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==Overview==
Tonsillitis develops when the pathogen, [[viral]] or [[bacterial]], infects the [[tonsils]] and elicits an [[inflammatory]] response. It develops when the [[viruses]] infiltrate the tonsils and cause an [[inflammatory]] response of up-regulated [[cytokines]]. [[Bacterial]] tonsillitis considered acute is primarily caused by [[Group A streptococcal infection|group A β-hemolytic streptococcus (GABHS)]] ''[[streptococcus pyogenes]]'' infection. ''[[s. pyogenes]]'' and taxonomically-similar [[bacteria]] infiltrate the [[tonsils|tonsillar]] [[epithelium]], successfully penetrating the protective [[mucosal]] films in the oral and nasal cavity. Recurrent [[bacterial]] tonsillitis is caused primarily by ''[[staphylococcus aureus]]''. Following invasion, ''[[S. aureus]]'' is internalized by non-[[phagocytic]] cells through [[fibronectin]]-binding [[protein]] and beta-[[integrins]]. Invasion of non-eukaryotic cells results in the up-regulation of [[cytokines]], resulting in tonsillitis. Tonsillitis is associated with conditions and diseases associated with its [[viral]] and [[bacterial]] pathogens.
 
==Pathogenesis==
Tonsillitis develops when the pathogen, [[viral]] or [[bacterial]], infects the [[tonsils]] and elicits an [[inflammatory]] response.<ref name="urlTonsillitis - Causes - NHS Choices">{{cite web |url=http://www.nhs.uk/Conditions/Tonsillitis/Pages/Causes.aspx |title=Tonsillitis - Causes - NHS Choices |format= |work= |accessdate=}}</ref>
 
===Viral Tonsillitis===
*Viral tonsillitis is usually caused by the following viruses:<ref name="urlTonsillitis - Causes - NHS Choices">{{cite web |url=http://www.nhs.uk/Conditions/Tonsillitis/Pages/Causes.aspx |title=Tonsillitis - Causes - NHS Choices |format= |work= |accessdate=}}</ref>
**[[Rhinovirus]]
**[[Influenza]]
**[[Parainfluenza virus]]
**[[Adenovirus]]
**[[Measles|Rubeola virus]]
**[[Epstein Barr virus|Epstein barr virus]]<ref name="pmid11249975">{{cite journal |vauthors=Endo LH, Ferreira D, Montenegro MC, Pinto GA, Altemani A, Bortoleto AE, Vassallo J |title=Detection of Epstein-Barr virus in tonsillar tissue of children and the relationship with recurrent tonsillitis |journal=Int. J. Pediatr. Otorhinolaryngol. |volume=58 |issue=1 |pages=9–15 |year=2001 |pmid=11249975 |doi= |url=}}</ref>
*Tonsillitis develops when the [[viruses]] infiltrate the tonsils and cause an [[inflammatory]] response of up-regulated [[cytokines]].
====Chronic Viral Tonsillitis====
The persistence of tonsillitis beyond 3 months is known as chronic tonsillitis. In case of chronic viral  tonsillitis the virus persist in the tonsils and lead to chronic inflammation. This persistent infection and [[inflammation]] leads to chronic tonsillitis. The most common involved [[viruses]] is [[EBV]].<ref name="pmid21377220">{{cite journal| author=Sadeghi-Shabestari M, Jabbari Moghaddam Y, Ghaharri H| title=Is there any correlation between allergy and adenotonsillar tissue hypertrophy? | journal=Int J Pediatr Otorhinolaryngol | year= 2011 | volume= 75 | issue= 4 | pages= 589-91 | pmid=21377220 | doi=10.1016/j.ijporl.2011.01.026 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21377220  }} </ref><ref name="pmid17136878">{{cite journal| author=Akcay A, Tamay Z, Dağdeviren E, Guler N, Ones U, Kara CO et al.| title=Childhood asthma and its relationship with tonsillar tissue. | journal=Asian Pac J Allergy Immunol | year= 2006 | volume= 24 | issue= 2-3 | pages= 129-34 | pmid=17136878 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17136878  }} </ref><ref name="pmid22870291">{{cite journal| author=Proenca-Modena JL, Pereira Valera FC, Jacob MG, Buzatto GP, Saturno TH, Lopes L et al.| title=High rates of detection of respiratory viruses in tonsillar tissues from children with chronic adenotonsillar disease. | journal=PLoS One | year= 2012 | volume= 7 | issue= 8 | pages= e42136 | pmid=22870291 | doi=10.1371/journal.pone.0042136 | pmc=3411673 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22870291  }} </ref>
 
