Tonsillitis causes
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Causes
Bacterial tonsillitis may be caused by Group A streptococcal bacteria,[1] resulting in strep throat.[2] Viral tonsillitis may be caused by numerous viruses[3] such as the Epstein-Barr virus[4] (the cause of infectious mononucleosis)[5] or the Adenovirus.[6]
Sometimes, tonsillitis is caused by a superinfection of spirochaeta and treponema, in this case called Vincent's angina or Plaut-Vincent angina.[7]
The most common causes of tonsillitis are adenovirus, rhinovirus, influenza, coronavirus, and respiratory syncytial virus.[8][9][10][11] It can also be caused by Epstein-Barr virus, herpes simplex virus, cytomegalovirus, or HIV.[8][9][10][11] The second most common causes are bacterial. The most common bacterial cause is Group A β-hemolytic streptococcus (GABHS), which causes strep throat.[8][9][10][11] Less common bacterial causes include: Staphylococcus aureus (including methicillin resistant Staphylococcus aureus or MRSA ),[12]Streptococcus pneumoniae, Mycoplasma pneumoniae, Chlamydia pneumoniae, pertussis, Fusobacterium, diphtheria, syphilis, and gonorrhea.[8][9][10][11] A concomitant GABHS and influenza A virus pharyngotonsillitis can occur, as was evident by an increased in the ASO and anti-DNase B titers in a third of the patients who had both of these organisms isolated.[13]
Anaerobic bacteria have been implicated in tonsillitis. These include pigmented Prevotella and Porphyromonas, Fusobacterium and Actinomyces spp. The possible role of anaerobes in the acute inflammatory process in the tonsils is supported by several clinical and scientific observations: anaerobes have been isolated from the cores of tonsils of children and adults with recurrent GABHS and non streptococcal tonsillitis, and peritonsillar and retropharyngeal abscesses in many cases without any aerobic bacteria, their recovery as pathogens in well-established anaerobic infections of the tonsils (Vincent's angina), the increased recovery rate of encapsulated pigmented Prevotella and Porphyromonas spp. in acutely inflamed tonsils, and the response to antibiotics in patients with non streptococcal tonsillitis.[14]
Under normal circumstances, as viruses and bacteria enter the body through the nose and mouth, they are filtered in the tonsils.[15][16] Within the tonsils, white blood cells of the immune system mount an attack that helps destroy the viruses or bacteria by producing inflammatory cytokines like Phospholipase A2, [17] which also lead to fever.[15][16] The infection may also be present in the throat and surrounding areas, causing inflammation of the pharynx.[18] This is the area in the back of the throat that lies between the voice box and the tonsils.
Sometimes, tonsillitis is caused by an infection of spirochaeta and treponema, in this case called Vincent's angina or Plaut-Vincent angina.[19]
References
- ↑ Putto, Anne. "Febrile Exudative Tonsillitis: Viral or Streptococcal?" Pediatrics 80 (1987): 6-12 - Putto studied 110 children treated for febrile exudates tonsillitis. The patients had at least one symptom like fever, pharyngeal edema, or sore throat. Two tests were performed. One method involved cotton tipped swabs that were used to collected specimens when swabbed over the patients tonsils. Second method involved the latex slide agglutination that used rayon tipped swabs to collected specimens. The results showed that 13 out of the 41 patients with bacterial tonsillitis were caused by Group A streptococci
- ↑ Putto, Anne. "Febrile Exudative Tonsillitis: Viral or Streptococcal?" Pediatrics 80 (1987): 6-12 - Putto studied 110 children treated for febrile exudates tonsillitis. The patients had to a symptom of fever, pharyngeal edema, or sore throat. Two tests were performed. One method involved cotton tipped swabs that were used to collected specimens when swabbed over the patients tonsils. Second method involved the latex slide agglutination that used rayon tipped swabs to collected specimens. The results had 92 patients that had traced of streptococci in their throat
- ↑ Putto, Anne. "Febrile Exudative Tonsillitis: Viral or Streptococcal?" Pediatrics 80 (1987): 6-12 - Putto studied 110 children treated for febrile exudates tonsillitis. The patients had to a symptom of fever, pharyngeal edema, or sore throat. Two tests were performed. One method involved cotton tipped swabs that were used to collected specimens when swabbed over the patients tonsils. Second method involved the latex slide agglutination that used rayon tipped swabs to collected specimens. The results had 46 of the 110 patients that had viruses like the Adenovirus that caused 21 of the 46 to get tonsillitis. Epstein-Barr virus caused 10 out of the 46 patient to get tonsillitis and Herpes Simplex virus caused 2 out of the 46
