Chronic tonsillitis ICD 10 disease codes. Chronic tonsillitis. Provoking factors, risk group

According to statistics, domestic doctors annually diagnose more than 5 million patients with tonsillitis. The current international classification of the 10th revision (ICD) defines such a disease in the section “respiratory diseases”. The disease is not life-threatening, but its uncontrolled course can cause serious complications.

Acute forms have codes 0, J03.8 and J03.9.
Chronic (chp) was assigned a code according to microbial disease 0.

This classification allows doctors to use common terminology and significantly streamlines document flow.

Acute course of the disease: symptoms and treatment

Acute tonsillitis - a common sore throat - is characterized by severe inflammation of the tonsils. The main symptoms remain fever up to 39-40o, pain in the throat, weakness, painful sensations in the muscles. Also, malaise is often accompanied by inflammatory processes in the lymph nodes.

To avoid serious complications, you need to consult a doctor in a timely manner and undergo a full course of treatment. Incomplete procedures and self-medication can cause serious complications, including peritonsillar abscess, tonsillogenic sepsis, all types of otitis media and many other unpleasant consequences.

Many doctors refer to ICD 10 tonsillitis as an ailment that can significantly reduce the body’s immune defense and cause a deterioration in the quality of life. The standard treatment regimen for the acute form depends on the type of pathogen and is aimed at relieving symptoms and relieving inflammation.

Traditionally effective:

Antibacterial drugs in tablets, injections. Local aerosols are applicable: for example, Bioparox.
Antiseptic sprays have additional anesthetic and anti-inflammatory effects. The most popular are Kameton, Ingalipt, Givalex and other options. Products in the form of lollipops and lozenges are also common, including Isla, Anzibel, Lizak.
Gargling with solutions of Chlorophyllipt, Octenisept, Rotocan, Furacilin or Chlorhexidine will get rid of the infection.
Anesthetics will help relieve pain: the newest line of Tantum Verde, Septolete Plus, Coldrex Lari, Strepsils.

Do not forget about traditional methods: drinking plenty of fluids, rinsing with chamomile decoction will speed up recovery.

Chronic form of tonsillitis. What measures are most effective?

Chronic tonsillitis develops after several untreated sore throats; occasionally, such a disease can be a consequence dental pathologies. The main pathogens are considered to be strains of streptococcus or staphylococcus. The tissues of the tonsils become loose, and cheesy light inclusions are visible on their surface. Frequent tonsillitis (tonsillitis) provokes enlargement and pain of the lymph nodes.

Treatment of the disease is similar to measures taken for acute course, and doctors enter an abbreviated designation marked “xp” into the card of patients with such a diagnosis. Antibiotics and antiseptics will relieve inflammation and prevent further development pathogenic microorganisms. And washing the lacunae with a solution of Chlorhexedine or Miramistin will remove the remaining plugs. Bactericidal physiotherapy is also indicated.

Along with the standard method, which is used to treat tonsillitis (ICD 10 designation) at all stages, an innovative one is considered effective laser therapy. The most effective simultaneous direct action a stream of red spectrum directly to the tonsil area plus infrared irradiation of this area through the skin.

The initial stages of the disease are stopped with the help of conservative treatment, with prolonged chronic pain. For tonsillitis, surgical intervention is possible. This will help remove the persistent source of infection and prevent kidney damage or cardiac failure. Treatment of chronic tonsillitis is a painstaking process that requires strict adherence to personal hygiene rules and scrupulous adherence to doctor’s recommendations.

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

Chronic tonsillitis can rightfully be called a “disease of the 20th century” that has “successfully” crossed the line of the 21st century. and still constitute one of the main problems not only of otorhinolaryngology, but also of many other clinical disciplines, in the pathogenesis of which main role Allergy, focal infection and deficient conditions of local and systemic immunity play a role. However, the basic factor that is 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 population groups, in the USSR in the second quarter of the 20th century. the incidence of chronic tonsillitis fluctuated between 4-10%, and already in the third quarter of this century, from a report by I.B. Soldatov at the VII Congress of Otorhinolaryngologists of the USSR (Tbilisi, 1975), it followed that this figure, depending on the region of the country, increased to 15.8 -31.1%. According to V.R. Goffman et al. (1984), chronic tonsillitis affects 5-6% of adults and 10-12% of children.

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 is necessary to keep in mind that between exacerbations, as well as in the non-anginal form of chronic tonsillitis, the symptoms of the disease are largely familiar and little or do not bother the patient at all, 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 tonsillar focal infection, weakens a person’s health, and worsens the quality of life.

Causes of chronic tonsillitis

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

Palatine tonsils - part immune system, which consists of three barriers: lymph-blood ( Bone marrow), lymphointerstitial (lymph nodes) and lymphothelial (lymphoid accumulations, including tonsils, in the mucous membrane various organs: pharynx, larynx, trachea and bronchi, intestines). The mass of the palatine tonsils makes up a small 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 tonsillitis in the anamnesis. In this case, it is necessary to find out from the patient what kind of increase in body temperature is accompanied by sore throat and for what period of time. Sore throats 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 shape, febrile body temperature, etc.), but in adults such classic symptoms of sore throat often do not occur. In such cases, exacerbations of chronic tonsillitis occur without pronounced severity of all symptoms: the temperature corresponds to low subfebrile values (37.2-37.4 C), pain in the throat when swallowing is insignificant, moderate deterioration is observed general well-being. The duration of the disease is usually 3-4 days.

Where does it hurt?

Sore throat Sore throat when swallowing

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 in case of general 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 - enlarged lymph nodes at the corners lower jaw and in front of the sternocleidomastoid muscle. Along with determining the enlargement of the 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, sinuses, etc.).

What needs to be examined?

Tonsils Palatine tonsil

What tests are needed?

Who to contact?

ENT - doctor Otolaryngologist

Treatment of chronic tonsillitis

In case of a simple form of the disease, it is carried out conservative treatment and for 1-2 years in 10-day courses. In cases where it is estimated local symptoms the effectiveness is insufficient or an exacerbation has occurred (angina), a decision may be made to repeat the course of treatment. However, the absence of convincing signs of improvement, and especially the occurrence of repeated sore throats, is considered an indication for removal of the tonsils.

In the toxic-allergic form of degree I, it is still possible to carry out conservative treatment of chronic tonsillitis, however, the activity of the chronic tonsillar source 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 prolonged unless significant improvement is observed. The toxic-allergic form of the II degree of chronic tonsillitis is dangerous with rapid progression and irreversible consequences.