===Bacterial Tonsillitis===
[[Bacterial]] tonsillitis develops upon infection of the [[tonsils]] with pathogenic [[bacteria]].<ref name="pmid9804015">{{cite journal |vauthors=Lilja M, Räisänen S, Stenfors LE |title=Initial events in the pathogenesis of acute tonsillitis caused by Streptococcus pyogenes |journal=Int. J. Pediatr. Otorhinolaryngol. |volume=45 |issue=1 |pages=15–20 |year=1998 |pmid=9804015 |doi= |url=}}</ref>
 
====Acute Bacterial Tonsillitis====
*[[Bacterial]] tonsillitis considered acute is primarily caused by [[Group A streptococcal infection|group A β-hemolytic streptococcus (GABHS)]] ''[[Streptococcus pyogenes]]'' infection.<ref name="pmid9804015">{{cite journal |vauthors=Lilja M, Räisänen S, Stenfors LE |title=Initial events in the pathogenesis of acute tonsillitis caused by Streptococcus pyogenes |journal=Int. J. Pediatr. Otorhinolaryngol. |volume=45 |issue=1 |pages=15–20 |year=1998 |pmid=9804015 |doi= |url=}}</ref>
**''[[S. pyogenes]]'' and taxonomically-similar [[bacteria]] infiltrate the [[tonsils|tonsillar]] [[epithelium]], successfully penetrating the protective [[mucosal]] films in the oral and nasal cavity.<ref name="pmid3317744">{{cite journal |vauthors=Beachey EH, Courtney HS |title=Bacterial adherence: the attachment of group A streptococci to mucosal surfaces |journal=Rev. Infect. Dis. |volume=9 Suppl 5 |issue= |pages=S475–81 |year=1987 |pmid=3317744 |doi= |url=}}</ref><ref name="pmid2654229">{{cite journal |vauthors=Gibbons RJ |title=Bacterial adhesion to oral tissues: a model for infectious diseases |journal=J. Dent. Res. |volume=68 |issue=5 |pages=750–60 |year=1989 |pmid=2654229 |doi= |url=}}</ref>
***Colonization begins when the [[bacteria]] adheres to the [[tonsillar]] surface [[proteins]] through [[lipoteichoic acid]] (LTA), depositing [[fibronectin]] molecules that bind to the [[tonsillar]] [[epithelium]].<ref name="pmid3317744">{{cite journal |vauthors=Beachey EH, Courtney HS |title=Bacterial adherence: the attachment of group A streptococci to mucosal surfaces |journal=Rev. Infect. Dis. |volume=9 Suppl 5 |issue= |pages=S475–81 |year=1987 |pmid=3317744 |doi= |url=}}</ref>
***The following [[virulence factors]] contribute to ''[[S. pyogenes]]'' adhesion to the [[tonsils]]:<ref name="Cunningham2000">{{cite journal|last1=Cunningham|first1=M. W.|title=Pathogenesis of Group A Streptococcal Infections|journal=Clinical Microbiology Reviews|volume=13|issue=3|year=2000|pages=470–511|issn=0893-8512|doi=10.1128/CMR.13.3.470-511.2000}}</ref>
****Containing [[M protein]], allowing colonization<ref name="pmid4564883">{{cite journal |vauthors=Ellen RP, Gibbons RJ |title=M protein-associated adherence of Streptococcus pyogenes to epithelial surfaces: prerequisite for virulence |journal=Infect. Immun. |volume=5 |issue=5 |pages=826–30 |year=1972 |pmid=4564883 |pmc=422446 |doi= |url=}}</ref>
****Lipotechoic acid (LTA): Binds with [[fibronectin]] or [[fibrinogen]], causing adhesion of the bacteria to the [[dermis]]<ref name="pmid8063411">{{cite journal |vauthors=Courtney HS, Li Y, Dale JB, Hasty DL |title=Cloning, sequencing, and expression of a fibronectin/fibrinogen-binding