute tonsillitis is a pathological process that can affect absolutely everyone, regardless of age and gender. It is characterized by more pronounced symptoms and manifests itself in the form of fever, headache, poor appetite. Treatment is reduced to eliminating the pathogenic microorganism and alleviating the general condition of the patient. According to the International Classification of Diseases, acute tonsillitis has the following ICD 10 code - ICD-10: J03; ICD-9: 034.0.

Acute tonsillitis is a contagious disease. The highest percentage of infection is observed in the first days of illness. The symptoms of this pathological process may vary depending on which type of tonsillitis was diagnosed.

catarrhal

This type of angina involves damage to the surface of the palatine tonsils. The catarrhal form is considered one of the easiest. If it is treated in a timely and correct manner, then the sore throat ends in recovery. And if this is not done, then it goes into a serious stage.

In the photo - acute catarrhal tonsillitis

Catarrhal angina is manifested by such symptoms:

Of course, the most basic symptom of this form of tonsillitis is a sore throat. This is due to the fact that all other signs fade into the background due to their weak severity. Diagnosis of catarrhal angina is reduced to the fact that the doctor examines the patient. During the examination, he will be able to detect swelling and redness of the tonsils. In addition, the mucous membrane of the tonsils takes the same form as the mucous membrane located near them. A distinctive feature of catarrhal angina from pharyngitis is that with it, redness is observed in the sky and the back wall.

Lacunar

This form of tonsillitis has a rather severe course, compared with catarrhal. They are characterized by severe sore throat, which makes it difficult for the patient to eat. Hence there is a lack of appetite. Temperatures rise to 40 degrees.

In the photo - lacunar tonsillitis

In addition, the patient is visited by such signs:

• chills;
• pain in the head;
• weakness;
• earache;
• rise in temperature to 40 degrees;
• regional lymph nodes are enlarged and painful on palpation;
• pain syndrome in the limbs and lower back.

Follicular

As for follicular tonsillitis, follicles are formed during its course. They look like formations of a yellow or yellowish-white hue. They pass through the affected mucous membrane of the tonsils. Their size does not exceed the size of the pin head.

In the photo - follicular tonsillitis

With follicular tonsillitis, the lymph nodes are enlarged, and when they are plucked, they bring pain to the patient. There are situations when follicular angina contributes to an increase in the spleen. The duration of this form of the disease will be 5-7 days. Symptoms such as fever, diarrhea, vomiting, sore throat are observed.

Lacunar

This form of tonsillitis is accompanied by the formation of lacunae. They look like purulent or whitish formations that affect the mucous membrane of the tonsils. Over time, they increase in size and affect a large part of the tonsil.

In the photo - lacunar tonsillitis

But education does not go beyond its boundaries. When removing lacunae, they do not leave bleeding wounds. The development of lacunar angina is carried out similarly to follicular, but only the course is more severe.

fibrous

For this disease, the presence of a continuous plaque is characteristic. It can take on white or yellow color. Compared to previous forms of tonsillitis, where plaque did not leave the borders of the tonsils, with fibrous angina, it can go beyond.

In the photo - fibrous angina

The formation of the film is carried out in the first hours of the onset of pathology. The acute form is characterized by the presence of fever, headache, general weakness, lack of appetite. Against the background of these symptoms, brain damage may develop.

Phlegmous

This form of angina is diagnosed extremely rarely. It is characterized by melting of the tonsil area. The defeat is applied to only one tonsil.

You can recognize the phlegmous form of tonsillitis by the following symptoms:

• sharp pain in the throat;
• chills;
• weakness;
• profuse salivation;
• body temperature;
• bad smell.

When examining the patient, one can detect an increase in the lymph nodes, when they are probed, they cause pain. During the examination, the doctor will note reddening of the sky on one side, swelling and displacement of the palatine tonsil. Since the mobility of the inflamed soft palate is limited, when taking liquid food, it can flow out through the nasal passages.

