Tonsillitis

Question 1

Definiiton

Answer 1

Inflammation due to infection of the tonsils.

Question 2

Aetiology/Risk factors

Answer 2

· Usually VIRAL (e.g. common cold or influenza)

· Can be bacterial (caused by group A streptococci)

· Risk Factors
o Immune deficiency
o Family history of tonsillitis or atopy

Question 3

Epidemiology

Answer 3

· VERY COMMON

· Usually in children and young adults

Question 4

Presenting symptoms

Answer 4

· Pain in the throat
· Painful swallowing
· Pain may be referred to ears
· Abdominal pain (in small children)
· Headache
· Loss of voice or changes in voice

Question 5

Signs on physical examination

Answer 5

· Red throat
· Swollen tonsils, which may have white flecks of pus
· High temperature (sometimes)
· Swollen lymph nodes

· Classic streptococcal tonsilitis features:
o Acute onset
o Headache
o Abdominal pain
o Dysphagia

· Examination:
o Intense erythema of tonsils and pharynx
o Yellow exudate
o Tender, enlarged anterior cervical glands

Question 6

Investigations

Answer 6

· Throat swabs and rapid antigen tests can be performed (but are NOT recommended)

· Swabs may not be able to distinguish between infection and colonisation