protein from group A streptococci |journal=Infect. Immun. |volume=62 |issue=9 |pages=3937–46 |year=1994 |pmid=8063411 |pmc=303051 |doi= |url=}}</ref>
****[[Protein]] F: Binds with [[fibronectin]] to mediate adhesion<ref name="pmid1385871">{{cite journal |vauthors=Hanski E, Caparon M |title=Protein F, a fibronectin-binding protein, is an adhesin of the group A streptococcus Streptococcus pyogenes |journal=Proc. Natl. Acad. Sci. U.S.A. |volume=89 |issue=13 |pages=6172–6 |year=1992 |pmid=1385871 |pmc=402144 |doi= |url=}}</ref>
****29-kDa [[fibronectin]]-binding [[protein]]<ref name="CourtneyHasty1992">{{cite journal|last1=Courtney|first1=Harry S.|last2=Hasty|first2=David L.|last3=Dale|first3=James B.|last4=Poirier|first4=Thomas P.|title=A 28-kilodalton fibronectin-binding protein of group a streptococci|journal=Current Microbiology|volume=25|issue=5|year=1992|pages=245–250|issn=0343-8651|doi=10.1007/BF01575856}}</ref>
****[[Glyceraldehyde 3-phosphate dehydrogenase]]<ref name="pmid8760943">{{cite journal |vauthors=Winram SB, Lottenberg R |title=The plasmin-binding protein Plr of group A streptococci is identified as glyceraldehyde-3-phosphate dehydrogenase |journal=Microbiology (Reading, Engl.) |volume=142 ( Pt 8) |issue= |pages=2311–20 |year=1996 |pmid=8760943 |doi=10.1099/13500872-142-8-2311 |url=}}</ref>
****70-kDa [[galactose]]-binding [[protein]]<ref name="WalströmTylewska1982">{{cite journal|last1=Walström|first1=Torkel|last2=Tylewska|first2=Stanislawa|title=Glycoconjugates as possible receptors forStreptococcus pyogenes|journal=Current Microbiology|volume=7|issue=6|year=1982|pages=343–346|issn=0343-8651|doi=10.1007/BF01572601}}</ref>
****[[Vitronectin]]-binding S [[protein]]<ref name="pmid2459063">{{cite journal |vauthors=Valentin-Weigand P, Grulich-Henn J, Chhatwal GS, Müller-Berghaus G, Blobel H, Preissner KT |title=Mediation of adherence of streptococci to human endothelial cells by complement S protein (vitronectin) |journal=Infect. Immun. |volume=56 |issue=11 |pages=2851–5 |year=1988 |pmid=2459063 |pmc=259660 |doi= |url=}}</ref>
****[[Collagen]]-binding protein<ref name="pmid7814395">{{cite journal |vauthors=Visai L, Bozzini S, Raucci G, Toniolo A, Speziale P |title=Isolation and characterization of a novel collagen-binding protein from Streptococcus pyogenes strain 6414 |journal=J. Biol. Chem. |volume=270 |issue=1 |pages=347–53 |year=1995 |pmid=7814395 |doi= |url=}}</ref>
****[[Serum]] opacity factor
****[[Hyaluronate]] capsule<ref name="pmid7991612">{{cite journal |vauthors=Wessels MR, Bronze MS |title=Critical role of the group A streptococcal capsule in pharyngeal colonization and infection in mice |journal=Proc. Natl. Acad. Sci. U.S.A. |volume=91 |issue=25 |pages=12238–42 |year=1994 |pmid=7991612 |pmc=45412 |doi= |url=}}</ref>
**This results in an [[inflammatory]] response of up-regulated [[cytokines]], leading to tonsillitis.<ref name="pmid17426506">{{cite journal |vauthors=Zhang JM, An J |title=Cytokines, inflammation, and pain |journal=Int Anesthesiol Clin |volume=45 |issue=2 |pages=27–37 |year=2007 |pmid=17426506 |pmc=2785020 |doi=10.1097/AIA.0b013e318034194e |url=}}</ref>
 
