Tonsillitis natural history

Jump to navigation Jump to search

Tonsillitis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Tonsillitis from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

X Ray

USG

CT Scan

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Tonsillitis natural history On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Tonsillitis natural history

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Tonsillitis natural history

CDC on Tonsillitis natural history

Tonsillitis natural history in the news

Blogs on Tonsillitis natural history

Directions to Hospitals Treating Tonsillitis

Risk calculators and risk factors for Tonsillitis natural history

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Complications

An abscess may develop lateral to the tonsil during an infection, typically several days after the onset of tonsillitis. This is termed a peritonsillar abscess (or quinsy). Rarely, the infection may spread beyond the tonsil resulting in inflammation and infection of the internal jugular vein giving rise to a spreading septicaemia infection (Lemierre's syndrome).

In chronic/recurrent cases (generally defined as seven episodes of tonsillitis in the preceding year, five episodes in each of the preceding two years or three episodes in each of the preceding three years),[1][2][3] or in acute cases where the palatine tonsils become so swollen that swallowing is impaired, a tonsillectomy can be performed to remove the tonsils. Patients whose tonsils have been removed are certainly still protected from infection by the rest of their immune system.

Bacteria feeding on mucus which accumulates in pits (referred to as 'crypts') in the tonsils, produce whitish-yellow deposits known as tonsilloliths. These "tonsil stones" emit a very pungent odour due to the presence of volatile sulphur compounds.

Tonsilloliths which occur in the crypts of the tonsils can only be completely cured by tonsillectomy or by resurfacing the tonsil by laser, but practicing good oral hygiene and use of a water pick may help lessen the symptoms.

Hypertrophy of the tonsils can result in snoring, mouth breathing, disturbed sleep, and obstructive sleep apnea, during which the patient stops breathing and experiences a drop in the oxygen content in the bloodstream. A tonsillectomy can be curative.

In very rare cases, diseases like rheumatic fever or glomerulonephritis can occur. These complications are extremely rare in developed nations but remain a significant problem in poorer nations.

References

  1. "6.3 Referral Criteria for Tonsillectomy". Management of Sore Throat and Indications for Tonsillectomy. Scottish Intercollegiate Guidelines Network. 1999. ISBN 1-899893-66-0. Unknown parameter |month= ignored (help); External link in |publisher= (help) - notes though that these criteria "have been arrived at arbitrarily" from:
    Paradise J, Bluestone C, Bachman R, Colborn D, Bernard B, Taylor F, Rogers K, Schwarzbach R, Stool S, Friday G (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. PMID 6700642.
  2. Paradise J, Bluestone C, Colborn D, Bernard B, Rockette H, Kurschildren. (2002). Pediatrics. 110 (1 Pt 1): 7–15. PMID 12093941. Missing or empty |title= (help) - this later study by the same team looked at less severely affected children and concluded "modest benefit conferred by tonsillectomy or adenotonsillectomy in children moderately affected with recurrent throat infection seems not to justify the inherent risks, morbidity, and cost of the operations"
  3. Wolfensberger M, Mund M (2004). "[Evidence based indications for tonsillectomy]". Ther Umsch. 61 (5): 325–8. PMID 15195718. - review of literature of the past 25 years concludes "No consensus has yet been reached, however, about the number of annual episodes that justify tonsillectomy"


Template:WikiDoc Sources