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

According to statistics, Russian doctors annually diagnose tonsillitis in more than 5 million patients. The current international classifier of the 10th revision (ICB) defines such a disease in the section "respiratory diseases". The disease is not life-threatening, but its uncontrolled course can provoke serious complications.

Sharp forms have codes 0, J03.8, and J03.9.
Chronic (xp) was assigned a code for mkb0.

Such a classification allows doctors to operate with a common terminology and significantly streamlines the workflow.

Acute course of the disease: symptoms and treatment

Acute tonsillitis - common tonsillitis - is characterized by a sharp inflammation of the tonsils. The main symptoms are fever up to 39-40o, pain in the throat, weakness, soreness 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, self-medication can cause severe complications, including paratonsillar abscess, tonsilogenic sepsis, all types of otitis media and many other unpleasant consequences.

Many doctors speak of mkb 10 tonsillitis as an ailment that can significantly reduce the body's immune defenses 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, relieving inflammation.

Traditionally effective:

Antibacterial drugs in tablets, injections. Topical 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. Also distributed are products in the form of candies, lozenges, including Isla, Anzibel, Lizak.
Gargling with solutions of Chlorophyllipt, Octenisept, Rotokan, Furacilin or Chlorhexidine will relieve the infection.
Anesthetics will help relieve pain: the newest line of Tantum Verde, Septolete plus, Coldrex Larry, Strepsils.

Do not forget about folk methods: drinking plenty of fluids, rinsing with chamomile decoction will accelerate recovery.

Chronic tonsillitis. What measures are most effective.

Chronic tonsillitis develops after several untreated sore throats, sometimes such a disease can be the result of dental pathologies. The main pathogens are streptococcus or staphylococcus strains. The tissues of the tonsils become loose, on their surface are visible cheesy light blotches. Frequent sore throats (tonsillitis) provoke enlargement and soreness of the lymph nodes.

Treatment of the disease is similar to the measures taken in the acute course, and physicians write an abbreviation marked "xp" in the card of patients with such a diagnosis. Antibiotics and antiseptics will relieve inflammation and prevent the further development of pathogens. And washing the lacunae with a solution of Chlorhexedine or Miramistin will remove the remnants of the corks. Also shown is bactericidal physiotherapy.

Along with the standard technique that is used to treat tonsillitis (designation by μb 10) at all stages, innovative laser therapy is considered effective. The most effective is the simultaneous direct action of the red spectrum flux directly on 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 protracted chronic disease. tonsillitis, surgery is possible. This will help remove a persistent infection and prevent kidney damage or heart failure. Treatment of chronic tonsillitis is a painstaking process that requires strict adherence to the rules of personal hygiene and scrupulous implementation of the doctor's recommendations.

Chronic tonsillitis is an active chronic inflammatory focus of infection in the tonsils with periodic exacerbations with a general infectious-allergic reaction. An infectious-allergic reaction is caused by constant intoxication from the tonsillar focus of infection, it increases with an exacerbation of the process. It disrupts the normal functioning of the whole organism and aggravates the course of common 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", "successfully" overstepped 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 infections and deficits of local and systemic immunity play a major role. However, the basic factor of particular importance in the onset of this disease, according to many authors, is the genetic regulation of the immune response of the tonsils to the action of specific antigens. On average, according to a survey of different population groups, in the USSR in the second quarter of the XX 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. Soldatov at the VII Congress of otorhinolaryngologists of the USSR (Tbilisi, 1975), it followed that this indicator, depending on the region of the country, increased to 15.8 -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 should be borne in mind that between exacerbations, as well as in the angina-free form of chronic tonsillitis, the symptoms of the disease are in many ways familiar and do not bother the patient at all 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 an important role. In many cases, chronic tonsillitis, while remaining unrecognized, has all the negative factors of tonsillar focal infection, weakens human health, and worsens the quality of life.