If you do not start timely therapy, then an abscess will begin to form on the tissues of the tonsils. It is also called a perinthosillar abscess. It can open on its own or have to use surgical methods.

On the video, phlegmonous tonsillitis:

After autopsy, the reverse development of the pathology occurs. It may happen that phlegmous tonsillitis is delayed for 2-3 months, while from time to time an abscess occurs. This kind of process can occur with improper prescription or administration of antibacterial drugs.

How to treat tonsillitis at home, and what means should be used in the first place, this article will help you understand.

But is it possible to warm the throat with tonsillitis, and how effective this remedy is, is described in great detail here in the article.

It will also be interesting to learn more about how tonsillitis is treated in a child: http://prolor.ru/g/bolezni-g/tonzillit/u-detej-simptomy-i-lechenie.html

It will also be interesting to learn about how to treat tonsillitis with folk remedies, and how to use these remedies correctly, this article will help you understand.

herpetic

This form of the disease is characterized by fever, abdominal pain, vomiting, pharyngitis, and the formation of ulcers that affect the back of the throat or soft palate. The Coxsackie virus can affect the development of herpetic sore throat. Most often, the disease is diagnosed in people in the summer and autumn. Infection occurs through contact with a sick person.

In the photo, it looks like herpetic sore throat

At the initial stage of the disease, there is a rise in temperature indicators, general weakness, fatigue, irritability. After a person experiences a sore throat, profuse salivation, runny nose. Redness is formed on the tonsils, palate and posterior pharyngeal wall. Their mucosa is covered with blisters, inside of which there is a serous fluid. Over time, they dry out, and crusts form in their place. With herpetic sore throat, diarrhea, vomiting and nausea can occur. For diagnosis, the doctor examines the patient and sends for a blood test.

Ulcerative nercotic

The development of this form of angina is associated with reduced immunity and a lack of vitamins. The causative agent is a spindle-shaped stick. It is located in the mouth of every person. Most often, the disease is diagnosed in older people. People who suffer from heart disease are also at risk.

Ulcerative necrotic angina has completely different symptoms compared to the diseases presented above:

• no rise in temperature;
• no sore throat and general weakness;
• there is a feeling of the presence of a foreign object in the throat;
• halitosis.

On the video, ulcerative nercotic angina:

During the examination of the patient, the doctor will be able to see a plaque of green or gray color. It focuses on the affected tonsil. After plaque removal, a bleeding sore is present.

Which antibiotic for tonsillitis and pharyngitis is the best and most effective is indicated in great detail here in the article.

But how to apply and use Lugol for tonsillitis in children, and how effective this remedy is, this information will help to understand.

How vacuum cleaning of the tonsils occurs with tonsillitis, and how effective this procedure is, is described in great detail here in the article.

It will also be interesting to learn about whether chronic tonsillitis can be cured, and whether it can be done at home.

What can be the consequences of the disease and treatment of tonsillitis during pregnancy, and what means can be used, is indicated in this article.

unspecified

This form of tonsillitis is accompanied by local and general manifestations. Ulcerative-necrotic lesions of the upper respiratory tract mucosa are observed. Unspecified angina does not belong to independent ailments, but is the result of certain irritating factors.

Symptoms of the disease occur during the day. Characterized by a high rise in temperature, general malaise and severe chills. On the mucous membrane of the tonsils, an ulcerative necrotic process is formed. If you do not start treatment, then the oral mucosa will begin to be involved in the pathological process. The inflammatory process will begin to affect periodontal tissues, which will lead to the formation of stomatitis and gingivitis.

On the video, acute unspecified tonsillitis:

Acute tonsillitis today has a fairly extensive classification. Each of the presented species has its own clinical picture and treatment regimen. It is important to recognize the symptoms in time and understand what kind of angina is occurring and which pathogen is responsible for its occurrence. Treatment is prescribed only after a full diagnosis and diagnosis.