More information about treatment

Tonsillitis: treatment Antibiotics for tonsillitis Removal of tonsils (tonsillectomy) Physiotherapy for sore throat Antibiotics for sore throat Antibiotics for sore throat in children How to treat? Tsebopim

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Sore throat (acute tonsillitis) - Review of information

Sore throat (acute tonsillitis) - acute infection, caused by streptococci or staphylococci, less commonly 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 tonsillitis, or acute tonsillitis?

Inflammatory diseases of the pharynx have been known since ancient times. They received the common name “angina”. In essence, as B.S. Preobrazhensky (1956) believes, the name “throat sore throat” unites a group of heterogeneous diseases of the pharynx and not only inflammation of the lymphadenoid formations themselves, but also the tissue, the clinical manifestations of which are characterized, along with signs of acute inflammation, by pharyngeal constriction syndrome space.

Judging by the fact that Hippocrates (V-IV centuries BC) repeatedly provided 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. Removal of tonsils in connection with their disease was described by Celsus. The introduction of the bacteriological method into medicine gave rise to classifying the disease according to the type of pathogen (streptococcal, staphylococcal, pneumococcal). The discovery of Corynebacterium diphtheria made it possible to differentiate a common sore throat from a sore throat-like disease - diphtheria of the pharynx, and scarlet fever manifestations in the pharynx, due to the presence of a rash characteristic of scarlet fever, were identified as an independent symptom characteristic of this disease even earlier, in the 17th century.

At the end of the 19th century. described special shape ulcerative-necrotic tonsillitis, the occurrence of which is due to the fusospirochetal symbiosis of Plaut - Vincent, and when hematological studies were introduced into clinical practice, special forms of pharyngeal lesions were identified, called agranulocytic and monocytic tonsillitis. Somewhat later, a special form of the disease was described that occurs during alimentary-toxic aleukia, similar in its manifestations to agranulocytic tonsillitis.

It is possible to damage not only the palatine, but also the lingual, pharyngeal, and laryngeal tonsils. However, most often the inflammatory process is localized in the palatine tonsils, so it is customary to mean “tonsillitis” under the name acute inflammation palatine tonsils. This is an independent nosological form, but in modern understanding this 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, but tonsillitis and pharyngitis are included separately in ICD-10. Taking into account the exceptional importance of the streptococcal etiology of the disease, streptococcal tonsillitis J03.0) is distinguished, as well as acute tonsillitis caused by other specified pathogens (J03.8). If it is necessary to identify the infectious agent, an additional code (B95-B97) is used.

ICD-10 code J03 Acute tonsillitis J03.8 Acute tonsillitis caused by other specified pathogens J03.9 Acute tonsillitis, unspecified

Epidemiology of tonsillitis

In terms of the number of days of incapacity, angina ranks third after influenza and acute respiratory diseases. Children and people under 30-40 years of age get sick more often. The frequency of visits to a doctor per year is 50-60 cases per 1000 population. The incidence depends on population density, household, sanitary and hygienic, geographical and climatic conditions. It should be noted that among the urban population the disease is more common than among the rural population. According to the literature, 3% of those who have recovered from the disease develop rheumatism, and in patients with rheumatism after past illness in 20-30% of cases, a heart defect is formed. In patients with chronic tonsillitis, tonsillitis is observed 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 sore throat

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

The main cause of sore throat 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 can be 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 (adenoviruses types 1-9, 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 bacterial flora.

Symptoms of a sore throat

Typical symptoms of sore throat - sharp pain sore throat, increased body temperature. Among the various clinical forms, banal tonsillitis is most common, and among them are catarrhal, follicular, lacunar. The separation of these forms is purely conditional; in essence, it is a single pathological process, which can progress quickly or stop at one of the stages of its development. Sometimes catarrhal tonsillitis is the first stage of the process, followed by a more severe form or another disease.

Where does it hurt?

Sore throat Sore throat during pregnancy Sore throat in children

Classification of sore throat

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 due to 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 sore throats, 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 diagnosis and treatment, they often simplified the classifications they proposed, which, at times, were reduced to classical concepts.

These classifications had and still have a pronounced clinical content and, of course, have great practical importance, however, these classifications do not reach a truly scientific level due to the extreme multifactorial nature of the etiology, clinical forms and complications. Therefore, from a practical point of view, it is advisable to divide tonsillitis into nonspecific acute and chronic and specific acute and chronic.

Classification presents certain difficulties due to the variety of types of disease. The classifications are based on V.Y. Voyacheka, A.Kh. Minkovsky, V.F. Undrica 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 most widespread among practitioners is the classification of the disease developed by B.S. Preobrazhensky and subsequently supplemented by V.T. Finger. This classification is based on pharyngoscopic signs, supplemented by data obtained from laboratory tests, sometimes with 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 unfavorable environmental conditions, most often after local or general cooling;
epidemic form, which occurs as a result of infection from a patient with tonsillitis or a 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 reactions results in chronic inflammation of the 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;
- for HIV infection;
- damage to the pharynx due to typhoid fever;
- with tularemia.
For blood diseases:
- monocytic;
- for leukemia:
- agranulocytic.
Some forms according to localization:
- tonsil tray (adenoiditis);
- lingual tonsil;
- laryngeal;
- lateral ridges of the pharynx;
- tubar tonsil.

“Sore throats” mean a group of inflammatory diseases of the pharynx and their complications, which are based on damage to the anatomical formations of the pharynx and adjacent structures.

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

Catarrhal (banal) nonspecific (catarrhal, follicular), which, after localizing the inflammation, are defined as palatal and lingual amygdalitis, retronasal (adenoiditis), uvulitis. These inflammatory processes in the pharynx are called “red tonsillitis”.
Membranous (diphtheria, pseudomembranous non-diphtheria). These inflammatory processes are called “white tonsillitis”. To clarify the diagnosis, it is necessary to conduct a bacteriological study.
Sore throats accompanied by loss of structure (ulcerative-necrotic): herpetic, including Herpes zoster, aphthous, Vincent's ulcer, scurvy and impetigo, post-traumatic, toxic, gangrenous, etc.

Screening

When identifying a disease, they are guided by complaints of sore throat, as well as characteristic local and general symptoms. It should be taken into account that in the first days of the disease, many general and infectious diseases may cause 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 sore throat

The history must be collected with special care. Great importance attach 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 into the ear, the so-called pharyngeal cough, a feeling of dryness, soreness, burning, hypersalivation - sialorrhea, etc.).

Endoscopy of the pharynx for most inflammatory diseases makes it possible to establish an accurate diagnosis, but it is unusual clinical course and endoscopic picture are forced to resort to additional methods of laboratory, bacteriological and, according to indications, histological examination.

