KENYA METHODIST UNIVERSITY

SCHOOL OF MEDICINE AND HEALTH SCIENCES

DEPARTMENT OF NURSING

NAME: DANIEL WACHIRA

REG. NO: BSN-1-8217-2/2017

UNIT CODE: NRSG 429

UNIT TITLE: SPECIAL CONDITIONS NURSING (CLINICALS) CASE STUDY

TITLE: TONSILLITIS

LECTURER: MR. MOSES MUTUA

DATE OF SUBMISSION: 02 /08/2021.

PRELIMINARY
This clinical rotation was conducted in the Coast Provisional Referral and Training Hospital, in
Mombasa County. It is a referral hospital in the Coast region. Special conditions rotation started
from 4th July 2021 to 30th July 2021. Below is a report about the history of how this
hospital was established since 1908 to date.
Coast Provisional Referral and Training Hospital
VISION
To be a centre of excellence offering quality health service to the people of the coast
region and beyond.
MISSION
To offer curative, preventive, rehabilitative and conduct continuous training programme
To take head in comprehensive care intervention.
To foster collaboration in areas of affordable specialized medical care and medical research.
BACKGROUND
The Coast Provisional Referral and Training Hospital was founded in 1908 as the native civil
hospital in Makadara area within Mombasa Island. It was built with eight wards which where
manned by the White Asian doctors and a multinational staff of nurses and subordinate
staff.
With increased utilization , need for expansion of medical facilities in the town was looked
upon in 1957. The new group hospital was built on 12 acre piece of land in Tononoka area
offering only outpatient services. Cases that required admission continued to be referred to the
native civil hospital Makadara.
Coast Provisional Referral and Training Hospital is the second largest after the Kenyatta
National Hospital here in Kenya. It has 700 bed capacities; presently it has 672 beds comprising
546 beds and 126 cots. It is a teaching and referral hospital in the whole coast region. The
facility caters for a primary areas population of over 700,000 people and a secondary population
of about 2 million. It is situated in the Mombasa Island along Kisauni road.
The Coast Provisional Referral and Training Hospital distributed its wards in three sections,
general side, amenity and maternity unit. The general side has 12 wards that are:-
The Wards
1 and 2 Female medical
5 and 6 Male medical ward
Ward 3 emergency surgical wards
Ward 4 male surgical wards
Ward 7 Female and children surgical ward
Ward 8 Orthopedic ward
Ward 9 gynecology ward
Ward 10 Pediatric ward
POW Pediatric observation ward

INTRODUCTION
Tonsillitis as a condition affecting throat region , I chose the condition during my rotation in the
EAR, NOSE and THROAT CLINIC. Patient presented with the above condition to the clinic
after going to clinic in Qatar where he said he was not satisfied with the treatment offered.
JUSTIFICATION OF THE CASE
It is a very common condition, most frequent in children aged 5-10 years and young adults
between 15 and 25 years.