The causes of chronic tonsillitis

The cause of chronic tonsillitis is a pathological transformation (development of chronic inflammation) of the physiological process of the formation of immunity 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: lymph-blood (bone marrow), lymph-interstitial (lymph nodes) and lymph-elithelial (lymphoid accumulations, including tonsils, in the mucous membrane of various organs: pharynx, larynx, trachea and bronchi, intestines). The mass of the tonsils is an insignificant part (about 0.01) of the lymphoid apparatus of the immune system.

Chronic tonsillitis symptoms

One of the most reliable signs of chronic tonsillitis is the presence of tonsillitis and a history. In this case, the patient must definitely find out what increase in body temperature is accompanied by pain in the throat and during what period of time. Sore throats in chronic tonsillitis can be pronounced (severe sore throat when swallowing, significant hyperemia of the mucous membrane of the pharynx, with purulent attributes on the palatine tonsils, according to the forms, febrile body temperature, etc.), but in adults often such classic symptoms of angina do not happen. In such cases, exacerbations of chronic tonsillitis proceed without a pronounced severity of all symptoms: the temperature corresponds to low subfebrile values (37.2-37.4 C), the sore 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?

Sore throat Sore throat when swallowing

Screening

It is necessary to carry out screening for chronic tonsillitis in patients with rheumatism, cardiovascular diseases, joint diseases, kidneys, In these cases, examination for chronic tonsillitis is also necessary. \

Diagnostics of the 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 mandible and in front of the sternocleidomastoid muscle. Along with the definition of an increase in lymph nodes, it is necessary to note their pain 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 should be examined?

Tonsils Palatine tonsil

What tests are needed?

Who to contact?

ENT - doctor Otolaryngologist

Chronic tonsillitis treatment

With a simple form of the disease, conservative treatment is carried out and for 1-2 years in 10-day courses. 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 even more so the occurrence of repeated tonsillitis, is considered an indication for the removal of the tonsils.

In case of toxic-allergic form I 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 prolonged if significant improvement is not observed. Toxic-allergic form II degree of chronic tonsillitis is dangerous with rapid progression and irreversible consequences.

Additional treatment

Tonsillitis: treatment Antibiotics for tonsillitis Removal of tonsils (tonsillectomy) Physiotherapy for angina Antibiotics for angina Antibiotics for angina in children How to treat? Cebopim

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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 are collectively called angina. In fact, according to BS Preobrazhensky (1956), the name "throat angina" unites a group of heterogeneous diseases of the pharynx and not only inflammation of the lymphadenoid formations themselves, but also of cellulose, 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 (V-IV centuries BC) repeatedly cited information relating to the disease of the pharynx, very similar to angina, 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 in medicine gave rise to classifying the disease by the type of pathogen (streptococcal, staphylococcal, pneumococcal). The discovery of corynebacterium diphtheria made it possible to differentiate a banal sore throat from a sore throat-like disease - pharyngeal diphtheria, 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 sore throat 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 sore throat. A little 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 widely used in the literature, but tonsillitis and pharyngitis are included separately in the ICD-10. Given the extreme importance of streptococcal etiology of the disease, streptococcal tonsillitis J03.0), as well as acute tonsillitis caused by other specified pathogens (J03.8), are isolated. If it is necessary to identify the infectious agent, use an additional code (B95-B97).

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

Epidemiology of sore throat

In terms of the number of days of disability, angina ranks third after influenza and acute respiratory diseases. Children and persons 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 the population density, household, sanitary and hygienic, geographical and climatic conditions.It should be noted that the disease is found cleaner 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 a previous illness, a heart defect is formed in 20-30% of cases. In patients with chronic tonsillitis, angina 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 the wide access to it of pathogenic factors of the external environment, as well as the abundance of vascular plexuses and lymphadenoid tissue, turn it into a wide entrance gate for various kinds of pathogenic microorganisms. The elements that primarily react 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 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 (type 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.

Sore throat symptoms

The symptoms of sore throat are typical - a sharp sore throat, an increase in body temperature. Among the various clinical forms, banal sore throats are more common than others, and among them - 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 sore throat is the first stage of the process, followed by a more severe form or another disease occurs.

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 some sort of 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 tonsillitis, 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 their proposed classifications, which, at times, were reduced to classical concepts.

