Tonsillitis natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Luke Rusowicz-Orazem, B.S.

Overview

Acute tonsillitis will usually present with erythema and edema of the tonsils rapidly upon infiltration of the pathogen. It is usually self-limited and symptoms will be resolved within 3-4 days. Recurrent tonsillitis will usually not resolve itself and will require antimicrobrial therapy or tonsillectomy when indicated. Complications of tonsillitis are caused by persistence and/or spread of the responsible pathogen - usually bacterial. The prognosis for acute tonsillitis without treatment is usually good, while the prognosis for untreated recurrent tonsillitis will vary based on presence of life-threatening complications. With treatment, the prognosis of acute and recurrent tonsillitis is usually good.

Natural History

  • Acute tonsillitis will usually present with erythema and edema of the tonsils rapidly upon infiltration of the pathogen.[1]
    • Symptoms, including fever and sore throat, will usually manifest within 24 hours of infection.
  • Acute tonsillitis is usually self-limited and will be resolved within 3-4 days.
  • Recurrent tonsillitis will usually not resolve itself and will require antimicrobrial therapy or tonsillectomy when indicated.[2]
    • Left untreated, recurrent tonsillitis may persist and recur over periods of time and can lead to infectious complications.

Complications

Complications of tonsillitis are caused by persistence and/or spread of the responsible pathogen - usually bacterial - and include the following:[1]

Prognosis

  • The prognosis for acute tonsillitis without treatment is usually good; the disease is usually self-limited and will resolve itself within 3-4 days.[1]
  • The prognosis for recurrent tonsillitis varies based on the presence of life-threatening complications.[4]
  • With treatment, the prognosis of acute and recurrent tonsillitis is usually good.

References

  1. 1.0 1.1 1.2 "Tonsillitis - NHS Choices".
  2. Stuck BA, Götte K, Windfuhr JP, Genzwürker H, Schroten H, Tenenbaum T (2008). "Tonsillectomy in children". Dtsch Arztebl Int. 105 (49): 852–60, quiz 860–1. doi:10.3238/arztebl.2008.0852. PMC 2689639. PMID 19561812.
  3. Rio AC, Franchi-Teixeira AR, Nicola EM (2008). "Relationship between the presence of tonsilloliths and halitosis in patients with chronic caseous tonsillitis". Br Dent J. 204 (2): E4. doi:10.1038/bdj.2007.1106. PMID 18037821.
  4. "Rheumatic fever: MedlinePlus Medical Encyclopedia".

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