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{{Tonsillitis}}
{{Tonsillitis}}
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==Overview==
==Overview==
The most common causes of tonsillitis are [[adenovirus]], [[rhinovirus]], [[influenza]], [[coronavirus]], and [[respiratory syncytial virus]]. It can also be caused by [[Epstein-Barr virus|epstein-barr virus]], [[herpes simplex virus]], [[cytomegalovirus]], or [[HIV]]. The second most common causes are bacterial which may be caused by ''[[Group A streptococcal infection|group A streptococcal bacteria]]'',<ref name="pmid3601520">{{cite journal |author=Putto A |title=Febrile exudative tonsillitis: viral or streptococcal? |journal=[[Pediatrics]] |volume=80 |issue=1 |pages=6–12 |year=1987 |pmid=3601520 |doi= |issn=}}</ref> resulting in [[strep throat]].<ref name="pmid3601520">{{cite journal |author=Putto A |title=Febrile exudative tonsillitis: viral or streptococcal? |journal=[[Pediatrics]] |volume=80 |issue=1 |pages=6–12 |year=1987 |pmid=3601520 |doi= |issn=}}</ref>.  Sometimes, tonsillitis is caused by a [[superinfection]] of [[spirochaeta]] and [[treponema]], in this case called [[Trench mouth|Vincent's angina]] or Plaut-Vincent angina.<ref name="pmid1015288">{{cite journal |author=Van Cauwenberge P |title=[Significance of the fusospirillum complex (Plaut-Vincent angina)] |language=Dutch; Flemish |journal=Acta Otorhinolaryngol Belg |volume=30 |issue=3 |pages=334–45 |year=1976 |pmid=1015288 |doi=}} - fusospirillum complex (Plaut-Vincent angina) Van Cauwenberge studied the tonsils of 126 patients using direct microscope observation.  The results showed that 40% of acute tonsillitis was caused by Vincent’s agina and 27% of chronic tonsillitis was caused by Spirochaeta</ref>
==Causes==
===Life-Threatening Causes===
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
===Common Causes===
*[[Adenovirus]]
*[[Common cold]]
*[[Coronavirus]]
*[[Cytomegalovirus]]
*[[Epstein-Barr virus]]
*[[Group A streptococcus]]
*[[Herpes simplex virus]]
*[[Influenza]]
*[[Respiratory syncytial virus]]
*[[Rhinovirus]]
===Causes by Organ System===
{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" |'''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" |[[Obstructive sleep apnea]]
|-
|bgcolor="LightSteelBlue"| '''Chemical/Poisoning'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dental'''
|bgcolor="Beige"| [[Pericoronitis]], [[trench mouth]], [[Vincent's angina]]
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"| [[psoriasis|Guttate psoriasis]], [[hand-foot-and-mouth disease]], [[dermatoses|neutrophilic dermatoses]]
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|bgcolor="Beige"| [[Alemtuzumab]], [[carglumic acid]], [[cyclosporine]], [[formoterol]], [[fusidic acid|fusidic acid (ophthalmic)]], [[HPV Vaccine|human papillomavirus 9-valent vaccine]], [[montelukast]], [[natalizumab]], [[pimecrolimus]], [[secukinumab]], [[tobramycin]]
|-
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
|bgcolor="Beige"| [[Angina tonsillaris]], [[tonsil cancer]], [[tonsillolith]], [[trench mouth]], [[Vincent's angina]]
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"|[[Gastroesophageal reflux disease]]