Chronic tonsillitis

Definition and background[edit]

Chronic tonsillitis is a common infectious-allergic disease with local manifestations in the form of a persistent inflammatory reaction of the palatine tonsils, morphologically expressed as alteration, exudation and proliferation.

Synonyms: Chronic tonsillopharyngitis, chronic inflammation of the palatine tonsils.

The prevalence of chronic tonsillitis in children in the territory of the Russian Federation ranges from 6 to 16%. The incidence is increased in regions with harsh climatic conditions: in Western and Eastern Siberia, in the Far North. Over 70% of children suffering from chronic tonsillitis have a combined pathology of the respiratory and digestive organs in the form of various syndromes.

a) Classification according to I.B. Soldatov (1975):

Chronic nonspecific tonsillitis:

Chronic specific tonsillitis.

b) Classification B.S. Preobrazhensky and V.T. Palchuna (1997)

Chronic tonsillitis is divided into two forms:

Simple form: initial stage

Not so much frequent sore throats in the anamnesis are characteristic, as local signs. In this case, concomitant diseases may occur that do not have a single pathogenetic basis with chronic tonsillitis.

1. Toxic-allergic form I: a history of recurrent tonsillitis is characteristic, all signs of the first stage in combination with general toxic-allergic symptoms (periodically subfebrile temperature, weakness, malaise, fatigue, joint pain, with exacerbation of chronic tonsillitis - pain in the heart without objective disturbances on the electrocardiogram), prolonged asthenic syndrome after suffering a sore throat.

2. Toxic-allergic form II: more pronounced symptoms are characteristic than in form I, as well as associated diseases that have common pathogenetic factors with chronic tonsillitis.

Etiology and pathogenesis[edit]

Features of the development of the disease depend on the individual reactivity of the macroorganism, the characteristics of the microbial landscape of tonsil lacunae, structural changes in the palatine tonsils and the peritonsilic region. Immunological reactivity in childhood has physiological characteristics. In children aged 1.5-3 years, the cellular composition of the tonsils is 80% represented by T-lymphocytes; in subpopulations of T-lymphocytes, a relatively small number of T-helpers can be detected, which leads to insufficiency of the cellular link of immunity and explains the prevalence of viral, fungal and opportunistic microflora in the pathology of the tonsils of the pharyngeal ring. The lack of T-helpers with an increased antigenic load leads to inadequate differentiation of B-lymphocytes and causes hyperproduction of IgE compared to IgA in the lymphoid tissue, which causes an infectious-allergic pathogenesis of chronic tonsillitis.

The formation of chronic tonsillitis in children is facilitated by a violation of the drainage of tonsil lacunae, immune imbalance, frequent inflammatory diseases of the upper respiratory tract, and a persistent violation of nasal breathing. In turn, these predisposing factors may be the result of long-term exposure to adverse external causes: atmospheric and food pollution, infection carriers among the child's close environment, frequent hypothermia, and irrational daily routine. The pubertal period is characterized by rapid stimulation of the humoral immunity, which in some cases leads to a decrease in the severity of atypical diseases, the allergic component of chronic tonsillitis, and in others to the development of associated autoimmune diseases.

In chronic tonsillitis, a histological examination of the deep sections of the lacunae of the palatine tonsils reveals leukocyte infiltration of epithelial and stromal elements, dystrophic and necrotic changes in the basal sections of the crypts. There is an increase in the activity of phagocytes.

Clinical manifestations[edit]

The most reliable pharyngoscopic signs of chronic tonsillitis:

Hyperemia and ridge-like thickening of the edges of the palatine arches;

Cicatricial adhesions between the tonsils and palatine arches;

Loose or scar-hardened tonsils;

Caseous-purulent plugs or liquid pus in the lacunae of the tonsils;

Enlargement of the submandibular lymph nodes (regional lymphadenitis).