LITERATURE REVIEW.
Tonsillitis
Tonsillitis is inflammation of the tonsils, two oval-shaped pads of tissue at the back of the throat
— one tonsil on each side.
Risk Factors
Risk factors for tonsillitis involve increasing the risk of invasion by pathogenic viruses or
bacteria
Living or working in close proximity to children.
Living in an urban environment with more exposure to viruses or bacteria.
Being a young child or elderly adult.
Being immunocompromised.
Living or working in close proximity to airborne pollutants, such as smoke.
Living in colder climates.
Suffering from diabetes.
Suffering from cardiac disease.
Excessive and prolonged use of corticosteroids
Obesity or overweight.
Etiology
Tonsillitis often occurs with pharyngitis. Because of the abundant lymphoid tissue and the
frequency of URIs, tonsillitis is a common cause of illness in young children. The causative
agent may be viral or bacterial.
Pathophysiology
The tonsils are masses of lymphoid tissue located in the pharyngeal cavity. They filter and
protect the respiratory and alimentary tracts from invasion by pathogenic organisms and play a
role in antibody formation. Although their size varies, children generally have much larger
tonsils than adolescents or adults. This difference is thought to be a protective mechanism
because young children are especially susceptible to upper respiratory infections.
Tonsillitis develops when the pathogen, viral or bacterial, infects the tonsils and elicits an
inflammatory response. It develops when they infiltrate the tonsils and cause an inflammatory
response of up-regulated cytokines. Bacterial tonsillitis considered acute is primarily caused by
group A β-hemolytic streptococcus (GABHS) streptococcus pyogenes infection. s. pyogenes and
taxonomically-similar bacteria infiltrate the tonsillar epithelium, successfully penetrating the
protective mucosal films in the oral and nasal cavity. Recurrent bacterial tonsillitis is caused
primarily by staphylococcus aureus. Following invasion, S. aureus is internalized by non-
phagocytic cells through fibronectin-binding protein and beta-integrins. Invasion of non-
eukaryotic cells results in the up-regulation of cytokines, resulting in tonsillitis. Common viral
causes are Adenovirus and Epstein Barr Virus.
Signs and Symptoms of Tonsillitis
Sore throat – commonly the first symptom noted in tonsillitis; the tonsils and the surrounding
organs swell causing pain and sore throat
Swelling of the tonsils – due to the inflammatory response from infection
Erythema – the tonsils turn red in colour with yellowish coating or patches
Dysphagia – difficulty swallowing occurs due to the swollen tonsils; food and drink are not be
able to pass through the throat easily
Swollen and painful lymph nodes in the neck- the lymph nodes, as part of the immune system,
react to the infection; may feel tender upon palpation
Fever – occurs as the body’s response to the infection process
Headache
Loss of appetite – the general unwell feeling caused by tonsillitis together with dysphagia can
cause loss of appetite
Fatigue – the decline in oral fluid and food intake can reduce energy causing easy fatiguability
Bad breath – caused by the presence of bacteria in the mouth
Complications
Spread of the infection into the peritonsillar space may result in peritonsillar abscess (Quinsy)
Spread into the retropharyngeal or parapharyngeal spaces is classified as a deep neck space
abscess which requires prolonged IV antibiotics and sometimes surgical drainage
Recurrent tonsillitis – not strictly a complication of an acute episode of tonsillitis, but children
may often suffer from recurrent episodes of acute tonsillitis which can result in prolonged time
off school.
MANAGEMENT