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"| [[Adenovirus]], [[bordetella pertussis]], [[chlamydia pneumoniae]], [[common cold]], [[corynebacterium diphtheriae]], [[cytomegalovirus]],[[diphtheria]], [[enteroviruses]], [[Epstein-Barr virus]], [[fusobacterium necrophorum]], [[Group A streptococcal infection]], [[psoriasis|guttate psoriasis]],[[hand-foot-and-mouth disease]], [[herpes simplex ]], [[herpes simplex virus]], [[HIV]], [[infectious mononucleosis]], [[influenza ]], [[influenza virus]], [[Lemierre's syndrome]], [[measles]], [[mycoplasma pneumoniae]], [[neisseria gonorrhoeae]], [[parainfluenza viruses]], [[plague]], [[respiratory syncytial virus]], [[rhinovirus]], [[rubeola]], [[staphylococcus aureus]], [[streptococcus pneumoniae]], [[streptococcus pyogenes]], [[syphilis]], [[trench mouth]], [[treponema pallidum]], [[tuberculosis]], [[tularemia]], [[Vincent's angina]], [[yersinia pestis infection]]
|-
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal/Orthopedic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"|[[Obstructive sleep apnea]]
|-
|-bgcolor="LightSteelBlue"
| '''Nutritional/Metabolic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"| [[Malignancy]], [[tonsil cancer]]
|-
|-bgcolor="LightSteelBlue"
| '''Ophthalmologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Overdose/Toxicity'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"| [[Asthma]], [[bordetella pertussis]], [[common cold]], [[obstructive sleep apnea]], [[tuberculosis]]
|-
|-bgcolor="LightSteelBlue"
| '''Renal/Electrolyte'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Rheumatology/Immunology/Allergy'''
|bgcolor="Beige"|[[Allergies]]
|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"| No underlying causes
|-
|}
===Causes in Alphabetical Order===
{{columns-list|
*[[Adenovirus]]
*[[Alemtuzumab]]
*[[Allergies]]
*[[Angina tonsillaris]]
*[[Asthma]]
*[[Bordetella pertussis]]
*[[Carglumic acid]]
*[[Chlamydia pneumoniae]]
*[[Common cold]]
*[[Corynebacterium diphtheriae]]
*[[Cyclosporine]]
*[[Cytomegalovirus]]
*[[Diphtheria]]
*[[Enteroviruses]]
*[[Epstein-Barr virus]]
*[[Formoterol]]
*[[fusidic acid|Fusidic acid (ophthalmic)]]
*[[Fusobacterium necrophorum]]
*[[Gastroesophageal reflux disease]]
*[[Group A streptococcal infection]]
*[[psoriasis|Guttate psoriasis]]
*[[Hand-foot-and-mouth disease]]
*[[Herpes simplex ]]
*[[Herpes simplex virus]]
*[[HIV]]
*[[HPV Vaccine|Human papillomavirus 9-valent vaccine]]
*[[Infectious mononucleosis]]
*[[Influenza ]]
*[[Influenza virus]]
*[[Lemierre's syndrome]]
*[[Malignancy]]
*[[Measles]]
*[[Montelukast]]
*[[Mycoplasma pneumoniae]]
*[[Natalizumab]]
*[[Neisseria gonorrhoeae]]
*[[dermatoses|Neutrophilic dermatoses]]
*[[Obstructive sleep apnea]]
*[[Parainfluenza viruses]]
*[[Pericoronitis]]
*[[Pimecrolimus]]
*[[Plague]]
*[[Respiratory syncytial virus]]
*[[Rhinovirus]]
*[[Rubeola]]
*[[Secukinumab]]
*[[Staphylococcus aureus]]
*[[Streptococcus pneumoniae]]
*[[Streptococcus pyogenes]]
*[[Syphilis]]
*[[Tobramycin]]
*[[Tonsil cancer]]
*[[Tonsillolith]]
*[[Trench mouth]]
*[[Treponema pallidum]]
*[[Tuberculosis]]
*[[Tularemia]]
*[[Vincent's angina]]
*[[Yersinia pestis infection]]
}}


