| ID | 297 |
|---|---|
| Name | CHRONIC TONSILLITIS |
| Cause | Tonsillitis is most often caused by common viruses, but bacterial infections also can be the cause. The most common bacterium causing tonsillitis is Streptococcus pyogenes (group A streptococcus), the bacterium that causes strep throat. Other strains of strep and other bacteria also may cause tonsillitis |
| Signs Symptoms | Red, swollen tonsils. White or yellow coating or patches on the tonsils. Sore throat. Difficult or painful swallowing. Fever. Enlarged, tender glands (lymph nodes) in the neck. A scratchy, muffled or throaty voice. Bad breath. |
| Diagnosis | Sore or scratchy throat. Pain or difficulty swallowing. Red, swollen tonsils and throat. White spots on your tonsils. White, yellow or gray coating on your tonsils. Fever above 100.4 degrees Fahrenheit (38 degrees Celsius). Swollen lymph nodes (glands on the sides of your neck below your ears). Stomachache or vomiting (more common in younger children). |
| Investigations | Throat swab The sample will be checked in the clinic or in a lab for streptococcal bacteria. Many clinics are equipped with a lab that can get a test result within a few minutes. However, a second more reliable test is usually sent out to a lab that can often return results within several hours or a couple of days |
| Management | Management: 1. Treatment is conservative at first with attention to general health, nutritious diet, well ventilated room, like that of acute tonsillitis. 2. If trouble persists & recurrent attacks i.e. at least 2 to 3 attacks a year for consecutive 2 years, then tonsillectomy is advised. |
| Introduction | Chronic tonsillitis is a tenacious infection of the tonsils which may result in tonsil stones. Recurrent tonsillitis ensues when an individual suffers from several incidents of tonsillitis per year |
| History | |
| Etiology | See under causes |
| Clinical Features | Clinical f eatures: 1. Recurrent sore throat, difficulty in swallowing, rise of temperature, occasional malaise, chronic ill health. 2. Hawking & choking. 3. Tonsils are often enlarged in children but in Adult it is fibrotic, ant. pillars are congested.On pressing the ant. pillars pus comes out of the tonsillar crypts. 4. Tonsillar glands are enlarged. |
| Preventions | Wash his or her hands thoroughly and frequently, especially after using the toilet and before eating. Avoid sharing food, drinking glasses, water bottles or utensils. Replace his or her toothbrush after being diagnosed with tonsillitis |
| Treatment | At-home care Whether tonsillitis is caused by a viral or bacterial infection, at-home care strategies can make your child more comfortable and promote better recovery. If a virus is the expected cause of tonsillitis, these strategies are the only treatment. At-home care strategies to use during the recovery time include the following: Encourage rest. Encourage your child to get plenty of sleep. Provide adequate fluids. Give your child plenty of water to keep his or her throat moist and prevent dehydration. Provide comforting foods and beverage. Warm liquids — broth, caffeine-free tea or warm water with honey — and cold treats like ice pops can soothe a sore throat. Prepare a saltwater gargle. If your child can gargle, a saltwater gargle of 1/2 teaspoon (2.5 milliliters) of table salt to 8 ounces (237 milliliters) of warm water can help soothe a sore throat. Have your child gargle the solution and then spit it out. Humidify the air. Use a cool-air humidifier to eliminate dry air that may further irritate a sore throat, or sit with your child for several minutes in a steamy bathroom. Offer lozenges. Children older than age 4 can suck on lozenges to relieve a sore throat. Avoid irritants. Keep your home free from cigarette smoke and cleaning products that can irritate the throat. Treat pain prescribe ibuprofen or acetaminophen to minimize throat pain and control a fever. Low fevers without pain do not require treatment. Antibiotics If tonsillitis is caused by a bacterial infection, prescribe a course of antibiotics. Penicillin taken by mouth for 10 days is the most common antibiotic treatment prescribed for tonsillitis caused by group A streptococcus. If your child is allergic to penicillin, prescribe an alternative antibiotic. Failure to take all of the medication recommended is Surgery Surgery Surgery to remove tonsils (tonsillectomy) may be used to treat frequently recurring tonsillitis, chronic tonsillitis or bacterial tonsillitis that doesn't respond to antibiotic treatment. Frequent tonsillitis is generally defined as: At least seven episodes in the preceding year At least five episodes a year in the past two years At least three episodes a year in the past three years A tonsillectomy may also be performed if tonsillitis results in difficult-to-manage complications, such as: Obstructive sleep apnea Breathing difficulty Swallowing difficulty, especially meats and other chunky foods An abscess that doesn't improve with antibiotic treatment A tonsillectomy is usually done as an outpatient procedure, unless your child is very young, has a complex medical condition or if complications arise during surgery. That means your child should be able to go home the day of the surgery. A complete recovery usually takes seven to 14 days. |
| Complications | eritonsillar abscess ("Quinsy") ... Rheumatic Fever. ... Post-streptococcal arthritis. ... Post-streptococcal Glomerulonephritis. ... Scarlet Fever. ... Toxic Shock Syndrome. ... Ear infections and sinusitis. ... Meningitis and brain abscess. |
| Prognosis | Tonsillitis symptoms due to strep will often get better within 2 or 3 days after you start the antibiotics. Children with strep throat should be kept home from school or day care until they have been on antibiotics for 24 hours. This helps reduce the spread of illness |
| Types | |
| Classification | |
| Observation | |
| Pathology | Pathologically, the acute tonsillitis usually takes a form of an exudative inflammation, which may be catarrhal, vesiculous, purulent, pseudomembranous, or gangrenous. In the clinical practice, the most frequent is the acute purulent tonsillitis |
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