THROAT - Tonsillitis

What is tonsillitis?

Infection of the tonsils is one of the most common pathology in the oral cavity. Depending on the time period and recurrence of the infection, tonsillitis is divided into:

  • Acute tonsillitis
  • Chronic tonsillitis

About Acute tonsillitis:

It is an acute infection of the tonsils often accompanied by fever, malaise and sore throat.

What are the predisposing factors for acute tonsillitis?

  • Ingestion of cold or infected food stuff
  • Low immunity and resistance
  • Upper respiratory tract infection
  • Pollution and ill-ventilated environment
  • Close contact with infected persons
  • Residual tonsillar tissue left post-tonsillectomy

What are the common causative organisms for acute tonsillitis?

Most common organism hemolytic streptococcus, haemophilus and anaerobic organism. Viruses such as influenza, para influenza, adenoviruses and rhinoviruses also infect the tonsils.

What are the different types of Acute tonsillitis:

  • Acute follicular tonsillitis
  • Acute parenchymatous tonsillitis
  • Acute membranous tonsillitis

What are the symptoms of acute tonsillitis?

  • Throat pain is acute, especially on swallowing
  • High grade fever, malaise with tachycardia
  • Enlarged and tender jugulodigastric lymph nodes
  • Voice may be changed due to accumulation of saliva
  • Referred pain to the ear via the glossopharyngeal nerve

What are the signs seen on examination in acute tonsillitis?

  • Both tonsils are congested and swollen with accumulation of pus in the tonsillar crypts
  • Pharyngitis is usually present
  • Foul breath may be present
  • Patient makes efforts to restrict the movement of the soft palate and tongue

What is the treatment of acute tonsillitis?

Local:

  • Antiseptic Gargles
  • Steam Inhalation

General:

  • Bed rest
  • Plenty of fluids

Systemic:

  • I.V Antibiotics
  • Analgesics
  • Multivitamins

What are the complications of acute tonsillitis?

  • Quinsy (peritonsillar abscess)
  • Parapharyngeal abscess
  • Respiratory obstruction
  • Septicemia
  • Rarely mediastinitis due to rapid spread of infection in the neck

About Chronic tonsillitis:

Chronic tonsillitis is caused by recurrent attacks of acute tonsillitis.

What are the causes of chronic tonsillitis?

Causes of chronic tonsillitis are similar to acute tonsillitis.

What are the symptoms of chronic tonsillitis?

  • Recurrent throat pain, fever
  • Recurrent upper respiratory tract infection
  • Enlarged Cervical lymph nodes

What are the signs of chronic tonsillitis?

  • Tonsils are hypertrophied and fibrotic
  • On pressing the tonsil, cheesy material can be seen
  • Enlarged, non tender, jugulodigastric lymph nodes

What is the treatment of chronic tonsillitis?

  • Nutritious and high protein diet
  • Antibiotics, analgesics, antiseptic gargles
  • Tonsillectomy for recurrent attacks


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