Tonsilitis
Defintion: inflammation of the tonsils.
Symptoms and signs:
Red swollen tonsils.
Patches on the tonsils( white or yellow).
Tender stiff or swollen neck.
Swollen cervical lymph nodes.
Sore throat.
Cough.
Headache.
Earache.
Fever.
Chills.
Nasal congestion.
Fever.
Causes:
The most common are:
viral: the most common are Adenovirus, Rhinovirus, Influenza,
Coronavirus, Respiratory syncytial virus.
Bacterial: The most common is group A β- hemolytic streptococcus.
1
Less are:Staphylococcus aureus, Streptococcus pneumonia,
Fusobacterium and Diphteria.
Pathogenesis:
Tonsils filter the viruses and bacteria enter the nose and mouth.
The immune system present in the tonsils attack the viruses and
bacteria.
The reaction between the immune system and the organism leads to
inflammation of the tonsils and the surrounding pharynx and to the
Symptoms and signs.
Treatment:
1- Reduce fever through pathing or cold fomites as fever reducing
drugs only work if temperature less than 39C°.
2- Fever reducing, pain relief, anti inflammatory drugs: as
Paracetamol, Ibuprofen or Acetaminophen.
3- Sore throat relief: as salt water gargle, lozengs or warm liquids.
4- Antibiotics only are useful if the cause is bacterial.
The first line antibiotics are: Penicillin or Amoxacillin.
Macrolide or Erythromycin are used in allergic patients.
Clindamycin or Amoxicillin- Clavulanate are the second line.
5- There is no drug for virus: complet recovery within a week can
occur.
6- Chronic cases needs tonsillectomy.
2
Case no.1:
A child 7 years complain from fever , headache, chills , cough and
nasal congestion. When the doctor examine found that the
temperature is 40 C°, swollen cervical lymph nodes and swollen
tonsils with yellow patches on its surface.
1- What is the diagnosis?
2- What is the causes?
3- Discuss the pathogensis of the disease?
4- What is the treatment?
3