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

In particular, it is important microbiological diagnostics streptococcal tonsillitis, which includes a bacterial examination of a smear from the surface of the tonsil or the back wall of the pharynx. The results of sowing largely depend on the quality of the material obtained. The smear is taken using a sterile swab; the material is delivered to the laboratory within 1 hour (for longer periods it is necessary to use special media). Before collecting material, you should not rinse your mouth or use deodorants for at least 6 hours. With the correct technique for collecting material, the sensitivity of the method reaches 90%, specificity - 95-96%.

What needs to be examined?

Pharyngeal (adenoid) tonsil Tonsils

How to examine?

X-ray of the larynx and pharynx

What tests are needed?

Antistreptolysin O in the blood serum Antibodies to streptococci A, B, C, D, F, G in the blood Staphylococcal infections: antibodies to staphylococci in the blood serum

Who to contact?

Otolaryngologist ENT - doctor

Treatment of sore throat

The basis of drug treatment for angina is systemic antibacterial therapy. In outpatient settings, the prescription 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 penicillin series, since beta-hemolytic streptococcus is most sensitive to penicillins. In outpatient settings, oral medications should be prescribed.

More information about treatment

Physiotherapy for sore throat Antibiotics for sore throat Antibiotics for sore throat in children Removal of tonsils (tonsillectomy) Tonsillitis: treatment Antibiotics for tonsillitis How to treat? Dazel Tsebopim Tsedex Thyme herb Sage DR. THEISS Baishitzinge

Prevention of sore throat

Measures to prevent the disease are based on the principles that have been developed for infections transmitted by airborne droplets or nutrition, since sore throat is an infectious disease.

Preventive measures should be aimed at improving the health of the external environment, eliminating factors that reduce the body’s protective properties against pathogens (dust, smoke, excessive crowding, etc.). Individual preventive measures include hardening the body, physical education, establishing a reasonable work and rest schedule, staying on fresh air, food with sufficient vitamin content, etc. The most important are therapeutic and preventive measures, such as sanitation of the oral cavity, timely treatment(surgical if necessary) 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, local or general complications may develop, the formation of chronic tonsillitis. The patient's period of incapacity for work is on average 10-12 days.

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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. Acute inflammation is typical for acute tonsillitis (tonsillitis) lymphoid tissue mainly palatine tonsils. Tonsillopharyngitis is characterized by a combination of inflammation in the lymphoid pharyngeal ring and the pharyngeal mucosa, and for acute pharyngitis 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 caused by other specified pathogens. J03 Acute tonsillitis.
J03.0 Streptococcal tonsillitis.
J03.8 Acute tonsillitis caused by other specified pathogens.
J03.9 Acute tonsillitis, unspecified.

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

Epidemiology of sore throat and acute pharyngitis in children

Acute tonsillitis, tonsillopharyngitis and acute pharyngitis develop in children mainly after the age of 1.5 years, which is due to the development of 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 viral nature and are most often caused by adenoviruses, in addition, viruses can be the cause of acute tonsillitis/tonsillopharyngitis and acute pharyngitis herpes simplex and Coxsackie enteroviruses. Starting from the age of 5 years, B-hemolytic streptococcus group A becomes of great importance in the occurrence of acute tonsillitis. (S. pyogenes), which becomes the leading cause of acute tonsillitis/tonsillopharyngitis (up to 75% of cases) at the age of 5-18 years. Along with this, the causes of acute tonsillitis/tonsillopharyngitis and pharyngitis can be group C and G streptococci, M. pneumoniae, Ch. pneumoniae And Ch. psittaci, influenza viruses.

Causes of sore throat 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 of the condition, the appearance of a sore throat, refusal of small children to eat, malaise, lethargy, and other signs of intoxication. Upon examination, redness and swelling of the tonsils and the mucous membrane of the posterior wall of the pharynx, its “graininess” and infiltration, the appearance of purulent exudation and plaque mainly on the tonsils, enlargement and soreness of the regional anterior cervical lymph nodes are revealed.

Symptoms of sore throat and acute pharyngitis in children

Where does it hurt?

Sore throat Sore throat when swallowing Sore throat in children

What's troubling?

Lump in the throat

Classification of sore throat and acute pharyngitis in children

It is possible to distinguish primary tonsillitis/tonsillopharyngitis and pharyngitis and secondary ones, which develop in infectious diseases such as diphtheria, scarlet fever, tularemia, Infectious mononucleosis, typhoid fever, human immunodeficiency virus (HIV). In addition, there is a non-severe form of acute tonsillitis, tonsillopharyngitis and acute pharyngitis and a severe, uncomplicated and complicated form.

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, an analysis is performed peripheral blood, which in uncomplicated cases reveals leukocytosis, neutrophilia and a shift of the formula to the left with streptococcal etiology of the process and normal leukocytosis or a tendency to leukopenia and lymphocytosis with viral etiology diseases.

Diagnosis of sore throat and acute pharyngitis in children

What needs to be examined?

Pharynx Pharyngeal (adenoid) tonsil

How to examine?

X-ray of the larynx and pharynx

What tests are needed?

Complete blood count Infectious mononucleosis: antibodies to Epstein-Barr virus in the blood Antistreptolysin O in the blood serum Antibodies to streptococci A, B, C, D, F, G in the blood

Who to contact?

Pediatrician ENT - doctor Otolaryngologist

Treatment varies depending on the etiology of acute tonsillitis and strep throat. For streptococcal tonsillopharyngitis, antibiotics are indicated; for viral tonsillitis, they are not indicated; for mycoplasma and chlamydial tonsillitis, 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 indicated. 1-2% solution of hexethidium (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 sore throat and acute pharyngitis in children

More information about treatment

Antibiotics for pharyngitis Physiotherapy for tonsillitis Antibiotics for tonsillitis in children Removal of tonsils (tonsillectomy) Tonsillitis: treatment Antibiotics for tonsillitis How to treat? Paxeladin Cebopim Cedex Thyme herb

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. No. 170

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

With changes and additions from WHO.

Processing and translation of changes © mkb-10.com

Chronic tonsillitis code according to ICD 10, treatment

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

Microbial pathogens are often group A streptococcus, and slightly less commonly staphylococcus, pneumococcus and adenoviruses. Almost all healthy people can have streptococcus A, which poses a danger to others.

Acute tonsillitis, ICD 10 code of which is J03, if it occurs repeatedly, is dangerous for humans, so re-infection should be avoided and a sore throat should be completely cured.

Symptoms of acute tonsillitis

The main symptoms of acute tonsillitis include the following:

High temperature up to 40 degrees
Soreness and sensation of a foreign body in the throat
Acute sore throat that gets worse when swallowing
General weakness
Headache
Pain in muscles and joints
Sometimes there is pain in the heart area
Inflammation of the lymph nodes, which causes pain in the neck when turning the head.

