Angina
Etiologia i przyczyny

Angina, czyli zapalenie migdałków podniebiennych, jest najczęściej wywoływana infekcjami wirusowymi (70-95% przypadków), z dominującymi patogenami takimi jak rhinowirusy, wirusy grypy, adenowirusy, koronawirusy oraz RSV. Bakterie odpowiadają za 5-40% przypadków, z głównym udziałem Streptococcus pyogenes (GABHS), szczególnie u dzieci w wieku 5-15 lat (15-30% przypadków). Inne bakterie to m.in. Staphylococcus aureus (w tym MRSA), Haemophilus influenzae, Mycoplasma pneumoniae oraz beztlenowce jak Prevotella i Fusobacterium, które odgrywają istotną rolę w nawracających i przewlekłych zapaleniach migdałków. Czynniki ryzyka obejmują wiek, osłabienie odporności, bliski kontakt z zakażonymi, czynniki środowiskowe oraz predyspozycje genetyczne, w tym nieprawidłową odpowiedź immunologiczną na białko SpeA paciorkowca. Biofilmy bakteryjne w kryptach migdałków są istotnym mechanizmem przewlekłości i nawrotów infekcji, zwłaszcza u dorosłych.

Etiologia Anginy (Tonsillitis)

Angina (zapalenie migdałków podniebiennych) to stan zapalny migdałków, objawiający się ich obrzękiem i zaczerwienieniem. Choroba ta może być wywołana różnymi czynnikami patogennymi, głównie wirusami i bakteriami. Poznanie dokładnej etiologii anginy jest kluczowe dla właściwego leczenia tego schorzenia.12

Etiologia wirusowa

Infekcje wirusowe są główną przyczyną anginy, stanowiąc około 70-95% wszystkich przypadków.12 Wśród najczęstszych wirusów powodujących zapalenie migdałków można wymienić:34

  • Rhinowirusy – najczęstsza przyczyna przeziębień
  • Wirusy grypy (influenza) i paragrypy
  • Adenowirusy
  • Koronawirusy
  • Wirus syncytialny układu oddechowego (RSV)
  • Enterowirusy

45

Rzadziej angina może być wywołana przez:31

  • Wirus Epsteina-Barr (EBV) – powodujący mononukleozę zakaźną
  • Wirus cytomegalii (CMV)
  • Wirus opryszczki zwykłej (HSV)
  • Wirus odry
  • Wirus zapalenia wątroby typu A
  • Wirus różyczki
  • HIV

51

Wirusy te zwykle charakteryzują się niższą zjadliwością i rzadziej prowadzą do powikłań w porównaniu z infekcjami bakteryjnymi, jednak mogą powodować bardziej rozległe zapalenie gardła i migdałków.36

Etiologia bakteryjna

Bakterie są przyczyną około 5-40% przypadków anginy.71 Infekcje bakteryjne częściej występują u dzieci w wieku 5-15 lat (15-30% przypadków), podczas gdy u dorosłych stanowią około 5-15% przypadków.18

Głównym czynnikiem bakteryjnym powodującym anginę jest paciorkowiec beta-hemolizujący grupy A (Streptococcus pyogenes, GABHS), powodujący tzw. anginę paciorkowcową.92 Bakteria ta przyczepia się do receptorów adhezyjnych znajdujących się na nabłonku migdałków, co inicjuje proces zapalny.1

Inne bakterie mogące wywoływać zapalenie migdałków to:34

  • Paciorkowce grup C i G
  • Staphylococcus aureus (w tym szczepy MRSA)
  • Streptococcus pneumoniae
  • Haemophilus influenzae
  • Mycoplasma pneumoniae
  • Chlamydia pneumoniae
  • Bordetella pertussis (krztuśca)
  • Fusobacterium
  • Neisseria gonorrhoeae
  • Corynebacterium diphtheriae (powodująca błonicę)

310

Warto zauważyć, że w infekcjach migdałków często występuje flora mieszana składająca się zarówno z bakterii tlenowych, jak i beztlenowych. W przypadkach nawracającego zapalenia gardła i migdałków oraz przewlekłego zapalenia migdałków obserwuje się polimikrobiologiczną florę, obejmującą paciorkowce alfa i beta-hemolizujące, S. aureus, H. influenzae i gatunki z rodzaju Bacteroides.1112

Bakterie beztlenowe, takie jak pigmentowane Prevotella i Porphyromonas, Fusobacterium i Actinomyces, odgrywają istotną rolę w chorobach migdałków, co potwierdzają obserwacje kliniczne i naukowe. Beztlenowce zostały wyizolowane z rdzeni migdałków dzieci i dorosłych z nawracającymi angami paciorkowcowymi i niepaciorkowcowymi.12

Czynniki predysponujące do zachorowania

Istnieje kilka czynników zwiększających ryzyko rozwoju anginy:1314

  • Wiek – dzieci i młodzież są bardziej narażone ze względu na niedojrzały układ odpornościowy
  • Osłabiony układ odpornościowy – choroby przewlekłe, stres, nieodpowiednie nawyki życiowe
  • Bliski kontakt z osobami zakażonymi – patogeny przenoszone są drogą kropelkową
  • Czynniki środowiskowe – narażenie na drażniące substancje, alergeny i zanieczyszczenia
  • Przeludnione warunki życia i niedożywienie
  • Sezonowość – infekcje bakteryjne częściej występują zimą, wirusowe latem i jesienią

115

Predyspozycje genetyczne do nawracających angin

Badania naukowe wskazują na istnienie genetycznych uwarunkowań skłonności do nawracających zapaleń migdałków. U dzieci z nawracającymi anginami paciorkowcowymi zaobserwowano nieprawidłową odpowiedź immunologiczną związaną z niedostateczną produkcją przeciwciał przeciwko białku bakteryjnemu SpeA.16

