Tonsillitis

 What is it?

Tonsillitis is a very common type of infection among children, and less common in adults. The condition causes inflammation of the throat and tonsils and is caused by different types of viruses or bacteria. Group A streptococci, responsible for streptococcal tonsillitis, are the most common.

This type of bacteria can also live in the nose and throat without causing any illness and can infect another person through contact with the bacteria, either through coughing or simply sneezing from an infected person.

Main Causes

The tonsils are the lymphatic tissue responsible for eliminating bacteria and microorganisms that can enter the body and cause infections. They are located at the back or inside of the mouth and in the upper throat. The most common cause of tonsillitis is not just contact with the secretions of an infected person. The use of glass cups and cutlery, as well as contact with wounds infected with group A streptococcus on the skin, are also sources of infection. Bacterial tonsillitis occurs less frequently than its viral form, but any of them can cause complications if not treated properly. The microorganisms that most affect humans when it comes to tonsillitis are: Group A Streptococcus, Epstein-Barr virus, Influenza virus, Herpes simplex virus, Adenovirus, Enterovirus, Parainfluenza virus, and Paraflu virus.

How to identify

The most common symptoms of the condition are: 

Inflammation of the tonsils, cervical adenopathy (enlarged lymph nodes) with pain, Ulceration, and the appearance of white or yellow areas on the tonsils. Sore throat that usually lasts more than 48 hours, especially when the mouth is open or solid foods and liquids are ingested. Difficulty swallowing, also called dysphagia. Cough Excessive saliva production, loss of speech, Headache, pain extending to the ears and eyes, Fever and chills, Jaw and throat sensitivity, Bad breath, Nasal congestion and runny nose, Abdominal pain, Bleeding tonsils. One of the complications that can occur if the tonsils are very large is possible respiratory problems, although this is not very common. Tonsil pain is the main symptom of tonsillitis. 

How to prevent it

To prevent infection, the following recommendations should be followed: Wash your hands frequently, especially after using the bathroom and before eating. Avoid sharing food, cups, and utensils. Stay away from people who may be infected, especially when they sneeze or cough. Some bad habits not only reduce the effectiveness of the immune system but also cause significant damage to the body, making the patient more likely to develop tonsillitis. Some of these bad habits are smoking (even when the individual is exposed to secondhand smoke) and alcohol abuse. These habits irritate the mucous membranes, which play a fundamental role in the well-being of these tissues.

 Types

 Tonsil infections are classified according to the duration of symptoms and the causative source: virus or bacteria. 

Viral tonsillitis: The Epstein-Barr virus causes most cases of the disease. The infection is diagnosed through a blood test that determines whether the white blood cell count is elevated or if the cells are abnormal. Treatment focuses on reducing inflammation. 

Bacterial tonsillitis: When group A Streptococcus bacteria is the likely cause of the infection, a throat swab is taken to confirm the presence of the bacteria.

Acute tonsillitis: when the infection lasts up to 3 months.

Chronic tonsillitis: When the infection lasts more than 3 months or is recurrent. This is a much more serious infection that is neglected by the patient, becoming recurrent and affecting and inflaming the tonsil tissue with disturbing frequency. Due to the severity and level of infection, chronic tonsillitis often leads to pharyngitis.

What tests are used for diagnosis?

Initially, the specialist performs a scan of the patient's mouth and throat to observe the condition of the tonsils. A person usually presents with tonsillitis if the tonsils are red or have white patches. Another visual and physical test that can be used to confirm the diagnosis is when the lymph nodes in the jaw and neck are swollen and tender to the touch. The otolaryngologist may also choose to perform a rapid strep test, but this is not a completely reliable method due to its extreme urgency. Another option is to send a sample of the inflamed pharyngeal tissue to the laboratory, although the results may take a few days.

How is treatment performed?

Painless tonsil infections do not require treatment, although the otolaryngologist may ask the patient to return to the office for a follow-up examination. If the test results are positive, the patient will be prescribed antibiotics and anti-inflammatories, which should be taken even after symptoms subside, as directed by the specialist. In cases where infections are recurrent or abscesses develop, the otolaryngologist may opt to remove the tonsils through a tonsillectomy, which in some cases is performed using radiofrequency, minimizing post-surgical symptoms and potential complications.

To learn how to safely remove tonsils, read the article: Tonsillectomy: How the tonsil removal surgery is performed.

