| ID | 296 |
|---|---|
| Name | ACUTE TONSILLITIS |
| Cause | Tonsillitis is most often caused by common viruses, but bacterial infections also can be the cause. The most common bacterium causing tonsillitis is Streptococcus pyogenes (group A streptococcus), the bacterium that causes strep throat. Other strains of strep and other bacteria also may cause tonsillitis |
| Signs Symptoms | Red, swollen tonsils. White or yellow coating or patches on the tonsils. Sore throat. Difficult or painful swallowing. Fever. Enlarged, tender glands (lymph nodes) in the neck. A scratchy, muffled or throaty voice. Bad breath. |
| Diagnosis | Examine throat for redness and swelling. other symptoms you've had, like a fever, cough, runny nose, rash or stomachache. ... Look in ears and nose for other signs of infection. |
| Investigations | Investigation: 1. Throat swab-C/S 2. Blood for T.C, D.C, E.S.R. Differntial diagnosis: 1. Diptheria. 2. Vincent’s angina (sloughy ulcer on tonsil, presence of dental sepsis, smear confirms) 3. Agranulocytosis (neutropenia + ulcer of pharynx & oral cavity) 4. Glandular fever (ulcer on tonsil and pharyn)- lymphocytic leucocytosis and positive Paul-Bunnel test. 5. Thrush (multiple white dots on pharynx and oral cavity, culture confirms). 6. Keratosis pharyngis- multiple yellowish white elongated keratinized masses- project from near the crypt of tonsillar lymphoid tissue, base of the tongue, posterior pharyngeal wall. |
| Management | Management: 1. Antibiotic- Injection cryst. penicillin 5 lacs i.m twice daily or phenoxymethyl penicillin 250mg orally 6-hourly for 5-7 days may be given. Or, erythromycin 500mg 6-8 hourly for 7 days. 2. For pain and temperature- paracetamol 500mg thrice daily. Or, soluble aspirin 300mg t.d.p.c. 3. Warm water gurgling, mouth wash with saline water or NaHCO3. 4. For constipation- milk of magnesia 1 tsf thrice daily. 5. Soft diet & vitamin- C is given. |
| Introduction | This is generalised inflammation of he faucial tonsils & is caused by B-hemolytic streptococcus, virus, staph. & pneumococcus. |
| History | |
| Etiology | Tonsillitis is most often caused by common viruses, but bacterial infections also can be the cause. The most common bacterium causing tonsillitis is Streptococcus pyogenes (group A streptococcus), the bacterium that causes strep throat. Other strains of strep and other bacteria also may cause tonsillitis |
| Clinical Features | Clinical features: Symptoms: 1. Sore throat, difficulty in swallowing, refuse food. 2. Fever, cold cough, pain in the throat & ear. 3. Malaise, headache, constipation etc.’ Signs: 1. Temp. 103-104°F. 2. The tonsils are enlarged & congested. 3. Whitish membrane on the tonsil, pus on sneez-ing, foul smelling, cervical lymphnodes are enlarged, and tender. |
| Preventions | Wash his or her hands thoroughly and frequently, especially after using the toilet and before eating. Avoid sharing food, drinking glasses, water bottles or utensils. Replace his or her toothbrush after being diagnosed with tonsillitis. |
| Treatment | At-home care Whether tonsillitis is caused by a viral or bacterial infection, at-home care strategies can make your child more comfortable and promote better recovery. If a virus is the expected cause of tonsillitis, these strategies are the only treatment. prescribe antibiotics. At-home care strategies to use during the recovery time include the following: Encourage rest. Encourage your child to get plenty of sleep. Provide adequate fluids. Give your child plenty of water to keep his or her throat moist and prevent dehydration. Provide comforting foods and beverage. Warm liquids — broth, caffeine-free tea or warm water with honey — and cold treats like ice pops can soothe a sore throat. Prepare a saltwater gargle. If your child can gargle, a saltwater gargle of 1/2 teaspoon (2.5 milliliters) of table salt to 8 ounces (237 milliliters) of warm water can help soothe a sore throat. Have your child gargle the solution and then spit it out. Humidify the air. Use a cool-air humidifier to eliminate dry air that may further irritate a sore throat, or sit with your child for several minutes in a steamy bathroom. Offer lozenges. Children older than age 4 can suck on lozenges to relieve a sore throat. Avoid irritants. Keep your home free from cigarette smoke and cleaning products that can irritate the throat. Treat pain and fever. Talk to your doctor about using ibuprofen (Advil, Children's Motrin, others) or acetaminophen (Tylenol, others) to minimize throat pain and control a fever. Low fevers without pain do not require treatment. Antibiotics If tonsillitis is caused by a bacterial infection, prescribe a course of antibiotics. Penicillin taken by mouth for 10 days is the most common antibiotic treatment prescribed for tonsillitis caused by group A streptococcus. If your child is allergic to penicillin, prescribe an alternative antibiotic such as mascrolides. |
| Complications | Complications: 1. Peritonsillar abscess. 2. Parapharyngeal & retro-pharyngeal abscess. 3. Septicemia. 4. Acute rheumatism, acute nephritis etc. |
| Prognosis | ys with fluids and plenty of rest. Antibiotics typically eliminate bacterial tonsillitis in about 10 days. Tonsillitis usually doesn't cause any serious or lasting health problems |
| Types | |
| Classification | |
| Observation | |
| Pathology | Pathologically, the acute tonsillitis usually takes a form of an exudative inflammation, which may be catarrhal, vesiculous, purulent, pseudomembranous, or gangrenous. In the clinical practice, the most frequent is the acute purulent tonsillitis |
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