II. Symptoms

  1. See Pharyngitis
  2. Difficulty taking oral intake
  3. Difficulty swallowing secretions
  4. Otalgia (common innervation of ear and throat)

III. 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

IV. Differential Diagnosis: Select Causes

VI. Management: General

  1. See Pharyngitis for symptomatic management
  2. See Group A Streptococcal Pharyngitis for specific antibiotics for Streptococcal Pharyngitis
  3. Unresponsive to medications for Pharyngitis
    1. Consider Pharyngitis Causes
    2. Consider Point-Of-Care GAS Nucleic Acid Amplification Test
    3. Consider Monospot
    4. Consider STD Causes (Gonorrhea, Acute HIV Infection, HSV)
    5. Consider empiric antibiotics for Lemierre Syndrome (Fusobacterium Necrophorum)
    6. Consider Clindamycin 300 mg orally four times daily (with or without Dexamethasone 10 mg orally once)
    7. Assess for Peritonsillar Abscess and Retropharyngeal Abscess
    8. Assess for Laryngeal pathology (e.g. Epiglottitis, Bacterial Tracheitis)
    9. Consider ENT referral

VII. Management: Tonsillectomy for Recurrent Tonsillitis

  1. See Tonsillectomy Indications
  2. Prognosis following Tonsillectomy
    1. Reduces Pharyngitis frequency (esp. Streptococcus)
    2. Effect lasts 2-3 years after surgery

VIII. Resources

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Related Studies (from Trip Database) Open in New Window

Ontology: Acute tonsillitis (C0001361)

Definition (NCI) An acute inflammation of the tonsils caused by viruses or bacteria. Signs and symptoms include fever, enlargement of the tonsils, difficulty swallowing, and enlargement of the regional lymph nodes.
Concepts Disease or Syndrome (T047)
ICD9 463
ICD10 J03 , J03.9, J03.90
SnomedCT 195665006, 312424000, 155503001, 195678006, 17741008
English Acute tonsillitis NOS, Acute tonsillitis, unspecified, acute tonsillitis, acute tonsillitis (diagnosis), Tonsillitis acute NOS, Tonsillitis (acute) NOS, Tonsillitis;acute, infective tonsillitis, Acute Tonsillitis, Tonsillitis (& acute) (disorder), Infective tonsillitis (disorder), Acute tonsillitis NOS (disorder), Tonsillitis (& acute), Acute tonsillitis, Infective tonsillitis, Acute tonsillitis (disorder), Tonsillitis acute, Acute tonsillitis, NOS, Tonsillitis, infective
Italian Tonsillite acuta, Tonsillite acuta NAS
Dutch tonsillitis acuut NAO, Acute tonsillitis, Acute tonsillitis, niet gespecificeerd, acute tonsillitis
French Angine aiguë SAI, Amygdalite aiguë
German Tonsillitis akut NNB, Akute Tonsillitis, nicht naeher bezeichnet, Akute Tonsillitis, akute Tonsillitis
Portuguese Amigdalite aguda NE, Amigdalite aguda
Spanish Amigdalitis aguda NEOM, amigdalitis aguda, SAI, amigdalitis aguda, SAI (trastorno), amigdalitis aguda (trastorno), amigdalitis aguda, amigdalitis infecciosa, Amigdalitis aguda
Japanese 急性扁桃炎, 急性扁桃炎NOS, キュウセイヘントウエンNOS, キュウセイヘントウエン
Czech Akutní tonzilitida NOS, Akutní tonzilitida
Korean 급성 편도염, 상세불명의 급성편도염
Hungarian acut tonsillitis, Tonsillitis acuta k.m.n.