Naukowcy zidentyfikowali specyficzne warianty genetyczne w układzie odpornościowym, które są związane z ryzykiem nawracającego zapalenia migdałków. Wiele dzieci z nawracającymi anginami ma rodzinną historię tej choroby, co dodatkowo potwierdza genetyczne podłoże predyspozycji.1718

U osób z nawracającymi anginami migdałki zawierają stosunkowo większą liczbę nietypowych komórek TFH oraz mniejszą liczbę komórek B. Podatność na ten proces wydaje się mieć komponent genetyczny, co sugeruje, że niewystarczająca odpowiedź przeciwciał przeciwko białku SpeA jest kluczowym problemem u tych pacjentów.1617

Rola biofilmów bakteryjnych

Nowsze badania sugerują, że przewlekłe i nawracające zapalenie migdałków może być związane z tworzeniem się biofilmów bakteryjnych w zagłębieniach migdałków. Biofilmy to społeczności mikroorganizmów, które wykształciły oporność na antybiotyki i mogą powodować nawracające infekcje.1920

W przypadku nawracających angin u dorosłych, przyczyną jest często biofilm bakteryjny, zwykle powodowany przez paciorkowce. Inna bakteria bytująca w jamie ustnej, Actinomyces, również stanowi częsty problem u dorosłych z częstymi infekcjami migdałków. Bakteria ta może być zwalczana jedynie przez antybiotyki penicylinowe, na które wiele osób ma alergie.20

Inne przyczyny zapalenia migdałków

Istnieją również rzadsze przyczyny zapalenia migdałków, które nie są związane z infekcjami:2122

  • Refluks żołądkowo-przełykowy (GERD)
  • Pericoronitis (zapalenie tkanek wokół częściowo wyrzniętego zęba)
  • Angina Vincenta (spowodowana przez zakażenie krętkami i wrzecionowcami)
  • Gruźlica
  • Reakcje na leki jako efekt uboczny
  • Palenie tytoniu
  • Alergie
  • Narażenie na promieniowanie

1023

Mechanizm rozwoju zapalenia

Infekcje wirusowe lub bakteryjne oraz czynniki immunologiczne prowadzą do zapalenia migdałków i jego powikłań. Migdałki, jako elementy układu limfatycznego, stanowią pierwszą linię obrony przed patogenami wnikającymi przez jamę ustną, co czyni je podatnymi na infekcje.124

W obrębie migdałków białe krwinki układu odpornościowego niszczą wirusy lub bakterie, wytwarzając cytokiny zapalne, takie jak fosfolipaza A2, co prowadzi również do gorączki.7 U pacjentów z przewlekłym zapaleniem migdałków immunoglobuliny pokrywające patogeny mogą odgrywać ważną rolę w początkowej indukcji bakteryjnego zapalenia migdałków.1

Dzieci z nawracającymi infekcjami Streptococcus pyogenes mają inną populację bakteryjną niż dzieci, które nie miały tak wielu infekcji, co może tłumaczyć skłonność do nawrotów choroby.11

Epidemiologia anginy

Zapalenie migdałków jest częstszym problemem u dzieci i młodzieży niż u dorosłych. Dzieci w wieku szkolnym (5-15 lat) częściej chorują na bakteryjne zapalenie migdałków, podczas gdy młodsze dzieci częściej doświadczają infekcji wirusowych.825

Funkcja immunologiczna migdałków zaczyna słabnąć po okresie dojrzewania, co sprawia, że infekcje migdałków u dorosłych są rzadsze.26 Osoby starsze z osłabionym układem odpornościowym również mogą być narażone na zapalenie migdałków.25

Infekcje wywołane przez wirusy układu oddechowego są najczęściej obserwowane jesienią, zimą i wczesną wiosną. Ryzyko zachorowania jest bardzo zależne od etiologii. Kontakt z małymi dziećmi predysponuje do infekcji wirusami oddechowymi i herpeswirusami.27

Zakaźność anginy

Samo zapalenie migdałków nie jest zakaźne, natomiast wirusy i bakterie, które je powodują, są wysoce zakaźne i mogą rozprzestrzeniać się drogą kropelkową, gdy zakażona osoba kaszle, kicha lub mówi.928

Okres inkubacji w przypadku paciorkowca grupy A wynosi 2-5 dni. Pacjenci są zakaźni do 24 godzin po rozpoczęciu skutecznego leczenia przeciwbakteryjnego lub przez około 7 dni po ustąpieniu objawów w przypadku braku leczenia przeciwbakteryjnego. Ryzyko przeniesienia zakażenia na domowników jest znaczne.27

Paciorkowcowe zapalenie gardła i migdałków może być przeniesione przez bliski kontakt z osobą zakażoną. Możliwe jest również zakażenie poprzez spożywanie lub picie z tego samego naczynia co osoba chora.29

Powikłania związane z etiologią anginy

Nieleczone bakteryjne zapalenie migdałków, szczególnie wywołane przez paciorkowce grupy A, może prowadzić do poważnych powikłań:3031

  • Gorączka reumatyczna – zapalny stan autoimmunologiczny, który może uszkodzić zastawki serca
  • Pokrztuścowe zapalenie stawów – zapalenie stawów występujące w ciągu miesiąca od anginy spowodowanej przez paciorkowce grupy A
  • Kłębuszkowe zapalenie nerek – zapalne schorzenie nerek mogące rozwinąć się po infekcji paciorkowcowej
  • Zespół wstrząsu toksycznego – rzadkie, ale bardzo poważne powikłanie
  • Zapalenie ucha środkowego – gdy infekcja rozprzestrzenia się przez trąbkę Eustachiusza
  • Zapalenie zatok – gdy infekcja rozprzestrzenia się przez tylną część nosa
  • Zapalenie opon mózgowych – rzadko, gdy infekcja rozprzestrzenia się na opony mózgowe
  • Ropień okołomigdałkowy – zbiornik ropy tworzący się obok migdałka
  • Zespół Lemierre’a – zakażenie żyły szyjnej