====Recurrent Bacterial Tonsillitis====
*Recurrent [[bacterial]] tonsillitis is caused primarily by ''[[Staphylococcus aureus]]''.<ref name="pmid20209109">{{cite journal |vauthors=Zautner AE, Krause M, Stropahl G, Holtfreter S, Frickmann H, Maletzki C, Kreikemeyer B, Pau HW, Podbielski A |title=Intracellular persisting Staphylococcus aureus is the major pathogen in recurrent tonsillitis |journal=PLoS ONE |volume=5 |issue=3 |pages=e9452 |year=2010 |pmid=20209109 |pmc=2830486 |doi=10.1371/journal.pone.0009452 |url=}}</ref>
**''[[S. aureus]]'' invades the [[tonsils]] through microbial surface components recognizing adhesive matrix molecules ([[MSCRAMM]]<nowiki/>s)<ref name="pmid20209109">{{cite journal |vauthors=Zautner AE, Krause M, Stropahl G, Holtfreter S, Frickmann H, Maletzki C, Kreikemeyer B, Pau HW, Podbielski A |title=Intracellular persisting Staphylococcus aureus is the major pathogen in recurrent tonsillitis |journal=PLoS ONE |volume=5 |issue=3 |pages=e9452 |year=2010 |pmid=20209109 |pmc=2830486 |doi=10.1371/journal.pone.0009452 |url=}}</ref>
**Following invasion, ''[[S. aureus]]'' is internalized by non-[[phagocytic]] cells through [[fibronectin]]-binding [[protein]] and beta-[[integrins]].<ref name="pmid11549002">{{cite journal |vauthors=Alexander EH, Hudson MC |title=Factors influencing the internalization of Staphylococcus aureus and impacts on the course of infections in humans |journal=Appl. Microbiol. Biotechnol. |volume=56 |issue=3-4 |pages=361–6 |year=2001 |pmid=11549002 |doi= |url=}}</ref>
**Invasion of non-eukaryotic cells results in the up-regulation of [[cytokines]], resulting in tonsillitis.
 
====Chronic Bacterial Tonsillitis====
The persistence of tonsillitis beyond 3 months is known as chronic tonsillitis. In case of chronic bacterial tonsillitis the bacteria persist in the tonsils and lead to chronic inflammation. This persistent infection and inflammation leads to chronic tonsillitis. Manifestations appear whenever the patient has decline in immunity.
 
===Non-infectious Tonsillitis===
*It is a type of [[Chronic (medicine)|chronic]] that can be caused due to allergies, [[asthma]], [[GERD]],that persists beyond 3 months.<ref name="pmid21377220">{{cite journal| author=Sadeghi-Shabestari M, Jabbari Moghaddam Y, Ghaharri H| title=Is there any correlation between allergy and adenotonsillar tissue hypertrophy? | journal=Int J Pediatr Otorhinolaryngol | year= 2011 | volume= 75 | issue= 4 | pages= 589-91 | pmid=21377220 | doi=10.1016/j.ijporl.2011.01.026 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21377220  }} </ref><ref name="pmid17136878">{{cite journal| author=Akcay A, Tamay Z, Dağdeviren E, Guler N, Ones U, Kara CO et al.| title=Childhood asthma and its relationship with tonsillar tissue. | journal=Asian Pac J Allergy Immunol | year= 2006 | volume= 24 | issue= 2-3 | pages= 129-34 | pmid=17136878 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17136878  }} </ref><ref name="pmid22870291">{{cite journal| author=Proenca-Modena JL, Pereira Valera FC, Jacob MG, Buzatto GP, Saturno TH, Lopes L et al.| title=High rates of detection of respiratory viruses in tonsillar tissues from children with chronic adenotonsillar disease. | journal=PLoS One | year= 2012 | volume= 7 | issue= 8 | pages= e42136 | pmid=22870291 | doi=10.1371/journal.pone.0042136 | pmc=3411673 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22870291  }} </ref>
**Recurrent [[GERD]] or [[allergies]] or [[astma]] can cause repeated irritation of the tonsils leading to chronic tonsillitis.


