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TONSILLITIS 
Dr. Angelo Smith M.D 
WHPL
TONSILLITIS 
• Inflammation or infection of the tonsils is 
medically termed as Tonsillitis. 
• Tonsils are protective (lymph) glands that are 
situated on both sides in the throat. 
• The tonsils constitute an important part of the 
body's immune system and are vital defense 
organs. 
• They protect the body from bacteria and 
viruses by fighting these as soon as they enter 
the body (via the oral / nasal cavity).
ANATOMY 
• In the normal state, tonsils are pink in color (similar 
to their surroundings tissues) and about the same 
size. 
• The tonsils along with adenoids are said to form the 
'first line of defense' against infective organisms.
PATHOLOGY 
• When the tonsils get inflamed, they become red, 
swollen and may develop pus pockets that start 
exuding a discharge. 
• In cases with recurrent infections, the tonsils may 
become so swollen over a period of time so as to 
almost touch each other. 
• Tonsillitis is very common amongst children. 
• No particular gender predilection is seen in cases of 
tonsillitis.
CAUSES 
• Bacterial and viral infections can cause tonsillitis 
through droplet infection. 
• A common cause is Streptococcus bacteria. 
• Other common causes include: 
o Adenoviruses 
o Influenza virus 
o Epstein-Barr virus 
o Parainfluenza viruses 
o Enteroviruses 
o Herpes simplex virus
TRIGGERING FACTORS 
• Foods with artificial colors and preservatives. 
• Peanuts. 
• Cold foods, cold drinks, Ice creams. 
• Changes of weather. 
• Extremely cold climate, 
• Damp weather. 
• Exposure to a lot of pollution. 
• Sour fruits, lemon, pineapple, grapes, oranges.
SIGNS 
Red and swollen tonsils 
White spots (specks or patches) on the 
tonsils 
Enlarged lymph nodes in neck region 
Bad and foul breath 
Cough 
Running Nose
SYMPTOMS 
• Soreness of throat 
• Difficulty in swallowing or painful swallowing of food 
and drinks 
• Pain / discomfort while swallowing saliva 
• Change of voice 
• Pain in the ears (due to common nerve supply of the 
back of the throat and ears) 
• Headache 
• Malaise, tiredness 
• Difficulty in taking feeds in babies - this may be the 
sole indicator in some cases of tonsillitis in infants
CATARRHAL TONSILLITIS 
• When tonsils are 
inflamed as part of 
the generalised 
infection of the 
oropharyngeal 
mucosa it is called 
catarrhal tonsillitis.
MEMBRANOUS TONSILLITIS 
• Some times 
exudation from crypts 
may coalesce to form 
a membrane over the 
surface of tonsil, 
giving rise to clinical 
picture of 
membranous 
tonsillitis.
PARENCHYMATOUS TONSILLITIS 
• When the whole 
tonsil is uniformly 
congested and 
swollen it is called 
acute 
parenchymatous 
tonsillitis
DIAGNOSIS 
 Examination of the throat in tonsillitis: 
• Redness and swelling of the tonsils 
• Pus pockets on the tonsils 
• Discharge from the tonsils 
• In case of peritonsillar abscess, there 
may be a shift of the involved tonsil 
towards the center of the throat. The 
uvula may be shifted towards the 
opposite side (away from the affected 
tonsil).
DIAGNOSIS 
 Throat swab :This is used to get a sample of the 
secretion from the back of the throat. 
• Monospot test: A blood test can detect certain 
antibodies, which can help confirm that a person’s 
symptoms are due to mononucleosis. 
• Epstein-Barr virus antibodies: If a monospot test is 
negative, antibodies in the blood against EBV might 
help diagnose mononucleosis. 
• Blood tests: This primarily includes a complete blood 
count (CBC) which is done to confirm the presence of 
infection.
COMPLICATIONS 
• Local: Severe 
swelling with spread 
of infection and 
inflammation to the 
hypopharynx and 
larynx may 
occasionally produce 
increasing respiratory 
obstruction, although 
it is very rare in 
uncomplicated acute 
tonsillitis.
COMPLICATIONS 
• Peritonsillar abscess is one 
of the complications of acute 
tonsillitis and its development 
means that infection has 
spread outside tonsillar 
capsule. 
• Spread of infection from 
tonsil or more usually from a 
peritonsillar abscess through 
the superior constrictor 
muscle of the pharynx first 
results in cellulitis of the neck 
and later in parapharyngeal 
space abscess.
• The systemic or general complications of 
acute tonsillitis are rare and almost confined to 
childhood. 
• Septicemia: Untreated acute tonsillitis can 
result in septicemia with septic abscesses, 
septic arthritis and meningitis
ALLOPATHIC TREATMENT 
• Acetaminophen & Ibuprufen are given for relieving the 
symptoms. 
• Antibiotics are prescribed once bacterial infection is confirmed. 
• Tonsillectomy – 
• For those children's who do not repond to 
antibiotics 
• Quinsy - It is usually treated by draining the 
abscess and antibiotics. Sometimes 
removing the tonsils is needed to treat 
quinsy.
PREVENTION 
• Avoid close contact with others who are sick. 
• Keep children away from kids who are known to have 
tonsillitis or a sore throat. 
• Remind kids about the importance of proper hand-washing, 
especially when around people who appear to 
be sick. 
• Wash and disinfect surfaces and toys. 
