Tonsillitis.in children

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TONSILLITIS IN CHILDREN

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Tonsillitis.in children

  1. 1. TONSILLITIS AMRUTHA R
  2. 2. TONSILLITIS • Inflammation of tonsils • 3-7yrs
  3. 3. RESEARCH • Health news of NHS choices • Admission rates for tonsillectomy has reduced between 1999 and 2010
  4. 4. Tonsils
  5. 5. WALDEYERS RING
  6. 6. TONSILS
  7. 7. TONSILLITIS DEFINITION • Infection of tonsils which are glands on either side of the throat.
  8. 8. CAUSES • Bacterial • Viral • Infectious mononucleosis
  9. 9. Bacterial • Group A beta hemolytic streptococcus VIRAL • • • • • Adenovirus Rhinovirus Influenza virus Para influenza virus Entero virus
  10. 10. Infectious mononucleosis • Epstein barr virus
  11. 11. Types ACUTE • Catarrhal stage • Follicular • Parenchymatous • Peritonsillar abscess/ quincy
  12. 12. Catarrhal Follicular Parenchymatous Peritonsillar abscess/ quincy
  13. 13. Chronic • • • • • Repeated attacks Enlarged spongy appearance Fibrous tissue Scarring of tissue Adults
  14. 14. Pathophysiology
  15. 15. tonsillitis - pathogenesis • disruption of the drainage function of the lacunae, accumulation of a secretion and waste products of microbes; • disturbance of tissue metabolism in the tonsils; • reduction of barrier properties of the tonsils, including production of secretory immunoglobulins A; • appearance of inflammatory reactions in the form of frequent pain and metatonsillar complications.
  16. 16. Clinical features • • • • • • • Frequent throat infections Breathing difficulties Dysphagia Redness of anterior pillers Breathing through mouth Dry mucous membrane Oedema
  17. 17. Clinical features • • • • • • Drooling Fever Loss of appetite General feeling of unwell Swollen tonsils Change in sound
  18. 18. Clinical features • • • • • Nausea vomiting Abdominal pain Furry tongue Halitosis Trismus
  19. 19. Local signs of tonsillitis Unpleasant mouth odor Unpleasant feeling in the throat Lymph nodes are small and dense Pus or tonsil stones in lacunae
  20. 20. Local signs of tonsillitis - changes in the palatine arches Hyperemia Slight swelling
  21. 21. Investigations • History collection • Physical examination
  22. 22. • Throat swab • Blood tests • ASO titre
  23. 23. Management General measures • Gargles • Rest • Hydration • Foods • Air • Lozenges • Avoid irritants
  24. 24. DRUGS Analgesics • Ibuprofen • Acetaminophen Antibiotics
  25. 25. ANTIBIOTICS • Penicillin V 25-50 mg/kg/day divided q6h for 10d or • Benzathine penicillin G 25,000 U/kg IM once (maximum 1.2 million U) or • Amoxicillin 50 mg/kg/day PO in 2 or 3 divided doses for 10d or
  26. 26. ANTIBIOTICS • Amoxicillin-clavulanate 500-875 mg PO q12h for 10d • Cefdinir 14 mg/kg PO once daily for 10d or • Cefuroxime axetil 10 mg/kg PO BD for 410d
  27. 27. ANTIBIOTICS • Azithromycin 12 mg/kg PO once daily for 5d or • Clarithromycin 250 mg PO q12h for 10d or • Erythromycin succinate 20 mg/kg PO BID for 10d or • Clindamycin 20 mg/kg/day PO in 3 divided doses (maximum 1.8 g/d) for 10d
  28. 28. RESEARCH • JOURNAL of antimicrobial chemotherapy • Sept 1993- J HAMMIL
  29. 29. SURGICAL MANAGEMENT
  30. 30. Surgery • • • • • Indications Obstructive sleep apnoea Breathing difficulty Absess Dysphagia Malignant growth
  31. 31. TONSILLECTOMY
  32. 32. METHODS • Cold stress • Diathermy • Coblation • Electrocautery
  33. 33. CARE AFTER SURGERY • • • • • Antibiotics Analgesics Fluid intake Food Prevention of complications
  34. 34. COMPLICATIONS
  35. 35. Research • Child health news in Feb. 2011 • Tonsillectomy increases the risk of pediatric obesity • 795 children selected
  36. 36. Nursing management ASSESSMENT
  37. 37. DIAGNOSIS
  38. 38. INTERVENTION • • • • • Promoting airway clearance Maintaining fluid volume Pain management Prevent complications Health education
  39. 39. Evaluation

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