Acute Tonsillitis

Question 1

According to SIGN guidelines, what are the indications for tonsillectomy?

Answer 1

7 episodes in one year
5 episodes in two consecutive years
3 episodes in three consecutive years
Significant disabling impact on work or school

Question 2

What is the most common aetiology of acute tonsillitis?

Answer 2

Viral (rhinovirus, coronavirus, adenovirus)

Question 3

What are the common causative agents of bacterial tonsillitis?

Answer 3

Beta-haemolytic strep

Question 4

What important differentials are important to consider in acute tonsillitis?

Answer 4

Retropharyngeal abscess
Acute epiglottitis
HIV
Infectious mononucleosis

Question 5

What is the typical clinical presentation of tonsillitis?

Answer 5

Sudden onset sore throat
Odynophagia
Fever
Headache
N&V
Cough
Rhinorrhoea

Question 6

Describe the use of the Censor criteria in acute tonsillitis:

Answer 6

In patients >14 years if three or more are true, then tonsillitis is likely bacterial and therefore requires swabs/antibiotics:

History of fever over 38 degrees celsius
Tonsillar exudate
Absence of cough
Tender anterior cervical lymphadenopathy

Question 7

Describe the management of acute tonsillitis

Answer 7

Viral - rest and analgesia
Bacterial - antibiotics

If recurrent then consider tonsillectomy