Home Treatments

To reduce throat pain, the patient is advised to follow some simple instructions at home: Drink cold liquids or eat ice cream. Although it may seem strange, it's important that the liquids you drink aren't hot, as they can intensify the pain. Gargling with warm water and salt also reduces the burning sensation (we've listed some solutions below). Maintaining adequate hydration is essential. One of the most effective and popular methods used at home is to keep the child in the bathroom with the steam from the shower for a few minutes. This not only moisturizes the throat, but also moistens the respiratory mucosa. As a complement to the treatment prescribed by an otolaryngologist, individuals can also use some home remedies. An excellent home treatment for tonsillitis is gargling. Gargling is effective in facilitating hydration and compensating for the loss of salts and fluids caused by sweat and the high temperature of a fever. Gargling also relieves a sore throat. The best gargling mixtures are: honey and lemon, boiled water with sea salt, water and red pepper, chamomile and honey.

Check out other home treatments for tonsillitis

 Is tonsillitis contagious? Yes, tonsillitis can be more or less contagious, depending on the causative agent. If it's a virus, it can usually be transmitted to someone who hasn't had contact with the virus before. In the case of bacteria, the condition is easily transmitted, especially by group A Streptococcus. In cases where the individual suffers from chronic tonsillitis or is caused by other conditions, such as sinusitis or allergic rhinitis, it is generally not contagious.

Throat

Protect it well. With sudden fluctuations in temperature, the organs of the respiratory system are most exposed to viruses. At these times, it's important to protect the throat, as it's a sensitive area and the first entry point for air and, therefore, microorganisms.

Source: How to Identify and Treat Tonsillitis

Link: https://www.educarsaude.com/amigdalite/

Site: https://www.educarsaude.com/amigdalite/ | Reviewed by Dr. Marcelo Amarante (Family and Community Physician - CRM-RS: 42408 - RQE No. 29881)

Phenylketonuria

Phenylketonuria is an inborn error of metabolism caused by a deficiency of the enzyme phenylalanine hydroxylase, the enzyme responsible for catalyzing the conversion of the essential amino acid phenylalanine to the amino acid tyrosine. Due to the enzyme deficiency, phenylalanine accumulates, which is toxic to the central nervous system.

The enzyme deficiency is caused by mutations in the PAH gene. Both alleles of the gene must carry the mutation, making it an autosomal recessive condition.

In its classic form, if not treated correctly, phenylketonuria can lead to severe intellectual disability, as well as microcephaly, seizures, behavioral changes, and eczema. Symptoms develop over the months after birth as phenylalanine accumulation increases.

There are milder forms of the condition, which vary according to phenylalanine levels.

Diagnosis

Phenylketonuria can be detected early in newborns through the heel prick test, a free test provided by the Unified Health System (SUS) since 1992. It is crucial to perform the test, which should preferably be performed between the third and fifth days of the baby's life. If an increase in serum phenylalanine levels is identified, a protocol for diagnostic confirmation and treatment is initiated.

Treatment

Phenylketonuria is primarily treated with a phenylalanine-restricted diet, aiming to reduce serum phenylalanine levels and prevent neurological complications.

Patients should be monitored by a multidisciplinary team, working with a geneticist and nutritionist to prescribe an appropriate diet that meets the patient's needs and does not aggravate the condition.

Pregnant women with phenylketonuria require special monitoring during pregnancy. Phenylalanine accumulation is toxic to the baby and can lead to intrauterine growth restriction, microcephaly, heart defects, and neurological developmental disorders.

Services for assistance to people with phenylketonuria

If you have already been diagnosed with phenylketonuria or a rare disease, or if you have symptoms and/or characteristics of a pathology, contact Casa Hunter. The institution will assist you from obtaining a correct and specific diagnosis to defending your rights with the Unified Health System (SUS) and/or health plans, ensuring quality treatment.

Casa Hunter has a team of qualified professionals and a department specialized in administrative processes that seek access to your rights. The service is free of charge.

Alkaptonuria

 Alkaptonuria is a rare genetic disease caused by a deficiency in the enzyme homogentisate oxidase, which is responsible for the metabolism of homogentisic acid. It is caused by alterations in the HGD gene.

When homogentisic acid accumulates in the body, it is excreted in the urine, resulting in a color.

Symptoms

The main symptoms are: dark urine after exposure to air, hyperpigmented spots on the skin and sclera, and arthritis. The condition can also lead to changes in the heart valves.