Chronic tonsillitis is diagnosed when two or more of these signs are detected.

With compensated chronic tonsillitis, only local signs of chronic inflammation of the palatine tonsils occur. The barrier function of the tonsils and the reactivity of the body are not disturbed, and therefore there is no general inflammatory reaction of the body. The diagnosis is most often established during a routine examination, patients feel almost healthy. Due to stagnation and decay of the contents of the gaps, bad breath occurs.

With decompensation of chronic tonsillitis, a general reaction of the body occurs in the form of a long-term (for several weeks or months) general intoxication syndrome - low-grade fever, decreased appetite, increased fatigue. The general reaction of the body can be expressed in the recurrence and complicated course of angina, the development of diseases of organs and systems distant from the pharynx (rheumatism, glomerulonephritis, arthropathy, cardiopathy, thyrotoxicosis, infectious-dependent bronchial asthma).

Chronic tonsillitis: Diagnosis[edit]

Diagnosis of chronic tonsillitis is based on pharyngoscopy and a study of the history of the disease, while in the anamnesis they find out the presence of tonsillitis, their number and severity of each case. Angina more than 1 time in 2 years indicate chronic tonsillitis, and the course of angina, complicated by paratonsillar or pharyngeal abscess, indicates decompensation of chronic tonsillitis. In the anamnesis, recurrences of paratonsillar or pharyngeal abscesses are noted. In the nonanginal course of chronic tonsillitis, the complaints of patients correspond to pathological changes in the body systems involved in the pathological process - frequent sore throats and palpitations, tachycardia, and heart rhythm disturbances.

Use bacteriological examination of the contents of the lacunae of the palatine tonsils, scraping from the mucous membrane of the tonsils on the mycelium of the fungus. With decompensation of tonsillitis, the state of the immune system is examined (hemogram, functional immune tests). Associated pathology of the heart muscle is checked using electrocardiography, a biochemical blood test; in the pathology of the joints or kidneys, a biochemical blood test is also prescribed with the determination of acute phase proteins, urea.

Instrumental research methods

Inspection of the palatine tonsils is carried out using mesopharyngoscopy.

Differential diagnosis[edit]

Differential diagnosis is carried out between a nonspecific form of chronic tonsillitis and infectious granulomas - tuberculosis, scleroma and secondary syphilis, for which chest x-ray is performed, peripheral blood is examined for the Wasserman reaction, sowing of the separated lacunae of the palatine tonsils on standard nutrient media.

Chronic tonsillitis: Treatment[edit]

Sanitation of the focus of infection and prevention of the development of associated diseases of organs and systems distant from the tonsils.

Indications for hospitalization

Angina against the background of chronic tonsillitis, severe degree.

Angina against the background of chronic tonsillitis in a child from a closed children's group.

In the case of an uncomplicated course of angina, the child is hospitalized in an infectious diseases hospital. With local purulent complications of tonsillitis, sepsis - in the otorhinolaryngological department of a multidisciplinary hospital. Indication for hospitalization in remission: planned surgical treatment of chronic tonsillitis.

Mechanical cleansing of tonsil lacunae from stagnant contents.

Physiotherapy of the region of the palatine tonsils.

Climatic resorts, speleotherapy.

Mechanical cleansing of the lacunae of the tonsils is carried out in two ways.

Through a cannula inserted into the lacuna.

Hardware washing of tonsil lacunae through a vacuum nozzle with cleansing of the lacuna with running water under low pressure using the Tonsillor apparatus with simultaneous low-frequency ultrasonic treatment of the palatine tonsils.

Of the physiotherapeutic methods, phonophoresis of drugs in the tissue of the tonsils, ultraviolet irradiation of the oropharynx, laser illumination of the palatine tonsils, electrophoresis of the submandibular lymph nodes, often with mud pressing, are used. Climatotherapy in the summer on the southern coast of the Crimea and the Black Sea coast of the Caucasus. Hardening of the body is carried out under the supervision of a pediatrician after the rehabilitation of the palatine tonsils, depending on the somatic health of the child.

