Tonsillitis

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What is Tonsillitis?

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Tonsillitis involves infection of the pharyngeal tonsils (at the back of the throat). These are symmetrical areas of lymphoid tissue located in the pharynx, on either side of the hard palate.

Who gets Tonsillitis?

Tonsillitis usually occurs in children between 4 and 7 years of age. It is rare in those under 2 or over 40.

Predisposing Factors

Tonsillitis may be caused by viral or bacterial infection.

The viruses causing tonsillitis are the same viruses causing the common cold (rhinovirus, parainfluenza and influenza virus, respiratory syncitial virus, adenovirus) as well as the
Epstein-Barr Virus (EBV) which causes glandular fever.

Bacterial tonsillitis is usually due to Group A beta-haemolytic streptococci.

Progression

Tonsillitis often occurs along with viral pharyngitis (sore throat). Whether it is referred to as tonsillitis or pharyngitis depends on the area of predominant inflammation.

Bacterial tonsillitis is generally a more severe illness. It is usually caused by streptococcal bacteria. Complications of streptococcal tonsillitis include:

1. Quinsy - an abscess (area of continued infection and pus) forms in tissue bordering on the tonsil. This causes further pain, fever, and difficulty swallowing.

2. Post-streptococcal glomerulonephritis - may occur 2-3 weeks after infection. This causes bloody urine, oedema (swelling of arms, feet, around eyes), headache, loin pain, fever, and high blood pressure. Glomerulonephritis may go on to cause serious, progressive kidney damage.

3. Rheumatic fever - may cause fever, joint pains and swelling, skin rash and nodules, heart disease and abnormal limb movements. Rheumatic fever may later cause serious, permanent heart damage (rheumatic heart disease).
NOTE - all these are rare complications. Glomerulonephritis and rheumatic fever are especially rare in Australian urban populations. However, they occur relatively often among some Aboriginal communities. The high prevalence of these conditions in the indigineous population has been linked with poor sanitation and overcrowding.

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