These classifications were and are to this day 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 etiology, clinical forms and complications.Therefore, from a practical point of view, it is advisable to subdivide tonsillitis into nonspecific acute and chronic and specific acute and chronic.

The classification presents certain difficulties due to the variety of types of disease. The classifications of V.Y. Voyachek, A.Kh. Minkovsky, V.F. Undritsa and S.Z. Romm, L.A. Lukozsky, I.B. Soldatov et al. Is 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 practical doctors was the classification of the disease developed by B.S. Preobrazhensky and subsequently supplemented by V.T. Palchunom. This classification is based on pharyngoscopic signs, supplemented by data obtained in laboratory studies, sometimes by information of an etiological or pathogenetic nature. By origin, the following main forms are distinguished (according to Preobrazhensky Palchun):

an 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 angina or a bacillus carrier of a virulent infection; usually the infection is transmitted by contact or airborne droplets;
sore throats as another exacerbation of chronic tonsillitis, in this case, a violation of local and general immune reactions is a consequence of 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;
- defeat of the pharynx with typhoid fever;
- with tularemia.
With blood diseases:
- monocytic;
- with leukemia:
- agranulocytic.
Some forms according to localization:
- tray tonsil (adenoiditis);
- lingual tonsil;
- laryngeal;
- lateral ridges of the pharynx;
- tubular tonsil.

Under "angina" 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 tonsillitis and presented it in the following form:

Catarrhal (banal) nonspecific (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".
Filmy (diphtheria, pseudomembranous nondiphtheritic). These inflammatory processes are called "white tonsillitis". To clarify the diagnosis, it is necessary to conduct a bacteriological study.
Angina accompanied by loss of structure (ulcerative necrotic): herpetic, including with Herpes zoster, aphthous, ulcerative Vincent, with mourning and impetigo, post-traumatic, toxic, gangrenous, etc.

Screening

When a disease is detected, they are guided by complaints of a 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.

Diagnostics of the sore throat

The history must be collected with great 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.).

Pharyngeal endoscopy 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, microbiological diagnostics of streptococcal sore throat is of great importance, which includes a bacteriological examination of a smear from the surface of the amygdala or the posterior pharyngeal wall. The sowing results largely depend on the quality of the material obtained. The swab is taken using a sterile swab; the material is delivered to the laboratory within 1 hour (for longer periods, special media must be used). Before taking the material, you should not rinse your mouth or use deodorant agents for at least 6 hours. With the correct technique of sampling, the sensitivity of the method reaches 90%, the specificity is 95-96%.

What should be examined?

Pharyngeal (adenoid) tonsil Tonsils

How to examine?

X-ray of the larynx and pharynx

What tests are needed?

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

Who to contact?

Otolaryngologist ENT - doctor

Sore throat treatment

The basis of the drug treatment of angina is systemic antibiotic therapy. On an outpatient basis, antibiotic prescription is usually carried out empirically, therefore, information on 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 has the greatest sensitivity to penicillins. On an outpatient basis, oral medications should be prescribed.

Additional treatment

Physiotherapy for angina Antibiotics for angina Antibiotics for angina in children Removal of tonsils (tonsillectomy) Tonsillitis: treatment Antibiotics for tonsillitis How to treat? Dazel Cebopim Tsedeks Thyme herb Sage DR. TYSS Baishicinje

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 alimentary, since angina 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 scarcity, etc.). Individual prevention measures include hardening the body, exercising, establishing a reasonable regime of work and rest, staying in the fresh air, food with a sufficient content of vitamins, etc. The most important are therapeutic and prophylactic 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 with timely initiation and full treatment. Otherwise, local or general complications may develop, the formation of chronic tonsillitis. The period of the patient's 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. 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, 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-related 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, herpes simplex viruses and Coxsackie enteroviruses can cause acute tonsillitis / tonsillopharyngitis and acute pharyngitis. Beginning at the age of 5, B-hemolytic group A streptococcus is of great importance in the development 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, accompanied, as a rule, by a rise in body temperature and worsening of the condition, 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 mucous membrane of the posterior pharyngeal wall, its "granularity" and infiltration, the appearance of purulent exudation and plaque mainly on the tonsils, an increase 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 worried about?

