Tonsilitis

Question 1

What is Tonsillitis?

Answer 1

• Inflammation of the tonsils
• Typical cause is a viral cause - These do not require/ respond to antibiotics

Question 2

What is the most common cause of Bacterial Tonsillitis?

Answer 2

• Group A streptococcus

Question 3

What are the other causes of bacterial tonsillitis?

Answer 3

• Streptococcus pneumoniae
• Haemophilus Influenzae
• Moraxella catarrhalis
• Staphylococcus aureus

Question 4

What is the presentation of Tonsillitis?

Answer 4

• Sore throat
• Fever above 38 degrees
• Pain on Swallowing

Question 5

What will you see on examination of the throat?

Answer 5

• Red, inflamed and enlarged tonsils with or without exudates
• Anterior Cervical lymphadenopathy = swollen, tender lymph nodes
• Tonsillar lymph nodes

Question 6

What is the Centor Critieria?

Answer 6

• This is a score that can estimate the probability that tonsillitis is due to bacterial infection and will benefit from antibiotics
• A score of 3 or more gives a 40-60% probability of bacterial tonsillitis

Question 7

What is included in the Centor Criteria?

Answer 7

• Fever - over 38
• Tonsillar exudates
• Absence of cough
• Tender anterior cervical lymph nodes

Question 8

What is the management of Tonsillitis?

Answer 8

• Bacterial causes: Penicillin V (phenoxymethylpenicillin) for a 10 day course
• Viral: analgesia (paracetamol and ibuprofen)

Question 9

What are the complications of Tonsillitis?

Answer 9

• Peri-tonsillar Abscess
• Otitis Media
• Scarlet Fever
• Rheumatic Fever
• Post-streptococcal glomerulonephritis
• Post-streptococcal reactive arthritis