What is Acute Tonsillitis?
The term acute tonsillitis typically refers to inflammation of the palatine tonsils. In some cases, the inflammation extends from the adenoids to the lingual tonsils, and the term pharyngitis may also be used.
Tonsillitis can be caused by viral or bacterial infections or may be associated with immunological factors. Most episodes of pharyngitis and acute tonsillitis are caused by viruses such as the Herpes Simplex Virus, Epstein-Barr Virus (infectious mononucleosis), or Cytomegalovirus, among others.
Bacteria account for approximately 30% of cases of pharyngotonsillitis, with the majority caused by Group A beta-hemolytic Streptococcus Pyogenes.
Acute pharyngotonsillitis
Symptoms of Acute Tonsillitis
- Fever
- Bad breath
- Odynophagia (pain when swallowing)
- Dysphagia (difficulty swallowing)
- Swelling of the cervical lymph nodes
Complications
The most common complication of acute tonsillitis is a peritonsillar abscess, which presents with:
- Severe sore throat
- Fever
- Drooling
- Bad breath
- Trismus (difficulty opening the mouth)
- Voice changes (muffled or “hot potato” voice)
Examination of the Oropharynx
Diagnosis of Acute Tonsillitis
The diagnosis of tonsillitis is based on a physical examination, conducted through the mouth. This may reveal inflammation and enlargement of the palatine tonsils, which can present with exudates, petechiae on the palate, and aphthae. If a peritonsillar abscess is suspected, the most common findings during the examination include unilateral bulging above and lateral to the tonsil, with displacement of the uvula toward the contralateral side. In some cases, a fiberoptic laryngoscopy may be necessary.
Imaging studies, such as cervical CT scans, are generally not required and are only indicated if there is suspicion of the infection spreading to deeper neck spaces.
A throat culture may be useful in cases of resistance to conventional medical treatments.
Treatment
For the treatment of acute tonsillitis, general measures are crucial. These include adequate hydration and management of pain and fever. For medication prescriptions, it is essential to consult a specialist for proper evaluation.