==Causes==
==Causes==
The most common causes of tonsillitis are [[adenovirus]], [[rhinovirus]], [[influenza]], [[coronavirus]], and [[respiratory syncytial virus]]. It can also be caused by [[Epstein-Barr virus]], [[herpes simplex virus]], [[cytomegalovirus]], or [[HIV]]. The second most common causes are bacterial.
===Bacterial causes===
*The most common bacterial cause is Group A β-hemolytic streptococcus ([[GABHS]]), which causes [[strep throat]]. Less common bacterial causes include: ''[[Staphylococcus aureus]]'' (including methicillin resistant Staphylococcus aureus or MRSA ),<ref>{{cite journal |last=Brook |first=I. |last2=Foote |first2=P. A. |title=Isolation of methicillin resistant ''Staphylococcus aureus'' from the surface and core of tonsils in children |journal=Int J Pediatr Otorhinolaryngol |year=2006 |volume=70 |issue=12 |pages=2099–2102 |pmid=16962178 |doi=10.1016/j.ijporl.2006.08.004 }}</ref>''[[Streptococcus pneumoniae]]'', ''[[Mycoplasma pneumoniae]]'', ''[[Chlamydia pneumoniae]]'', [[pertussis]], [[Fusobacterium]], [[diphtheria]], [[syphilis]], and [[gonorrhea]]. A concomitant GABHS and influenza A virus pharyngotonsillitis can occur, as was evident by an increased in the ASO and anti-DNase B titers in a third of the patients who had both of these organisms isolated.<ref>{{cite journal |last=Brook |first=I. |last2=Gober |first2=A. E. |title=Concurrent influenza A and group A beta-hemolytic streptococcal pharyngotonsillitis |journal=Ann Otol Rhinol Laryngol |year=2008 |volume=117 |issue=4 |pages=310–312 |doi= |pmid=18478842 }}</ref>
*The most common bacterial cause is Group A β-hemolytic streptococcus ([[GABHS]]), which causes [[strep throat]]. Less common bacterial causes include: ''[[Staphylococcus aureus]]'' (including methicillin resistant Staphylococcus aureus or MRSA ),<ref>{{cite journal |last=Brook |first=I. |last2=Foote |first2=P. A. |title=Isolation of methicillin resistant ''Staphylococcus aureus'' from the surface and core of tonsils in children |journal=Int J Pediatr Otorhinolaryngol |year=2006 |volume=70 |issue=12 |pages=2099–2102 |pmid=16962178 |doi=10.1016/j.ijporl.2006.08.004 }}</ref>''[[Streptococcus pneumoniae]]'', ''[[Mycoplasma pneumoniae]]'', ''[[Chlamydia pneumoniae]]'', [[pertussis]], [[Fusobacterium]], [[diphtheria]], [[syphilis]], and [[gonorrhea]]. A concomitant GABHS and influenza A virus pharyngotonsillitis can occur, as was evident by an increased in the ASO and anti-DNase B titers in a third of the patients who had both of these organisms isolated.<ref>{{cite journal |last=Brook |first=I. |last2=Gober |first2=A. E. |title=Concurrent influenza A and group A beta-hemolytic streptococcal pharyngotonsillitis |journal=Ann Otol Rhinol Laryngol |year=2008 |volume=117 |issue=4 |pages=310–312 |doi= |pmid=18478842 }}</ref>
*[[Anaerobic bacteria]] have been implicated in tonsillitis. These include pigmented [[Prevotella]] and Porphyromonas, [[Fusobacterium]] and [[actinomyces|Actinomyces spp.]] The possible role of anaerobes in the acute inflammatory process in the tonsils is supported by several clinical and scientific observations: anaerobes have been isolated from the cores of tonsils of children and adults with recurrent [[GABHS]] and non streptococcal tonsillitis,  and [[peritonsillar]]  and [[retropharyngeal]]  abscesses in many cases without any aerobic bacteria, their recovery as pathogens in well-established [[anaerobic infections]] of the tonsils ([[Vincent's angina]]), the increased recovery rate of encapsulated pigmented ''Prevotella'' and ''Porphyromonas'' spp. in acutely inflamed tonsils, and the response to antibiotics in patients with non streptococcal tonsillitis.<ref>{{cite journal |last=Brook |first=I. |title=The role of anaerobic bacteria in tonsillitis |journal=Int J Pediatr Otorhinolaryngol |year=2005 |volume=69 |issue=1 |pages=9-19 |doi=10.1016/j.ijporl.2004.08.007 |pmid=15627441 }}</ref>