Ontology: Tonsillitis (C0040425)

Definition (MSH) Inflammation of the tonsils, especially the PALATINE TONSILS but the ADENOIDS (pharyngeal tonsils) and lingual tonsils may also be involved. Tonsillitis usually is caused by bacterial infection. Tonsillitis may be acute, chronic, or recurrent.
Definition (MSHCZE) Zánět krčních mandlí. Katarální t. – zarudnutí a zvětšení tonzil. Folikulární t. s tvorbou hnisavých čepů. Lakunární t. s tvorbou splývavých povlaků; původci větš. různé typy virů, často též beta-hemolytické streptokoky (srov. fokální infekce). Monocytární t. – viz infekční mononukleóza. Ulceromembranózní t. – viz Plautova-Vincentova angína. Dalšími typy jsou např. t. při agranulocytóze, herpetiformní t., syfilitická t. apod. Akutní zánět mandlí se označuje jako angína. Chronický zánět bývá následkem jedné nebo více angín, může být zdrojem tzv. fokální infekce. Krypty při chronické t. často obsahují tzv. čepy tvořené zahuštěným hnisem na rozdíl od „povlaků“ při angíně tvořených řídkým hnisem. Větší čep vyvolává pocit cizího tělesa v krku, zpravidla se uvolní spontánně a pacient jej vyplivne. (cit. Velký lékařský slovník online, 2013 http://lekarske.slovniky.cz/ )
Concepts Disease or Syndrome (T047)
MSH D014069
SnomedCT 195665006, 90176007
English Tonsillitides, TONSILLITIS, Tonsillar inflammation, tonsillitis (diagnosis), tonsillitis, Tonsillitis NOS, Tonsillitis [Disease/Finding], tonsil inflammation, Inflammation;tonsils, inflammation tonsils, tonsils inflammation, Throat infection - tonsillitis, Inflammation of tonsil, Tonsillitis (disorder), inflammation; tonsil, tonsil; inflammation, Tonsillitis, Tonsillitis, NOS, inflammation of the tonsils
French AMYGDALITE, Amygdalite SAI, Angine, Amygdalite, Inflammation des amygdales, Tonsillite
Portuguese AMIGDALITE, Inflamação amigdalina, Amigdalite NE, Angina Tonsilar, Amigdalite, Tonsilite
Spanish AMIGDALITIS, Inflamación tonsilar, Amigdalitis NEOM, tonsilitis, Amigdalitis, amigdalitis (trastorno), amigdalitis, Tonsilitis
German TONSILLITIS, Tonsillitis NNB, Mandelentzuendung, Tonsillitis, Gaumenmandelentzündung, Mandelentzündung
Dutch tonsillitis NAO, ontsteking van amandelen, ontsteking; tonsil, tonsil; ontsteking, tonsillitis, Tonsillitis
Italian Infiammazione tonsillare, Tonsillite NAS, Tonsillite
Japanese 扁桃の炎症, 扁桃炎, 扁桃炎NOS, ヘントウエンNOS, ヘントウエン, ヘントウノエンショウ
Swedish Halsfluss
Czech tonzilitida, angína, Zánět mandlí, Tonzilitida NOS, Tonzilitida, tonsilitida
Finnish Tonsilliitti
Russian TONZILLIT, ТОНЗИЛЛИТ
Croatian TONZILITIS
Polish Zapalenie migdałków podniebiennych
Hungarian Mandulagyulladás, tonsillitis k.m.n., tonsillitis
Norwegian Tonsillitt, Halsbetennelse

Ontology: Acute catarrhal tonsillitis (C0396012)

Concepts Disease or Syndrome (T047)
SnomedCT 195669000
English Acute catarrhal tonsillitis (diagnosis), tonsillitis acute catarrhal, Acute catarrhal tonsillitis, Acute exudative tonsillitis, Acute catarrhal tonsillitis (disorder)
Spanish amigdalitis catarral aguda (trastorno), amigdalitis catarral aguda, amigdalitis exudativa aguda (trastorno), amigdalitis exudativa aguda

Ontology: Exudative pharyngitis (C0747555)

Concepts Disease or Syndrome (T047)
SnomedCT 126664009
English Exudative pharyngitis (disorder), Exudative pharyngitis
Spanish faringitis exudativa (trastorno), faringitis exudativa