In the remission stage, the following drugs are used:

Vitamins of groups B, C, E.

Drug treatment for exacerbation of chronic tonsillitis is carried out using the following groups of drugs:

Antibiotics of a wide spectrum of bactericidal action;

Antiseptics in solutions, sprays, tablet forms;

non-steroidal anti-inflammatory drugs;

For antibiotic therapy in the outpatient management of a child under 14 years of age, protected aminopenicillins and oral cephalosporins are considered the drugs of choice. After 14 years, the use of respiratory fluoroquinolones is possible. The course of treatment is 7-10 days. With a pronounced pain syndrome, gargling is prescribed using antiseptic solutions, infusions of medicinal herbs - chamomile, calendula, sage, herbal remedies. Assign irrigation of the tonsils with antibacterial sprays: biclotymol, fusafungin, benzydamine. Rinsing or irrigation of the throat is carried out 4-6 times a day. With a decrease in sore throat, they switch to the use of tableted antiseptics. Non-steroidal anti-inflammatory drugs significantly reduce the activity of the inflammatory process, reduce pain and fever. Children under 12 years of age use ibuprofen.

The goal of surgical treatment is the complete removal of the focus of chronic infection. Indications for surgical treatment of chronic tonsillitis:

Chronic non-specific decompensated tonsillitis, relapses of tonsillitis with the ineffectiveness of conservative therapy for 1 year;

Chronic non-specific decompensated tonsillitis, recurrence of paratonsillar abscesses (or one abscess) or complicated course of angina;

Chronic nonspecific decompensated tonsillitis, associated diseases of organs and systems remote from the pharynx.

Currently, there are different ways to remove the palatine tonsils (using a surgical laser, cryodestruction, coblation techniques, etc.), the classical bilateral tonsillectomy has become widespread.

In the postoperative period, a sparing diet is recommended for 2 weeks, rinsing the throat with a decoction of medicinal herbs, irrigation with sprays with antiseptic, antibacterial and analgesic properties, resorption of antiseptics, and limitation of physical activity for 1 month.

Prevention[edit]

Other [edit]

Chronic tonsillitis in the stage of compensation with timely sanitation of the tonsils has a favorable prognosis. Tonsillectomy eliminates the substrate of the disease - palatine tonsils, which automatically eliminates chronic tonsillitis. However, for a favorable prognosis (restoration of the body, improvement in the course of associated pathology), observation and treatment by an otorhinolaryngologist, rheumatologist, immunologist, etc. is necessary. The course of decompensated tonsillitis against the background of metabolic diseases (diabetes mellitus) can lead to severe complications, with an unfavorable course of which a lethal outcome is not excluded.

Chronic tonsillitis code for mcb 10, treatment

Acute tonsillitis (tonsillitis) is a common infectious disease in which inflammation of the palatine tonsils (glands) occurs. It is a contagious disease that is transmitted by airborne droplets, direct contact or food. Self-infection (autoinfection) with microbes that live in the pharynx is often noted. With a decrease in immunity, they become more active.

Microbial pathogens are often group A streptococcus, a little less often staphylococcus aureus, pneumococcus and adenoviruses. Almost all healthy people can have streptococcus A, which is dangerous to others.

Acute tonsillitis, the ICD 10 code of which is J03, recurring, is dangerous for humans, so re-infection should be avoided and completely cured of angina.

Symptoms of acute tonsillitis

The main symptoms of acute tonsillitis include the following:

• High temperature up to 40 degrees
• Itching and feeling of a foreign body in the throat
• Sharp pain in the throat that worsens when swallowing
• General weakness
• Headache
• Pain in muscles and joints
• Sometimes there is pain in the region of the heart
• Inflammation of the lymph nodes, which causes pain in the neck when turning the head.

