Tonsillitis

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Tonsillitis is a common condition that can cause a great deal of misery.

Contents

Aetiology

  • Common disease
  • Most frequent in childhood

Pathology

Clinical assessment

  • Usually a prodromal illness with pyrexia, malaise
  • Sore throat
  • Pain may radiate to the ears (otalgia) or to the neck
  • Swallowing painful (odynophagia)
  • Occasionally trismus due to pterygoid plate irritation
  • Tonsils are found to be hyperaemic
  • Often enlarged
  • Tonsillary crypts are filled with yellow discharge
  • Cervical lymphadenopathy

Management

Indications to refer a case of tonsillitis to ENT

  • Patient unable to swallow liquids
  • Does not respond to antibiotics
  • Abscess formation

Usual management is IV antibiotics, usually cefuroxime and metronidazole along with IV fuid replacement and analgesia. Some advocate the use of steroids.

Complications

Local

  • Abscess formation
    • Peritonsillary (quinsy)
    • Parapharyngeal
    • Retropharyngeal
  • Acute otitis media
  • Recurrent acute tonsillitis

General

Differential diagnosis

There are several other conditions that can cause an inflamed or ulcerated tonsil.

Infection

Neoplasm

Blood diseases

Other causes

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