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==Overview==
Tonsillitis can be classified into [[Acute (medical)|acute]], and recurrent forms. Acute tonsillitis is primarily caused by [[viral]] or [[bacterial]] infection; the former of which is usually self-limited. [[Bacterial]] acute tonsillitis will usually resolve with [[antimicrobial]] therapy. Recurrent tonsillitis is primarily caused by [[bacterial]] infection - usually [[group A streptococcus]]. Systemic symptoms, including [[fever]], are usually absent due to their association with [[viral]] acute manifestations of tonsillitis. [[Tonsillectomy]] may be indicated for patients with recurrent tonsillitis if [[antimicrobial]] therapy is ineffective.


==Overview==
==Classification==
There are 3 main types of tonsillitis: [[Acute (medical)|acute]], [[subacute]] and [[Chronic (medicine)|chronic]]. Acute tonsillitis can either be [[bacterial]] or [[viral]] (75%) in origin. Subacute tonsillitis (which can last between 3 weeks and 3 months) is caused by the bacterium ''[[Actinomyces]]''. Chronic tonsillitis, which can last for long periods if not treated, is almost always bacterial.
Tonsillitis can be classified into<ref name="pmid25587367">{{cite journal |vauthors=Stelter K |title=Tonsillitis and sore throat in children |journal=GMS Curr Top Otorhinolaryngol Head Neck Surg |volume=13 |issue= |pages=Doc07 |year=2014 |pmid=25587367 |pmc=4273168 |doi=10.3205/cto000110 |url=}}</ref><ref name="pmid12172229">{{cite journal| author=Darrow DH, Siemens C| title=Indications for tonsillectomy and adenoidectomy. | journal=Laryngoscope | year= 2002 | volume= 112 | issue= 8 Pt 2 Suppl 100 | pages= 6-10 | pmid=12172229 | doi=10.1002/lary.5541121404 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12172229  }} </ref>
*[[Acute (medical)|Acute]] tonsillitis, either [[bacterial]] or [[viral]]
*[[Subacute]] tonsillitis, mostly caused by a bacteria [[actinomyces]]
*[[Chronic (medicine)|Chronic]] tonsillitis, mostly [[bacterial]]
*Recurrent tonsillitis
 
===Acute Tonsillitis===
*Primarily caused by [[bacterial]] or [[viral]] infection.<ref name="pmid25587367">{{cite journal |vauthors=Stelter K |title=Tonsillitis and sore throat in children |journal=GMS Curr Top Otorhinolaryngol Head Neck Surg |volume=13 |issue= |pages=Doc07 |year=2014 |pmid=25587367 |pmc=4273168 |doi=10.3205/cto000110 |url=}}</ref>
*Presents with [[tonsillar]] [[erythema]], [[edema]], [[odynophagia]], [[dysphonia]], [[fever]], [[rhinorrea]], [[cough]] and [[headache]].<ref name="urlTonsillitis - NHS Choices">{{cite web |url=http://www.nhs.uk/conditions/tonsillitis/Pages/Introduction.aspx |title=Tonsillitis - NHS Choices |format= |work= |accessdate=}}</ref><ref name="pmid19561812">{{cite journal |vauthors=Stuck BA, Götte K, Windfuhr JP, Genzwürker H, Schroten H, Tenenbaum T |title=Tonsillectomy in children |journal=Dtsch Arztebl Int |volume=105 |issue=49 |pages=852–60; quiz 860–1 |year=2008 |pmid=19561812 |pmc=2689639 |doi=10.3238/arztebl.2008.0852 |url=}}</ref>
*[[Tonsillectomy]] is not usually indicated to treat acute tonsillitis; [[viral]] tonsillitis is self-limited and [[bacterial]] tonsillitis will resolve with [[antimicrobial]] therapy.<ref name="pmid19561812">{{cite journal |vauthors=Stuck BA, Götte K, Windfuhr JP, Genzwürker H, Schroten H, Tenenbaum T |title=Tonsillectomy in children |journal=Dtsch Arztebl Int |volume=105 |issue=49 |pages=852–60; quiz 860–1 |year=2008 |pmid=19561812 |pmc=2689639 |doi=10.3238/arztebl.2008.0852 |url=}}</ref>
 
===Recurrent Tonsillitis===
*Tonsillitis that is recurrent is primarily caused by [[bacterial]] infection - usually [[group A streptococcus]].<ref name="pmid19561812">{{cite journal |vauthors=Stuck BA, Götte K, Windfuhr JP, Genzwürker H, Schroten H, Tenenbaum T |title=Tonsillectomy in children |journal=Dtsch Arztebl Int |volume=105 |issue=49 |pages=852–60; quiz 860–1 |year=2008 |pmid=19561812 |pmc=2689639 |doi=10.3238/arztebl.2008.0852 |url=}}</ref>
*Presents primarily with [[tonsillar]] [[erythema]] and [[edema]], along with [[odynophagia]], [[dysphonia]], [[dyspnea]], and [[dysphagia]].
**Systemic symptoms, including [[fever]], are usually absent due to their association with [[viral]] acute manifestations of tonsillitis.
*[[Tonsillectomy]] is indicated for patients with recurrent tonsillitis if the following criteria are met:<ref name="pmid6700642">{{cite journal |vauthors=Paradise JL, Bluestone CD, Bachman RZ, Colborn DK, Bernard BS, Taylor FH, Rogers KD, Schwarzbach RH, Stool SE, Friday GA |title=Efficacy of tonsillectomy for recurrent throat infection in severely affected children. Results of parallel randomized and nonrandomized clinical trials |journal=N. Engl. J. Med. |volume=310 |issue=11 |pages=674–83 |year=1984 |pmid=6700642 |doi=10.1056/NEJM198403153101102 |url=}}</ref>
**7 episodes of tonsillitis in a single year {{Or}}
**5 episodes in each of 2 consecutive years {{Or}}
**3 episodes in each of 3 consecutive years
 
