Acute Tonsillitis


Causes of acute tonsillitis:

  1. Age-children 5-10 years (Common)
  2. Causative organism’s bacteria and or viruses bacterial- Streptococci stapahylococci, H.inflauenzae.Viruses-rhinovirus, adenovirus.
  3. General factors-a. Malnutrition.
  4. Metabolic abnormalities.
  5. Immunological deficiency states.
  6. Environmental factors- Exposure to cold & Atmospheric pollution

Clinical features of acute tonsillitis:

Symptoms: 1. Sever pain in the throat & difficulty in swallowing there

May be dribbling of saliva.

  1. High rise of temperature (101-104 F)
  2. There are chills, malaise, headache & earache.

Signs: A. General-Temperature, Pulse, Jugulodigastric lymph nodes are   Enlarged & tender


  1. The tonsils are swollen, inflammed, congested. It progresses To acute follicular tonsillitis- the tonsillar crypts become

Filled with debris, desquamated epithelium & pus & the

Pus exudates    from the surface giving follicular appearance.

At times these follicles will coalesce forming a patchy

Membrane on the tonsillar surface (membranous tonsillitis).

  1. The pharyngeal wall may be congested red.
  2.    The uvula may be edematous.

Treatment of acute tonsillitis:

A. General measure (Utmost important).

  1. 1.Bed rest.
  2. Plenty of oral fluid & soft diet.
  3. Analgesic & antipyretic (Paracetamol, asprin).
  4. Warm saline gurgles.

B.Chemotherapy (limits 2ndary infection & prevents complication). Injectable penicillin but oral penicillin is usually

Used-Phenoxymethyl penicillin (oracyn K ) 125-250 mg 6hrly for

5-7 days. Should be change according to c/s report or if there

Is no improvement after 24-48 hrs of penicillin administration.

Complication of acute tonsillitis:

  1. Peritonsillar abscess (common)
  2. Parapharyngeal & retropharyngeal abscess.
  3. Laryngeal oedema.
  4. Rheumatic fever
  5. Nephrits
  6. Acute infection of the middle ear cleft.
  7. Septicaemia.
  8. Ch.tonsillits.

Differential diagnosis of acute tonsillitis:

  1. Infectious mononucleosis (from blood count & monospot test).
  2. Vincent’s angina ( throat swab)
  3. Agranulocytosis (white cell count )
  4. Faucal diphtheria.
  5. Oral thrush.

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