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Etiology of Tonsillitis

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Etiology of tonsillitis

• Bacterial
– Beta-hemolytic streptocococuss
– Pneumococcus
– Stahylococcus
– Treponema Pallidum
– Neisseria gonorrhea
– Haemophilus influenza
• Viral
– Adeno virus
– Rhino virus
– Respiratory synctial virus
– Influenza virus
– Epstein-Barr virus
• Fungal
– Candida albicans
Pathogenesis of tonsillitis
• Bacteria/Microorganism infiltrates epithellium
of tonsilla palatina>trigger local immunity
mechanism>result in purulent material
accumulation (detritus)>fill tonsillar
crypt>seen as yellowish spot
Complication of tonsillitis
• Untreated GABHS infection, which is the most
common bacterial agent in Tonsillitis, may
cause the following condition
– Scarlet fever
– Rheumatic fever
– Glomerulonephritis
– Peritonsillar abscess
Predisposing factor
• Bad oral hygiene
• Immunocompromise
• Smoking
• Weather/climate
• Fatigue
Chronic tonsillitis
SIGN AND SYMPTOMS
• Symptoms
– Odinophagia
– Sore throat
– Snoring
– Breathing difficulty
– Fever
– Halitosis
• Signs
– Tonsills enlargement
– Enlargement of the crypts
– Crypts usually contains Detritus
– Peritonsillar erythema
– Smooth glistening
Tonsill grading
Treatment
• Treatment for chronictonsillitis are either
conservative or tonsillectomy
Acute Tonsillitis
Sign and symptoms
• Symptoms
– Fever
– Malaise
– Headache
– Sore throat
• Sign
– Limited redness of tonsill
– Swelling of tonsill
Treatment
• Bed rest with sufficient fluid intake
• Analgetics (paracetamol or ibuprofen) to
relieve pain and fever
• Antibiotics such as penicillin or Eryhthromycin
– For GABHS first line of treatment is Penicillin V
– For patients with penicillin alergies, Azithromycin
can be use instead
SUPPORTING EXAMINATION
• Laboratory blood exam > increase in
leukocyte, Hematocrit, and C- reactive protein
(CRP)
• ASTO (Anti Streptolysin O) test > to distinguish
GABHS
• Bacterial cultures from pharyngeal swab >
gold standard

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