ACUTE INFECTION OF THE

PHARYNX AND TONSILS

Most frequent in childhood (does occur in adults)Virus Infection attack of tonsillitis

ACUTE 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 Diagnosisa. 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 FeaturesPrevious 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