Tonsillitis

Question 1

What is the most common cause of bacterial tonsillitis?

Answer 1

Group A streptococcus (strep pyogenes)

Question 2

What are the other causes of bacterial tonsillitis?

Answer 2

Streptococcus pneumoniae
Haemophilus influenzae
Moraxella catarrhalis
Staphylococcus aureus

Question 3

What is the presentation of acute tonsillitis?

Answer 3

Sore throat
Fever
Lymphadenopathy
Pain on swallowing
Exudative tonsils

Question 4

What is the centor criteria?

Answer 4

Criteria that indicates tonsillitis is due to a bacterial infection:
- Fever over 38
- Tonsillar exudates
- Absence of cough
- Tender anterior cervical lymphadenopathy

Question 5

What is the feverPAIN score?

Answer 5

Alternative criteria that indicates tonsillitis is due to a bacterial infection:
Fever over 38 degrees
Purulence
Attended within 3 days of onset of symptoms
Inflamed tonsils
No cough or coryza

Question 6

When should antibiotics be prescribed for tonsillitis?

Answer 6

When the centor score is more than 3 or the feverPAIN score is more than 4

Question 7

What is the first line treatment of tonsillitis?

Answer 7

10 day course of phenoxymethylpenicillin

Question 8

What is the second line treatment of tonsillitis?

Answer 8

Clarithromycin (used in those with penicillin allergy)

Question 9

What are the complications of tonsillitis?

Answer 9

Quinsy (peritonsillar abscess)
Otitis media
Scarlet fever
Rheumatic fever
Post-streptococcal glomerulonephritis
Post-streptococcal reactive arthritis