Acute and Chronic Tonsilitis:
Tonsilitis refers to the inflammation of tonsils and lymphatic tissue that are located on each side of oropharynx. Acute infection of tonsils usually occurs as a complication of pharyngitis and is usually caused by bacteria mainly; streptococcus, staphlococcus, ' H. Influenzae and pneumococcus. It may also be caused by virus. Chronic tonsilitis results from recurrent infection.
Pathophysiology
As a result of inflammation the tonsils. palatine or fauces enlarge, with the result they obstruct the airway and food passages. If adenoids are also involved, they may block posterior nares resulting in mouth breathing. The eustachian tubes may also get blocked which may lead to otitis media.
Medical Management
If throat culture shows B haemolytic streptococici then antibiotic are given for 8-10 days and child is followed up.
Surgical Management
Surgical management includes removal of the tonsils which is a controversial issue
Assessment
You will find that the child with tonsilitis presents with mild to severe sore throat, fever, muscle aches, chills, dysphagia, pain in the ears, headache, anorexia and malaise. Inspection of the tonsils reveal swelling and redness with pus. There may be yellow or white exudate over the tonsils. The uvula may be edematous and inflammed. The cervical lymphnodes are usually tender. This includes evaluation of child for history of evidence of allergic symptoms, recurrent respiratory infections and for symptoms of upper air way obstruction affecting respiration. You also need to assess the child by examining/inspecting mucosal lining of nares, appearance of tonsils which are inflammed and enlarged, nature of respiration and serous otitis media.
Diagnostic evaluation includes, complete blood count which reveals elevated white blood cell count, throat culture and sensitivity and chest X-ray if respiratory