Because tonsillitis is self-limiting, treatment of viral pharyngitis is symptomatic. Throat cultures
positive for GABHS infection warrant antibiotic treatment. It is important to differentiate
between viral and streptococcal infection in febrile exudative tonsillitis. Because most infections
are of viral origin, early rapid tests can eliminate unnecessary antibiotic administration.
Initial Management
The first key decision is whether the patient requires inpatient admission or not. The following
suggest severe tonsillitis or possibly an alternative diagnosis; they require urgent admission and
assessment.
Respiratory compromise (tachypnoea, low saturations, use of accessory muscles) suggest that the
tonsils are so large that they are affecting the child’s ability to ventilate. Alternatively, this may
be an indication of possible epiglottitis.
Patients who are unable to eat or drink are at risk of dehydration – they should be admitted for
treatment and monitoring until able to drink again
Patients who have been treated with appropriate antibiotics in the community who are still not
getting better should also be admitted for IV therapy and further investigation
Antibiotics
Patients who fulfill the centor criteria should be given antibiotics to prevent Group A
Streptococci. Typically, this will be a penicillin, usually Benzylpenicillin, dosed according to the
child’s weight. Route depends on the degree of odynophagia.
Although penicillins are the most common agent used, there is evidence that suggest
effectiveness of penicillin in providing complete resolution is diminishing and that
cephalosporins may in fact be more effective
Antibiotic therapy is usually continued for between 7 and 10 days and should be switched to oral
penicillin V when the child is clinically improving and able to swallow
Co-amoxiclav is often avoided in cases of tonsillitis due to the small risk of permanent skin rash
if the tonsillitis is due to glandular fever.
Analgesia
Paracetamol and Ibuprofen are effective pain relief in tonsillitis and can be alternated in order to
give effective pain relief.
Topical analgesia, such as difflam (benzydramine) spray/mouthwash, can be helpful to reduce
pain and allow the child to swallow oral analgesic agents.
Steroids
Steroids help reduce inflammation hence effective respiration
Operative Treatment
Tonsillectomy is the surgical removal of the palatine tonsils. Absolute indications for a
tonsillectomy are recurrent peritonsillar abscess, airway obstruction, tonsillitis resulting in febrile
convulsions, and tonsils requiring tissue pathology (American Academy of Otolaryngology—
Head and Neck Surgery, 2011). Relative indications include three or more tonsil infections per
year, persistent foul taste or breath caused by chronic tonsillitis, unilateral tonsil hypertrophy
presumed to be malignant, and chronic tonsillitis in a streptococcus carrier who fails to respond
to antibiotics (American Academy of Otolaryngology—Head and Neck Surgery, 2011).
Adenoidectomy (the surgical removal of the adenoids) is recommended for children who have
hypertrophied adenoids that obstruct nasal breathing; additional indications for adenoidectomy
include recurrent adenoiditis and sinusitis, chronic otitis media (OM) with effusion (especially if
associated with hearing loss), airway obstruction and subsequent sleep-disordered breathing,
persistent mouth-breathing, nasal speech, and recurrent nasopharyngitis (Benninger and Walner,
2007a).
Contraindications tonsillectomy or adenoidectomy
cleft palate because the tonsils help minimize escape of air during speech,
acute infections at the time of surgery because locally inflamed tissues increase the risk of
bleeding,
uncontrolled systemic diseases or blood dyscrasias, and
poor anesthetic risk.