• Teaching kids to cover their mouths when coughing or 
sneezing, preferably using a tissue so that germs do 
not get on their hands. And show them how to use 
tissues to wipe their noses. 
• Carry disposable wipes and a hand sanitizer to clean 
hands

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Tonsillitis

  • 1. TONSILLITIS Dr. Angelo Smith M.D WHPL
  • 2. TONSILLITIS • Inflammation or infection of the tonsils is medically termed as Tonsillitis. • Tonsils are protective (lymph) glands that are situated on both sides in the throat. • The tonsils constitute an important part of the body's immune system and are vital defense organs. • They protect the body from bacteria and viruses by fighting these as soon as they enter the body (via the oral / nasal cavity).
  • 3.
  • 4. ANATOMY • In the normal state, tonsils are pink in color (similar to their surroundings tissues) and about the same size. • The tonsils along with adenoids are said to form the 'first line of defense' against infective organisms.
  • 5. PATHOLOGY • When the tonsils get inflamed, they become red, swollen and may develop pus pockets that start exuding a discharge. • In cases with recurrent infections, the tonsils may become so swollen over a period of time so as to almost touch each other. • Tonsillitis is very common amongst children. • No particular gender predilection is seen in cases of tonsillitis.
  • 6.
  • 7. CAUSES • Bacterial and viral infections can cause tonsillitis through droplet infection. • A common cause is Streptococcus bacteria. • Other common causes include: o Adenoviruses o Influenza virus o Epstein-Barr virus o Parainfluenza viruses o Enteroviruses o Herpes simplex virus
  • 8.
  • 9. TRIGGERING FACTORS • Foods with artificial colors and preservatives. • Peanuts. • Cold foods, cold drinks, Ice creams. • Changes of weather. • Extremely cold climate, • Damp weather. • Exposure to a lot of pollution. • Sour fruits, lemon, pineapple, grapes, oranges.
  • 10. SIGNS Red and swollen tonsils White spots (specks or patches) on the tonsils Enlarged lymph nodes in neck region Bad and foul breath Cough Running Nose
  • 11. SYMPTOMS • Soreness of throat • Difficulty in swallowing or painful swallowing of food and drinks • Pain / discomfort while swallowing saliva • Change of voice • Pain in the ears (due to common nerve supply of the back of the throat and ears) • Headache • Malaise, tiredness • Difficulty in taking feeds in babies - this may be the sole indicator in some cases of tonsillitis in infants
  • 12. CATARRHAL TONSILLITIS • When tonsils are inflamed as part of the generalised infection of the oropharyngeal mucosa it is called catarrhal tonsillitis.
  • 13. MEMBRANOUS TONSILLITIS • Some times exudation from crypts may coalesce to form a membrane over the surface of tonsil, giving rise to clinical picture of membranous tonsillitis.
  • 14. PARENCHYMATOUS TONSILLITIS • When the whole tonsil is uniformly congested and swollen it is called acute parenchymatous tonsillitis
  • 15. DIAGNOSIS  Examination of the throat in tonsillitis: • Redness and swelling of the tonsils • Pus pockets on the tonsils • Discharge from the tonsils • In case of peritonsillar abscess, there may be a shift of the involved tonsil towards the center of the throat. The uvula may be shifted towards the opposite side (away from the affected tonsil).
  • 16. DIAGNOSIS  Throat swab :This is used to get a sample of the secretion from the back of the throat. • Monospot test: A blood test can detect certain antibodies, which can help confirm that a person’s symptoms are due to mononucleosis. • Epstein-Barr virus antibodies: If a monospot test is negative, antibodies in the blood against EBV might help diagnose mononucleosis. • Blood tests: This primarily includes a complete blood count (CBC) which is done to confirm the presence of infection.
  • 17. COMPLICATIONS • Local: Severe swelling with spread of infection and inflammation to the hypopharynx and larynx may occasionally produce increasing respiratory obstruction, although it is very rare in uncomplicated acute tonsillitis.
  • 18. COMPLICATIONS • Peritonsillar abscess is one of the complications of acute tonsillitis and its development means that infection has spread outside tonsillar capsule. • Spread of infection from tonsil or more usually from a peritonsillar abscess through the superior constrictor muscle of the pharynx first results in cellulitis of the neck and later in parapharyngeal space abscess.
  • 19. • The systemic or general complications of acute tonsillitis are rare and almost confined to childhood. • Septicemia: Untreated acute tonsillitis can result in septicemia with septic abscesses, septic arthritis and meningitis
  • 20. ALLOPATHIC TREATMENT • Acetaminophen & Ibuprufen are given for relieving the symptoms. • Antibiotics are prescribed once bacterial infection is confirmed. • Tonsillectomy – • For those children's who do not repond to antibiotics • Quinsy - It is usually treated by draining the abscess and antibiotics. Sometimes removing the tonsils is needed to treat quinsy.
  • 21. PREVENTION • Avoid close contact with others who are sick. • Keep children away from kids who are known to have tonsillitis or a sore throat. • Remind kids about the importance of proper hand-washing, especially when around people who appear to be sick. • Wash and disinfect surfaces and toys. • Teaching kids to cover their mouths when coughing or sneezing, preferably using a tissue so that germs do not get on their hands. And show them how to use tissues to wipe their noses. • Carry disposable wipes and a hand sanitizer to clean hands