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1、TonsillitisandAdenoidsPresentedby:Dr.MonaAhmedA/RahimAssistantProfessorFacultyofMedicine&HealthSciencesAlneelainUniversityWaldeyer’sRingTonsillitisDefinition:Isaninflammationofthetonsils.Types:AcutetonsillitisChronictonsillitisAcutetonsillitisClassification:
2、acutecatarrhalorsuperficialtonsillitis:Heretonsillitisisapartofgeneralizedpharyngitisandseeninviralinfectionsacutefolliculartonsillitis:Inwhichtonsillarcryptsbecomefilledwithpurulentmaterialsacuteparenchymatoustonsillitis:Heretonsilsareuniformlyenlargedandre
3、dacutemembranoustonsillitis:TheexudatesinthecryptscoalescestoformmembraneonthesurfaceAcuteMembranousTonselitisAcuteFolliculerTonselitisAcuteParenchymatousTonselitisAcutecatarhaltonselitisEtiology:Affectsschool-agechildrenbutadultscanalsobeaffected.Itisrarein
4、infants(<1yearage)andpersonsabove50years.Causativeorganisms:GroupAbetahemolyticstreptococciHaemophilusinfluenzaeStreptococcuspneumoniaeStaphylococciTuberculosis(inimmunocompromised)Viruses:adenovirus,Epstein-BarvirusandherpessimplexvirusSymptoms:sorethroatdi
5、fficultyinswallowing+painfever(canbeaccompaniedbyrigorsandchills)earacheheadachegeneralizedbodyfatigueSigns:breathisfoetidandtongueiscoatedhyperaemiaofthepillars,softpalateanduvularedandswollentonsilswithyellowishspotsinthecrypts(folliculartonsillitis),whiti
6、shmembraneonthemedialsurfaceofthetonsils(membranoustonsillitis)orenlargedandcongestivetonsilswithswollenuvula(acuteparenchymatoustonsillitis)enlargedandtenderjugulodigastriclymphnodesTreatment:bedrest+plentyoffluidsanalgesia(AspirinorParacetamol)antimicrobia
7、l(Penicillinisthedrugofchoice)shouldbecontinuedfor7-10daysComplications:chronictonsillitiswithrecurrentacuteattacksperitonsillarabscess(quinsy)parapharyngealabscesscervicalabscessacuteotitismediarheumaticfeveracutegolomerulonephritissubacutebacterialendocard
8、itisDifferentialdiagnosis:DiphtheriaInfectiousmononucleosismalignancy(lymphoma,leukemia)Indicationsfortonsillectomy:recurrentinfections(>6timesperyear)peritonsilarabscesspossibilityofmalignancys