==Overview==
==Genetics==
Tonsillitis is associated with [[infection]], it is currently unknown if the swelling and other symptoms are caused by the infectious agents themselves, or by the host immune response to these agents. Tonsillitis may be a result of aberrant [[immune]] responses to the normal bacterial flora of the [[nasopharynx]].
*White not fully understood, there is quantitative evidence of recurrent tonsillitis heritability.<ref name="KvestadKværner2005">{{cite journal|last1=Kvestad|first1=Ellen|last2=Kværner|first2=Kari Jorunn|last3=Røysamb|first3=Espen|last4=Tambs|first4=Kristian|last5=Harris|first5=Jennifer Ruth|last6=Magnus|first6=Per|title=Heritability of Recurrent Tonsillitis|journal=Archives of Otolaryngology–Head & Neck Surgery|volume=131|issue=5|year=2005|pages=383|issn=0886-4470|doi=10.1001/archotol.131.5.383}}</ref>
**Parental history of [[tonsillectomy]] and [[atopy]] hold significant predictive power in pediatric tonsillitis.<ref name="pmid11843928">{{cite journal |vauthors=Capper R, Canter RJ |title=Is the incidence of tonsillectomy influenced by the family medical or social history? |journal=Clin Otolaryngol Allied Sci |volume=26 |issue=6 |pages=484–7 |year=2001 |pmid=11843928 |doi= |url=}}</ref>


==Pathophysiology==
==Associated conditions==
* Under normal circumstances, as viruses and bacteria enter the body through the nose and mouth, they are filtered in the [[tonsil]]s.<ref name="Kempen" /><ref name="Perry" />
Tonsillitis is associated with conditions and diseases associated with its [[viral]] and [[bacterial]] pathogens, including the following:
* Acute tonsillitis may occur as a result of a Streptococcus pyogenes infection.  
*[[Streptococcal pharyngitis]]<ref name="urlPharyngitis - sore throat: MedlinePlus Medical Encyclopedia">{{cite web |url=https://medlineplus.gov/ency/article/000655.htm |title=Pharyngitis - sore throat: MedlinePlus Medical Encyclopedia |format= |work= |accessdate=}}</ref>
* S. pyogenes may be identified within the mucous layer that covers the tonsils as well as the surface of epithelial cells.  
*[[Influenza]]<ref name="urlFlu: MedlinePlus Medical Encyclopedia">{{cite web |url=https://medlineplus.gov/ency/article/000080.htm |title=Flu: MedlinePlus Medical Encyclopedia |format= |work= |accessdate=}}</ref>
* The progression of the infection begins with penetration of infectious bacteria into the mucous barrier.  
*[[Common cold]]<ref name="urlCommon Cold: MedlinePlus">{{cite web |url=https://medlineplus.gov/commoncold.html |title=Common Cold: MedlinePlus |format= |work= |accessdate=}}</ref>
* Further progression results in the attachment of  the infectious bacteria to the surfaces of epithelial cells. .
*[[Scarlet fever]]<ref name="urlGroup A Strep | Scarlet Fever | GAS | CDC">{{cite web |url=http://www.cdc.gov/groupastrep/diseases-public/scarlet-fever.html |title=Group A Strep &#124; Scarlet Fever &#124; GAS &#124; CDC |format= |work= |accessdate=}}</ref>
* Infection may then spread from cell to cell with the appearance of long chains of coccus-bacteria, encroaching on the border of the epithelial cells.
*[[Rheumatic fever]]<ref name="urlRheumatic fever - NHS Choices">{{cite web |url=http://www.nhs.uk/Conditions/Rheumatic-fever/Pages/Introduction.aspx |title=Rheumatic fever - NHS Choices |format= |work= |accessdate=}}</ref>
* Spread of infection may lead to the penetration of infectious bacteria into the outermost layers of epithelial cells - resulting in inflammation of the tonsils.  
*Acute [[glomerulonephritis]]<ref name="pmid16454159">{{cite journal |vauthors=Almroth G, Lindell A, Aselius H, Sörén L, Svensson L, Hultman P, Eribe ER, Olsen I |title=Acute glomerulonephritis associated with streptococcus pyogenes with concomitant spread of streptococcus constellatus in four rural families |journal=Ups. J. Med. Sci. |volume=110 |issue=3 |pages=217–31 |year=2005 |pmid=16454159 |doi= |url=}}</ref>
* Within the tonsils, [[white blood cell]]s of the immune system mount an attack that helps destroy the viruses or bacteria by producing inflammatory cytokines like [[Phospholipase A2]], <ref>{{cite journal | title = Circulating phospholipase-A2 activity in obstructive sleep apnea | journal = International Journal of Pediatric Otorhinolaryngology | date = 2012 | id = PMID 22297210 | doi = 10.1016/j.ijporl.2011.12.026 | accessdate = 2012-08-28}}</ref> which also lead to fever.<ref name="Kempen">{{cite journal |author=van Kempen MJ, Rijkers GT, Van Cauwenberge PB |title=The immune response in adenoids and tonsils |journal=Int. Arch. Allergy Immunol. |volume=122 |issue=1 |pages=8–19 |year=2000 |month=May |pmid=10859465 |doi= 10.1159/000024354}}</ref><ref name="Perry">{{cite journal |author=Perry M, Whyte A |title=Immunology of the tonsils |journal=Immunology Today |volume=19 |issue=9 |pages=414–21 |year=1998 |month=September |pmid=9745205 |doi= 10.1016/S0167-5699(98)01307-3}}</ref>
*[[Peritonsillar abscess]]<ref name="pmid27026737">{{cite journal |vauthors=Klug TE, Rusan M, Fuursted K, Ovesen T |title=Peritonsillar Abscess: Complication of Acute Tonsillitis or Weber's Glands Infection? |journal=Otolaryngol Head Neck Surg |volume=155 |issue=2 |pages=199–207 |year=2016 |pmid=27026737 |doi=10.1177/0194599816639551 |url=}}</ref>
* Infection also provokes the production of cytokines and the activation of a complement immune response - both of which contribute to the overall inflammation of the tonsils. 


