Acute tonsillitis

palatine tonsil ,acute tonsillitis , membrane over tonsil , follicular tonsillitis

1. PALATINE TONSILS

2. ANATOMY

3. Development? Achieves its maximum size? Lining epithelium? Largest crypt?

4. ? Eagle’s syndrome? Glossopharyngeal neuralgia? Pulsatile tonsil?

5. BLOOD SUPPLY

6. Denis browne vein ?

7. FUNCTIONS Local immunity Surveillance mechanism

8. Acute tonsillitis

9. calssification Acute cattarhal / superficial Acute folllicular tonsillitis Acute parenchymatous tonsillitis Acute membranous tonsillitis

10. etiology School going children Most common cause –viral infections Hemolytic streptococci- GABS

11. symptoms Sore throat Difficulty in swallowing Fever Earache Constitutional symptoms abdominal pain ?

12. signs Foetid breath Coasted tongue Red, swollen tonsils with yellowish spots Whitish membrane Enlarged and congested tonsil Enlarged and tender jugulodigastric lymphnodes

13. DIAGNOSIS OF CAUSATIVE AGENT Throat swab TC , DC Blood smear Rapid antigen testing

14. Treatment supportive Bed rest Adequate hydration Analgesics Antibiotics – DOC ? duration-?( British national formulatory ) steroids ?

15. COMPLICATIONS Chronic tonsillitis Peritonsillar abscess ( indication for Sx ?) Parapharyngeal abcess ( CT) Cervical abcess Acute otitis media Scarlet fever , systemic sepsis Rheumatic fever Acute glomerulonephritis SABE – streptococcus viridans PANDAS- OCD & TICS

16. complications Lemierre’s syndrome ? Psoriasis ?

17. DIFFERENTIAL DIAGNOSIS MEMBRANE OVER TONSIL MEMBRANOUS TONSILLITIS ? DIPHTHERIA ? VINCENT ANGINA ? IMN ? AGRANULOCYTOSIS ? LEUKAEMIA ? APTHOUS ULCERS ? MALIGNANCY ? TRAUMATIC ULCER ? CANDIDAL INFECTION ?

18. Dirty grey

19. Yellow slough is typical

20. Key points Acute tonsillitis is common and self limiting Complications are rare Treatment is largely symptomatic

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