Tonsillitis overview: Difference between revisions
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===Physical Examination=== | ===Physical Examination=== | ||
Tonsillitis is characterized by signs of red, swollen tonsils which may have a [[exudate|purulent exudative]] coating of white patches (i.e. [[pus]]). In addition, there may be enlarged and tender neck [[cervical lymph nodes]]. | Tonsillitis is characterized by signs of red, swollen tonsils which may have a [[exudate|purulent exudative]] coating of white patches (i.e. [[pus]]). In addition, there may be enlarged and tender neck [[cervical lymph nodes]]. | ||
===Laboratory Findings=== | |||
The diagnosis of [[GABHS]] [[tonsillitis]] can be confirmed by culture. Samples are obtained by swabbing both tonsillar surfaces and the posterior pharyngeal wall are plated on sheep blood agar medium. The isolation rate can be increased by incubating the cultures under anaerobic conditions and using selective media. | |||
==Treatment== | ==Treatment== | ||
Revision as of 21:15, 14 December 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]}
Overview
Tonsillitis is an infection of the tonsils and will often, but not necessarily, cause a sore throat and fever.
Classification
There are 3 main types of tonsillitis: acute, subacute and chronic. Acute tonsillitis can either be bacterial or viral (75%) in origin. Subacute tonsillitis (which can last between 3 weeks and 3 months) is caused by the bacterium Actinomyces. Chronic tonsillitis, which can last for long periods if not treated, is almost always bacterial.
Pathophysiology
Tonsillitis is associated with infection, it is currently unknown if the swelling and other symptoms are caused by the infectious agents themselves, or by the host immune response to these agents. Tonsillitis may be a result of aberrant immune responses to the normal bacterial flora of the nasopharynx.
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.
Diagnosis
History and Symptoms
Symptoms of tonsillitis include a severe sore throat (which may be experienced as referred pain to the ears), painful/ difficult swallowing, headache, fever and chills, and change in voice causing a "hot potato" voice.
Physical Examination
Tonsillitis is characterized by signs of red, swollen tonsils which may have a purulent exudative coating of white patches (i.e. pus). In addition, there may be enlarged and tender neck cervical lymph nodes.
Laboratory Findings
The diagnosis of GABHS tonsillitis can be confirmed by culture. Samples are obtained by swabbing both tonsillar surfaces and the posterior pharyngeal wall are plated on sheep blood agar medium. The isolation rate can be increased by incubating the cultures under anaerobic conditions and using selective media.
Treatment
Surgery
Chronic cases may indicate tonsillectomy (surgical removal of tonsils) as a choice for treatment[1]
References
- ↑ Paradise JL, Bluestone CD, Bachman RZ; et al. (1984). "Efficacy of tonsillectomy for recurrent throat infection in severely affected children. Results of parallel randomized and nonrandomized clinical trials". N. Engl. J. Med. 310 (11): 674–83. PMID 6700642. - Paradise studied 187 children with tonsillectomy or tonsillectomy and adenoidectomy. 91 children were randomly put in surgical and non-surgical groups. The other 96 were place by parent’s choice. The results favored the surgical group on reoccurrence of throat infections during their initial and second year follow-up where the data was collected. While non-surgical groups did better in the long run. 13 out of the 95 surgical group encountered surgical complications after their second year follow up