Tonsillitis is a type of pharyngitis characterized by the inflammation of the tonsils.
It is commonly referred as tonsils by the general population.
SIGNS & SYMPTOMS OF TONSILLITIS
- Sore throat
- Red & swollen tonsils
- White pus filled spots on the tonsils
- High fever
- Fatigue
- Chills
- Headache
- Pain in swallowing
- Difficulty in swallowing
- Malaise
- Difficulty falling asleep
- Swollen lymph nodes
- Nausea & vomiting
- Pain in the ear or neck
- Weight loss
- Anxiety/fear of choking
- Bad breath.
COMPLICATIONS
- Dehydration
- Blocked airways due to inflammation
- Pharyngitis
- Peritonsillar abscess, developed lateral to the tonsils
- Lemierre’s Syndrome, infection & inflammation of the internal jugular vein which can lead to sepsis
- Inability to swallow anything
- In strep throat associated with tonsillitis very rarely diseases like rheumatic fever or glomerulonephritis can occur.
- Untreated strep throat related to tonsillitis can lead to pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS).
CAUSES OF TONSILLITIS
Virus
- Adeno virus
- Rhino virus
- Influenza virus
- Corona virus
- Parainfluenza
- Epstein Barr Virus
- HIV
- Herpes simplex virus
- Cytomegalovirus
- Respiratory syncytial virus
Bacteria
- Group A β-hemolytic streptococcus (GABHS)
- Staphylococcus aureus
- Streptococcus pneumoniae
- Mycoplasma pneumoniae
- Chlamydia pneumoniae
- Bordetella pertussis
- Spirochaeta
DIAGNOSIS
- Physical symptoms like swollen tonsils, swelling of the lymph nodes in the neck, presence of exudate, sore throat, inability to swallow & fever are noted.
- For the detection of the particular bacterial strain causing the infection, a bacterial culture stain is produced by a throat swab test.
- An increase in antistreptolysin O (ASO) streptococcal antibody titer 3–6 weeks following the acute infection can provide definitive confirmation of GABHS infection.
- Lymphocyte count in a full blood test is done for detection of Epstein Barr Virus.
- Increased values of secreted phospholipase A2 & altered fatty acid metabolism in patients with tonsillitis is identified and provides a positive diagnostic approach.
- Nasoendoscopy in patients with severe neck pain and inability to swallow food, for differential diagnosis of masked epiglottis & supraglotitis.
TREATMENT FOR TONSILLITIS
- Antibiotics like;
- Penicillin
- Amoxicillin-Clavulanic acid
- Clindamycin
- Azithromycin
- Erythromycin
- Cephalosporins like cefixime
- IV antibiotics
- Pain medications/NSAIDs like ibuprofen
- Drugs for fever like paracetamol
- Opioid drugs like codeine & tramadol
- Anesthetic mouthwash
- Corticosteroids to reduce inflammation
- Chronic cases can involve surgical removal of the tonsils: Tonsillectomy
MANAGEMENT
- Warm water gargles
- Lozenges
- Honey
- Management of bacterial infections.