3025

Ponadto, przewlekłe i częste zapalenia migdałków mogą prowadzić do powiększenia migdałków, co z kolei może powodować zaburzenia oddychania podczas snu (bezdech senny), zmniejszenie wydajności poznawczej i duszność.3231

Znaczenie etiologii dla leczenia

Identyfikacja czynnika etiologicznego anginy jest kluczowa dla określenia właściwego leczenia.5 Leczenie zależy od przyczyny zapalenia migdałków:833

  • Angina wirusowa – zazwyczaj ustępuje samoistnie, a leczenie jest objawowe; antybiotyki nie są skuteczne
  • Angina bakteryjna – często wymaga leczenia antybiotykami, zwłaszcza jeśli przyczyną jest paciorkowiec grupy A

3435

W przypadku nawracających angin paciorkowcowych, gdy nie udaje się osiągnąć trwałej poprawy poprzez leczenie antybiotykami, może być konieczne usunięcie migdałków (tonsillektomia).536 Zabieg ten usuwa tkankę, która stała się siedliskiem bakterii, często prowadząc do zmniejszenia liczby infekcji gardła w przyszłości.36

Warto zauważyć, że nawracające infekcje paciorkowcowe mogą być spowodowane szczepami bakterii opornymi na antybiotyki, osłabionym układem odpornościowym lub możliwością, że pacjent lub ktoś z jego rodziny jest nosicielem paciorkowca (nie ma objawów, ale może rozprzestrzeniać bakterie).23

Znajomość etiologii anginy pomaga również przewidzieć możliwe powikłania i zapobiegać im, co jest szczególnie ważne w przypadku zakażeń bakteryjnych, które mogą prowadzić do poważnych konsekwencji, jeśli nie są właściwie leczone.37