- ↑ Putto, Anne. "Febrile Exudative Tonsillitis: Viral or Streptococcal?" Pediatrics 80 (1987): 6-12 - Putto studied 110 children treated for febrile exudates tonsillitis. The patients had to a symptom of fever, pharyngeal edema, or sore throat. Two tests were performed. One method involved cotton tipped swabs that were used to collected specimens when swabbed over the patients tonsils. Second method involved the latex slide agglutination that used rayon tipped swabs to collected specimens. The results had 46 of the 110 patients that had viruses like the Adenovirus that caused 21 of the 46 to get tonsillitis. Epstein-Barr virus caused 10 out of the 46 patient to get tonsillitis and Herpes Simplex virus caused 2 out of the 46
- ↑ Renn, Claudia N. and et al. "Amoxicillin-induced exanthema in young adults with infectious mononucleosis: demonstration of drug-specific lymphocyte reactivity." British Journal of Dermatology 147 (2002): 1166-1170 -Renn studied 4 patients who where treated amoxicillin for throat infection and lymphadenopathy. Infectious mononucleosis was present in the patient’s blood due to trace of Epstein-Barr antibodies. The three tests performed where the patched test, intracutaneous test, and lymphocyte transformation test. The results of the patched test that pointed to amoxicillin as the caused of their rash were 1 out of 4 patients. The intracutaneous showed 2 out of 4 patients with positive results that pointed to amoxicillin. The LTT results showed 3 out of 4 that pointed to amoxicillin
- ↑ Putto, Anne. "Febrile Exudative Tonsillitis: Viral or Streptococcal?." Pediatrics 80 (1987): 6-12 - Putto studied 110 children treated for febrile exudates tonsillitis. The patients had to a symptom of fever, pharyngeal edema, or sore throat. Two tests were performed. One method involved cotton tipped swabs that were used to collected specimens when swabbed over the patients tonsils. Second method involved the latex slide agglutination that used rayon tipped swabs to collected specimens. The results had 46 of the 110 patients that had viruses like the Adenovirus that caused 21 of the 46 to get tonsillitis. Epstein-Barr virus caused 10 out of the 46 patient to get tonsillitis and Herpes Simplex virus caused 2 out of the 46
- ↑ Van Cauwenberge P (1976). "[Significance of the fusospirillum complex (Plaut-Vincent angina)]". Acta Otorhinolaryngol Belg. 30 (3): 334–45. PMID 1015288. - fusospirillum complex (Plaut-Vincent angina) Van Cauwenberge studied the tonsils of 126 patients using direct microscope observation. The results showed that 40% of acute tonsillitis was caused by Vincent’s agina and 27% of chronic tonsillitis was caused by Spirochaeta
- ↑ 8.0 8.1 8.2 8.3
- ↑ 9.0 9.1 9.2 9.3
- ↑ 10.0 10.1 10.2 10.3
- ↑ 11.0 11.1 11.2 11.3
- ↑ Brook, I.; Foote, P. A. (2006). "Isolation of methicillin resistant Staphylococcus aureus from the surface and core of tonsils in children". Int J Pediatr Otorhinolaryngol. 70 (12): 2099–2102. doi:10.1016/j.ijporl.2006.08.004. PMID 16962178.
- ↑ Brook, I.; Gober, A. E. (2008). "Concurrent influenza A and group A beta-hemolytic streptococcal pharyngotonsillitis". Ann Otol Rhinol Laryngol. 117 (4): 310–312. PMID 18478842.
- ↑ Brook, I. (2005). "The role of anaerobic bacteria in tonsillitis". Int J Pediatr Otorhinolaryngol. 69 (1): 9–19. doi:10.1016/j.ijporl.2004.08.007. PMID 15627441.
- ↑ 15.0 15.1 van Kempen MJ, Rijkers GT, Van Cauwenberge PB (2000). "The immune response in adenoids and tonsils". Int. Arch. Allergy Immunol. 122 (1): 8–19. doi:10.1159/000024354. PMID 10859465. Unknown parameter
|month=ignored (help) - ↑ 16.0 16.1 Perry M, Whyte A (1998). "Immunology of the tonsils". Immunology Today. 19 (9): 414–21. doi:10.1016/S0167-5699(98)01307-3. PMID 9745205. Unknown parameter
|month=ignored (help) - ↑ "Circulating phospholipase-A2 activity in obstructive sleep apnea". International Journal of Pediatric Otorhinolaryngology. 2012. doi:10.1016/j.ijporl.2011.12.026. PMID 22297210.
|access-date=requires|url=(help) - ↑ MedlinePlus Encyclopedia Tonsillitis
- ↑ Van Cauwenberge P (1976). "[Significance of the fusospirillum complex (Plaut-Vincent angina)]". Acta Otorhinolaryngol Belg (in Dutch; Flemish). 30 (3): 334–45. PMID 1015288. — fusospirillum complex (Plaut-Vincent angina) Van Cauwenberge studied the tonsils of 126 patients using direct microscope observation. The results showed that 40% of acute tonsillitis was caused by Vincent's angina and 27% of chronic tonsillitis was caused by Spirochaeta