===Chronic Tonsillitis===
Persistence of the infection for a duration over 3 months is known as chronic tonsillitis. The viruses usually stay and lead to chronic inflammation or it results from repeated allergies or [[GERD]].<ref name="pmid21377220">{{cite journal| author=Sadeghi-Shabestari M, Jabbari Moghaddam Y, Ghaharri H| title=Is there any correlation between allergy and adenotonsillar tissue hypertrophy? | journal=Int J Pediatr Otorhinolaryngol | year= 2011 | volume= 75 | issue= 4 | pages= 589-91 | pmid=21377220 | doi=10.1016/j.ijporl.2011.01.026 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21377220  }} </ref><ref name="pmid17136878">{{cite journal| author=Akcay A, Tamay Z, Dağdeviren E, Guler N, Ones U, Kara CO et al.| title=Childhood asthma and its relationship with tonsillar tissue. | journal=Asian Pac J Allergy Immunol | year= 2006 | volume= 24 | issue= 2-3 | pages= 129-34 | pmid=17136878 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17136878  }} </ref><ref name="pmid22870291">{{cite journal| author=Proenca-Modena JL, Pereira Valera FC, Jacob MG, Buzatto GP, Saturno TH, Lopes L et al.| title=High rates of detection of respiratory viruses in tonsillar tissues from children with chronic adenotonsillar disease. | journal=PLoS One | year= 2012 | volume= 7 | issue= 8 | pages= e42136 | pmid=22870291 | doi=10.1371/journal.pone.0042136 | pmc=3411673 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22870291  }} </ref>


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


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Latest revision as of 00:26, 30 July 2020

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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., Usama Talib, BSc, MD [2]

Overview

Tonsillitis can be classified into acute, and recurrent forms. Acute tonsillitis is primarily caused by viral or bacterial infection; the former of which is usually self-limited. Bacterial acute tonsillitis will usually resolve with antimicrobial therapy. Recurrent tonsillitis is primarily caused by bacterial infection - usually group A streptococcus. Systemic symptoms, including fever, are usually absent due to their association with viral acute manifestations of tonsillitis. Tonsillectomy may be indicated for patients with recurrent tonsillitis if antimicrobial therapy is ineffective.

Classification

Tonsillitis can be classified into[1][2]

Acute Tonsillitis

Recurrent Tonsillitis

  • Tonsillitis that is recurrent is primarily caused by bacterial infection - usually group A streptococcus.[4]
  • Presents primarily with tonsillar erythema and edema, along with odynophagia, dysphonia, dyspnea, and dysphagia.
    • Systemic symptoms, including fever, are usually absent due to their association with viral acute manifestations of tonsillitis.
  • Tonsillectomy is indicated for patients with recurrent tonsillitis if the following criteria are met:[5]
    • 7 episodes of tonsillitis in a single year OR
    • 5 episodes in each of 2 consecutive years OR
    • 3 episodes in each of 3 consecutive years

Chronic Tonsillitis

Persistence of the infection for a duration over 3 months is known as chronic tonsillitis. The viruses usually stay and lead to chronic inflammation or it results from repeated allergies or GERD.[6][7][8]

References

  1. 1.0 1.1 Stelter K (2014). "Tonsillitis and sore throat in children". GMS Curr Top Otorhinolaryngol Head Neck Surg. 13: Doc07. doi:10.3205/cto000110. PMC 4273168. PMID 25587367.
  2. Darrow DH, Siemens C (2002). "Indications for tonsillectomy and adenoidectomy". Laryngoscope. 112 (8 Pt 2 Suppl 100): 6–10. doi:10.1002/lary.5541121404. PMID 12172229.
  3. "Tonsillitis - NHS Choices".
  4. 4.0 4.1 4.2 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.
  5. Paradise JL, Bluestone CD, Bachman RZ, Colborn DK, Bernard BS, Taylor FH, Rogers KD, Schwarzbach RH, Stool SE, Friday GA (1984). "Efficacy of tonsillectomy for recurrent throat infection in severely affected children. Results of parallel randomized and nonrandomized clinical trials". N. Engl. J. Med. 310 (11): 674–83. doi:10.1056/NEJM198403153101102. PMID 6700642.
  6. Sadeghi-Shabestari M, Jabbari Moghaddam Y, Ghaharri H (2011). "Is there any correlation between allergy and adenotonsillar tissue hypertrophy?". Int J Pediatr Otorhinolaryngol. 75 (4): 589–91. doi:10.1016/j.ijporl.2011.01.026. PMID 21377220.
  7. Akcay A, Tamay Z, Dağdeviren E, Guler N, Ones U, Kara CO; et al. (2006). "Childhood asthma and its relationship with tonsillar tissue". Asian Pac J Allergy Immunol. 24 (2–3): 129–34. PMID 17136878.
  8. Proenca-Modena JL, Pereira Valera FC, Jacob MG, Buzatto GP, Saturno TH, Lopes L; et al. (2012). "High rates of detection of respiratory viruses in tonsillar tissues from children with chronic adenotonsillar disease". PLoS One. 7 (8): e42136. doi:10.1371/journal.pone.0042136. PMC 3411673. PMID 22870291.


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