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  1. 10.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Tonsillitis and Peritonsillar Abscess: Practice Essentials, Background, Pathophysiology and Etiology
    https://emedicine.medscape.com/article/871977-overview
    Tonsillitis is inflammation of the palatine tonsils. The inflammation usually extends to the adenoid and the lingual tonsils; therefore, the term pharyngitis may also be used. Most cases of bacterial tonsillitis are caused by group A beta-hemolytic Streptococcus pyogenes (GABHS). […] Viral or bacterial infections and immunologic factors lead to tonsillitis and its complications. Overcrowded conditions and malnourishment promote tonsillitis. Most episodes of acute pharyngitis and acute tonsillitis are caused by viruses such as the following: Herpes simplex virus, Epstein-Barr virus (EBV), Cytomegalovirus, Other herpes viruses, Adenovirus, Measles virus. […] Bacteria cause 15-30% of cases of pharyngotonsillitis. Anaerobic bacteria play an important role in tonsillar disease. Most cases of bacterial tonsillitis are caused by group A beta-hemolytic Streptococcus pyogenes (GABHS). S pyogenes adheres to adhesin receptors that are located on the tonsillar epithelium. Immunoglobulin coating of pathogens may be important in the initial induction of bacterial tonsillitis.
  • #1 Tonsillitis and Tonsilloliths: Diagnosis and Management | AAFP
    https://www.aafp.org/pubs/afp/issues/2023/0100/tonsillitis-tonsilloliths.html
    Tonsillitis is caused by a viral infection in 70% to 95% of cases. […] Bacterial infections caused by group A beta-hemolytic streptococcus (Streptococcus pyogenes) account for tonsillitis in 5% to 15% of adults and 15% to 30% of patients five to 15 years of age. […] The most common viral causes include rhinovirus, respiratory syncytial virus, adenovirus, and coronavirus. […] Less common causes include Epstein-Barr virus, cytomegalovirus, hepatitis A, and rubella. […] Tonsillitis is less commonly caused by other bacteria such as groups C and G streptococci, Hemophilus influenzae, Nocardia, and Corynebacteriaceae. […] The exact mechanism of tonsillolith development is not well understood but may be related to recurrent tonsillitis.
  • #2 Tonsillitis | healthdirect
    https://www.healthdirect.gov.au/tonsillitis
    Tonsillitis is inflammation (swelling) of the tonsils. […] It can be caused by viruses or bacteria. […] Tonsillitis is usually caused by viruses, often the same viruses that cause colds and flu. […] Glandular fever, usually caused by the Epstein-Barr virus, can cause severe tonsillitis, usually in teenagers. […] Tonsilitis can also be caused by bacteria. The most common type of bacteria involved is streptococcus (sometimes called 'strep’ throat). […] Regardless of whether tonsillitis is caused by a virus or bacteria, the symptoms may include sore throat, pain with swallowing, and fever etc.
  • #2 Tonsillitis: Symptoms, Causes & Treatment
    https://my.clevelandclinic.org/health/diseases/21146-tonsillitis
    Tonsillitis occurs when your tonsils become infected. […] Viral infections are the most common cause of tonsillitis. But bacterial infections can cause it, too. […] Viruses like those that cause the common cold and the flu cause up to 70% of tonsillitis cases. […] Bacteria, like Group A Streptococcus, cause other cases of tonsillitis. A common name for bacterial tonsillitis is strep throat.
  • #3 Tonsillitis – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK544342/
    Tonsillitis is generally the result of an infection, which may be viral or bacterial. Viral etiologies are the most common. The most common viral causes are usually those that cause the common cold, including rhinovirus, respiratory syncytial virus, adenovirus, and coronavirus. These typically have low virulence and rarely lead to complications. Other viral causes such as Epstein-Barr (causing mononucleosis), cytomegalovirus, hepatitis A, rubella, and HIV may also cause tonsilitis. […] Bacterial infections are typically due to group A beta-hemolytic Streptococcus (GABHS), but Staphylococcus aureus, Streptococcus pneumoniae, and Haemophilus influenza have also been cultured. Bacterial tonsillitis can result from both aerobic and anaerobic pathogens. In unvaccinated patients, Corynebacterium diphtheriae causing diphtheria should even merit consideration as an etiology. In sexually active patients, HIV, syphilis, gonorrhea, and chlamydia are possible as additional causes. Tuberculosis has also been implicated in recurrent tonsilitis, and clinicians should assess patients’ risks.
  • #4 Tonsillitis: Symptoms, pictures, causes, and treatment
    https://www.medicalnewstoday.com/articles/156497
    Tonsillitis is typically viral. Less commonly, bacteria can cause the infection. […] A viral infection is the most common cause of tonsillitis. The most common types of virus that infect the tonsils include: adenovirus, which is a possible cause of the common cold and sore throat; rhinovirus, which is the most common cause of the common cold; influenza, or flu; respiratory syncytial virus, which often leads to acute respiratory tract infections; two subtypes of coronavirus, one of which causes SARS. […] The most common type of bacteria to infect the tonsils is Streptococcus pyogenes. However, less often, other species can cause tonsillitis, including: Staphylococcus aureus, Mycoplasma pneumonia, Chlamydia pneumonia, Bordetella pertussis, Fusobacterium, Neisseria gonorrhoeae.
  • #5 Tonsillitis: Symptoms, Causes, Treatments, Surgery, and Remedies
    https://www.webmd.com/oral-health/tonsillitis-symptoms-causes-and-treatments
    Both bacterial and viral infections cause tonsillitis. If you have tonsillitis, it’s important for your doctor to determine the correct cause in order to find the right treatment. […] Several different viruses may make your tonsils inflamed, leading to tonsillitis. Some include: Adenoviruses, Influenza virus, Epstein-Barr virus, Parainfluenza viruses, Enteroviruses, Herpes simplex virus, HIV. […] Another common cause of tonsillitis is Streptococcus (strep) bacteria, which can also lead to strep throat. Occasionally other bacteria, such as Staphylococcus aureus, can inflame your tonsils as well. These infections are usually treatable with antibiotics. […] Repeated strep throat infections might indicate that you need to have your tonsils removed.
  • #6 Tonsillitis – Stanford Medicine Children’s Health
    https://www.stanfordchildrens.org/en/services/ear-nose-throat/conditions/tonsillitis.html
    Tonsillitis is often the result of an upper respiratory infection, either viral or bacterial. A number of viruses can result in tonsillitis, including the common cold, influenza, adenovirus, parainfluenza, and infectious mononucleosis. Bacterial infections, including streptococcus (strep), can also cause tonsillitis. […] While viruses tend to produce more cases of tonsillitis, bacterial infections can bring children in for care more often because they tend to have more severe symptoms.