Complications of acute tonsillitis

Angina is a danger due to possible complications:

• Peritonsillar abscess
• Tonsilogenic sepsis
• Cervical lymphadenitis
• Tonsilogenic mediastinitis
• Acute otitis media and others.

Complications may appear due to incorrect, incomplete, untimely treatment. Also at risk are those who do not go to the doctor and try to cope with the disease on their own.

Treatment of acute tonsillitis

Treatment of angina is aimed at local and general effects. Conducted restorative and hyposensitizing treatment, vitamin therapy. This disease does not require hospitalization, except for severe cases.

Acute tonsillitis should be treated only under medical supervision. The following measures are taken to combat diseases:

• If the disease is caused by bacteria, then antibiotics are prescribed: general and local effects. Sprays are used as local remedies, for example, Cameton, Miramistin, Bioparox. For resorption, lollipops with an antibacterial effect are prescribed: Lizobakt, Heksaliz and others.
• To relieve sore throat, drugs are prescribed that contain antiseptic components - Strepsils, Tantum Verde, Strepsils.
• Antipyretics are needed at high temperatures.
• Antiseptic and anti-inflammatory agents are used for rinsing - Furacilin, Chlorhexilin, decoctions of medicinal herbs (sage, chamomile).
• Antihistamines are prescribed for severe swelling of the tonsils.

The patient is isolated and a sparing regimen is prescribed. You need to follow a diet, do not eat hot, cold, spicy food. Full recovery occurs in a few days.

Chronic tonsillitis: ICD code 10, description of the disease

Chronic tonsillitis is a general infectious disease in which the foci of infection are the palatine tonsils, which cause an inflammatory process. Chronic tonsillitis is a periodic exacerbation of angina or a chronic disease without angina.

Chronic tonsillitis code for mcb 10, symptoms

Chronic tonsillitis can be formed as a result of a previous sore throat, that is, when inflammatory processes continue to secretly become chronic. However, there are cases when the disease appears without previous tonsillitis.

The main symptoms of the disease include:

• Headache
• Fast fatiguability
• General weakness, lethargy
• Elevated temperature
• Discomfort when swallowing
• Bad breath
• Sore throat that comes on intermittently
• Dry mouth
• Cough
• Frequent sore throats
• Enlarged and painful regional lymph nodes.

Symptoms are similar to those of acute tonsillitis, so similar treatment is prescribed.

In chronic tonsillitis, damage to the kidneys or heart often occurs, since toxic and infectious factors enter the internal organs from the tonsils.

Chronic tonsillitis according to ICD 10 - J35.0.

Treatment of chronic tonsillitis

During the period of exacerbation of angina, the same measures are taken as in the acute form of the disease. The disease is dealt with in the following way.

• Physiotherapeutic procedures for the restoration of tonsil tissues, accelerating their regeneration.
• Antiseptics (hydrogen peroxide, Chlorhexidine, Miramistin) for washing lacunae.
• To strengthen the immune system, vitamins, hardening, Imudon are prescribed.

Removal of the tonsils (tonsilectomy) is carried out if chronic tonsillitis occurs with frequent exacerbations.

Tonsillitis: symptoms and treatment in adults

How to treat chronic tonsillitis with folk remedies

With reddening of the throat, which did not go away for a long time, the ENT prescribed me Tonsilotren. Adhering to the recommendations of the doctor, the pills were taken for 7 days. First every 2 hours, then every 3 hours. The result was not long in coming. The redness has gone and the throat is no longer sore.

Karina, I have had chronic tonsillitis since childhood, so I tried a lot of things .... Of course, rinsing is good, and hydrogen peroxide helps, and propolis infusion, and tea tree oil can be used, but for a long time! Doctors prescribe antibiotics, sometimes you have to use them. I noticed the greatest and best effect from Azitral capsules. And it helped quickly and did not notice any negative impact. So I recommend combining this drug with rinsing!