Nursing Care Management

Nursing care involves providing comfort and minimizing activities or interventions that
precipitate bleeding.
Patients with sleep-disordered breathing require close monitoring of airway and breathing
postoperatively.
A soft to liquid diet is preferred.
A cool-mist vaporizer keeps the mucous membranes moist during periods of mouth breathing.
Warm salt-water gargles, throat lozenges, and analgesic–antipyretic drugs such as
acetaminophen are used to promote comfort. Often opioids are needed to reduce pain for the
child to drink. Combination nonopioid and opioid elixirs such as acetaminophen with codeine or
with hydrocodone (Lortab) relieve pain and should be given routinely every 4 hours.
If surgery is required, the child requires the same psychological preparation and physical care as
for any other surgical procedure .
Until they are fully awake, the child is placed on his or her abdomen or side to facilitate drainage
of secretions.
Routine suctioning is avoided, but when performed, it is done carefully to avoid trauma to the
oropharynx.
When alert, the child may prefer sitting up. The child is discouraged from coughing frequently,
clearing the throat, blowing the nose, and any other activity that may aggravate the operative site.
All secretions and vomitus are inspected for evidence of fresh bleeding (some blood-tinged
mucus is expected). Dark brown (old) blood is usually present in the emesis, in the nose, and
between the teeth. If parents do not expect this, they often become frightened at a time when they
need to be calm and reassuring.
The throat is sore after surgery. An ice collar may provide relief, but many children find it
bothersome and refuse to use it. Most children experience moderate pain and may need pain
medication regularly for at least the first few days. Analgesics may be given rectally or
intravenously to avoid the oral route. Because the pain is continuous, analgesics should be
administered at regular intervals even at night (see Pain Management.
An antiemetic such as ondansetron (Zofran) may be administered postoperatively if nausea or
vomiting is present.
Food and fluids are restricted until the child is fully alert and there are no signs of hemorrhage.
Cool water, crushed ice, flavored ice pops, or diluted fruit juice may be given, but fluids with a
red or brown color are avoided to distinguish fresh or old blood in emesis from the ingested
liquid. Citrus juice may cause discomfort and is usually poorly tolerated. Soft foods, particularly
gelatin, cooked fruits, sherbet, soup, and mashed potatoes, are started on the first or second
postoperative day or as the child tolerates feeding.
The pain from surgery often inhibits fluid intake, reinforcing the need for adequate pain control.
Milk, ice cream, and pudding are usually not offered because milk products coat the mouth and
throat and may cause the child to clear the throat, which can initiate bleeding.
Postoperative hemorrhage is uncommon but can occur in up to 5% of patients up to 14 days after
surgery. The nurse observes the throat directly for evidence of bleeding; using a good source of
light; and, if necessary, carefully inserting a tongue depressor. Other signs of hemorrhage are
tachycardia, pallor, frequent clearing of the throat or swallowing by a younger child, and
vomiting of bright red blood. Restlessness, an indication of hemorrhage, may be difficult to
differentiate from general discomfort after surgery. Decreasing blood pressure is a late sign of
shock.
Surgery may be required to ligate a bleeding vessel. Airway obstruction may also occur as a
result of edema or accumulated secretions and is indicated by signs of respiratory distress, such
as stridor, drooling, restlessness, agitation, increasing respiratory rate, and progressive cyanosis.
Suction equipment and oxygen should be available after tonsillectomy.
The most obvious early sign of bleeding is the child’s continuous swallowing of the trickling
blood. While the child is sleeping, note the frequency of swallowing. If continuous bleeding is
suspected, notify the surgeon immediately.
THE CASE
Biographic data
Name: G. M.
Age: 3 year.
Sex: Female.
County: Makueni
Location: kathonzweni
Sub location- kathonzweni
Residence: likoni
Op no: 691243
Diagnosis: Tonsillitis
Chief complaints
Swelled tonsil, running nose, inability to swallow food, difficulty in breathing, hotness of body
and bad breath
History of presenting illness
The patient was well till 1 days ago when her tonsils swelled, she started having difficulty in
swallowing or drinking fluids due to pain from the inflamed tonsils. Later at night her body
became hot accompanied by difficulty in breathing that goes away when seated.
Past medical history
No history of chronic illness. No history of recurrent Tonsillitis. No known food and drug
allergy.
Past surgical history.
No history of any surgical procedure, no history of blood transfusion.
Family history.
She is 2nd Born daughter in the family of three. All other siblings are well and Lives with both
parents.
Antenatal history
Attended first antenatal visit at six months, 2nd at seventh month, third at 8th and fourth at 9th
month of pregnancy. No history of intrauterine infection and TORCHES
Birth history
Born on 14 may 2020 at kathonzweni hospital via Spontaneous vertex delivery, the outcome was
live female infant at 3 kg. Didn't cry immediately after birth. Had history of vomiting, no other
complication.
Developmental history
Social smile 3 weeks, neck support 2 months, sitting 5 months, crawling 7 months, from 11
months regression of milestones.
Immunization history
Received all immunization as per KEPI schedule.
Nutritional history
Exclusive breastfeeding for four months then introduced uji. Right now can only eat blended
foods, has difficulties in swallowing solid food.
PHYSICAL EXAMINATION
The general examination
The child is conscious and sick looking in appearance, has running nose, excessive mucus
prevent adequate breathing.
Vitals