  • #7 Tonsillitis – Wikipedia
    https://en.wikipedia.org/wiki/Tonsillitis
    Tonsillitis is most commonly caused by a viral infection and about 5% to 40% of cases are caused by a bacterial infection. […] When tonsillitis recurs after antibiotic treatment for streptococcus bacteria, it is usually due to the same bacteria as the first time, which suggests that the antibiotic treatment was not fully effective. […] Tonsillitis can also stem from infection with bacteria, predominantly Group A -hemolytic streptococci (GABHS), which causes strep throat. […] Anaerobic bacteria have been implicated in tonsillitis, and a possible role in the acute inflammatory process is supported by several clinical and scientific observations. […] Sometimes tonsillitis is caused by an infection of spirochaeta and treponema, which is called Vincent’s angina or Plaut-Vincent angina. […] Within the tonsils, white blood cells of the immune system destroy the viruses or bacteria by producing inflammatory cytokines like phospholipase A2, which also lead to fever.
  • #8 Tonsillitis | Tonsillitis Symptoms | Tonsillitis Treatment | MedlinePlus
    https://medlineplus.gov/tonsillitis.html
    Tonsillitis is an inflammation (swelling) of the tonsils. […] The cause of tonsillitis is usually a viral infection. Bacterial infections such as strep throat can also cause tonsillitis. […] Tonsillitis caused by bacteria is more common in kids ages 5-15. Tonsillitis caused by a virus is more common in younger children. […] Treatment for tonsillitis depends on the cause. If the cause is a virus, there is no medicine to treat it. If the cause is a bacterial infection, such as strep throat, your child will need to take antibiotics.
  • #9 Tonsillitis | NHS inform
    https://www.nhsinform.scot/illnesses-and-conditions/ears-nose-and-throat/tonsillitis/
    Tonsillitis is an infection that causes inflammation (redness and swelling) of the tonsils. […] Most cases of tonsillitis are caused by a viral infection, such as cold or flu. […] Some cases can also be caused by a bacterial infection, typically a strain of bacteria called group A streptococcus bacteria. […] Tonsillitis itself isnt contagious, but the infections that cause it are.
  • #10 Tonsillitis: Causes, Diagnosis, and Treatment
    https://www.verywellhealth.com/what-causes-swollen-tonsils-1192012
    Tonsillitis is inflammation of the tonsils, which are two lymph nodes located on each side of the back of your throat. A viral or bacterial infection can cause tonsillitis, resulting in sore throat and other symptoms. […] The majority of cases of tonsillitis are caused by a virus, while anywhere from 5% to 40% are believed to be caused by bacteria. […] Some of the more common viral causes include: Cold viruses (including rhinoviruses and adenoviruses), Infectious mononucleosis, Cytomegalovirus (CMV), Epstein-Barr virus (EBV), Herpes simplex virus (HSV), Measles. […] The most common bacterial causes include: Staphylococcus aureus (including MRSA), Whooping cough (pertussis), Bacterial pneumonia, Streptococcal pyogenes (strep throat). […] Non-infectious causes of swollen tonsils are rarer but may include cancer of the tonsils and cryptic tonsils.
  • #11 Tonsillitis and Peritonsillar Abscess: Practice Essentials, Background, Pathophysiology and Etiology
    https://emedicine.medscape.com/article/871977-overview
    A polymicrobial flora consisting of both aerobic and anaerobic bacteria has been observed in core tonsillar cultures in cases of recurrent pharyngitis, and children with recurrent GABHS tonsillitis have different bacterial populations than children who have not had as many infections. […] A polymicrobial bacterial population is observed in most cases of chronic tonsillitis, with alpha- and beta-hemolytic streptococcal species, S aureus, H influenzae, and Bacteroides species having been identified. […] A polymicrobial flora is isolated from peritonsillar abscesses (PTAs). Predominant organisms are the anaerobes Prevotella, Porphyromonas, Fusobacterium, and Peptostreptococcus species. Major aerobic organisms are GABHS, S aureus, and H influenzae.
  • #12 Tonsillitis causes – wikidoc
    https://www.wikidoc.org/index.php/Tonsillitis_causes
    Anaerobic bacteria have been implicated in tonsillitis. These include pigmented Prevotella and Porphyromonas, Fusobacterium and Actinomyces spp. The possible role of anaerobes in the acute inflammatory process in the tonsils is supported by several clinical and scientific observations: anaerobes have been isolated from the cores of tonsils of children and adults with recurrent GABHS and non streptococcal tonsillitis, and peritonsillar and retropharyngeal abscesses in many cases without any aerobic bacteria, their recovery as pathogens in well-established anaerobic infections of the tonsils (Vincent’s angina), the increased recovery rate of encapsulated pigmented Prevotella and Porphyromonas spp. in acutely inflamed tonsils, and the response to antibiotics in patients with non streptococcal tonsillitis. […] Viral tonsillitis may be caused by numerous viruses such as the Epstein-Barr virus (the cause of infectious mononucleosis) or the Adenovirus.
  • #13 Practical Ways to Prevent Recurrent Tonsillitis in Adults
    https://entlondon.org.uk/blogs/practical-ways-to-prevent-recurrent-tonsillitis-in-adults/
    Infections are the primary reason behind tonsillitis. The tonsils at the back of the throat can become inflamed when they come into contact with bacteria or viruses. The most common culprits behind adult tonsillitis include: […] Bacterial Infections: Streptococcus pyogenes, also known as strep throat, is a bacteria that can trigger tonsillitis. This type of infection often requires medical attention, as untreated strep throat can lead to complications like rheumatic fever. […] Viral Infections: Viruses like the EBV and the adenovirus are frequently responsible for causing tonsillitis. These infections are usually self-limiting and resolve on their own with proper rest and care. […] Reduced Immune Function: A weakened immune system can make adults more prone to frequent tonsillitis. Chronic illnesses, stress, and poor lifestyle habits can lower immunity.
  • #14 When to Seek Emergency Room for Tonsillitis
    https://www.eroftexas.com/when-is-tonsillitis-an-emergency/
