Tonsillitis

Question 1

def

Answer 1

inflammation of the tonsils

Question 2

aetiology

Answer 2

1 viral (most common)
-rhinovirus>coronavirus>adenovirus
2 bacteria
-beta-haemolytic streptococci (most common is group A beta-haemolytic streptococci followed by group C)

Question 3

what are group A beta-haemolytic streptococci

Answer 3

streptococcus pyogenes

Question 4

what are group C beta-haemolytic streptococci

Answer 4

streptooccus dysgalactiae

Question 5

epi

Answer 5

common in children

Question 6

risk factors

Answer 6

children

contact with infected people

Question 7

history

Answer 7

sudden onset sore throat with pain on swallowing

associated symptoms such as cough or runny nose, fever, headache, N+V

Question 8

examination

Answer 8

tonsillar redness and enlargement, tonsillar exudate (esp with Group A beta-haemolytic streptococci)
lymphadenopathy (anterior cervical lymph nodes)

Question 9

investigations

Answer 9

1 rapid streptococcal antigen test
-identifies GABHS
2 throat culture is a definitive diagnosis for bacterial tonsilitis
3 bloods
-raised CRP, WCC

Question 10

what are the centor criteria

Answer 10

indicates the likelihood of a sore throat being due to a bacterial infection
1 tonsillar exudate
2 tender anterior cervical lymphadenopathy
3 fever >38
4 absence of cough

Question 11

what is the streptococcal score card

Answer 11

indicates the likelihood of a sore through being due to GABHS
1 age 5-15yrs
2 season (late autumn, winter, early spring)
3 fever >38.3
4 cervical lymphadenopathy
5 pharyngeal erythema, oedema, exudate
6 no symptoms of a viral URI (cough, runny nose)