Complications of acute tonsillitis

Sore throat is dangerous due to possible complications:

Peritonsillar abscess
Tonsillogenic sepsis
Cervical lymphadenitis
Tonsillogenic mediastinitis
Spicy otitis media and others.

Complications may arise due to incorrect, incomplete, untimely treatment. Those who do not see a doctor and try to cope with the disease on their own are also at risk.

Treatment of acute tonsillitis

Treatment of angina is aimed at local and general effects. General strengthening and hyposensitizing treatment and vitamin therapy are carried out. This disease does not require hospitalization, with the exception of severe cases.

Acute tonsillitis should be treated only under medical supervision. To combat diseases, the following measures are taken:

If the disease is caused by bacteria, then antibiotics are prescribed: general and local. Sprays are used as local remedies, for example, Kameton, Miramistin, Bioparox. For resorption, lozenges with antibacterial effect: Lyzobakt, Hexaliz and others.
To relieve a sore throat, medications are prescribed that contain antiseptic components - Strepsils, Tantum Verde, Strepsils.
Antipyretics are necessary for high temperatures.
For rinsing, antiseptic and anti-inflammatory agents are used - Furacilin, Chlorhexilin, decoctions of medicinal herbs (sage, chamomile).
Antihistamines are prescribed for severe swelling tonsils

The patient is isolated and a gentle regime is prescribed. You need to follow a diet, do not eat hot, cold, spicy foods. Full recovery occurs within a day.

Chronic tonsillitis: ICD 10 code, description of the disease

Chronic tonsillitis is a general infectious disease in which the source of infection is the palatine tonsils, causing an inflammatory process. Chronic tonsillitis is a periodic exacerbation of a sore throat or a chronic disease without a sore throat.

Chronic tonsillitis ICD 10 code, symptoms

Chronic tonsillitis can form as a result of a previous sore throat, that is, when inflammatory processes secretly continue to 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
Fever
Discomfort when swallowing
Bad breath
Sore throat that appears periodically
Dry mouth
Cough
Frequent sore throats
Enlarged and painful regional lymph nodes.

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

With 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.

During the period of exacerbation of sore throat, the same measures are taken as in the acute form of the disease. The disease is fought as follows.

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

Removal of the tonsils (tonsillectomy) is performed if chronic tonsillitis occurs with frequent exacerbations.

Tonsillitis: symptoms and treatment in adults

How to treat chronic tonsillitis with folk remedies

When the redness of my throat did not go away for a long time, the ENT doctor prescribed me Tonsilotren. Following the doctor’s recommendations, I took the pills for 7 days. First every 2 hours, then every three hours. The result was not long in coming. The redness went away and my throat no longer hurt.

Karina, I have had chronic tonsillitis since childhood, so I’ve tried a lot of things…. Of course, rinsing is good, and hydrogen peroxide helps, and propolis infusion, and oil tea tree can be applied, but it will take a long time! Doctors prescribe antibiotics, and sometimes they have to be used. largest and best effect I noticed from Azitral capsules. And it helped quickly and I didn’t notice any negative effects. So I recommend combining this drug with rinsing!

Use of materials only if there is an active link to the source

Coding of chronic tonsillitis

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

When preparing medical documentation, doctors general practice and otolaryngologists use the ICD 10 code for chronic tonsillitis. International classification diseases of the tenth revision 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 arise due to infection by pathogenic microorganisms and are accompanied by a number of unpleasant symptoms. If a child has adenoids, the risk of developing the disease increases due to difficulty breathing. Chr. Tonsillitis has the following symptoms:

redness of the edges of the palatine arches;
changes in tonsil tissue (thickening or loosening);
purulent discharge in the lacunae;
inflammation of regional lymph nodes.

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

Delayed 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, and also carry out antibacterial and anti-inflammatory therapy.

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

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Chronic tonsillitis

ICD-10 code

Associated diseases

Titles

Description

Long-term inflammation of the pharyngeal and palatine tonsils develops after a sore throat and other infectious diseases accompanied by inflammation of the mucous membrane of the pharynx (scarlet fever, measles, diphtheria), or without previous acute illness. In chronic tonsillitis, ulceration of the mucous membrane, granulation, pustules in the thickness of the tonsils, and proliferation of connective tissue are observed. The simple form of chronic tonsillitis is characterized only by local symptoms (sore throat and), if they are accompanied by general phenomena (persistent cervical lymphadenitis, elevated body temperature, changes in the heart), this form is called toxic-allergic. Chronic tonsillitis can contribute to the occurrence or exacerbation of rheumatism, nephritis, thyrotoxicosis and other diseases.

Historically, chronic tonsillitis has long been considered as a disease of infectious-allergic origin (B. S. Preobrazhensky, 1966).

Symptoms

Classification

I. Simple form. This includes cases of chronic tonsillitis that occur only with local symptoms, subjective complaints and objective signs of the disease, with frequent sore throats, and in other cases - without repeated sore throats (non-angina chronic tonsillitis).

II. Toxicallergic form. Occurs as a result of a violation of protective and adaptive mechanisms. These or other local changes are accompanied by general phenomena. This includes forms of chronic tonsillitis that occur with low-grade fever and symptoms of tonsillogenic intoxication; Tonsillo-cardiac syndrome is often stated. The importance of toxic-allergic manifestations varies, and therefore it is advisable to distinguish between grade 1 (with milder phenomena) and degree 2 (with significantly more pronounced phenomena).

Causes

The starting points in the development of the disease are repeated inflammatory processes leading to local immunosuppression, which largely concerns the ability of tonsil cells to form antibodies and the level of cytotoxic activity of immunocompetent cells, a decrease in the reception and production of cytokine molecules in their tissue. With chronic inflammation, cells appear in the tonsils that have the ability to inhibit the natural cytolytic activity of blood cells, and also, apparently, the tonsils themselves. There is an antigenic overload of the tonsil tissue, which leads to the phenomenon of antigen competition. Toxic substances from microorganisms and general allergic reactions play an important role.

The development of chronic tonsillitis is also facilitated by persistent impairment of nasal breathing (adenoids in children, deviated nasal septum, enlargement of the inferior turbinates, nasal polyps, etc.). Local causes are often infectious foci in nearby organs: carious teeth, purulent sinusitis, chronic adenoiditis.

Treatment

Conservative treatment is indicated for the compensated form, as well as for the decompensated form, manifested by repeated sore throats, and in cases where there are contraindications for surgical treatment. Quite a lot of conservative treatment methods have been proposed.

Briefly and schematically, the means of conservative treatment according to the nature of their main action can be grouped as follows.

1. Means that help increase the body's defenses: correct mode day, balanced diet consuming enough natural vitamins, physical exercise, resort climatic factors, biostimulants, gamma globulin, iron supplements, etc.