    Tonsillitis can be caused by a variety of factors, including viral and bacterial infections. Some of the most common causes of tonsillitis include: […] Viral infections: Many cases of tonsillitis are caused by viruses, such as the common cold virus, influenza virus, or the Epstein-Barr virus (which causes mononucleosis). These types of infections typically resolve on their own within a week or two. […] Bacterial infections: Streptococcus pyogenes (group A streptococcus) is a common bacterial cause of tonsillitis, which is also known as strep throat. Other bacteria, such as Staphylococcus aureus or Haemophilus influenzae, may also cause tonsillitis. […] Fungal infections: In rare cases, tonsillitis may be caused by a fungal infection, such as candidiasis. […] Environmental factors: Exposure to irritants in the environment, such as pollution or cigarette smoke, can also cause inflammation of the tonsils.
  • #15 Tonsillitis: What it is, Causes, Symptoms & Treatment
    https://www.utentclinic.com/news/tonsillitis-what-it-is-causes-symptoms-treatment
    Tonsillitis can be caused by a virus or bacteria. The most common culprit behind viral tonsillitis is the common cold or flu virus. Other viruses that can cause tonsillitis include the Epstein-Barr virus, adenoviruses, and herpes simplex virus. Bacteria such as strep throat and mononucleosis can also cause tonsillitis. […] In addition to these causes, some risk factors can make you more susceptible to developing tonsillitis. These include: […] Age – Children and adolescents are more likely to develop tonsillitis than adults. This is because their immune systems are still developing and are not as strong as an adult’s immune system. […] Frequent exposure to viruses and bacteria – If you’re frequently exposed to viruses and bacteria, you’re more likely to develop tonsillitis. This is especially true for children who attend daycare or school.
  • #16 Understanding recurrent tonsillitis | National Institutes of Health (NIH)
    https://www.nih.gov/news-events/nih-research-matters/understanding-recurrent-tonsillitis
    In children with recurrent tonsillitis, the bacteria that cause the disease trick immune cells into destroying each other instead of remembering the bacteria. […] Tonsillitis, or swelling of the tonsils, is usually caused by a viral infection. But it can also be caused by strep bacteria, Streptococcus pyogenes. […] Strep throat can be treated effectively with antibiotics, but some children get the disease repeatedly (recurrent tonsillitis). […] It hasnt been clear why some children are more likely than others to get recurrent tonsillitis. […] The team found that the tonsils of children with recurrent tonsillitis contained relatively higher numbers of a novel TFH cell type. The children with recurrent tonsillitis also had fewer B cells in their tonsils. […] The scientists found that children with recurrent tonsillitis had low levels of antibodies against SpeA in their blood.
  • #17 Understanding recurrent tonsillitis | National Institutes of Health (NIH)
    https://www.nih.gov/news-events/nih-research-matters/understanding-recurrent-tonsillitis
    Vulnerability to this process appears to have a genetic component. […] The researchers saw that many of the children in their study had a family history of recurrent tonsillitis. […] The team was able to identify specific genetic variations in the immune system that were associated with risk of recurrent tonsillitis. […] These findings point to potential strategies to reduce the incidence of recurrent tonsillitis. […] Since the immunological connection as well as the genetic connection are all tied to an insufficient antibody response against SpeA, it suggests that recognizing this factor is actually a key problem for these kids.
  • #18 Recurrent Tonsillitis: Causes, Treatment, and Prevention
    https://www.healthline.com/health/what-causes-recurrent-tonsillitis-and-how-is-it-treated
    Recurrent tonsillitis is a tonsil infection that returns frequently, even with treatment. […] Most often, a viral infection, such as the common cold, is responsible for tonsillitis. But bacterial infections, particularly from Streptococcus pyogenes, can also be the cause. […] When it comes to recurrent bacterial tonsillitis, researchers have found some clues as to why some people are more likely to keep getting infections. Their research centers on genetic components that affect the immune system. […] Researchers also found that there was a genetic connection to this immune response, as many of the children had a family history of recurrent tonsillitis. […] Recurrent tonsillitis may also occur in children with: periodic fever, aphthous stomatitis, pharyngitis, cervical adenitis (PFAPA syndrome).
  • #19 Tonsillitis: Causes, Symptoms, and Diagnosis
    https://www.healthline.com/health/tonsillitis
    A variety of bacterial and viral infections can cause tonsillitis. […] A virus, such as the common cold, can trigger tonsillitis. Bacterial infections, such as strep throat, are also possible causes of tonsillitis. […] The germs that trigger tonsillitis can be transmitted to others, and a variety of common viruses and bacteria can cause it. Tonsillitis-causing microorganisms include Streptococcal bacteria. […] A 2018 review suggests that chronic and recurrent tonsillitis may occur due to biofilms in the folds of the tonsils. Biofilms are communities of microorganisms that have developed antibiotic resistance, and they can cause repeated infections. […] Genetics may also be a reason for recurrent tonsillitis. […] A 2019 study examined the tonsils of children who had recurrent tonsillitis. Researchers found that genetics may cause an insufficient immune response to group A streptococcus bacteria, which cause strep throat and tonsillitis.
  • #20 Recurrent Tonsillitis in Adults
    https://www.laent.com/about/our-practice/blog/recurrent-tonsillitis-in-adults/
    Recurrent tonsil infections are a common problem for adults. This is commonly due to a bacterial biofilm often caused by streptococcus. […] Another bacteria which lives in the mouth called Actinomyces is also a common problem in adults with frequent tonsil infections. This bacteria can only be fought off by penicillin antibiotics which many people have allergies to.
  • #21 Tonsillitis (for Parents) | Nemours KidsHealth
    https://kidshealth.org/en/parents/tonsillitis.html
    Tonsillitis is an inflammation of the tonsils, usually caused by an infection by viruses or bacteria. […] Tonsillitis is usually caused by a virus such as adenovirus, the flu, or Epstein-Barr virus (mono). Bacteria also can cause it, most commonly group A streptococcus (then, it is called strep throat). […] Rarely, tonsillitis can be caused by something other than an infection.
  • #22 Tonsillitis Causes, Symptoms, Diagnosis and Treatment – Cura4U
    https://cura4u.com/conditions/tonsillitis
