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Dr. Angelo Smith M.D WHPL Tonsillitis

Tonsillitis :

Tonsillitis Inflammation or infection of the tonsils is medically termed as Tonsillitis. Tonsils are protective (lymph) glands that are situated on both sides in the throat. The tonsils constitute an important part of the body's immune system and are vital defense organs. They protect the body from bacteria and viruses by fighting these as soon as they enter the body (via the oral / nasal cavity).

Anatomy :

Anatomy In the normal state, tonsils are pink in color (similar to their surroundings tissues) and about the same size. The tonsils along with adenoids are said to form the 'first line of defense' against infective organisms.


Pathology When the tonsils get inflamed, they become red, swollen and may develop pus pockets that start exuding a discharge. In cases with recurrent infections, the tonsils may become so swollen over a period of time so as to almost touch each other. Tonsillitis is very common amongst children. No particular gender predilection is seen in cases of tonsillitis.


Causes Bacterial and viral infections can cause tonsillitis through droplet infection. A common cause is Streptococcus bacteria. Other common causes include: Adenoviruses Influenza virus Epstein-Barr virus Parainfluenza viruses Enteroviruses Herpes simplex virus

Triggering Factors:

Triggering Factors Foods with artificial colors and preservatives. Peanuts. Cold foods, cold drinks, Ice creams. Changes of weather. Extremely cold climate, Damp weather. Exposure to a lot of pollution. Sour fruits, lemon, pineapple, grapes, oranges.


Signs Red and swollen tonsils White spots (specks or patches) on the tonsils Enlarged lymph nodes in neck region Bad and foul breath Cough Running Nose


Symptoms Soreness of throat Difficulty in swallowing or painful swallowing of food and drinks Pain / discomfort while swallowing saliva Change of voice Pain in the ears (due to common nerve supply of the back of the throat and ears) Headache Malaise, tiredness Difficulty in taking feeds in babies - this may be the sole indicator in some cases of tonsillitis in infants

Catarrhal tonsillitis:

Catarrhal tonsillitis When tonsils are inflamed as part of the generalised infection of the oropharyngeal mucosa it is called catarrhal tonsillitis .

Membranous tonsillitis:

Membranous tonsillitis Some times exudation from crypts may coalesce to form a membrane over the surface of tonsil, giving rise to clinical picture of membranous tonsillitis .

Parenchymatous tonsillitis :

Parenchymatous tonsillitis When the whole tonsil is uniformly congested and swollen it is called acute parenchymatous tonsillitis


Diagnosis Examination of the throat in tonsillitis: Redness and swelling of the tonsils Pus pockets on the tonsils Discharge from the tonsils In case of peritonsillar abscess, there may be a shift of the involved tonsil towards the center of the throat. The uvula may be shifted towards the opposite side (away from the affected tonsil).


Diagnosis Throat swab : This is used to get a sample of the secretion from the back of the throat. Monospot test : A blood test can detect certain antibodies, which can help confirm that a person’s symptoms are due to mononucleosis. Epstein-Barr virus antibodies : If a monospot test is negative, antibodies in the blood against EBV might help diagnose mononucleosis. Blood tests : This primarily includes a complete blood count (CBC) which is done to confirm the presence of infection.

Complications :

Complications Local: Severe swelling with spread of infection and inflammation to the hypopharynx and larynx may occasionally produce increasing respiratory obstruction, although it is very rare in uncomplicated acute tonsillitis.


Complications Peritonsillar abscess is one of the complications of acute tonsillitis and its development means that infection has spread outside tonsillar capsule. Spread of infection from tonsil or more usually from a peritonsillar abscess through the superior constrictor muscle of the pharynx first results in cellulitis of the neck and later in parapharyngeal space abscess.

PowerPoint Presentation:

The systemic or general complications of acute tonsillitis are rare and almost confined to childhood. Septicemia : Untreated acute tonsillitis can result in septicemia with septic abscesses, septic arthritis and meningitis

Allopathic Treatment:

Allopathic Treatment Acetaminophen & Ibuprufen are given for relieving the symptoms. Antibiotics are prescribed once bacterial infection is confirmed. Tonsillectomy – For those children's who do not repond to antibiotics Quinsy - It is usually treated by draining the abscess and antibiotics. Sometimes removing the tonsils is needed to treat quinsy.


Prevention Avoid close contact with others who are sick. Keep children away from kids who are known to have tonsillitis or a sore throat. Remind kids about the importance of proper hand-washing, especially when around people who appear to be sick. Wash and disinfect surfaces and toys. Teaching kids to cover their mouths when coughing or sneezing, preferably using a tissue so that germs do not get on their hands. And show them how to use tissues to wipe their noses. Carry disposable wipes and a hand sanitizer to clean hands

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