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Luke Rusowicz-Orazem, B.S., Usama Talib, BSc, MD [2]

Overview

Tonsillitis develops when the pathogen, viral or bacterial, infects the tonsils and elicits an inflammatory response. It develops when the viruses infiltrate the tonsils and cause an inflammatory response of up-regulated cytokines. Bacterial tonsillitis considered acute is primarily caused by group A β-hemolytic streptococcus (GABHS) streptococcus pyogenes infection. s. pyogenes and taxonomically-similar bacteria infiltrate the tonsillar epithelium, successfully penetrating the protective mucosal films in the oral and nasal cavity. Recurrent bacterial tonsillitis is caused primarily by staphylococcus aureus. Following invasion, S. aureus is internalized by non-phagocytic cells through fibronectin-binding protein and beta-integrins. Invasion of non-eukaryotic cells results in the up-regulation of cytokines, resulting in tonsillitis. Tonsillitis is associated with conditions and diseases associated with its viral and bacterial pathogens.

Pathogenesis

Tonsillitis develops when the pathogen, viral or bacterial, infects the tonsils and elicits an inflammatory response.[1]

Viral Tonsillitis

Chronic Viral Tonsillitis

The persistence of tonsillitis beyond 3 months is known as chronic tonsillitis. In case of chronic viral tonsillitis the virus persist in the tonsils and lead to chronic inflammation. This persistent infection and inflammation leads to chronic tonsillitis. The most common involved viruses is EBV.[3][4][5]

Bacterial Tonsillitis

Bacterial tonsillitis develops upon infection of the tonsils with pathogenic bacteria.[6]

Acute Bacterial Tonsillitis

Recurrent Bacterial Tonsillitis

Chronic Bacterial Tonsillitis

The persistence of tonsillitis beyond 3 months is known as chronic tonsillitis. In case of chronic bacterial tonsillitis the bacteria persist in the tonsils and lead to chronic inflammation. This persistent infection and inflammation leads to chronic tonsillitis. Manifestations appear whenever the patient has decline in immunity.