Lump in the throat

Classification of angina and acute pharyngitis in children

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

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 in the formula to the left with streptococcal etiology of the process and normal leukocytosis or a tendency towards leukopenia and lymphocytosis of the disease.

Diagnostics of the sore throat and acute pharyngitis in children

What should 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 the 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?

ENT pediatrician - doctor Otolaryngologist

Treatment differs depending on the etiology of acute tonsillitis and acute pharyngitis. With streptococcal tonsillopharyngitis, antibiotics are shown, with viral they are not indicated, with mycoplasma 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. Throat rinsing with 1-2% Lugol's solution is shown. 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 angina and acute pharyngitis in children

Additional treatment

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

ICD-10 was introduced into health care practice throughout the Russian Federation in 1999 by order of the Ministry of Health of Russia dated 05/27/97. No. 170

A new revision (ICD-11) is planned by WHO in 2017 2018.

As amended and supplemented by WHO

Processing and translation of changes © mkb-10.com

Chronic tonsillitis code according to mkb 10, treatment

Acute tonsillitis (tonsillitis) is a common infectious disease in which the tonsils (tonsils) become inflamed. 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, pneumococcus and adenoviruses. Almost all healthy people can have streptococcus A, which is dangerous to others.

Acute tonsillitis, the ICD code 10 of which is J03, reoccurring, is dangerous to humans, therefore, re-infection should be avoided and completely cured of sore throat.

Symptoms of acute tonsillitis

The main symptoms of acute tonsillitis include the following:

High temperature up to 40 degrees
Sore throat and foreign body sensation
Sharp sore throat, worse when swallowing
General weakness
Headache
Muscle and joint pain
Sometimes there is pain in the region of the heart
Inflammation of the lymph nodes, which causes neck pain when turning the head.

Complications of acute tonsillitis

Angina is a danger due to possible complications:

Paratonsillar 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 are trying to cope with the disease on their own.

Acute tonsillitis treatment

Treatment of sore throat is aimed at local and general effects. General strengthening and hyposensitizing treatment, vitamin therapy is carried out. This disease does not require hospitalization, the only exceptions are 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 effects. Sprays are used as local agents, for example, Cameton, Miramistin, Bioparox. For resorption, lozenges with an antibacterial effect are prescribed: Lizobact, Hexaliz and others.
To relieve a sore throat, drugs are prescribed that contain antiseptic components - Strepsils, Tantum Verde, Strepsils.
Antipyretics are necessary at high temperatures.
For rinsing, antiseptic and anti-inflammatory drugs are used - 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 comes in days.

Chronic tonsillitis: ICD code 10, description of the disease

Chronic tonsillitis is an infectious disease of a general nature, in which the tonsils are the focus of the infection, causing an inflammatory process. Chronic tonsillitis is a recurrent exacerbation of a sore throat or a chronic disease without a sore throat.

Chronic tonsillitis ICD code 10, symptoms

Chronic tonsillitis can form as a result of a previous sore throat, that is, when the inflammatory processes continue to pass latently into chronic ones. However, there are times when the disease appears without previous sore throats.

The main symptoms of the disease include:

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

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

In chronic tonsillitis, kidney or heart damage 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 angina, the same measures are taken as in the acute form of the disease. The disease is fought in the following way.

Physiotherapy procedures to restore tonsil tissue, accelerate their regeneration.
Antiseptics (hydrogen peroxide, Chlorhexidine, Miramistin) for washing lacunae.
To strengthen the immune system, vitamins, hardening, Imudon are prescribed.

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

Tonsillitis: symptoms and treatment in adults

How to treat chronic tonsillitis with folk remedies

With a reddening of the throat, which did not go away for a long time, ENT prescribed Tonsilotren for me. Adhering to 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 was gone and the throat no longer hurt.

Karina, I have chronic tonsillitis since childhood, so I've tried a lot of everything…. Rinsing is certainly good, and hydrogen peroxide helps, and propolis infusion and tea tree oil can be used, but for a long time! Doctors prescribe antibiotics, sometimes they have to be used. The greatest and best effect I noticed from Azitral capsules. And I helped quickly and did not notice the negative impact. So I recommend combining this medication with a rinse!