2. Hyposensitizing agents: calcium preparations, antihistamines, ascorbic acid, epsilon-aminocaproic acid, small doses of allergens, etc.

3. Immunocorrection agents: levamisole, prodigiosan, thymalin, IRS-19, bronchomunal, ribomunil, etc.

4. Means of reflex action: various types novocaine blockades, acupuncture, manual therapy cervical spine (it has been noted that in patients with chronic tonsillitis and frequent sore throats, there is impaired mobility in the craniocervical joint with spasm of the short extensors of the neck, and that blockade at this level increases susceptibility to recurring tonsillitis).

5. Means that have a sanitizing effect on the palatine tonsils and their regional lymph nodes (active, medical manipulations).

A. Washing the lacunae of the tonsils. It is used to remove the pathological contents of the tonsils (plugs, pus). They are usually washed with a syringe and a cannula, using various solutions. Such solutions can be antiseptics, antibiotics, enzymes, antifungal, antiallergic, immunostimulating drugs, biological active agents and Properly performed rinsing helps reduce inflammation in the lacunae of the tonsils; the size of the tonsils usually decreases.

B. Suction of the contents of the lacunae of the tonsils. Using an electric suction and cannula, you can remove liquid pus from the lacunae of the tonsils. And, using a special tip with a vacuum cap and a connection medicinal solution, you can simultaneously wash the lacunae.

B. Introduction to Gaps medicinal substances. A syringe with a cannula is used for administration. Various emulsions, pastes, ointments, and oil suspensions are introduced. They linger in the gaps for a longer time, hence the more pronounced positive effect. The drugs have the same spectrum of action as those used for rinsing in the form of solutions.

D. Injections into the tonsils. A syringe with a needle is used to impregnate the tonsil tissue itself or the space surrounding it with various medications. Some time ago in Kharkov, it was proposed to make injections not with one needle, but with a special nozzle with a large number of small needles, which turned out to be more effective, since the tonsil tissue was actually saturated with the medicine, in contrast to injection with only one needle.

D. Lubricating the tonsils. Quite a lot is offered for lubrication a large number of different solutions or mixtures (the spectrum of action is the same as that of rinsing preparations). The most commonly used drugs: Lugol's solution, collargol, oil solution chlorophyllipt, propolis tincture with oil and.

E. Gargling. Performed independently by the patient. Countless rinses have been suggested by traditional medicine. You can also find it in pharmacies sufficient quantity ready-made solutions or concentrates for rinsing.

6. Physiotherapeutic methods of treatment.

Most often prescribed are ultrasound, microwave therapy, laser therapy, microwave, UHF, inductothermy, ultraviolet irradiation tonsils, magnetic therapy, electrophoresis, Vitafon (vibroacoustic device), mud therapy, inhalations. Methods with local use of immunomodulatory agents, such as levamisole, etc., have also been proposed.

The following technique is of interest. 2 times a day during the day, patients are recommended to use a mixture for resorption: 2 tablespoons of finely grated carrots + 1 spoon of honey + (the amount depends on age) drops of alcohol tincture of propolis + 0.5 ml of 5% ascorbic acid solution.

Let us briefly consider surgical treatment options. As a rule, surgery is prescribed for decompensated tonsillitis and in cases where repeated conservative treatment has not improved the condition of the tonsils.

Contraindications to tonsillectomy: hemophilia, severe cardiovascular and renal failure, severe diabetes, active tuberculosis, acute infectious diseases, last months of pregnancy, menstruation. If you had a sore throat the day before, the operation should be performed in 2-3 weeks.

Adults are usually operated on under local anesthesia, using dicaine or pyromecaine for terminal anesthesia, and novocaine or trimecaine for infiltration anesthesia.

An arcuate incision is made along the edge of the palatoglossus arch with transition to the velopharyngeal arch. Using a raspator or elevator, they penetrate through the incision into the paratonsillar space, behind the tonsil capsule, and separate the latter from the palatoglossal arch extracapsularly from the upper pole to the lower one. Then the tonsil is grasped with a clamp and separated from the velopharyngeal arch. Scar adhesions that are not amenable to blunt separation are cut with scissors, making small incisions. Having placed a cutting loop on the tonsil and deflecting it downwards, the entire tonsil is cut off with the loop. The tonsillar niche is treated with hemostatic paste. When separating the tonsil, it is taken into account that the internal and external carotid arteries pass near its poles.

After the operation, the patient is usually placed in bed on his right side, with his head elevated. On the first day you are allowed to take a few sips of water. In the following days, the patient receives pureed and liquid, non-hot food, and is prescribed antibacterial therapy. By the 4-5th day of hospital treatment, the tonsillar niches are cleared of fibrinous plaque. The patient is discharged for outpatient observation at the otorhinolaryngologist.

TO surgical methods Diathermocoagulation of the tonsils also applies (now rarely used).

In recent years, new methods of surgical treatment have been developed: tonsillectomy using a surgical laser.

The tonsils are also affected by surgical ultrasound. The cryosurgical method (freezing of the tonsils) is quite common. The method is used for small tonsils; some doctors also sound the tonsils with ultrasound before freezing, which helps reduce the tissue reaction to freezing and improve the healing of the wound surface on the tonsils.

ICD code: J35.0

Chronic tonsillitis

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Chronic tonsillitis: ICD code, description and treatment

The increasing number of patients with chronic tonsillitis is the result of a lack of attention to one’s own health. Doctors note that it is especially important not to stop the course of treatment for the acute form of the disease after some symptomatic relief. It is worth following all prescribed procedures and taking medications according to the regimen. In the case of constantly recurring tonsillitis, the disease becomes chronic.

Chronic tonsillitis, ICD code J35.0, is characterized by exacerbation in winter or in the off-season. The presence of a constant source of inflammation reduces immunity and increases the body's susceptibility to respiratory diseases. In the absence of proper therapy or general weakening of the body, as a result of which the tissues of the tonsils begin irreversible processes, surgery may be indicated.

Symptoms of the disease and its types

In case of chronic tonsillitis ICD 10, two types of sore throat can be considered. Compensated type is a disease in which the immune system helps stop pathological processes, and the use of appropriate medications effective. Decompensated chronic tonsillitis is a variant with constant exacerbations.

IN in this case the immune system is not able to cope with the disease, and the tonsils lose their basic functions. This severe form often ends with tonsillectomy - removal of the tonsils. This classification helps to clarify the degree of damage to the protective organ.