Diagnosis

Urinary tests can identify the presence of homogentisic acid. Genetic testing can confirm the diagnosis.

Treatment

There is no cure for the condition. Treatment consists of symptom management and, in some cases, a protein-restricted diet. With proper monitoring and management of complications, the prognosis is good.

The monitoring of these patients by a multidisciplinary team of professionals familiar with the condition is essential.

Services for people with alkaptonuria and rare diseases

If you have already been diagnosed with alkaptonuria or a rare disease, or if you have symptoms and/or characteristics of a pathology, contact Casa Hunter. The institution will assist you from obtaining a correct and specific diagnosis to defending your rights with the SUS and/or health plans, ensuring quality treatment.

Casa Hunter has a team of qualified professionals and a department specialized in administrative processes that seek access to your rights. The service is free of charge.

Achondroplasia

 Achondroplasia is a rare genetic condition caused by alterations in the FGFR3 gene. It occurs in approximately 1 in every 15,000 to 40,000 births worldwide.

It is transmitted in an autosomal dominant fashion, meaning only one altered copy is needed to cause the condition. Most cases occur in individuals with no family history of achondroplasia.

Characteristics

Patients present with short stature, shorter upper and lower limbs in relation to the torso, a prominent forehead, and trident hands.

Additionally, they may present with respiratory problems and spinal cord compression.

Diagnosis

Diagnosis is suspected based on a physical examination and imaging tests and is confirmed by genetic testing that identifies the mutation in the FGFR3 gene.

Treatment

Treatment of achondroplasia is multidisciplinary, with frequent follow-up.

Recently, ANVISA (Brazilian Health Regulatory Agency) approved the drug Vosorotide (VOXZOGO), which aims to increase the growth rate of patients with achondroplasia from 2 years of age. The medication must be prescribed and monitored by a geneticist and a specialized team.

Services for people with achondroplasia and rare diseases

If you have already been diagnosed with achondroplasia or a rare disease, or if you have symptoms and/or characteristics of a pathology, contact Casa Hunter. The institution will assist you from obtaining a correct and specific diagnosis to defending your rights with the SUS (Brazilian Unified Health System) and/or health plans, ensuring quality treatment.

Casa Hunter has a team of qualified professionals and a department specialized in administrative processes that seek access to your rights. The service is free of charge.

Rare diseases

 According to the Ministry of Health, rare diseases affect up to 65 out of every 100,000 people. Considering that there are between 6,000 and 8,000 different rare diseases, they affect a considerable percentage of the Brazilian population. The World Health Organization (WHO) estimates that 15 million Brazilians have some form of illness that falls into this category.

Because rare diseases are so diverse, affecting different organs and causing distinct symptoms, the National Policy for Comprehensive Care for People with Rare Diseases divided these diseases into two types, based on their characteristics:

Genetic origin: 80% are caused by factors linked to the patient's genetics. Some examples are inborn errors of metabolism (disorders that generally involve the production of enzymes in the body that fail to break down, store, or transport molecules within the body) and congenital or late-onset anomalies (changes that can occur during embryonic development that cause aesthetic deformities or even affect the functions of certain organs/systems).

Non-genetic origin: other diseases that can occur due to environmental factors, such as infectious, inflammatory, autoimmune, and other rare diseases of non-genetic origin.

Cocoa powder/Dark chocolate

 Who would have thought chocolate would be among the heart-healthy foods? However, it's worth noting that only chocolates with a high cocoa content are heart-friendly, as cocoa powder is rich in flavonoids, bioactive compounds with anti-inflammatory and antioxidant properties, and also helps release nitric oxide, responsible for vasodilation and consequent blood pressure reduction.

An interesting fact about cocoa is that although the fruit is also rich in potassium and flavonoids, approximately 70% of the cocoa is discarded in traditional production, leaving only the beans used. Cocoa also increases the production of serotonin, responsible for well-being, and is high in magnesium, a mineral that helps combat depression, insomnia, and anxiety.

Garlic

 Garlic is rich in sulfur compounds, especially allicin, an active compound that acts as a potent antioxidant, bactericide, and anti-inflammatory.

Ana explains that studies indicate that regularly consuming large amounts of raw garlic (about three cloves per day) can help lower LDL cholesterol, promote vasodilation, and thus promote blood pressure control, reducing the risk of acute myocardial infarction.