*[[Anaerobic bacteria]] have been implicated in tonsillitis. These include pigmented [[Prevotella]] and Porphyromonas, [[Fusobacterium]] and [[actinomyces|Actinomyces spp.]] The possible role of anaerobes in the acute inflammatory process in the tonsils is supported by several clinical and scientific observations: anaerobes have been isolated from the cores of tonsils of children and adults with recurrent [[GABHS]] and non streptococcal tonsillitis,  and [[peritonsillar]]  and [[retropharyngeal]]  abscesses in many cases without any aerobic bacteria, their recovery as pathogens in well-established [[anaerobic infections]] of the tonsils ([[Vincent's angina]]), the increased recovery rate of encapsulated pigmented ''Prevotella'' and ''Porphyromonas'' spp. in acutely inflamed tonsils, and the response to antibiotics in patients with non streptococcal tonsillitis.<ref>{{cite journal |last=Brook |first=I. |title=The role of anaerobic bacteria in tonsillitis |journal=Int J Pediatr Otorhinolaryngol |year=2005 |volume=69 |issue=1 |pages=9-19 |doi=10.1016/j.ijporl.2004.08.007 |pmid=15627441 }}</ref>
* Viral tonsillitis may be caused by numerous viruses<ref name="pmid3601520">{{cite journal |author=Putto A |title=Febrile exudative tonsillitis: viral or streptococcal? |journal=[[Pediatrics]] |volume=80 |issue=1 |pages=6–12 |year=1987 |pmid=3601520 |doi= |issn=}}</ref> such as the [[Epstein-Barr virus]]<ref name="pmid3601520">{{cite journal |author=Putto A |title=Febrile exudative tonsillitis: viral or streptococcal? |journal=[[Pediatrics]] |volume=80 |issue=1 |pages=6–12 |year=1987 |pmid=3601520 |doi= |issn=}}</ref> (the cause of [[infectious mononucleosis]])<ref name="pmid12452866">{{cite journal |author=Renn CN, Straff W, Dorfmüller A, Al-Masaoudi T, Merk HF, Sachs B |title=Amoxicillin-induced exanthema in young adults with infectious mononucleosis: demonstration of drug-specific lymphocyte reactivity |journal=Br. J. Dermatol. |volume=147 |issue=6 |pages=1166–70 |year=2002 |pmid=12452866 |doi=10.1046/j.1365-2133.2002.05021.x}} -Renn studied 4 patients who where treated amoxicillin for throat infection and lymphadenopathy.  Infectious mononucleosis was present in the patient’s blood due to trace of Epstein-Barr antibodies.  The three tests performed where the patched test, intracutaneous test, and lymphocyte transformation test.  The results of the patched test that pointed to amoxicillin as the caused of their rash were 1 out of 4 patients.  The intracutaneous showed 2 out of 4 patients with positive results that pointed to amoxicillin.  The LTT results showed 3 out of 4 that pointed to amoxicillin</ref> or the [[Adenovirus]].<ref name="pmid3601520">{{cite journal |author=Putto A |title=Febrile exudative tonsillitis: viral or streptococcal? |journal=[[Pediatrics]] |volume=80 |issue=1 |pages=6–12 |year=1987 |pmid=3601520 |doi= |issn=}}</ref>
* Drugs like [[Tobramycin]], [[Secukinumab]]


