Mouth

Tonsillitis

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Tonsillitis, Acute Tonsillitis, Exudative Pharyngitis, Acute Exudative Tonsillitis, Acute Catarrhal Tonsillitis

  • Symptoms
  1. See Pharyngitis
  2. Difficulty taking oral intake
  3. Difficulty swallowing secretions
  4. Otalgia (common innervation of ear and throat)
  • 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
  • Differential Diagnosis
  • Select Causes
  • 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
  1. See Tonsillectomy Indications
  2. Prognosis following Tonsillectomy
    1. Reduces Pharyngitis frequency (esp. Streptococcus)
    2. Effect lasts 2-3 years after surgery
  • Resources