TONSILLITIS

Definition: inflammation of tonsils due invade viral or bacterial

Anatomy: two tonsils, oval shape, as pads tissue bach of throat
Function: defence mechanism from invader of microorganism
tonsils collect lymphoid tissue
spread infection:contagious air borne
course of disease: acute rapid tonsilitis, episodic and recurrent
acute tosilitis, chronic tonsilitis
:Aetiology
mostly viral , bacterial 5% _ 40%
:bacterial
Strepotoccal (cocci) group A , B hemolytic -1
Hemophilus influenza -2
Corynebacterum diphtheria -3
Mycoplasma -4
Treponema pallidum -5
:Viral
Rhinovirus,adenovirus, Epstein
barre,parainflenza.corona,cytomegaly,HIV, herpes
simplex
:CLINICAL
Fever -1
Sore throat -2
Difficulty inswllowing( adenphagia) -3
:Plus genral symptoms
Headache , sleep trouble, vomiting ,
,polyarthralgia , polymyalgia
Chills, abdominal pain
.Physical examination: look sick, feverish
Palpation: tender and enlarged cervical and
tonsillar group lymph node
Tonsils examination:congested, enlarged,, coated
yellowish spot follicular, whitish membrane
Heperemia uvula and soft palate
:INVESTIGATION
CBC -1
Rapid streptoccal test ( ASO titer) -2
CRP,ESR -3
Throat swab -4
:COMPLICATION
Pertonsllar abcess -1
Sleep apnoe -2
Snoring -3
Tonsilla cellulitis -4
Difficulty in breathing and swallowing -5
Septicaemia( Lmierrs syndrome) -6
Meningitis -7
Otitis media, sinusitis, pneumonia -8
,Rheumatic fever -9
Glomerunephritis -10
:PREVENTIVE management
Penzathin pencillin 1,2 million IU (IM) ,ATS mounthly
Treatment: pencillin (procaine), cephalosporine
Macrolide( allergic)
:Indication for surgery
Recuurent,episodicexcerbation acute infection 3 -1
times per year
Sleep apnoe -2
Difficulty in breathing and swollwing -3
Associated with adenoid -4
5- tonsiilar cellulitis