TONSILLITIS

AMRUTHA R
 TONSILLITIS
• Inflammation of tonsils

• 3-7yrs
 RESEARCH
• Health news of NHS choices
• Admission rates for tonsillectomy has
reduced between 1999 and 2010
Tonsils
WALDEYERS RING
TONSILS
 TONSILLITIS DEFINITION
• Infection of tonsils which are glands on
either side of the throat.
 CAUSES

• Bacterial

• Viral

• Infectious mononucleosis
 Bacterial
• Group A beta hemolytic streptococcus

VIRAL
• Adenovirus
• Rhinovirus
• Influenza virus
• Para influenza virus
• Entero virus
 Infectious mononucleosis
• Epstein barr virus
 Types
ACUTE
• Catarrhal stage

• Follicular

• Parenchymatous

• Peritonsillar abscess/ quincy

 Catarrhal
Follicular

Parenchymatous
Peritonsillar
abscess/ quincy
 Chronic
• Repeated attacks
• Enlarged spongy appearance
• Fibrous tissue
• Scarring of tissue
• Adults
Pathophysiology
 tonsillitis - pathogenesis
• disruption of the drainage function of the lacunae,
accumulation of a secretion and waste products of
microbes;
• disturbance of tissue metabolism in the tonsils;

• reduction of barrier properties of the tonsils, including

production of secretory immunoglobulins A;
• appearance of inflammatory reactions in the form of
frequent pain and metatonsillar complications.
 Clinical features
• Frequent throat infections
• Breathing difficulties
• Dysphagia
• Redness of anterior pillers
• Breathing through mouth
• Dry mucous membrane
• Oedema
 Clinical features
• Drooling
• Fever
• Loss of appetite
• General feeling of unwell
• Swollen tonsils
• Change in sound
 Clinical features
• Nausea vomiting
• Abdominal pain
• Furry tongue
• Halitosis
• Trismus
 Local signs of tonsillitis
Lymph nodes
Unpleasant are small and
mouth dense
odor

Unpleasant
Pus or tonsil
feeling in stones in
the throat lacunae
Local signs of tonsillitis - changes
in the palatine arches
Slight
Hyperemia swelling
 Investigations

• History collection
• Physical examination
• Throat swab
• Blood tests
• ASO titre
 Management
General measures
• Gargles
• Rest
• Hydration
• Foods
• Air
• Lozenges
• Avoid irritants
 DRUGS
Analgesics
• Ibuprofen
• Acetaminophen

Antibiotics
 ANTIBIOTICS

• Penicillin V 25-50 mg/kg/day divided q6h for

10d or

• Benzathine penicillin G 25,000 U/kg IM once

(maximum 1.2 million U) or

• Amoxicillin 50 mg/kg/day PO in 2 or 3
divided doses for 10d or
 ANTIBIOTICS
• Amoxicillin-clavulanate 500-875 mg PO
q12h for 10d

• Cefdinir 14 mg/kg PO once daily for

10d or

• Cefuroxime axetil 10 mg/kg PO BD for 4-

10d
 ANTIBIOTICS
• Azithromycin 12 mg/kg PO once daily for
5d or

• Clarithromycin 250 mg PO q12h for

10d or

• Erythromycin succinate 20 mg/kg PO BID

for 10d or

• Clindamycin 20 mg/kg/day PO in 3
divided doses (maximum 1.8 g/d) for 10d
 RESEARCH
• JOURNAL of antimicrobial chemotherapy
• Sept 1993- J HAMMIL
 SURGICAL
MANAGEMENT
 Surgery
Indications
• Obstructive sleep apnoea
• Breathing difficulty
• Absess
• Dysphagia
• Malignant growth
TONSILLECTOMY
 METHODS
• Cold stress

• Diathermy

• Coblation

• Electrocautery
 CARE AFTER SURGERY
• Antibiotics
• Analgesics
• Fluid intake
• Food
• Prevention of complications
COMPLICATIONS
 Research

• Child health news in Feb. 2011

• Tonsillectomy increases the risk of
pediatric obesity
• 795 children selected
 Nursing management
ASSESSMENT
DIAGNOSIS
 INTERVENTION
• Promoting airway clearance
• Maintaining fluid volume
• Pain management
• Prevent complications
• Health education
Evaluation