Otolaryngology Book

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Tonsillitis

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  1. Etiologies
    1. Viral
      1. Epstein-Barr Virus (Mononucleosis)
    2. Bacterial
      1. Group A Beta Hemolytic Streptococcus
      2. Staphylococcus aureus
      3. Hemophilus Influenzae
  2. Symptoms
    1. Difficulty taking oral intake
    2. Difficulty swallowing secretions
    3. Otalgia (common innervation of ear and throat)
  3. Signs
    1. Febrile, appears ill
    2. Mucus membranes dry
    3. Tonsils enlarged, beefy red, exudate
    4. Tender cervical adenopathy
    5. Splenomegaly in Epstein-Barr Virus
  4. Labs: Epstein Barr Virus Infection
    1. Heterophil agglutination (Monospot Test)
    2. Liver Function Test Elevation
    3. Peripheral blood smear with Atypical lymphocytes
  5. Management
    1. SEE Pharyngitis for standard management
    2. Unresponsive to medications for Pharyngitis
      1. Obtain Throat Culture and Monospot
      2. Consider Clindamycin 300 mg PO qid
      3. Assess for Peritonsillar Abscess
      4. Assess for Laryngeal pathology
      5. Consider ENT referral
  6. Management: Tonsillectomy Indications
    1. Tonsillitis episodes 4 or more per year for 2 years
    2. Tonsillar size is not an indication for surgery
    3. Size diminishes naturally in early adolescence
  7. Prognosis: Following Tonsillectomy
    1. Reduces Pharyngitis frequency (esp. Streptococcus)
    2. Effect lasts 2-3 years after surgery

Tonsillitis (C0040425)

Definition (MSH)Inflammation of the tonsils, especially the palatine tonsils. It is often caused by a bacterium. Tonsillitis may be acute, chronic, or recurrent.
ConceptsDisease or Syndrome (T047)
ICD9463
EnglishTonsillitides, Tonsillitis
Spanishamigdalitis, tonsilitis
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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