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Chronic tonsillitis encoding

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

When preparing medical documentation, general practitioners and otorhinolaryngologists use the ICD 10 code for chronic tonsillitis. The international classification of 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 occur as a result of infection with 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 is distinguished by the following signs:

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

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

Chronic tonsillitis

ICD-10 code

Associated diseases

Names

Description

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

Historically, chronic tonsillitis has long been regarded as a disease of infectious and allergic genesis (B.S. Preobrazhensky, 1966).

Symptoms

Classification

I. Simple form. It includes cases of chronic tonsillitis, occurring only with local symptoms, subjective complaints and objective signs of the disease, with frequent tonsillitis, and in other cases - without repeated tonsillitis (angina-free chronic tonsillitis).

II. Toxicoallergic form. It occurs as a result of a violation of protective and adaptive mechanisms. These or those local changes are accompanied by general phenomena. These include forms of chronic tonsillitis, occurring with subfebrile condition, with symptoms of tonsillogenic intoxication; Tonsillo-cardiac syndrome is often stated. The importance of toxic-allergic manifestations is not the same, and therefore it is advisable to distinguish between 1 degree (with lighter symptoms) and 2 degree (with significantly 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 tissues. 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. An antigenic overload of the tonsil tissue occurs, which leads to the phenomenon of competition of antigens. An important role is played by toxic substances of microorganisms and general allergic reactions.

The development of chronic tonsillitis is also facilitated by a persistent violation of nasal breathing (adenoids in children, curvature of the 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 in the compensated form, as well as in decompensated, manifested by repeated tonsillitis, and in cases where there are contraindications for surgical treatment. There are many methods of conservative treatment.

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

1. Means that help to increase the body's defenses: the correct daily regimen, a balanced diet with the use of a sufficient amount of natural vitamins, exercise, resort and climatic factors, biostimulants, gamma globulin, iron preparations, etc.

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

3. Means of immunocorrection: levamisole, prodigiosan, thymalin, IRS-19, bronchomunal, ribomunil, etc.

4. Means of reflex action: various types of novocaine blockade, acupuncture, manual therapy of the cervical spine (it was noticed that in patients with chronic tonsillitis and frequent tonsillitis, there is impaired mobility in the cranio-cervical junction with spasm of the short extensors of the neck, and that blockade on this level increases susceptibility to recurrent 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). It is usually washed with a syringe with a cannula using various solutions. Such solutions can be antiseptics, antibiotics, enzymes, antifungal, antiallergic, immunostimulating drugs, biologically active agents and Correctly performed washing helps to 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. With the help of an electric pump and a cannula, you can remove liquid pus from the lacunae of the tonsils. And, using a special tip with a vacuum cap and supplying a medicinal solution, you can simultaneously rinse the lacunae.

B. Introduction to the lacunae of medicinal substances. A syringe with a cannula is used for the introduction. Various emulsions, pastes, ointments, oil suspensions are introduced. They linger in the gaps for a longer time, hence the more pronounced positive effect. Medicines in terms of the spectrum of action are the same as those used for washing in the form of solutions.

D. Tonsil injection. With a syringe with a needle, the tissue of the tonsils itself or the space surrounding it is impregnated with various drugs. Some time ago in Kharkov, it was proposed to inject 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 tissue of the tonsil was really soaked with the medicine, in contrast to the injection with only one needle.

D. Lubrication of the tonsils. For lubrication, a fairly large number of different solutions or mixtures have been proposed (the spectrum of action is the same as that of preparations for washing). The most commonly used drugs: Lugol's solution, collargol, chlorophyllipt oil solution, propolis tincture with oil, etc.

E. Gargling. They are performed independently by the patient. Countless rinses have been suggested by traditional medicine. In pharmacies, you can also find a sufficient number of ready-made solutions or concentrates for rinsing.