Head
Hair is well distributed, no masses,
Head circumference 37 cm.
Ear
No low set ears, no discharge from ear, no impaction,
cartilage are firm and non tender
Eyes
No sunken eyes, no jaundice, no discharge, no conjunctivitis, no paleness of conjunctiva
Nose
Blocked nostril with mucus, no nasal bridge deformity, mucus elicited bilateral from both
nostril. No nasal polyps
Mouth
Swollen tonsils, bad odor, no cleft lip palate, Pink lips, no paleness of the gums, and the tongue,
no varicose beneath the tongue.
Neck
No distention of jugular vein, no inflamed thyroid gland, uniform skin color, palpable tender
tonsils at superior part of the neck
Chest
The chest and abdomen moves synchronously on inspiration and expiration. Respiratory rate of
26, no paradoxical movement, uniform skin color. No wheezing or stridor was heard.
Bilateral air entry
S1 and s2 heard and no murmurs.
Upper extremity
They are equal, no extra digits, no paleness of the palm and nail bed, Capillary refill less than 2
seconds, Skin pinch less than 2 seconds, Temperature 38.0 degree celcious
Abdomen
Inspection
No distention, no surgical scars, no masses, no skin discoloration.
Auscultation
Bowel sounds heard, no abdominal bruits heard.
Palpation
no organomegally, soft and non tender.
Genitalia
No growths in the labia, no bisexuality, patent urethra
Back
The spine is smoothly continuous with no masses and deformity
Lower extremity
No varicose vein, equal extremity, no discoloration of the skin, no edema.
GORDON’S FUNCTIONAL HEALTH PATTERN
Health perception/ health promotion
She is generally weak and sick looking in appreciate. She has difficulty in breathing due to
mucus. Did not use any medication at home. She does not have allergic reaction to any
medication.
Nutritional needs
She feeds at least four times a day. She doesn't have favorite meals. She started deteriorating and
her appetite reduced, due to pain when swallowing food or fluids. She doesn't have any known
food allergies. She usually feeds on uji, mashed potatoes, bananas and green vegetables.
Elimination needs
She doesn't have problems with constipation or full bladder. After every elimination she's
cleaned and change to dry clothing. No episodes of diarrhea noted.
Sleep pattern
Sleeping during daytime has reduced. At night she tends to wake up, sometimes cry, her body
become hot accompanied with sweating. then she goes back to sleep. She sleeps at night after
she's taken meals.
Activity/ exercise
The mother does almost all work of cleaning, sometimes feeding, changing clothes. She's fully
dependent, but she's involved in plays with other children.
Perception/cognition
She is well oriented to her mother and family members, but in her sick condition she's irritated
when handled. She prefers to stay motionless in bed or bed babysitted by her mother.
Self perception
The child is friendly and calm
Relationship
She is friendly and relates well with other people

COLLABORATIVE MANAGEMENT
INVESTIGATIONS
Results Normal range
WBC. 10.5. 3.5-10.0
Lymphocyte. 21.1. 15-50
Hb. 11.0. 11.5-16.5
RBC. 2.6. 3.5-5.5
Blood slide for malarial parasite- no malarial parasite seen

MANAGEMENT
Ceflorex 9.6 mls twice a day for five day
Classification
Therapeutic: anti-infectives
Pharmacologic: third-generation cephalosporins
Indications
Treatment of: Urinary and gynecologic infections including gonorrhea, Respiratory tract
infections, Otitis media.
Mechanism of action
Binds to the bacterial cell wall membrane, causing cell death. Therapeutic effects: Bactericidal
action against susceptible bacteria.
Contraindications and precautions
Contraindicated in: Hypersensitivity to cephalosporins; Serious hypersensitivity to penicillins.
Use Cautiously in: Renal impairment , History of GI disease, especially colitis; Geriatric
patients,  Pregnancy and lactation.
Adverse effects and side effects
CNS: seizures (very high doses). GI: pseudomembranous
colitis, diarrhea, nausea, vomiting, cramps. Derm: rashes, urticaria. Hemat: bleeding, blood
dyscrasias, hemolytic anemia. miscellaneous: allergic reactions including anaphylaxis and serum
sickness
Nursing implications
Assess for infection (vital signs; appearance of wound, sputum, urine, and stool; WBC) at
beginning of and throughout therapy.
Before initiating therapy, obtain a history to determine previous use of and reactions to
penicillins or cephalosporins. Persons with a negative history of penicillin sensitivity may still
have an allergic response.
Obtain specimens for culture and sensitivity before initiating therapy. First dose may be given
before receiving results.
Observe patient for signs and symptoms of anaphylaxis (rash, pruritus, laryngeal edema,
wheezing). Discontinue the drug and notify the physician or other health care professional
immediately if these symptoms occur. Keep epinephrine, an antihistamine, and resuscitation
equipment close by in the event of an anaphylactic reaction.
Monitor bowel function. Diarrhea, abdominal cramping, fever, and bloody stools should be
reported to health care professional promptly as a sign of pseudomembranous colitis. May begin
up to several weeks following cessation of therapy.

