Sore throat Flashcards
Which bacteria is the most common cause of bacterial acute tonsillitis?
Streptococcus pyogenes (Group A strep)
What is the typical clinical presentation of viral tonsillitis?
Viral tonsillitis usually presents with malaise, sore throat (requiring mild analgesia), fever, possible lymphadenopathy, and symptoms lasting 3-4 days
What is the Centor scoring system used for?
Likelihood of bacterial tonsillitis, particularly from Streptococcus pyogenes
Points are awarded for
1. fever
2. absence of cough
3. tender anterior cervical
4. lymphadenopathy
5. tonsillar exudate
What antibiotics are typically used to treat bacterial tonsillitis caused by Streptococcus pyogenes?
Penicillin
= Clarithromycin if penicillin allergic
Management of tonsilitis in hospital
IV fluids, antibiotics and steroids
What is the most common potential complication of acute tonsillitis?
Otitis media
What is peritonsillar abscess (Quinsy)?
Main complication of acute tonsillitis
How does quinsy occur?
Bacteria between the muscle and the tonsil produce puss
Clinical presentation of quinsy
- Unilateral throat pain and odynophagia
- Trismus
= difficulty opening the mouth - 3-7 days preceding acute tonsillitis
- medial displacement of the tonsil and uvula
How is Quinsy distinguished from simple tonsillitis?
Trismus (difficulty opening the mouth) is a key feature of Quinsy and is not present in simple tonsillitis
How long does acute tonsillitis usually precede Quinsy?
develops 3-7 days after acute tonsillitis
What is the first-line management of Quinsy?
hospital admission for aspiration and intravenous antibiotics
What is Chronic Tonsillitis ?
Persistent infection of the tonsils - symptoms that persist beyond two weeks
= Manage with simple dental mouthwash
What is the pathophysiology of EBV?
EBV establishes a persistent infection in epithelial cells, especially in the pharynx
What is the classic triad of symptoms in EBV infection?
fever, pharyngitis, and lymphadenopathy
Infectious mononucleosis (Glandular Fever) is caused by what?
EBV
Key symptoms of glandular fever
Sore throat + lymphadenopathy = glandular fever (EBV)
What is the most accurate test for glandular fever?
EVB serology
= Monospot antibodies (+)
Why do you NOT prescribe ampicillin/amoxicillin in glandular fever?
A generalised macular rash will appear
What is the recommendation for physical activity in patients with EBV?
Patients should avoid sports for 6 weeks due to the risk of splenic rupture
A 5-year-old child presents with fever, drooling, and difficulty swallowing. On examination, the child is leaning forward with their chin protruding. What is the most likely diagnosis?
Epiglottitis
A 4-year-old has fever, drooling, and difficulty breathing while leaning forward. What’s the most serious diagnosis to consider?
Epiglottitis