    Tonsillitis is the inflammation of tonsils, a tissue mass located on either side of the upper part of your throat. In the majority of the cases, a viral or bacterial infection triggers the immune system, which causes inflammation and swelling of tonsils. […] About 40% to 60% of cases of tonsillitis are reported to be caused by viral infections. Adenovirus is a well-known pathogen that causes common cold. Tonsillitis occurs as a result of infection by this virus. […] Tonsillitis can also be caused by bacterial infections, out of which t group-A streptococcus bacteria cause the most common infection. […] A few non-infectious causes can also cause inflammation of the tonsils. These include gastroesophageal reflux disease, pericoronitis, Vincents angina, tuberculosis, etc. […] Certain medications can cause tonsillitis, too, as a side effect. Smoking and allergies can also be considered as triggering agents.
  • #23 Chronic Tonsillitis: Causes and Symptoms
    https://www.verywellhealth.com/chronic-and-recurrent-tonsillitis-1191984
    Tonsillitis can be caused by infections such as viruses (cytomegalovirus, herpes simplex, Epstein-Barr) or bacteria such as those that cause strep throat. […] If you have an infection with antibiotic-resistant bacteria or an immune system that doesn’t work correctly, you may develop chronic tonsillitis. […] You may also have an increased risk of developing chronic tonsillitis if you have been exposed to radiation. […] In children, recurrent tonsillitis is most commonly caused by group A beta-hemolytic Streptococcus pyogenes (GABHS) infections. It is also known as strep throat. Other bacteria are more likely to be the cause of adult recurrent tonsillitis. […] Reasons for recurring strep throat include strains of the bacteria that are resistant to antibiotics, weakened immune system, and the possibility that you or someone in your family is a strep carrier (who has no symptoms but can spread the bacteria).
  • #24 Tonsillitis: Symptoms & Causes | NewYork-Presbyterian
    https://www.nyp.org/primary-care/tonsillitis
    Tonsillitis can occur at any age but is most common in children. It can be caused by viral or bacterial infections, and treatment for tonsillitis depends on the cause. […] Tonsils act as the first line of protection from viruses and bacteria that enter the mouth, and this role makes them susceptible to infection. Tonsilitis is most often caused by viral infections, such as adenoviruses or influenza viruses. […] A bacterial infection can also cause tonsillitis. The most common bacterium that causes tonsillitis is Streptococcus pyogenes, the same bacterium that causes strep throat.
  • #25 Tonsillitis: causes, symptoms and treatment | Spire Healthcare
    https://www.spirehealthcare.com/health-hub/specialties/ear-nose-and-throat/tonsillitis-causes-symptoms-and-treatment/
    Tonsillitis is usually caused by viruses but it can also be caused by bacteria. A bacterial infection such as strep throat, caused by streptococcus bacteria, can lead to tonsillitis. […] Age is the main risk factor for tonsillitis. Young children are more likely to get viral tonsillitis, while school-age children more commonly get bacterial tonsillitis. The elderly are also at risk of getting tonsillitis. […] If tonsillitis is caused by streptococcus bacteria, an untreated infection can lead to more serious problems, such as rheumatic fever, sinusitis, kidney infection or scarlet fever.
  • #26 Tonsillitis – Symptoms, Causes and Treatment | MedPark Hospital
    https://www.medparkhospital.com/en-US/disease-and-treatment/tonsillitis
    Tonsillitis is often due to viral infection. However, bacterial infection can be the cause of tonsillitis as well. […] To successfully treat tonsillitis, identifying the actual cause of infection is key. […] Viruses are the most common cause of tonsil infections, whereas, for bacteria, Streptococcus pyogenes (group A streptococcus) is the most frequent agent of strep throat. However, other bacteria or strains of Streptococcus can also cause tonsil infection. […] Exposure to pathogens like viruses and bacteria increases the chance of tonsil infection and inflammation. The decline of the immune function of the tonsils starts after puberty making tonsil infection in adults a rarity.
  • #27 Pharyngitis (Tonsillitis) – Respirology – Diseases – McMaster Textbook of Internal Medicine
    https://empendium.com/mcmtextbook/chapter/B31.II.3.3.
    Given that most pharyngitis is caused by respiratory viruses, this infection is most commonly observed in the fall, winter, and early spring. Risk factors are very dependent on etiology. Contact with young children predisposes to infection with respiratory viruses and herpesviruses. Sexual contact is an obvious risk factor for HIV and N gonorrhoeae infection (the latter occurs via oral-genital contact). M pneumoniae and C pneumoniae, which commonly cause both upper and lower respiratory tract infections, and A haemolyticum, which chiefly causes pharyngitis, are more commonly found in adolescents and young adults. C diphtheriae is extremely rare and usually occurs in unvaccinated individuals who travel to areas where diphtheria is still endemic. […] The incubation period for GAS is 2 to 5 days. The patients are contagious up to 24 hours after the start of an effective antimicrobial treatment or for ~7 days after the resolution of symptoms in the case of no antimicrobial treatment. The risk of transmission to household contacts is substantial.
  • #28 Is tonsillitis contagious? Symptoms, causes, when to see a doctor
    https://www.usatoday.com/story/life/health-wellness/2024/10/14/is-tonsillitis-contagious/75496548007/
    Tonsillitis occurs when the tonsils become infected, usually by viruses or bacteria. […] Tonsillitis is usually caused by a viral infection, although in some cases it can be caused by a bacterial infection, says Clark. Streptococcus pyogenes, the same bacterium that causes strep throat, is responsible for most bacterial infections of tonsillitis, according to WebMD. […] Tonsillitis itself is not contagious. However, the viruses and bacteria that cause tonsillitis are highly contagious and can spread through respiratory droplets when an infected person coughs, sneezes or talks, says Clark.
  • #29 Pediatric tonsillitis – Children’s Health ENT
    https://www.childrens.com/specialties-services/conditions/tonsillitis
    Tonsillitis is the result of either a bacterial or viral infection, sometimes due to strep throat. If the infection occurs farther down the throat it’s known as pharyngitis. […] Viruses, bacteria, allergens or irritants such as air pollution or cigarette smoke may cause a sore throat. Fungi or chronic postnasal drip may also result in a sore throat. […] Contact with droplets from a sick persons cough or sneeze may get your child sick. […] Epstein-Barr virus (EBV) […] Your child can also pick up tonsillitis by eating or drinking from the same glass or plate as a sick person. Strep throat is the result of streptococcus bacteria (group A strep) and may be picked up from the above or contact with a group A strep skin infection. […] Herpes simplex virus […] Streptococcus pyogenes (strep throat)