6. Physiotherapy treatments.

Most often, ultrasound, microwave therapy, laser therapy, microwave, UHF, inductothermy, ultraviolet irradiation of the tonsils, magnetotherapy, electrophoresis, Vitafon (vibroacoustic apparatus), mud therapy, inhalations are prescribed. Also proposed are methods with the local use of immunomodulatory agents, such as levamisole and.

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

Let us consider briefly the options for surgical treatment. As a rule, the operation 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 mellitus, active tuberculosis, acute infectious diseases, the last months of pregnancy, menstruation. If the day before there was a sore throat, then the operation should be performed in 2-3 weeks.

Adults usually operate 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 palatine-lingual arch with the transition to the palatopharyngeal. With a raspor or an elevator, they penetrate through the incision into the paratonsillar space, behind the tonsil capsule, separate the latter from the palatine-lingual arch extracapsularly from the upper pole to the lower one. Then grab the tonsil with a clamp and separate it from the palatopharyngeal arch. Cicatricial adhesions that are not amenable to blunt separation are dissected with scissors, making small notches. Having placed a cutting loop on the amygdala and deflected it downward, cut off the entire amygdala with a loop. The tonsillar niche is treated with hemostatic paste. When separating the amygdala, it is taken into account that the internal and external carotid arteries pass near its poles.

After the operation, the patient is usually put to bed on the right side, giving his head an elevated position. On the first day, it is allowed to take a few sips of water. In the following days, the patient receives mashed and liquid non-hot food, he is prescribed antibiotic therapy. By the 4-5th day of the hospital regimen, the tonsillar niches are cleared of fibrinous plaque. The patient is discharged for outpatient observation by an otorhinolaryngologist.

Surgical methods also include diathermocoagulation of the tonsils (now rarely used).

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

Affect the tonsils and surgical ultrasound. The cryosurgical method (tonsil freezing) is quite common. The method is used for small tonsils, some doctors pre-sound the tonsils with ultrasound before freezing, which helps to 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 was the result of inattention to their own health. Doctors note that it is especially important not to stop treatment for an acute form of the disease after some symptomatic relief. It is worth following all the prescribed procedures and taking medications according to the scheme. In the case of constantly recurring sore throats, the ailment becomes chronic.

For chronic tonsillitis, the ICB code J35.0 is characterized by an exacerbation in winter or in the off-season. The presence of a constant source of inflammation reduces immunity, 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 irreversible processes begin in the tissues of the tonsils, surgical intervention may be indicated.

Symptoms of the disease and its types

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

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.

Chronic tonsillitis symptoms:

Discomfort, perspiration, some burning sensation in the throat.
Reflex attacks of coughing, which are caused by irritation of the mucous membrane of the palate and larynx.
Enlarged cervical lymph nodes. Massively, such a symptom with tonsillitis is characteristic of children, adolescents, but also occurs in adult patients.
The increased body temperature, which accompanies the inflammatory process, does not get confused by the usual means, it can last for a long time. In this case, doctors recommend visiting a doctor, even if the symptoms are somewhat blurred and do not seem to be acute.
Headache, constant fatigue, muscle pain.
On examination, the surface of the tonsils appears loose. The palatine arches are hyperemic. On examination, the doctor will detect the presence of purulent plugs that have 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 routine check-ups.

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

Conservative treatment of chronic tonsillitis ICB code 10 includes:

Taking antibiotics, which will be prescribed by the ENT, taking into account the individual characteristics of each.
The use of antiseptics, sanitizing gaps and nearby surfaces. Chlorhexidine, Hexoral, Octenisept, traditional Furacilin are usually used.
Effective physiotherapy supplement. Standard procedures allow tissue regeneration, and innovative laser therapy will not only reduce inflammation, but also help strengthen the immune system. The technique combines the direct effect of a laser on the throat area and irradiation of the tonsils through the skin with IR rays at a certain frequency.

During periods of remission, special attention should be paid to fortification, the formation of immune mechanisms using hardening, special drugs - for example, Imudon. Removal is resorted to only in the presence of constant, increasing in complexity of exacerbations that threaten with serious complications.

Chronic tonsillitis ICD code

Chronic tonsillitis - Overview of information

ICD-10 code

J35.0 Chronic tonsillitis.