==References==
==References==
{{Reflist|2}}


{{Reflist|2}}
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Latest revision as of 00:25, 30 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ogheneochuko Ajari, MB.BS, MS [2] Luke Rusowicz-Orazem, B.S.

Overview

The most common causes of tonsillitis are adenovirus, rhinovirus, influenza, coronavirus, and respiratory syncytial virus. It can also be caused by epstein-barr virus, herpes simplex virus, cytomegalovirus, or HIV. The second most common causes are bacterial which may be caused by group A streptococcal bacteria,[1] resulting in strep throat.[1]. Sometimes, tonsillitis is caused by a superinfection of spirochaeta and treponema, in this case called Vincent's angina or Plaut-Vincent angina.[2]

Causes

Life-Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Common Causes

Causes by Organ System

Cardiovascular Obstructive sleep apnea
Chemical/Poisoning No underlying causes
Dental Pericoronitis, trench mouth, Vincent's angina
Dermatologic Guttate psoriasis, hand-foot-and-mouth disease, neutrophilic dermatoses
Drug Side Effect Alemtuzumab, carglumic acid, cyclosporine, formoterol, fusidic acid (ophthalmic), human papillomavirus 9-valent vaccine, montelukast, natalizumab, pimecrolimus, secukinumab, tobramycin
Ear Nose Throat Angina tonsillaris, tonsil cancer, tonsillolith, trench mouth, Vincent's angina
Endocrine No underlying causes
Environmental No underlying causes
Gastroenterologic Gastroesophageal reflux disease
Genetic No underlying causes
Hematologic No underlying causes
Iatrogenic No underlying causes
Infectious Disease Adenovirus, bordetella pertussis, chlamydia pneumoniae, common cold, corynebacterium diphtheriae, cytomegalovirus,diphtheria, enteroviruses, Epstein-Barr virus, fusobacterium necrophorum, Group A streptococcal infection, guttate psoriasis,hand-foot-and-mouth disease, herpes simplex , herpes simplex virus, HIV, infectious mononucleosis, influenza , influenza virus, Lemierre's syndrome, measles, mycoplasma pneumoniae, neisseria gonorrhoeae, parainfluenza viruses, plague, respiratory syncytial virus, rhinovirus, rubeola, staphylococcus aureus, streptococcus pneumoniae, streptococcus pyogenes, syphilis, trench mouth, treponema pallidum, tuberculosis, tularemia, Vincent's angina, yersinia pestis infection
Musculoskeletal/Orthopedic No underlying causes
Neurologic Obstructive sleep apnea
Nutritional/Metabolic No underlying causes
Obstetric/Gynecologic No underlying causes
Oncologic Malignancy, tonsil cancer
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary Asthma, bordetella pertussis, common cold, obstructive sleep apnea, tuberculosis
Renal/Electrolyte No underlying causes
Rheumatology/Immunology/Allergy Allergies
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Miscellaneous No underlying causes

Causes in Alphabetical Order

Causes

References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 Putto A (1987). "Febrile exudative tonsillitis: viral or streptococcal?". Pediatrics. 80 (1): 6–12. PMID 3601520.
  2. ↑ Van Cauwenberge P (1976). "[Significance of the fusospirillum complex (Plaut-Vincent angina)]". Acta Otorhinolaryngol Belg (in Dutch; Flemish). 30 (3): 334–45. PMID 1015288. - fusospirillum complex (Plaut-Vincent angina) Van Cauwenberge studied the tonsils of 126 patients using direct microscope observation. The results showed that 40% of acute tonsillitis was caused by Vincent’s agina and 27% of chronic tonsillitis was caused by Spirochaeta
  3. ↑ Brook, I.; Foote, P. A. (2006). "Isolation of methicillin resistant Staphylococcus aureus from the surface and core of tonsils in children". Int J Pediatr Otorhinolaryngol. 70 (12): 2099–2102. doi:10.1016/j.ijporl.2006.08.004. PMID 16962178.
  4. ↑ Brook, I.; Gober, A. E. (2008). "Concurrent influenza A and group A beta-hemolytic streptococcal pharyngotonsillitis". Ann Otol Rhinol Laryngol. 117 (4): 310–312. PMID 18478842.
  5. ↑ Brook, I. (2005). "The role of anaerobic bacteria in tonsillitis". Int J Pediatr Otorhinolaryngol. 69 (1): 9–19. doi:10.1016/j.ijporl.2004.08.007. PMID 15627441.
  6. ↑ Renn CN, Straff W, Dorfmüller A, Al-Masaoudi T, Merk HF, Sachs B (2002). "Amoxicillin-induced exanthema in young adults with infectious mononucleosis: demonstration of drug-specific lymphocyte reactivity". Br. J. Dermatol. 147 (6): 1166–70. doi:10.1046/j.1365-2133.2002.05021.x. PMID 12452866. -Renn studied 4 patients who where treated amoxicillin for throat infection and lymphadenopathy. Infectious mononucleosis was present in the patient’s blood due to trace of Epstein-Barr antibodies. The three tests performed where the patched test, intracutaneous test, and lymphocyte transformation test. The results of the patched test that pointed to amoxicillin as the caused of their rash were 1 out of 4 patients. The intracutaneous showed 2 out of 4 patients with positive results that pointed to amoxicillin. The LTT results showed 3 out of 4 that pointed to amoxicillin

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