Tonsillitis

Question 1

Define tonsillitis.

Answer 1

Acute tonsillitis is an acute infection of the parenchyma of the palatine tonsils. The clinical distinction between tonsillitis and pharyngitis is unclear in the literature, and the condition is often referred to simply as ‘acute sore throat’.

Question 2

Explain the aetiology/risk factors of tonsillitis.

Answer 2

Age between 5 and 15 years
Contact with infected people in enclosed spaces (e.g., child care centres, schools, prison)

Question 3

Summarise the epidemiology of tonsillitis.

Answer 3

In UK general practice, recurrent sore throat has an annual incidence of 100 in 1000 population. Acute tonsillitis is more common in children between the ages of 5-15 years.

Question 4

Recognise the presenting symptoms of tonsillitis. Recognise the signs of tonsillitis on physical examination.

Answer 4

Pain on swallowing
Fever (>38°C)
Tonsillar exudate
Sudden onset of sore throat
Headache
Abdominal pain
Nausea and vomiting
Presence of cough or runny nose
Tonsillar erythema and enlargement
Enlarged anterior cervical lymph nodes

Question 5

Identify appropriate investigations for tonsillitis and interpret the results.

Answer 5

Throat culture
Rapid streptococcal antigen test