ICD-10 code J35.0 Chronic tonsillitis

Epidemiology of chronic tonsillitis

The causes of chronic tonsillitis

Chronic tonsillitis symptoms

Where does it hurt?

Screening

Diagnostics of the chronic tonsillitis

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

What should be examined?

What tests are needed?

Who to contact?

Chronic tonsillitis treatment

Additional treatment

Acute tonsillitis (tonsillitis) and acute pharyngitis in children

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

Epidemiology of angina and acute pharyngitis in children

There are age-related 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, herpes simplex viruses and Coxsackie enteroviruses can cause acute tonsillitis / tonsillopharyngitis and acute pharyngitis. Beginning at the age of 5 years, B-hemolytic group A streptococcus (S. pyogenes), which becomes the leading cause of acute tonsillitis / tonsillopharyngitis (up to 75% of cases) at the age of 5-18 years, becomes of great importance in the occurrence of acute tonsillitis. 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 worried about?

Classification of angina and acute pharyngitis in children

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

Diagnostics of the sore throat and acute pharyngitis in children

What should be examined?

How to examine?

What tests are needed?

Who to contact?

Treatment of angina and acute pharyngitis in children

Additional treatment

Angina (Acute Tonsillitis) - Overview of Information

What is angina, or acute tonsillitis?

ICD-10 code

J03 Acute tonsillitis (tonsillitis).

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

Epidemiology of sore throat

In terms of the number of days of disability, angina ranks third after influenza and acute respiratory diseases. Children and young people get sick more often. The frequency of visits to a doctor per year is cases per 1000 population. The incidence depends on the population density, household, sanitary and hygienic, geographical and climatic conditions.It should be noted that the disease is found cleaner 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 a previous illness, a heart defect is formed in 20-30% of cases. In patients with chronic tonsillitis, angina 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

Sore throat symptoms

Where does it hurt?

Classification of sore throat

an 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 angina or a bacillus carrier of a virulent infection; usually the infection is transmitted by contact or airborne droplets;
sore throats as another exacerbation of chronic tonsillitis, in this case, a violation of local and general immune reactions is a consequence of 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;
- defeat of the pharynx with typhoid fever;
- with tularemia.
With blood diseases:
- monocytic;
- with leukemia:
- agranulocytic.
Some forms according to localization:
- tray tonsil (adenoiditis);
- lingual tonsil;
- laryngeal;
- lateral ridges of the pharynx;
- tubular tonsil.

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

Catarrhal (banal) nonspecific (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".
Filmy (diphtheria, pseudomembranous nondiphtheritic). These inflammatory processes are called "white tonsillitis". To clarify the diagnosis, it is necessary to conduct a bacteriological study.
Angina accompanied by loss of structure (ulcerative necrotic): herpetic, including with Herpes zoster, aphthous, ulcerative Vincent, with mourning and impetigo, post-traumatic, toxic, gangrenous, etc.

Screening

Diagnostics of the sore throat

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

What should be examined?

How to examine?

What tests are needed?

Who to contact?

Sore throat treatment

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

Additional 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 alimentary, since angina is an infectious disease.

Forecast

The prognosis is favorable with timely initiation and full treatment. Otherwise, local or general complications may develop, the formation of chronic tonsillitis. The period of incapacity for work of the patient is on average equal.

It is characterized by inflammation of the tonsils.

When determining the tactics of treating chronic tonsillitis, it should be remembered that the development of the disease is facilitated by: persistent disturbance of nasal breathing (adenoids, curvature of the 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 with the subsequent elimination of metabolic and hemodynamic disorders. The list of measures to solve these problems includes percutaneous irradiation of the tonsil region, direct irradiation of the pharynx region (preferably with red laser light or associative IR and red spectrum). The effectiveness of treatment is significantly increased with simultaneous irradiation of the above zones with light of the red and IR spectrum according to the following technique: direct irradiation of the tonsils is performed with light of the red spectrum, their transdermal 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 LLLT modes at the initial stages of the course treatment, percutaneous irradiation of the projection zones of the tonsils with IR 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, the following is performed: NLOK 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 effect 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. Legend: pos. "1" - projection of the ulnar vessels, pos. "2" - jugular fossa, pos. "3" - zone of the 3rd cervical vertebra.