Non-infectious Tonsillitis

  • It is a type of chronic that can be caused due to allergies, asthma, GERD,that persists beyond 3 months.[3][4][5]
    • Recurrent GERD or allergies or astma can cause repeated irritation of the tonsils leading to chronic tonsillitis.

Genetics

  • White not fully understood, there is quantitative evidence of recurrent tonsillitis heritability.[22]

Associated conditions

Tonsillitis is associated with conditions and diseases associated with its viral and bacterial pathogens, including the following:

References

  1. ↑ 1.0 1.1 "Tonsillitis - Causes - NHS Choices".
  2. ↑ Endo LH, Ferreira D, Montenegro MC, Pinto GA, Altemani A, Bortoleto AE, Vassallo J (2001). "Detection of Epstein-Barr virus in tonsillar tissue of children and the relationship with recurrent tonsillitis". Int. J. Pediatr. Otorhinolaryngol. 58 (1): 9–15. PMID 11249975.
  3. ↑ 3.0 3.1 Sadeghi-Shabestari M, Jabbari Moghaddam Y, Ghaharri H (2011). "Is there any correlation between allergy and adenotonsillar tissue hypertrophy?". Int J Pediatr Otorhinolaryngol. 75 (4): 589–91. doi:10.1016/j.ijporl.2011.01.026. PMID 21377220.
  4. ↑ 4.0 4.1 Akcay A, Tamay Z, Dağdeviren E, Guler N, Ones U, Kara CO; et al. (2006). "Childhood asthma and its relationship with tonsillar tissue". Asian Pac J Allergy Immunol. 24 (2–3): 129–34. PMID 17136878.
  5. ↑ 5.0 5.1 Proenca-Modena JL, Pereira Valera FC, Jacob MG, Buzatto GP, Saturno TH, Lopes L; et al. (2012). "High rates of detection of respiratory viruses in tonsillar tissues from children with chronic adenotonsillar disease". PLoS One. 7 (8): e42136. doi:10.1371/journal.pone.0042136. PMC 3411673. PMID 22870291.
  6. ↑ 6.0 6.1 Lilja M, Räisänen S, Stenfors LE (1998). "Initial events in the pathogenesis of acute tonsillitis caused by Streptococcus pyogenes". Int. J. Pediatr. Otorhinolaryngol. 45 (1): 15–20. PMID 9804015.
  7. ↑ 7.0 7.1 Beachey EH, Courtney HS (1987). "Bacterial adherence: the attachment of group A streptococci to mucosal surfaces". Rev. Infect. Dis. 9 Suppl 5: S475–81. PMID 3317744.
  8. ↑ Gibbons RJ (1989). "Bacterial adhesion to oral tissues: a model for infectious diseases". J. Dent. Res. 68 (5): 750–60. PMID 2654229.
  9. ↑ Cunningham, M. W. (2000). "Pathogenesis of Group A Streptococcal Infections". Clinical Microbiology Reviews. 13 (3): 470–511. doi:10.1128/CMR.13.3.470-511.2000. ISSN 0893-8512.
  10. ↑ Ellen RP, Gibbons RJ (1972). "M protein-associated adherence of Streptococcus pyogenes to epithelial surfaces: prerequisite for virulence". Infect. Immun. 5 (5): 826–30. PMC 422446. PMID 4564883.
  11. ↑ Courtney HS, Li Y, Dale JB, Hasty DL (1994). "Cloning, sequencing, and expression of a fibronectin/fibrinogen-binding protein from group A streptococci". Infect. Immun. 62 (9): 3937–46. PMC 303051. PMID 8063411.
  12. ↑ Hanski E, Caparon M (1992). "Protein F, a fibronectin-binding protein, is an adhesin of the group A streptococcus Streptococcus pyogenes". Proc. Natl. Acad. Sci. U.S.A. 89 (13): 6172–6. PMC 402144. PMID 1385871.
  13. ↑ Courtney, Harry S.; Hasty, David L.; Dale, James B.; Poirier, Thomas P. (1992). "A 28-kilodalton fibronectin-binding protein of group a streptococci". Current Microbiology. 25 (5): 245–250. doi:10.1007/BF01575856. ISSN 0343-8651.