Paracetamol syrup 5 MLS three times a day for three days.

Classification
Therapeutic: antipyretics, nonopioid analgesics
Indications
Treatment of Mild, moderate, severe pain and Fever
ACTION
Inhibits the synthesis of prostaglandins that may serve as mediators of pain and fever, primarily
in the CNS.
Contraindications and precautions
Contraindicated in: Previous hypersensitivity; Severe hepatic impairment/active liver disease.
Use Cautiously in: Hepatic disease, renal disease, Alcoholism, chronic malnutrition, severe
hypovolemia or severe renal impairment, Chronic alcohol use; Malnutrition.
Adverse effects and side effects.
CNS: agitation, anxiety, fatigue, insomnia. Resp: atelectasis, dyspnea. CV: hypertension (IV),
hypotension (IV). GI: hepatotoxicity, constipation , elevated liver enzymes, nausea,
vomiting . Fluid and Electrolytes: hypokalemia. GU: renal failure (high doses/chronic
use). Hemat: neutropenia, pancytopenia. MS: muscle spasms, trismus. Derm: rash, urticaria.
Nursing implications
Assess overall health status and alcohol usage before administering acetaminophen. Patients who
are malnourished or chronically abuse alcohol are at higher risk of developing hepatotoxicity
with chronic use of usual doses of this drug.
Assess amount, frequency, and type of drugs taken in patients self-medicating, especially with
OTC drugs. Prolonged use of acetaminophen increases the risk of adverse renal effects. For
short-term use, combined doses of acetaminophen and salicylates should not exceed the
recommended dose of either drug given alone.
Montelukast 5 mg od for five days
Classification
Therapeutic: allergy, cold, and cough remedies, bronchodilators
Pharmacologic: leukotriene antagonists
INDICATIONS
Prevention and chronic treatment of asthma. Management of seasonal allergic rhinitis.
Prevention of exercise-induced bronchoconstriction in patients 15 yr and older.
ACTION
Antagonizes the effects of leukotrienes, which mediate the following: Airway edema, Smooth
muscle constriction, Altered cellular activity. Result is decreased inflammatory process, which is
part of asthma and allergic rhinitis.
CONTRAINDICATIONS AND PRECAUTIONS
Contraindicated in: Hypersensitivity.
Use Cautiously in: Acute attacks of asthma; Phenylketonuria. Hepatic impairment. Reduction of
corticosteroid therapy (may increase the risk of eosinophilic conditions).
ADVERSE REACTIONS AND SIDE EFFECTS
CNS: SUICIDAL THOUGHTS, agitation, aggression, anxiety, depression, disorientation, dream
abnormalities, fatigue, hallucinations, headache, insomnia, irritability, restlessness, tremor,
weakness. EENT: nosebleed, otitis (children), sinusitis (children). Resp: cough,
rhinorrhea. GI: abdominal pain, diarrhea (children), dyspepsia, nausea (children), ↑ liver
enzymes. Neuro: tremor. Derm: rash. Misc: eosinophilic conditions, fever.
Nursing implications.
Assess lung sounds and respiratory function prior to and periodically during therapy.
Assess allergy symptoms (rhinitis, conjunctivitis, hives) before and periodically during therapy.
Monitor closely for changes in behavior that could indicate the emergence or worsening of
depression or suicidal thoughts.

