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Chronic tonsillitis is one of the most common pathologies of the lymphoepithelial pharyngeal ring. The main pathogen in chronic tonsillitis and its complications is group a β-hemolytic Streptococcus A (BGSA). This pathogen is detected in 30–60% of patients. At the present stage, the role of latent viral infections (Epstein – Barr virus (EBV), cytomegalovirus (CMV)) in the formation of chronic tonsillitis in children has been proven. Treatment of frequently ill children with pathology of the pharyngeal lymphoid ring remains an urgent and widely discussed issue. Depending on the etiology and clinical form of chronic tonsillitis (simple, toxicallergic form (TAF I or II), the choice is between conservative methods and radical surgical treatment. Surgical treatment of chronic tonsillitis in children is recommended only if there are absolute indications. To standard methods of conservative treatment, such as sanation of lacunae of the tonsils with antiseptic solutions, the appointment of physiotherapy, funds for the correction of systemic and local immunity are actively used. In Pediatrics, the safe and optimal complex of effects of the herbal medicinal product Tonsilgon N is widely used. Based on the analysis of clinical observations of frequently ill children with chronic tonsillitis, the effectiveness of the herbal medicine Tonsilgon H (in monotherapy mode) was revealed. As a result, the expediency of using the drug Tonsilgon H in the treatment of compensated forms of chronic tonsillitis in frequently and long-term ill children was established. There was a significant decrease in the frequency of acute respiratory infections and, consequently, the risk of transition to a decompensated form of chronic tonsillitis.

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The aim of study was to assess the diagnostic value of ultrasound diagnostics of chronic lymphoproliferative syndrome in the young children. 88 children aged 2–3 years with pathology of the lymphadenoid ring of the pharynx, accompanied by regional cervical lymphadenitis, needing surgery were examined. Endoscopy of the nasopharynx, otomicroscopy, impedance, ultrasound examination of cervical and submandibular lymph nodes, abdominal organs, complete blood count with a manual differential, ELISA to determine specific IgM, IgG to cytomegalovirus (CMV) antigens, to human herpes virus type 6 (HCV-6) antigens, to nuclear, viral capsid and early antigens complex Epstein – Barr virus (EBV), PCR in scrapes from the oropharyngeal mucosa and blood were performed. The patients were divided into two groups: group I with pronounced lymphadenopathy (lymph nodes conglomerates 31×13 mm in size or multiple) (n = 32), group II with moderate lymphadenopathy (single symmetrical painless lymph nodes less than 16 mm in size) (n =  56). In the group I, the following were statistically significant more frequent: snore and sleep apnea (Fisher's exact test, p < 0,001, odds ratio (OR) 13,00, 95% confidence interval (CI) 4,439–38,07); manifestations of asthenic vegetative and intoxication syndromes (p < 0,001, OR 7,80, CI 2,248–27,06); ultrasound signs of hepatic splenic syndrome (p < 0,001, OR 34,71, CI 7,185–167,7); serological markers of contamination and active stages EBV infection (p < 0,001, OR 16,71, CI 4,673–55,27); markers of mixt EBV + CMV + HHV-6 infections (p < 0,001, OR 16,20, CI 3,327–78,87), compared to the group II. Regional cervical lymphadenitis with lymph nodes diameter more than 16 mm on ultrasound was a sign of pronounced chronic lymphoproliferative syndrome in the young children, in which half were found to have markers of the EBV infection active stage. The development of pronounced cervical lymphadenitis is associated with hepatic splenic syndrome, usually caused by the herpesvirus infections reactivation.