Zusammenfassung der Ressource
Tonsillitis
- Pathophysiology
- A bacterial or viral infection that causes inflammation of the tonsils.
- Between 15 to 30% of pharyngotonsillitis is caused by bateria.
- Anaerobic bacteria usually causes bacterial tonsillitis. The majority of bacterial tonsillitis is caused by group A beta-hemolytic Streptococcus pyogenes (GABHS)
- GABHS adheres to the epithelium of the tonsils.
- Epidemiology
- Tonsillitis occures most often in children though it rare in children under 2.
- Tonsillitis caused by Strep usually occurs between the ages of 5-15, though viral tonsillitis is more common in younger children.
- Risk Factors
- Exposure to someone with tonsillitis.
- Sinusitis
- Alcohol use
- Smoking or exposure to secondary smoke
- Weaked immune system
- Clinical Presentation
- Fever, sore throat, foul breath
- Dysphagia (dificulty swallowing), odynophagia (painful swallowing)
- Tender/enlarged cervical lymph nodes
- Airway obstruction manifested as mouth breathing
- Lethargy and malaise
- Enlarged tonsils
- Tonsillar exudates, and leukocytosis
- Diagnosis
- Rapid Strep test and throat cultures
- Radiologic imaging of the lateral neck or CT scans with contrast for those with suspected spread to deep neck structures.
- Test family member is there is a presence of streptococcal antibodies, especially if family member is immunocompromised
- Adaptive Response
- Swollen/ tender cervical lymph nodes
- Fever
- Enlarged tonsils with exudate
- Treatment
- If not bacterial, treat symptoms.
- Encourage fluids, adequate caloric intake, pain and fever control.
- If bacterial, treat with antistreptococcal antibiotics like erythromycin, penicillin, and clindamycin.
- If tonsillitis is secondary to mononucleosis, corticosteroids may decrease duration of fever and pharyngitis.