Tonsilitis

Question 1

Tonsilitis vs Pharyngitis vs Laryngitis

Answer 1

• Pharyngitis is inflammation of oropharynx not tonsils

- In laryngitis there are few visible signs, soreness lower down in throat, often with hoarseness

Question 2

Tonsilitis Presentation

Answer 2

• Pain in throat
• Made worse by swallowing, may be referred to ears
• Abdominal pain, headache, voice changes
• Strep tonsils has acute onset, headache, abdominal pain, dysphagia

Question 3

Tonsilitis Differentials

Answer 3

• Milder if due to virus
• In Coxsackievirus, small blisters develop on the tonsils and roof of mouth
• EBV
• Epiglottitis

Question 4

Tonsilitis Investigations

Answer 4

-Routine swabs not recommended

Question 5

Tonsilitis Centor Criteria

Answer 5

• History of fever
• Tonsillar exudates
• No cough
• Tender anterior cervical lymphadenopathy
• Patient with one or none of these criteria are unlikely to have GABS
• Antibiotics for those with three or more criteria

Question 6

Tonsilitis Management

Answer 6

• Isolation
• OTC pain relief
• Only antibiotics if systemic illness, unilateral peritonsillitis, PHx of rheumatic fever, increased risk, ≥3 centor
• Back up prescription, advise to use if symptoms do not improve or worsen
• Phenoxymethylpenicillin

Question 7

Tonsilitis Surgical Management

Answer 7

SIGN Criteria

-Tonsillitis 7 times in past year, 5 times per year in past two years, 3 times in last three years