Symptoms of chronic tonsillitis:

Discomfort, soreness, some burning in the throat.
Reflex coughing attacks, which are caused by irritation of the mucous membrane of the palate and larynx.
Enlarged cervical lymph nodes. This symptom of tonsillitis is common in children and adolescents, but also occurs in adult patients.
The elevated body temperature that accompanies the inflammatory process is not relieved by conventional means and can persist for a long time. In this case, doctors recommend visiting a doctor, even if the symptoms are somewhat blurred and do not seem acute.
Headache, constant fatigue, muscle pain.
Upon examination, the surface of the tonsils appears loose. The palatal arches are hyperemic. Upon examination, the doctor will detect the presence purulent plugs having an unpleasant odor.

Often the patient gets used to the altered state, resigns himself and does not take appropriate measures. The problem is sometimes discovered during preventive examinations.

The international classifier has identified this disease as an independent nosological unit, since it has a characteristic clinical and morphological picture.

Conservative treatment of chronic tonsillitis ICD code 10 includes:

Taking antibiotics prescribed by an ENT specialist, taking into account the individual characteristics of each person.
The use of antiseptics that sanitize lacunae and nearby surfaces. Chlorhexidine, Hexoral, Octenisept, and traditional Furacilin are usually used.
Physiotherapeutic adjunct is effective. Standard procedures allow tissue restoration, and innovative laser therapy will not only reduce inflammation, but also help strengthen the immune system. The technique combines direct laser exposure to the pharynx area and irradiation of the tonsils through the skin with infrared rays at a certain frequency.

During periods of remission you should Special attention pay attention to fortification, formation immune mechanisms with the help of hardening, special drugs - for example, Imudon. Removal is resorted to only in the presence of constant, increasingly complex exacerbations that threaten serious complications.

Chronic tonsillitis code ICD

Chronic tonsillitis - Review of information

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

Chronic tonsillitis can rightfully be called a “disease of the 20th century” that has “successfully” crossed the line of the 21st century. and still constitute one of the main problems not only of otorhinolaryngology, but also of many other clinical disciplines, in the pathogenesis of which allergies, focal infections and deficient conditions of local and systemic immunity play a major role. However, the basic factor that is 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 influence of specific antigens. On average, according to a survey of different population groups, in the USSR in the second quarter of the 20th century. the incidence of chronic tonsillitis fluctuated between 4-10%, and already in the third quarter of this century, from a report by I.B. Soldatov at the VII Congress of Otorhinolaryngologists of the USSR (Tbilisi, 1975), it followed that this figure, depending on the region of the country, increased to 15.8 -31.1%. According to V.R. Goffman et al. (1984), chronic tonsillitis affects 5-6% of adults and 10-12% of children.

ICD-10 code

J35.0 Chronic tonsillitis.

ICD-10 code J35.0 Chronic tonsillitis

Epidemiology of chronic tonsillitis

Causes of chronic tonsillitis

The cause of chronic tonsillitis is a pathological transformation (development of chronic inflammation) of the physiological process of immunity formation in the tissue of the palatine tonsils, where the normally limited process of inflammation 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-elithelial (lymphoid accumulations, including tonsils, in the mucous membrane of various organs: pharynx, larynx, trachea and bronchi, intestines). The mass of the palatine tonsils makes up a small 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 tonsillitis in the anamnesis. In this case, it is necessary to find out from the patient what kind of increase in body temperature is accompanied by sore throat and for what period of time. Sore throats 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 shape, febrile body temperature, etc.), but in adults such classic symptoms of sore throat often do not occur. In such cases, exacerbations of chronic tonsillitis occur without pronounced severity of all symptoms: the temperature corresponds to low subfebrile values (37.2-37.4 C), the pain in the throat when swallowing is insignificant, and a moderate deterioration in general well-being is observed. The duration of the disease is usually 3-4 days.

Where does it hurt?

Screening

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 - enlarged lymph nodes at the angles of the lower jaw and in front of the sternocleidomastoid muscle. Along with determining the enlargement of the 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 a clinical assessment it is necessary to exclude other foci of infection in this region (teeth, gums, sinuses, etc.).

What needs to be examined?

What tests are needed?

Who to contact?

Treatment of chronic tonsillitis

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

More information 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. Acute tonsillitis (tonsillitis) is typically characterized by acute inflammation of the lymphoid tissue, predominantly of the palatine tonsils. 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 wall of the pharynx. In children, tonsillopharyngitis is more often noted.

ICD-10 code

J02 Acute pharyngitis.
J02.0 Streptococcal pharyngitis.
J02.8 Acute pharyngitis caused by other specified pathogens. J03 Acute tonsillitis.
J03.0 Streptococcal tonsillitis.
J03.8 Acute tonsillitis caused by other specified pathogens.
J03.9 Acute tonsillitis, unspecified.

Epidemiology of sore throat and acute pharyngitis in children

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, the cause of acute tonsillitis/tonsillopharyngitis and acute pharyngitis can be herpes simplex viruses and Coxsackie enteroviruses. Starting from the age of 5 years, 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 this, the causes of acute tonsillitis/tonsillopharyngitis and pharyngitis can be group C and G streptococci, M. pneumoniae, Ch. pneumoniae and Ch. psittaci, influenza viruses.

Causes of sore throat and acute pharyngitis in children

Symptoms of sore throat and acute pharyngitis in children

Where does it hurt?

What's troubling?

Classification of sore throat and acute pharyngitis in children

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

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 streptococcal etiology of the process and normal leukocytosis or a tendency to leukopenia and lymphocytosis with a viral etiology of the disease.

Diagnosis of sore throat and acute pharyngitis in children

What needs to be examined?

How to examine?

What tests are needed?

Who to contact?

The patient is prescribed 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 indicated. 1-2% solution of hexethidium (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 sore throat and acute pharyngitis in children

More information about treatment

Sore throat (acute tonsillitis) - Review of information

Sore throat (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 tonsillitis, or acute tonsillitis?

At the end of the 19th century. a special form of ulcerative-necrotic tonsillitis is described, the occurrence of which is due to the fusospirochetal symbiosis of Plaut - Vincent, and with the introduction of hematological research into clinical practice, special forms of pharyngeal lesions were identified, called agranulocytic and monocytic tonsillitis. Somewhat later, a special form of the disease was described that occurs during alimentary-toxic aleukia, similar in its manifestations to agranulocytic tonsillitis.

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

ICD-10 code

J03 Acute tonsillitis (tonsillitis).

ICD-10 code J03 Acute tonsillitis J03.8 Acute tonsillitis caused by other specified pathogens J03.9 Acute tonsillitis, unspecified

Epidemiology of tonsillitis

In terms of the number of days of disability, angina ranks third after influenza and acute respiratory diseases. Children and pre-teens get sick more often. The frequency of visits to a 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 among the urban population the disease is more common than among the rural population. According to the literature, 3% of those who have recovered from the disease develop rheumatism, and in patients with rheumatism after an illness, heart disease develops in 20-30% of cases. In patients with chronic tonsillitis, tonsillitis is observed 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 sore throat

The anatomical position of the pharynx, which determines wide access to it by pathogenic environmental factors, as well as the abundance of choroid plexuses and lymphadenoid tissue, turns it into a wide entrance gate for various kinds of 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 area of the posterior pharyngeal wall.

