Tonsillitis

Question 1

What is tonsillitis?

Answer 1

Inflammation of the tonsils

Question 2

What is the most common cause of tonsillitis?

Answer 2

Viral infection

Question 3

What is the most common causative pathogen of tonsillitis?

Answer 3

Rhinovirus

Question 4

What are the other causative organsims of tonsillitis?

Answer 4

Viruses:
- Coronavirus
- Adenovirus

Bacteria:
- Group A Streptococcus (strep pyogenes) - most common bacterial cause
- Streptococcus pneumoniae
- Stapylococcus aureus

Question 5

What are the symptoms of acute tonsillitis?

Answer 5

Sore throat
Pain on swallowing
Fever

Question 6

What are the clinical signs of tonsillitis?

Answer 6

Pyrexia > 38
Tonsillar exudate
Enlargement and erythema of the tonsils
Anterior cervical lymphadenopathy

Question 7

What makes up the Centor criteria?

Answer 7

Fever > 38 degrees
Tonsillar exudates
Absence of cough
Tender anterior cervical lymph nodes

A score of 3 or more warrants antibiotics

Question 8

What makes up the feverPAIN score?

Answer 8

Fever in past 24 hours
Purulent tonsils
Attended within 3 days of onset of symptoms
Inflamed tonsils
No cough or coryza

A score of 4 or more warrants antibiotics

Question 9

What is the first line management of suspected bacterial tonsillitis?

Answer 9

Phenoxymethylpenicillin for 5-10 days
Clarithromycin or erythromycin for 5 days if penicillin allergic

Question 10

What are the complications of tonsillitis?

Answer 10

Acute otitis media
Peri-tonsilar abscess
Parapharyngeal abscess
Acute rheumatic fever
Post-streptococcal glomerulonephritis