TONSILLITIS

1. TONSILLITIS
Dr. Angelo Smith M.D
WHPL

2. TONSILLITIS
• Inflammation or infection of the tonsils is
medically termed as Tonsillitis.
• Tonsils are protective (lymph) glands that are
situated on both sides in the throat.
• The tonsils constitute an important part of the
body's immune system and are vital defense
organs.
• They protect the body from bacteria and
viruses by fighting these as soon as they enter
the body (via the oral / nasal cavity).

4. ANATOMY
• In the normal state, tonsils are pink in color (similar
to their surroundings tissues) and about the same
size.
• The tonsils along with adenoids are said to form the
'first line of defense' against infective organisms.

5. PATHOLOGY
• When the tonsils get inflamed, they become red,
swollen and may develop pus pockets that start
exuding a discharge.
• In cases with recurrent infections, the tonsils may
become so swollen over a period of time so as to
almost touch each other.
• Tonsillitis is very common amongst children.
• No particular gender predilection is seen in cases of
tonsillitis.

7. CAUSES
• Bacterial and viral infections can cause tonsillitis
through droplet infection.
• A common cause is Streptococcus bacteria.
• Other common causes include:
o Adenoviruses
o Influenza virus
o Epstein-Barr virus
o Parainfluenza viruses
o Enteroviruses
o Herpes simplex virus

9. TRIGGERING FACTORS
• Foods with artificial colors and preservatives.
• Peanuts.
• Cold foods, cold drinks, Ice creams.
• Changes of weather.
• Extremely cold climate,
• Damp weather.
• Exposure to a lot of pollution.
• Sour fruits, lemon, pineapple, grapes, oranges.

10. SIGNS
Red and swollen tonsils
White spots (specks or patches) on the
tonsils
Enlarged lymph nodes in neck region
Bad and foul breath
Cough
Running Nose

11. SYMPTOMS
• Soreness of throat
• Difficulty in swallowing or painful swallowing of food
and drinks
• Pain / discomfort while swallowing saliva
• Change of voice
• Pain in the ears (due to common nerve supply of the
back of the throat and ears)
• Headache
• Malaise, tiredness
• Difficulty in taking feeds in babies - this may be the
sole indicator in some cases of tonsillitis in infants

12. CATARRHAL TONSILLITIS
• When tonsils are
inflamed as part of
the generalised
infection of the
oropharyngeal
mucosa it is called
catarrhal tonsillitis.

13. MEMBRANOUS TONSILLITIS
• Some times
exudation from crypts
may coalesce to form
a membrane over the
surface of tonsil,
giving rise to clinical
picture of
membranous
tonsillitis.

14. PARENCHYMATOUS TONSILLITIS
• When the whole
tonsil is uniformly
congested and
swollen it is called
acute
parenchymatous
tonsillitis

15. DIAGNOSIS
 Examination of the throat in tonsillitis:
• Redness and swelling of the tonsils
• Pus pockets on the tonsils
• Discharge from the tonsils
• In case of peritonsillar abscess, there
may be a shift of the involved tonsil
towards the center of the throat. The
uvula may be shifted towards the
opposite side (away from the affected
tonsil).

16. DIAGNOSIS
 Throat swab :This is used to get a sample of the
secretion from the back of the throat.
• Monospot test: A blood test can detect certain
antibodies, which can help confirm that a person’s
symptoms are due to mononucleosis.
• Epstein-Barr virus antibodies: If a monospot test is
negative, antibodies in the blood against EBV might
help diagnose mononucleosis.
• Blood tests: This primarily includes a complete blood
count (CBC) which is done to confirm the presence of
infection.

17. COMPLICATIONS
• Local: Severe
swelling with spread
of infection and
inflammation to the
hypopharynx and
larynx may
occasionally produce
increasing respiratory
obstruction, although
it is very rare in
uncomplicated acute
tonsillitis.

18. COMPLICATIONS
• Peritonsillar abscess is one
of the complications of acute
tonsillitis and its development
means that infection has
spread outside tonsillar
capsule.
• Spread of infection from
tonsil or more usually from a
peritonsillar abscess through
the superior constrictor
muscle of the pharynx first
results in cellulitis of the neck
and later in parapharyngeal
space abscess.

19. • The systemic or general complications of
acute tonsillitis are rare and almost confined to
childhood.
• Septicemia: Untreated acute tonsillitis can
result in septicemia with septic abscesses,
septic arthritis and meningitis

20. ALLOPATHIC TREATMENT
• Acetaminophen & Ibuprufen are given for relieving the
symptoms.
• Antibiotics are prescribed once bacterial infection is confirmed.
• Tonsillectomy –
• For those children's who do not repond to
antibiotics
• Quinsy - It is usually treated by draining the
abscess and antibiotics. Sometimes
removing the tonsils is needed to treat
quinsy.

21. PREVENTION
• Avoid close contact with others who are sick.
• Keep children away from kids who are known to have
tonsillitis or a sore throat.
• Remind kids about the importance of proper hand-washing,
especially when around people who appear to
be sick.
• Wash and disinfect surfaces and toys.
• Teaching kids to cover their mouths when coughing or
sneezing, preferably using a tissue so that germs do
not get on their hands. And show them how to use
tissues to wipe their noses.
• Carry disposable wipes and a hand sanitizer to clean
hands