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ACUTE INFECTION OF THE

PHARYNX AND TONSILS


ACUTE TONSILLITIS

Most frequent in childhood (does occur in


adults)
Virus Infection  attack of tonsillitis
Etiology

a.Group A beta haemolytic streptococci


b.Haemophilus Influenzae
c.Streptococcus pneumoniae
d.Staphylococci
e.Tuberculosis
Clinical Features
•Sore throat  pyrexia, malaise, headache
•Referred pain to the ear
•Tonsil is very hyperaemic
Differential Diagnosis
a. Infectious mononucleosis
b.Malignancy
c. Diphtheria
d.Scarlet Fever
e. Vincent’s Angina
f. Leukemia
g.Agranulocytosis
h.Pemphigus
Treatment
Parenteral Antibiotic
Analgesic
Complications

Local
•Respiratory obstruction
•Peritonsillar abscess
•Parapharyngeal abscess

Systemic
•Septicaemia (septic abscess, septic arthritis, meningitis)
•Glomerulonephritis
•Rheumatic fever
Acute Tonsillitis Hypertrophy Tonsillitis
ACUTE PERITONSILLAR
ABSCESS
Rare condition in childhood
Collection of pus  fibrous capsule
upper pole superior constrictor
muscle of the pharynx
Usually complication of acute tonsillitis
Previous history of recurrent episodes ( acute tonsillitis)
Deviation of the tonsil and uvula  midline
Swelling of Soft Palate
Often TRISMUS
Etiology

Most frequent organism  Beta


haemolytic streptococcus
Clinical Features
Previous history attacks of acute tonsillitis
Sore throat ( 2 – 3 days )
Always unilateral
•Fever, headache, and severe pain
•Accumulation of saliva
•Pyrexia and trismus
•Oedem and hyperemia of the soft palate
•Infective lymphadenopathy
Differential Diagnosis
Parapharyngeal Abscess

Treatment:
•Antibiotics
•Analgesics
•Incision and drainage
 Emergency abscess tonsillectomy
Complications

a.Venous thrombosis
b.Mediastinitis
c.Brain abscess
d.Airway obstruction
e.Aspiration pneumoniae
f. Nephritis, peritonitis, and dehydration
Peritosillar Abscess