Acute tonsillitis is an acute bacterial infection of the tonsils with inflammation of the surrounding mucosa and lymphoid tissue, and is a very common disease of the pharynx. It occurs most often in children and young adults, and is most likely to develop in the spring and fall, mainly due to the large temperature difference. It is called acute tonsillitis in Chinese medicine as “rotten milk e”. A. Etiology 1. Streptococcus b haemolyticus is the main causative agent, non-haemolytic streptococcus, staphylococcus, streptococcus pneumoniae, bacillus influenzae and adenovirus, herpes virus can be caused. Sometimes mixed bacterial and viral infections. In recent years, an increase in anaerobic and gram-negative bacterial infections has been found. Normal human pharynx and tonsil crypt (pharyngeal mucosa and tonsils have many small nests invisible to the naked eye and a few large nests visible to the naked eye) contain many pathogens, and when the body’s resistance is reduced, these germs multiply, secrete toxins, destroy the tonsils and pharynx mucosal epithelium, invade the parenchymal tissue, and cause inflammatory reactions. 2, the factors that cause a decrease in low resistance are: cold, humidity, overwork, excessive smoking and alcohol, stimulation of harmful gases and chronic lesions of the nasal cavity and nasopharynx (such as acute and chronic rhinitis and sinusitis). 3, the disease has a certain degree of contagious, its mode of transmission: airborne droplet transmission and contact transmission. Outbreaks can occur when groups gather. The main manifestation is congestion in the tonsils and surrounding mucosa. 2. Acute follicular tonsillitis Inflammation invades the lymphatic follicles in the tonsil parenchyma, causing congestion, swelling and suppuration. Yellowish-white pus spots can be seen at the mouth of the crypt. 3. Acute crypt tonsillitis The tonsils are congested and swollen. Inflammation invades the tonsil parenchyma and further causes infectious inflammatory destruction, forming a large amount of purulent secretions in the crypt, which are connected into pieces and form a gray yellow pseudomembrane that can be easily wiped away. The symptoms of each type of tonsillitis are similar, and the systemic and local symptoms of acute catarrhal tonsillitis are lighter. 1, systemic symptoms The onset of the disease is rapid, there can be chills, high fever, headache, headache, decreased appetite, fatigue, general discomfort, constipation, etc.. In children, high fever convulsions, vomiting and lethargy may occur. 2. Local symptoms Intense sore throat is the main symptom, often radiating to the ear, and the pain is aggravated when swallowing. It may be accompanied by enlargement of mandibular lymph nodes. The tonsils are enlarged and congested to varying degrees, and the surface may be dotted or flaky with purulent secretions, and the surrounding pharyngeal mucosa is obviously congested and edematous. Complications 1. Local complications: peri-tonsillar abscess, acute otitis media, acute rhinitis and sinusitis, acute laryngitis, acute lymphadenitis, and parapharyngeal abscess. 2. Systemic complications: damage to multiple systems throughout the body, acute rheumatic fever, arthritis, acute osteomyelitis, acute myocarditis, nephritis, etc. V. Treatment: 1. Appropriate isolation and rest are the main focus, along with anti-infection and symptomatic treatment. 2. The disease is characterized by recurrent attacks, so for patients with recurrent attacks or complications, bilateral tonsillectomy should be performed after the acute inflammation subsides.