Symptoms of a sore throat

The symptoms of a sore throat are typical - a sharp sore throat, increased body temperature. Among the various clinical forms, banal tonsillitis is most common, and among them are catarrhal, follicular, lacunar. The separation 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 tonsillitis is the first stage of the process, followed by a more severe form or another disease.

Where does it hurt?

Classification of sore throat

episodic form associated with autoinfection, which is also activated under unfavorable environmental conditions, most often after local or general cooling;
epidemic form, which occurs as a result of infection from a patient with tonsillitis or a 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 reactions results in chronic inflammation of the 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;
- for HIV infection;
- damage to the pharynx due to typhoid fever;
- with tularemia.
For blood diseases:
- monocytic;
- for leukemia:
- agranulocytic.
Some forms according to localization:
- tonsil tray (adenoiditis);
- lingual tonsil;
- laryngeal;
- lateral ridges of the pharynx;
- tubar tonsil.

“Sore throats” mean a group of inflammatory diseases of the pharynx and their complications, which are based on damage to the anatomical formations of the pharynx and adjacent structures.

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

Catarrhal (banal) nonspecific (catarrhal, follicular), which, after localizing the inflammation, are defined as palatal and lingual amygdalitis, retronasal (adenoiditis), uvulitis. These inflammatory processes in the pharynx are called “red tonsillitis”.
Membranous (diphtheria, pseudomembranous non-diphtheria). These inflammatory processes are called “white tonsillitis”. To clarify the diagnosis, it is necessary to conduct a bacteriological study.
Sore throats accompanied by loss of structure (ulcerative-necrotic): herpetic, including Herpes zoster, aphthous, Vincent's ulcer, scurvy and impetigo, post-traumatic, toxic, gangrenous, etc.

Screening

Diagnosis of sore throat

The history must be collected with special 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 (unilateral, bilateral, with or without irradiation into the ear, the so-called pharyngeal cough, a feeling of dryness, tickling, 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 force one 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, microbiological diagnosis of streptococcal tonsillitis is important, which includes a bacterial examination of a smear from the surface of the tonsil or the posterior wall of the pharynx. The results of sowing largely depend on the quality of the material obtained. The smear is taken using a sterile swab; the material is delivered to the laboratory within 1 hour (for longer periods it is necessary to use special media). Before collecting material, you should not rinse your mouth or use deodorants for at least 6 hours. With the correct technique for collecting material, the sensitivity of the method reaches 90%, specificity%.

What needs to be examined?

How to examine?

What tests are needed?

Who to contact?

Treatment of sore throat

Preference is given to penicillin drugs, since beta-hemolytic streptococcus is most sensitive to penicillins. In outpatient settings, oral medications should be prescribed.

More information about treatment

Prevention of sore throat

Measures to prevent the disease are based on the principles that have been developed for infections transmitted by airborne droplets or nutrition, since sore throat is an infectious disease.

Preventive measures should be aimed at improving the health of the external environment, eliminating factors that reduce the body’s protective properties against pathogens (dust, smoke, excessive crowding, etc.). Among the individual prevention measures are hardening the body, physical exercise, establishing a reasonable work and rest schedule, staying in the fresh air, eating food with sufficient vitamin content, etc. The most important are therapeutic and preventive measures, such as sanitation of the oral cavity, timely treatment (surgical if necessary) of chronic tonsillitis, restoration of normal nasal breathing (if necessary, adenotomy, treatment of diseases of the paranasal sinuses, septoplasty, etc.).

Forecast

Characterized by inflammation of the tonsils.

When determining the treatment tactics for chronic tonsillitis, it should be remembered that the development of the disease is facilitated by: persistent impairment 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 body's energy rating, eliminating immunological abnormalities at the systemic and regional level, reducing inflammation in the tonsils with the subsequent elimination of metabolic and hemodynamic disorders. The list of measures to solve these problems includes percutaneous irradiation of the tonsil area, direct irradiation of the pharynx area (preferably with laser light of the red spectrum or, associatively, IR and red spectrum). The effectiveness of treatment is significantly increased by simultaneous irradiation of the above-mentioned zones with light from the red and infrared spectrum using the following method: direct irradiation of the tonsils is carried out with light from the red spectrum, and transcutaneous irradiation of them with light from the infrared spectrum. Rice. 67. Impact on the projection zones of the tonsils on the anterolateral surface of the neck.

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

Additionally, the following is performed: NLBI of the ulnar vessels, contact on 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, exposure to regional lymph nodes (irradiation is performed only in the absence of lymphadenitis!).

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

Rice. 69. Projection area 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, along the outer surface of the lower leg and forearm and in the dorsum of the foot.

Irradiation modes for treatment areas in the treatment of tonsillitis

Irradiation zone	Emitter	Power	frequency Hz	Exposure, min	Nozzle
Direct irradiation of tonsils	BIC	20 mW	-	8	KNS-Up, No. 4
Transcutaneous irradiation of the tonsils, Fig. 67	B2	14 W	300-600	2-4	MH30
Regional lymph nodes, Fig. 69	BI-1	4 W	300	2-4	KNS-Up, No. 4
Jugular fossa, Fig. 68, pos. "2"	BI-1	5 W	150	2	KNS-Up, No. 4
Spine, C3, fig. 68, pos. "3"	BI-1	5 W	300	2	LONO, M2
NLBI of the ulnar vessel, Fig. 68, pos. "1"	BIC	15-20 mW	-	4-6	KNS-Up, No. 4

The duration of treatment is 10-12 procedures. Repeated is required treatment course after 4-6 weeks and further anti-relapse courses of treatment once every six months during seasonal periods of exacerbations (autumn and spring).

Laser therapy is aimed at increasing the body's energy rating, eliminating immunological abnormalities at the systemic and regional level, reducing inflammation in the tonsils with the subsequent elimination of metabolic and hemodynamic disorders. The list of measures to solve these problems includes percutaneous irradiation of the tonsil area, direct irradiation of the pharynx area (preferably with laser light of the red spectrum or, associatively, IR and red spectrum). The effectiveness of treatment increases significantly with simultaneous irradiation of the above-mentioned zones with light from the red and infrared spectrum according to the following method: direct irradiation of the tonsils is carried out with light from the red spectrum, and transcutaneous irradiation of them with light from the infrared spectrum.