Rice. 69. The projection area of the submandibular lymph nodes.

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

Modes of irradiation of treatment zones in the treatment of tonsillitis

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

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

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

Rice. 69. The projection area of the submandibular lymph nodes.

Modes of irradiation of treatment 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) has been adopted as a single normative document to take into account the incidence, reasons for the population's visits to medical institutions of all departments, and causes of death.

ICD-10 was introduced into health care practice throughout the Russian Federation in 1999 by order of the Ministry of Health of Russia dated 05/27/97. No. 170

A new revision (ICD-11) is planned by WHO in 2017 2018.

As amended and supplemented by WHO

Chronic tonsillitis ICD code

Chronic tonsillitis - Overview of information

ICD-10 code

J35.0 Chronic tonsillitis.

ICD-10 code J35.0 Chronic tonsillitis

Epidemiology of chronic tonsillitis

The causes of chronic tonsillitis

Chronic tonsillitis symptoms

Where does it hurt?

Screening

Diagnostics of the chronic tonsillitis

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

What should be examined?

What tests are needed?

Who to contact?

Chronic tonsillitis treatment

Additional treatment

Acute tonsillitis (tonsillitis) and acute pharyngitis in children

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

Epidemiology of angina and acute pharyngitis in children

There are age-related 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, herpes simplex viruses and Coxsackie enteroviruses can cause acute tonsillitis / tonsillopharyngitis and acute pharyngitis. Beginning at the age of 5 years, B-hemolytic group A streptococcus (S. pyogenes), which becomes the leading cause of acute tonsillitis / tonsillopharyngitis (up to 75% of cases) at the age of 5-18 years, becomes of great importance in the occurrence of acute tonsillitis. 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 worried about?

Classification of angina and acute pharyngitis in children

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

Diagnostics of the sore throat and acute pharyngitis in children

What should be examined?

How to examine?

What tests are needed?

Who to contact?

Treatment differs depending on the etiology of acute tonsillitis and acute pharyngitis. With streptococcal tonsillopharyngitis, antibiotics are shown, with viral they are not indicated, with mycoplasma 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.

Treatment of angina and acute pharyngitis in children

Additional treatment

Angina (Acute Tonsillitis) - Overview of Information

What is angina, or acute tonsillitis?

ICD-10 code

J03 Acute tonsillitis (tonsillitis).

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

Epidemiology of sore throat

Causes of sore throat

Sore throat symptoms

Where does it hurt?

Classification of sore throat

an 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 angina or a bacillus carrier of a virulent infection; usually the infection is transmitted by contact or airborne droplets;
sore throats as another exacerbation of chronic tonsillitis, in this case, a violation of local and general immune reactions is a consequence of 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;
- defeat of the pharynx with typhoid fever;
- with tularemia.
With blood diseases:
- monocytic;
- with leukemia:
- agranulocytic.
Some forms according to localization:
- tray tonsil (adenoiditis);
- lingual tonsil;
- laryngeal;
- lateral ridges of the pharynx;
- tubular tonsil.

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

Catarrhal (banal) nonspecific (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".
Filmy (diphtheria, pseudomembranous nondiphtheritic). These inflammatory processes are called "white tonsillitis". To clarify the diagnosis, it is necessary to conduct a bacteriological study.
Angina accompanied by loss of structure (ulcerative necrotic): herpetic, including with Herpes zoster, aphthous, ulcerative Vincent, with mourning and impetigo, post-traumatic, toxic, gangrenous, etc.

Screening

Diagnostics of the sore throat

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

What should be examined?

How to examine?

What tests are needed?

Who to contact?

Sore throat treatment

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

Additional 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 alimentary, since angina is an infectious disease.

Forecast

The prognosis is favorable with timely initiation and full treatment. Otherwise, local or general complications may develop, the formation of chronic tonsillitis. The period of incapacity for work of the patient is on average equal.