  14. ↑ Winram SB, Lottenberg R (1996). "The plasmin-binding protein Plr of group A streptococci is identified as glyceraldehyde-3-phosphate dehydrogenase". Microbiology (Reading, Engl.). 142 ( Pt 8): 2311–20. doi:10.1099/13500872-142-8-2311. PMID 8760943.
  15. ↑ Walström, Torkel; Tylewska, Stanislawa (1982). "Glycoconjugates as possible receptors forStreptococcus pyogenes". Current Microbiology. 7 (6): 343–346. doi:10.1007/BF01572601. ISSN 0343-8651.
  16. ↑ Valentin-Weigand P, Grulich-Henn J, Chhatwal GS, Müller-Berghaus G, Blobel H, Preissner KT (1988). "Mediation of adherence of streptococci to human endothelial cells by complement S protein (vitronectin)". Infect. Immun. 56 (11): 2851–5. PMC 259660. PMID 2459063.
  17. ↑ Visai L, Bozzini S, Raucci G, Toniolo A, Speziale P (1995). "Isolation and characterization of a novel collagen-binding protein from Streptococcus pyogenes strain 6414". J. Biol. Chem. 270 (1): 347–53. PMID 7814395.
  18. ↑ Wessels MR, Bronze MS (1994). "Critical role of the group A streptococcal capsule in pharyngeal colonization and infection in mice". Proc. Natl. Acad. Sci. U.S.A. 91 (25): 12238–42. PMC 45412. PMID 7991612.
  19. ↑ Zhang JM, An J (2007). "Cytokines, inflammation, and pain". Int Anesthesiol Clin. 45 (2): 27–37. doi:10.1097/AIA.0b013e318034194e. PMC 2785020. PMID 17426506.
  20. ↑ 20.0 20.1 Zautner AE, Krause M, Stropahl G, Holtfreter S, Frickmann H, Maletzki C, Kreikemeyer B, Pau HW, Podbielski A (2010). "Intracellular persisting Staphylococcus aureus is the major pathogen in recurrent tonsillitis". PLoS ONE. 5 (3): e9452. doi:10.1371/journal.pone.0009452. PMC 2830486. PMID 20209109.
  21. ↑ Alexander EH, Hudson MC (2001). "Factors influencing the internalization of Staphylococcus aureus and impacts on the course of infections in humans". Appl. Microbiol. Biotechnol. 56 (3–4): 361–6. PMID 11549002.
  22. ↑ Kvestad, Ellen; Kværner, Kari Jorunn; Røysamb, Espen; Tambs, Kristian; Harris, Jennifer Ruth; Magnus, Per (2005). "Heritability of Recurrent Tonsillitis". Archives of Otolaryngology–Head & Neck Surgery. 131 (5): 383. doi:10.1001/archotol.131.5.383. ISSN 0886-4470.
  23. ↑ Capper R, Canter RJ (2001). "Is the incidence of tonsillectomy influenced by the family medical or social history?". Clin Otolaryngol Allied Sci. 26 (6): 484–7. PMID 11843928.
  24. ↑ "Pharyngitis - sore throat: MedlinePlus Medical Encyclopedia".
  25. ↑ "Flu: MedlinePlus Medical Encyclopedia".
  26. ↑ "Common Cold: MedlinePlus".
  27. ↑ "Group A Strep | Scarlet Fever | GAS | CDC".
  28. ↑ "Rheumatic fever - NHS Choices".
  29. ↑ Almroth G, Lindell A, Aselius H, Sörén L, Svensson L, Hultman P, Eribe ER, Olsen I (2005). "Acute glomerulonephritis associated with streptococcus pyogenes with concomitant spread of streptococcus constellatus in four rural families". Ups. J. Med. Sci. 110 (3): 217–31. PMID 16454159.
  30. ↑ Klug TE, Rusan M, Fuursted K, Ovesen T (2016). "Peritonsillar Abscess: Complication of Acute Tonsillitis or Weber's Glands Infection?". Otolaryngol Head Neck Surg. 155 (2): 199–207. doi:10.1177/0194599816639551. PMID 27026737.


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