Rice. 67. Impact on the projection zones of the tonsils on the anterolateral surface of the neck.

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

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

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

Irradiation modes for treatment areas in the treatment of tonsillitis

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Chronic diseases of the tonsils and adenoids (J35)

In Russia, the International Classification of Diseases, 10th revision (ICD-10) has been adopted as a single normative document to record morbidity, reasons for the population’s visits to medical institutions of all departments, 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. No. 170

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

With changes and additions from WHO.

Chronic tonsillitis code ICD

Chronic tonsillitis - Review of information

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

Chronic tonsillitis can rightfully be called a “disease of the 20th century” that has “successfully” crossed the line of the 21st century. and still constitute one of the main problems not only of otorhinolaryngology, but also of many other clinical disciplines, in the pathogenesis of which allergies, focal infections and deficient conditions of local and systemic immunity play a major role. However, the basic factor that is 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 influence of specific antigens. On average, according to a survey of different population groups, in the USSR in the second quarter of the 20th century. the incidence of chronic tonsillitis fluctuated between 4-10%, and already in the third quarter of this century, from a report by I.B. Soldatov at the VII Congress of Otorhinolaryngologists of the USSR (Tbilisi, 1975), it followed that this figure, depending on the region of the country, increased to 15.8 -31.1%. According to V.R. Goffman et al. (1984), chronic tonsillitis affects 5-6% of adults and 10-12% of children.

ICD-10 code

J35.0 Chronic tonsillitis.

ICD-10 code J35.0 Chronic tonsillitis

Epidemiology of chronic tonsillitis

Causes of chronic tonsillitis

Symptoms of chronic tonsillitis

One of the most reliable signs of chronic tonsillitis is the presence of tonsillitis in the anamnesis. In this case, it is necessary to find out from the patient what kind of increase in body temperature is accompanied by sore throat and for what period of time. Sore throats 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 shape, febrile body temperature, etc.), but in adults such classic symptoms of sore throat often do not occur. In such cases, exacerbations of chronic tonsillitis occur without pronounced severity of all symptoms: the temperature corresponds to low subfebrile values (37.2-37.4 C), the pain in the throat when swallowing is insignificant, and a moderate deterioration in general well-being is observed. The duration of the disease is usually 3-4 days.

Where does it hurt?

Screening

Diagnosis of chronic tonsillitis

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

What needs to be examined?

What tests are needed?

Who to contact?

Treatment of chronic tonsillitis

More information 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. Acute tonsillitis (tonsillitis) is typically characterized by acute inflammation of the lymphoid tissue, predominantly of the palatine tonsils. 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 wall of the pharynx. In children, tonsillopharyngitis is more often noted.

ICD-10 code

J02 Acute pharyngitis.
J02.0 Streptococcal pharyngitis.
J02.8 Acute pharyngitis caused by other specified pathogens. J03 Acute tonsillitis.
J03.0 Streptococcal tonsillitis.
J03.8 Acute tonsillitis caused by other specified pathogens.
J03.9 Acute tonsillitis, unspecified.

Epidemiology of sore throat and acute pharyngitis in children

Causes of sore throat and acute pharyngitis in children

Symptoms of sore throat and acute pharyngitis in children

Where does it hurt?

What's troubling?

Classification of sore throat and acute pharyngitis in children

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

Diagnosis of sore throat and acute pharyngitis in children

What needs to be examined?

How to examine?

What tests are needed?

Who to contact?

Treatment varies depending on the etiology of acute tonsillitis and strep throat. For streptococcal tonsillopharyngitis, antibiotics are indicated; for viral tonsillitis, they are not indicated; for mycoplasma and chlamydial tonsillitis, antibiotics are indicated only in cases where the process is not limited to tonsillitis or pharyngitis, but descends into the bronchi and lungs.

Treatment of sore throat and acute pharyngitis in children

More information about treatment

Sore throat (acute tonsillitis) - Review of information

What is tonsillitis, or acute tonsillitis?

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

ICD-10 code

J03 Acute tonsillitis (tonsillitis).

ICD-10 code J03 Acute tonsillitis J03.8 Acute tonsillitis caused by other specified pathogens J03.9 Acute tonsillitis, unspecified

Epidemiology of tonsillitis

Causes of sore throat

Symptoms of a sore throat

Where does it hurt?

Classification of sore throat

episodic form associated with autoinfection, which is also activated under unfavorable environmental conditions, most often after local or general cooling;
epidemic form, which occurs as a result of infection from a patient with tonsillitis or a 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 reactions results in chronic inflammation of the 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;
- for HIV infection;
- damage to the pharynx due to typhoid fever;
- with tularemia.
For blood diseases:
- monocytic;
- for leukemia:
- agranulocytic.
Some forms according to localization:
- tonsil tray (adenoiditis);
- lingual tonsil;
- laryngeal;
- lateral ridges of the pharynx;
- tubar tonsil.

“Sore throats” mean a group of inflammatory diseases of the pharynx and their complications, which are based on damage to the anatomical formations of the pharynx and adjacent structures.

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

Catarrhal (banal) nonspecific (catarrhal, follicular), which, after localizing the inflammation, are defined as palatal and lingual amygdalitis, retronasal (adenoiditis), uvulitis. These inflammatory processes in the pharynx are called “red tonsillitis”.
Membranous (diphtheria, pseudomembranous non-diphtheria). These inflammatory processes are called “white tonsillitis”. To clarify the diagnosis, it is necessary to conduct a bacteriological study.
Sore throats accompanied by loss of structure (ulcerative-necrotic): herpetic, including Herpes zoster, aphthous, Vincent's ulcer, scurvy and impetigo, post-traumatic, toxic, gangrenous, etc.

Screening

Diagnosis of sore throat

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

What needs to be examined?

How to examine?

What tests are needed?

Who to contact?

Treatment of sore throat

Preference is given to penicillin drugs, since beta-hemolytic streptococcus is most sensitive to penicillins. In outpatient settings, oral medications should be prescribed.

More information about treatment

Prevention of sore throat

Measures to prevent the disease are based on the principles that have been developed for infections transmitted by airborne droplets or nutrition, since sore throat is an infectious disease.

Preventive measures should be aimed at improving the health of the external environment, eliminating factors that reduce the body’s protective properties against pathogens (dust, smoke, excessive crowding, etc.). Among the individual prevention measures are hardening the body, physical exercise, establishing a reasonable work and rest schedule, staying in the fresh air, eating food with sufficient vitamin content, etc. The most important are therapeutic and preventive measures, such as sanitation of the oral cavity, timely treatment (surgical if necessary) of chronic tonsillitis, restoration of normal nasal breathing (if necessary, adenotomy, treatment of diseases of the paranasal sinuses, septoplasty, etc.).