Tonsillitis

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Tonsillitis is an inflammation of the tonsils ( A small, rounded mass of lymphoid tissue mainly found on the upper rear wall of the mouth cavity, they are of fair size in childhood but usually shrink after puberty ) characterized by sore throat, difficulty swallowing and fever caused by virus and bacteria.

What causes the tonsillitis?

Tonsillitis is caused by:

1. Common cold viruses including adenovirus, influenza , coronavirus, rhinovirus, respiratory syncytial virus.

2. Other viruses including herpes simplex virus, Epstein-Barr virus, cytomegalovirus and HIV.

3. Bacterial infection includes Group A beta-hemolytic streptococcus , staphylococcus aureus, streptococcus pneumoniae, chlamydia pneumoniae, pertussis, diphtheria and gonorrhea.

What are the signs and symptoms of tonsillitis?

1. Sore throat
2. Difficulty in swallowing
3. Pain during swallowing
4. Red, swollen tonsils
5. White or yellow patches on the tonsils
6. Cough
7. Runny nose
8. Nasal congestion
9. Redness of eyes
10. Fever
11. Headache
12. Nausea and vomiting
13. Bad breath
14. Stiff neck
15. Hoarseness
16. Refusal to eat
17. Rash

What are the complications of tonsillitis?

1. Difficulty in breathing
2. Tonsillar abscess( collection of pus behind a tonsil)
3. Peritonsillar abscess( quinsy)
4. Rheumatic fever
5. Post-streptococcal glomerulonephritis
6. Septicemia

How is a tonsillitis diagnosed ?

Diagnosis relies on history , physical examination and laboratory tests.

Laboratory tests includes:

1. Complete blood test
2. Throat swab and culture
3. Rapid strep test
4. Mononucleosis test

How is a tonsillitis managed?

1. Plenty of rest
2. Plenty of fluids
3. Avoid smoking , alcohol and caffeine
4. Gargle with saltwater
5. Ibuprofen or acetaminophen (paracetamol) is used to control a fever and decreased throat pain .
6. Penicillin with the dosage of ( 250 mg two or three times a day for children and 500mg two or there times a day for adults for 10 days) is the first line treatment for bacterial tonsillitis . People who are allergic to penicillin erythromycin or azithromycin is used.
7. Surgical removal of tonsil( tonsillectomy ) is indicated who have recurring tonsillitis, chronic tonsillitis, obstructed sleep apnea , dyspnea and peritonsillar abscess that refuse to respond to the antibiotic treatment.

What is the prognosis of tonsillitis?

Prognosis is excellent with early treatment .

References:

• http://www.emedicinehealth.com
• http://en.wikipedia.org
• http://www.mayoclinic.com
• http://www.medicinenet.com
• http://www.ncbi.nlm.nih.gov
• http://www.netdoctor.co.uk
• Harrison’s Principles of Internal Medicine, 17^th edition.
• Davidson’s Principles and Practice of Medicine, 20th Edition

Filed Under: Medicine

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