“If this blog helped you out, don’t keep it to yourself—share the link on your socials!” 👍 “Like what you read? Spread the love and share this blog on your social media.” 👍 “Found this useful? Hit share and let your friends know too!” 👍 “If you enjoyed this post, please share the URL with your friends online.” 👍 “Sharing is caring—drop this link on your social media if it helped you.”

Sunday, August 10, 2025

Tonsillitis


Definition
Tonsillitis is an acute or chronic inflammation of the palatine tonsils, most often due to viral or bacterial infection, causing sore throat and pharyngeal discomfort.

Causes

Viral (most common)

  • Adenovirus

  • Rhinovirus

  • Epstein–Barr virus (EBV – infectious mononucleosis)

  • Influenza virus

  • Parainfluenza virus

Bacterial

  • Group A β-haemolytic streptococcus (Streptococcus pyogenes) – most common bacterial cause

  • Group C or G streptococci

  • Neisseria gonorrhoeae (rare, sexually acquired)

  • Corynebacterium diphtheriae (rare, in unvaccinated)

Risk Factors

  • Age 5–15 years (most common)

  • Close contact in schools, dormitories

  • Exposure to individuals with pharyngitis

  • Immunosuppression

Clinical Features

Symptoms

  • Sore throat, odynophagia (pain on swallowing)

  • Fever

  • Malaise, fatigue

  • Earache (referred pain)

Signs

  • Enlarged, erythematous tonsils ± exudates (white/yellow patches)

  • Tender anterior cervical lymphadenopathy

  • Halitosis

  • Palatal petechiae (in streptococcal infection)

  • In EBV: hepatosplenomegaly, diffuse lymphadenopathy

Complications

Suppurative

  • Peritonsillar abscess (quinsy)

  • Retropharyngeal abscess

  • Otitis media, sinusitis

Non-suppurative (post-streptococcal)

  • Rheumatic fever

  • Post-streptococcal glomerulonephritis

  • Scarlet fever

Diagnosis

  • Clinical evaluation

  • Centor or FeverPAIN criteria to assess probability of Group A streptococcus (GAS) infection

  • Throat swab with rapid antigen detection test (RADT) or culture (if GAS suspected)

  • Monospot test / EBV serology if infectious mononucleosis suspected

Treatment

General measures

  • Rest, hydration, warm saline gargles

  • Analgesia/antipyretics: paracetamol or ibuprofen

Antibiotics (for confirmed/suspected bacterial tonsillitis with high Centor/FeverPAIN score)

  • Phenoxymethylpenicillin (penicillin V):

    • Adults: 500 mg orally every 6–12 hours for 10 days

    • Children: 12.5–25 mg/kg/dose every 6–12 hours (max 500 mg/dose) for 10 days

  • Amoxicillin: not recommended if EBV suspected (causes rash)

  • Penicillin allergy: clarithromycin or azithromycin for 5 days

Recurrent/severe cases

  • Consider tonsillectomy if ≥7 episodes/year, ≥5/year for 2 years, or ≥3/year for 3 years

Prognosis

  • Most cases resolve in 3–7 days with supportive care

  • Antibiotics shorten duration slightly in bacterial cases and reduce complications



on

No comments:

Post a Comment

Subscribe to: Post Comments (Atom)