Inflammation of the pharyngeal tonsils that can extend to the adenoid and lingual tonsils
May be acute or chronic
Typical viral infection: Mild and of limited duration
Overview-Pathophysiology
The inflammatory response to cell damage by viruses or bacteria may result in hyperemia and fluid exudation.
Overview-Causes
Bacterial infection (group A beta-hemolytic streptococci)
Viral infection (herpes simplex virus, Epstein-Barr virus, adenovirus, measles virus)
Overview-Incidence
Viral tonsillitis is more common than bacterial tonsillitis.
Bacterial infection occurs more commonly in the winter.
Overview-Complications
Chronic upper airway obstruction
Sleep disturbance or sleep apnea
Cor pulmonale
Failure to thrive
Eating or swallowing disorders
Speech abnormalities
Febrile seizures
Otitis media
Cardiac valvular disease
Peritonsillar abscesses
Glomerulonephritis (group A beta-hemolytic Streptococcus )
Rheumatic fever (group A beta-hemolytic Streptococcus )
Acute poststreptococcal glomerulonephritis (group A beta-hemolytic Streptococcus )
Bacterial endocarditis
Cervical lymph node abscesses
Assessment-History
Mild to severe sore throat
Hoarseness
Coughing
Muscle and joint pain
Chills
Malaise
Headache
Pain, commonly referred to the ears
Constant urge to swallow
Constricted feeling in the back of the throat
Assessment-Physical Findings
Fever
Foul breath
Snoring
Voice changes (thicker or deeper voice)
Swollen, tender submandibular lymph nodes
Generalized inflammation of the pharyngeal wall
Swollen tonsils projecting from between the pillars of the fauces and exuding white or yellow follicles (see Tonsillitis)
Purulent drainage with application of pressure to tonsillar pillars
Uvula that’s possibly edematous and inflamed
Soft palate petechiae
Cervical lymphadenopathy
Diagnostic Test Results-Laboratory
A throat culture may reveal the infecting organism (gold standard).
A serum white blood cell count usually reveals leukocytosis.
Antistreptococcal antibody titers are elevated.
Treatment-General
Symptom relief
Cool-mist humidifier
Saltwater gargles
Anesthetic throat lozenges
Airway management
Treatment-Diet
As tolerated
Adequate fluid intake
Treatment-Activity
Rest periods as needed
Treatment-Medications
Acetaminophen for fever and pain
Antibiotics, such as penicillins or amoxicillin, erythromycin, or cephalexin (if allergic to penicillin) as first-line agents for streptococcal infection; possibly azithromycin or clarithromycin as second-line agents
Treatment-Surgery
Incision and drainage of peritonsillar abscess
Possible tonsillectomy (for recurrent tonsillitis)