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Chronic tonsillitis coding

Chronic inflammatory diseases of the pharyngeal and palatine tonsils are very common among both adults and children.

When preparing medical documentation, general practitioners and otorhinolaryngologists use the chronic tonsillitis code according to ICD 10. The Tenth Revision International Classification of Diseases was created for the convenience of doctors around the world and is actively used in medical practice.

Causes and clinical picture of the disease

Acute and chronic diseases of the upper respiratory tract occur as a result of infection with pathogenic microorganisms and are accompanied by a number of unpleasant symptoms. If a child has adenoids, then due to difficulty in breathing, the risk of the disease increases. Chr. tonsillitis is characterized by such signs:

• reddening of the edges of the palatine arches;
• changes in the tissue of the tonsils (compaction or loosening);
• purulent discharge in lacunae;
• inflammation of regional lymph nodes.

With angina, which refers to the acute form of tonsillitis, the symptoms are more pronounced and the disease is more severe.

Late diagnosis of tonsillitis can lead to complications associated with other organs.

For effective treatment, it is necessary to identify and eliminate the cause of the pathological process, as well as conduct antibacterial and anti-inflammatory therapy.

In ICD 10, chronic tonsillitis is under the code J35.0 and belongs to the class of chronic diseases of the tonsils and adenoids.

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• Scottped on Acute gastroenteritis

Self-medication can be hazardous to your health. At the first sign of disease, consult a doctor.

Chronic tonsillitis (ICD-10 code: J35.0)

It is characterized by inflammation of the palatine tonsils.

When determining the tactics of treating chronic tonsillitis, it should be remembered that the development of the disease is facilitated by: a persistent violation of nasal breathing (adenoids, deviated nasal septum), as well as the presence of chronic foci of infection in this region (diseases of the paranasal sinuses, carious teeth, periodontitis, chronic catarrhal pharyngitis, chronic rhinitis ).

Laser therapy is aimed at increasing the energy rating of the body, eliminating immunological abnormalities at the systemic and regional levels, reducing inflammation in the tonsils, followed by the elimination of metabolic and hemodynamic disorders. The list of measures to solve these problems includes percutaneous irradiation of the tonsils, direct irradiation of the throat area (preferably with red spectrum laser light or associative IR and red spectrum). The effectiveness of treatment is significantly increased with simultaneous irradiation of the above-mentioned zones with light of the red and IR spectrum according to the following method: direct irradiation of the tonsils is carried out with light of the red spectrum, their percutaneous irradiation with light of the IR spectrum.

Rice. 67. Impact on the projection zones of the tonsils on the anterior-lateral surface of the neck.

When choosing LILI modes at the initial stages of the course treatment, percutaneous irradiation of the projection zones of the tonsils with IR spectrum light is performed at a frequency of 1500 Hz, and at the final stages, as the positive effects of the course therapy are obtained, the frequency decreases to 600 Hz, and then, at the final stage of the course treatment - up to 80 Hz.

Additionally performed: NLBI of the ulnar vessels, contact to the area of ​​the jugular fossa, the zone of segmental innervation of the tonsils in the projection of the paravertebral zones at the C3 level, the impact on regional lymph nodes (irradiation is performed only in the absence of lymphadenitis!).

Rice. 68. Zones of general influence in the treatment of patients with chronic tonsillitis. Symbols: pos. "1" - projection of the ulnar vessels, pos. "2" - jugular fossa, pos. "3" - zone of the 3rd cervical vertebra.

Rice. 69. Projection zone of the submandibular lymph nodes.

Also, to potentiate the effects of the regional level, distant irradiation with a defocused beam of receptor zones located in the anterior cervical region, on the scalp, in the anterior parietal, occipital, temporal zones, on the outer surface of the lower leg and forearm and in the rear of the foot is performed.

Modes of irradiation of medical zones in the treatment of tonsillitis

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