OROPHARYNX Acute tonsillitis

OROPHARYNX Acute tonsillitis

This common condition is characterised by a sore throat, fever, general malaise, dysphagia, enlarged upper cervical nodes and sometimes referred otalgia. Approximately half the cases are bacterial, the most common cause being a pyogenic group A Streptococcus . The remainder are viral and a wide variety of viruses have been implicated, in particular infectious mononu - cleosis (glandular fever), which may be mistaken for bacterial tonsillitis. On examination, the tonsils are swollen and erythema - tous, and yellow or white pustules may be seen on the palatine tonsils, hence the name ‘follicular tonsillitis’ ( Figure 52.24 ). A throat swab should be taken at the time of examination as well as blood for EBV testing to confirm or refute the diagnosis of ver. glandular fe Treatment Paracetamol and/or other analgesia may be administered to relieve pain and saline gargles are soothing. The condition is frequently sensitive to benzyl- or phenoxymethylpenicillin (penicillin V) and these are given until antibiotic sensitivities are established. Ampicillin is avoided as it may precipitate a rash in patients with infectious mononucleosis. Most cases resolve in a few days. OROPHARYNX Acute tonsillitis

This common condition is characterised by a sore throat, fever, general malaise, dysphagia, enlarged upper cervical nodes and sometimes referred otalgia. Approximately half the cases are bacterial, the most common cause being a pyogenic group A Streptococcus . The remainder are viral and a wide variety of viruses have been implicated, in particular infectious mononu - cleosis (glandular fever), which may be mistaken for bacterial tonsillitis. On examination, the tonsils are swollen and erythema - tous, and yellow or white pustules may be seen on the palatine tonsils, hence the name ‘follicular tonsillitis’ ( Figure 52.24 ). A throat swab should be taken at the time of examination as well as blood for EBV testing to confirm or refute the diagnosis of ver. glandular fe Treatment Paracetamol and/or other analgesia may be administered to relieve pain and saline gargles are soothing. The condition is frequently sensitive to benzyl- or phenoxymethylpenicillin (penicillin V) and these are given until antibiotic sensitivities are established. Ampicillin is avoided as it may precipitate a rash in patients with infectious mononucleosis. Most cases resolve in a few days.