  • #30 Complications of Tonsillitis — julianhamann.com
    https://www.julianhamann.com/throat-and-voice/complications-of-tonsillitis
    Tonsillitis is often caused by streptococcal infections, in particular Streptococcus Pyogenes (also known as Group A Streptococcus). […] Rheumatic fever (RF) can occur when tonsillitis is caused by a bacteria called group A streptococcus. […] Post-streptococcal arthritis is inflammation of the joints that occurs within a month of tonsillitis caused by Group A Streptococcus. […] Certain types of Group A Streptococcus are more likely to affect the kidneys. […] Toxic Shock Syndrome is a rare, but very serious complication of tonsillitis caused by GAS. […] Infections of the tonsils can spread through the Eustachian tube to cause ear infections, or via the back of the nose into the sinuses to cause sinus infections. […] Infections from the tonsil can very rarely spread to infect the lining of the brain (meningitis) or cause collections of pus (abscesses) in the brain. […] This occurs when infection from the tonsil spreads to the jugular vein, which is a large blood vessel that drains blood from the brain, head and neck region. […] This another very rare, but serious, complication of tonsillitis caused by Group A Streptococcus.
  • #31 Complications That Can Result From Tonsillitis
    https://www.everydayhealth.com/tonsillitis/complications/
    Tonsillitis can be caused by a viral infection or bacterial infection (like strep throat), and most of the time it goes away in a week or less. […] If bacterial infections do not go away on their own, they can continue to worsen and spread throughout the body. […] Tonsillitis can cause temporary or permanent sleep apnea if the tonsils become enlarged and obstruct the airway during sleep. […] Tonsillitis can lead to an ear infection when the adenoid tissue becomes swollen and blocks the eustachian tube, causing pressure buildup in the ear. […] If tonsillitis is caused by a strep throat infection, the bacteria can get into the blood system and cause a condition called rheumatic fever an inflammatory disorder primarily found in children between the ages of 6 and 16. […] Post-streptococcal glomerulonephritis (PSGN) is an inflammatory disorder of the kidneys that can develop after a strep throat infection. […] While there is no link between tonsillitis and cancer, sometimes they may have similar symptoms.
  • #32 What Causes Tonsillitis? – CV ENT Surgical Group
    https://www.cvsurgicalgroup.com/what-causes-tonsillitis/
    Tonsillitis is a condition that affects the tonsils hanging in the back of the throat. […] To help you better understand the importance of why medical intervention is sometimes advised instead of the usual wait-and-see self-care approach, C/V ENT Surgical Group offers this brief overview on the causes of tonsillitis. […] Viruses account for the majority of tonsillitis cases seen in the country. […] Currently, the Epstein-Barr virus, also known as mononucleosis, is the dominant cause of viral tonsillitis. […] Tonsil infections can also occur from bacteria, fungi, and parasitic infections, though they are less common, such as strep throat or meningitis. […] Serious and chronic cases of tonsillitis and adenoid infections can lead to poor sleep quality, decreased cognitive performance, shortness of breath, sleep apnea, and other concerns that greatly impact one’s overall ability to function daily. […] Though it is not specific to any age group, children over the age of three and seniors are more prone to this type of infection due to developing and waning immune system function respectively.
  • #33 Tonsillitis
    https://www.nhs.uk/conditions/tonsillitis/
    Tonsillitis is usually caused by a virus, such as a cold, but it can also be due to a bacterial infection such as strep throat. […] Treatment for tonsillitis will depend on what’s causing it: most children and adults get viral tonsillitis (caused by a virus), which clears up on its own; for bacterial tonsillitis (caused by bacteria), a GP may prescribe antibiotics.
  • #34 Tonsillitis
    https://www2.hse.ie/conditions/tonsillitis/
    Most children and adults get viral tonsillitis. This type has to run its course and antibiotics won’t help. […] Treatment will depend on what caused your tonsillitis. Most children and adults get viral tonsillitis. This type has to run its course and antibiotics won’t help. Your GP may prescribe antibiotics for bacterial tonsillitis.
  • #35 Tonsillitis | Effective Health Care (EHC) Program
    https://effectivehealthcare.ahrq.gov/health-topics/tonsillitis
    Tonsillitis is an inflammation (swelling) of the tonsils. Sometimes along with tonsillitis, the adenoids are also swollen. […] The cause of tonsillitis is usually a viral infection. Bacterial infections such as strep throat can also cause tonsillitis. […] Treatment for tonsillitis depends on the cause. If the cause is a virus, there is no medicine to treat it. If the cause is a bacterial infection, such as strep throat, your child will need to take antibiotics.
  • #36 Tonsillitis Causes & Treatment for Arizona — Valley ENT
    https://www.azvent.com/conditions/throat/tonsillitis-recurrent/
    Both viral and bacterial infections can cause tonsillitis. […] When tonsillitis becomes recurrent, it is thought that the tonsils may have become home to pathogenic bacteria, making the patient more susceptible to another infection whenever the immune system is stressed. […] If your doctor confirms a bacterial infection is the cause of your tonsillitis, you’ll get a prescription for antibiotics. […] Taking out the tonsils removes tissue that has become home to bacteria, often resulting in fewer throat infections in the future.
  • #37 3 Reasons Why Tonsillitis Should Never Go Untreated | Board Certified Otolaryngologist & Otolaryngologic Allergy located in Lake Oswego, OR | Lake Grove ENT
    https://www.lakegroveent.com/post/3-reasons-why-tonsillitis-should-never-go-untreated
    Tonsillitis is a very common condition in children and most cases are mild and clear up in a short time. […] Viral infections, such as adenovirus, influenza, and rhinovirus, are often responsible for tonsillitis, but there are bacterial infections that can cause tonsillitis too. […] Chronic tonsillar inflammation can lead to tonsillar enlargement and breathing problems while sleeping (obstructive sleep apnea), the spread of the infection to other tissue (tonsillar cellulitis), and pus collecting behind the tonsils (peritonsillar abscess). […] If your child gets tonsillitis from streptococcal bacteria, otherwise known as strep throat, it can increase the risk of some rare conditions.