NURSING CARE PLAN

ASSESSM NURSIN Expected INTERVEN RATION IMPLEMENT EVALUA

ENT G outcome TIONS ALE ATION TION
DIAGN
OSIS
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in ation of patency Clearing 19 breaths
breathing the as secretions per
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breathing swallowi 18-24 ds, reduces administered
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breathing verbalize as prescribed on in the mg once a day
ease of pharynx.
breathing
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data: the pain will analgesic ol work’s Daniel after two
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DISCHARGE PLAN
Discharge instructions include
(1) avoiding irritating hard solid food
(2) vigorous tooth brushing,
(3) avoiding putting objects in the mouth
(4) using analgesics or an ice collar for pain,
5. Chewing gum may prevent throat and ear pain in older children.
6. Gargle mouth with warm salty water daily
 CONCEPT MAP

Tonsils-are masses of Tonsillitis referPathophysiology:

to the inflamed
lymphoid tissue located in the Infection: tonsils
Tonsillitis develops when
pharyngeal cavity. They filter
Virus or the pathogen, viral or
and protect the respiratory
bacterial, infects the
and alimentary tracts from Bacteria tonsils and elicits an
invasion by pathogenic
inflammatory response. It
organisms and play a role in
develops when they
antibody formation.
infiltrate the tonsils and
cause an inflammatory
response of up-regulated
cytokines
Medical management
Signs and symptoms:
Antibiotics such as co
amoxiclav Dysphagia, fever, difficulty in
breathing, headache, sore throat,
Pain relief i.e. Paracetamol,
pain
Diclofenac

Corticosteroids Incase of
airway obstruction

Warm saline gargle or

lozenges

Fluid resuscitation
Discharge plan: Avoiding irritating hard solid food, Vigorous
tooth brushing, Avoiding putting objects in the mouth, Using
analgesics or an ice collar for pain,. Chewing gum may
prevent throat and ear pain in older children and Gargle
mouth with warm salty water daily
CRITIQUE
Poor Choice of antibiotics
Inadequate health message
Poor diagnosis technique, because tonsillitis is self-limiting, treatment of viral pharyngitis is
symptomatic. Throat cultures positive for GABHS infection warrant antibiotic treatment. It is
important to differentiate between viral and streptococcal infection in febrile exudative tonsillitis.
Because most infections are of viral origin, early rapid tests can eliminate unnecessary antibiotic
administration
Tonsillitis tends to be misdiagnosed, leading to inappropriate treatment with antibiotics
RECOMMENDATIONS
Penicillin is first line of treatment for tonsillitis before going for broad spectrum antibiotics such
as third and fourth generation cephalosporin. It’s essential to prevent resistance of bacteria to
antibiotics
Detailed health message to patient enhances faster recovery
Throat swab is important to identify the causative agent of Tonsillitis in order to accurately
manage it with antibiotics.
CONCLUSION
Tonsillitis is inflammation of the tonsils, two oval-shaped pads of tissue at the back of the throat
— one tonsil on each side. It is a very common condition, most frequent in children aged 5-10
years and young adults between 15 and 25 years. Penicillin is first line of treatment for tonsillitis
before going for broad spectrum antibiotics such as third and fourth generation cephalosporin.
It’s essential to prevent resistance of bacteria to antibiotics. It is important to differentiate
between viral and streptococcal infection in febrile exudative tonsillitis. Because most infections
are of viral origin, early rapid tests can eliminate unnecessary antibiotic administration. Detailed
health message to patient enhances faster recovery

REFERENCES
https://www.betterhealth.vic.gov.au/health/ConditionsAndTreatments/tonsillitis.
https://nursekey.com/the-child-with-respiratory-dysfunction/.
https://teachmepaediatrics.com/ent/throat/tonsillitis/.