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Tonsillitis
Aka: Tonsillitis
EtiologiesViralEpstein-Barr Virus (Mononucleosis ) BacterialGroup A Beta Hemolytic Streptococcus Staphylococcus aureus Hemophilus Influenza e
SymptomsDifficulty taking oral intake Difficulty swallowing secretions Otalgia (common innervation of ear and throat)
SignsFebrile, appears ill Mucus membranes dry Tonsils enlarged, beefy red, exudate Tender cervical adenopathy Splenomegaly in Epstein-Barr Virus
Labs: Epstein Barr Virus InfectionHeterophil agglutination (Monospot Test) Liver Function Test ElevationPeripheral blood smear with Atypical lymphocyte s
ManagementSEE Pharyngitis for standard management Unresponsive to medications for Pharyngitis Obtain Throat Culture and Monospot Consider Clindamycin 300 mg PO qid Assess for Peritonsillar Abscess Assess for Laryngeal pathology Consider ENT referral
Management: Tonsillectomy IndicationsTonsillitis episodes 4 or more per year for 2 years Tonsillar size is not an indication for surgery Size diminishes naturally in early adolescence
Prognosis: Following TonsillectomyReduces Pharyngitis frequency (esp. Streptococcus ) Effect lasts 2-3 years after surgery