Tonsillitis is an inflammation or infection of the tonsils, which are lymph glands located in the throat that help fight bacteria and viruses. Common causes are streptococcus bacteria and various viruses. Symptoms include sore throat, difficulty swallowing, and fever. Diagnosis involves examination of swollen tonsils and testing of throat secretions. Complications can include abscesses, but tonsillitis is usually treated with antibiotics, acetaminophen, and ibuprofen. Repeated cases may require tonsil removal. Prevention involves avoiding sick people and practicing good hand hygiene.

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).

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.

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

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