Tonsilitis, quincy, adenoids, stridor

Tonsillitis definition

Inflammation of palatine tonsils, usually viral or bacterial, causing sore throat and dysphagia

Causes tonsillitis

Viral: Adenovirus, Rhinovirus, EBV

Symptoms tonsillitis

Sore throat, fever, dysphagia, malaise, headache, referred ear pain via CN IX

Signs tonsillitis

Red, swollen tonsils, white/yellow exudates if bacterial, tender anterior cervical lymph nodes

Complications tonsillitis

Rheumatic fever, post-streptococcal glomerulonephritis, peritonsillar abscess

Management tonsillitis

Viral: supportive (hydration, analgesics, rest)

Mnemonic tonsillitis

TAPS = Tonsillitis, Antibiotics (if bacterial), Pain relief, Supportive care

Peritonsillar abscess definition

Collection of pus in peritonsillar space, usually complication of acute tonsillitis

Symptoms peritonsillar abscess

Severe unilateral sore throat, fever, trismus (difficulty opening mouth), muffled “hot potato” voice

Signs peritonsillar abscess

Swollen, fluctuant tonsil, uvula deviated to opposite side, erythematous tonsillar pillars

Complications peritonsillar abscess

Airway compromise, deep neck infection, sepsis

Management peritonsillar abscess

Needle aspiration or incision and drainage, antibiotics (Amoxicillin-clavulanate or Clindamycin), analgesics, hydration, monitor airway

Mnemonic peritonsillar abscess

PUS = Peritonsillar, Uvula deviated, Severe sore throat

Stridor definition

High-pitched inspiratory noise caused by upper airway obstruction (larynx or trachea)

Types stridor

Inspiratory = extrathoracic obstruction (larynx/pharynx), Expiratory = intrathoracic obstruction (trachea/bronchi)

Causes stridor children

Croup, laryngomalacia, foreign body aspiration

Causes stridor adults

Tumors, vocal cord paralysis, infection/edema (epiglottitis)

Clinical points stridor

Medical emergency if severe, evaluate airway, severity worsens with exertion or supine position

Management stridor

Assess airway, humidified oxygen, nebulized epinephrine for croup, steroids if inflammation, remove obstruction if foreign body, ENT consultation if severe

Mnemonic stridor

S-LIDE = Stridor, Laryngeal obstruction, Inspiratory, Danger (airway), Evaluate urgently

Adenoids definition

Lymphoid tissue in nasopharynx, part of Waldeyer’s ring, traps pathogens entering via nose

Function adenoids

Part of immune defense, especially in children

Clinical significance adenoids

Hypertrophy → nasal obstruction, mouth breathing, snoring, recurrent otitis media, nasal speech

Signs adenoids

Enlarged adenoids on lateral neck X-ray or nasopharyngoscopy, nasal speech, chronic mouth breathing

Management adenoids

Medical: treat infection with antibiotics

Mnemonic adenoids

ANOS = Adenoids, Nasal obstruction, Otitis media, Snoring

Chronic tonsilitis

🦠 Chronic Tonsillitis ✅ Definition

Chronic tonsillitis is persistent or recurrent inflammation of the palatine tonsils, usually due to repeated acute infections leading to chronic changes.

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🔎 Causes

• Recurrent acute tonsillitis

• Incomplete antibiotic treatment

• Chronic bacterial infection

• Poor oral hygiene

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🧠 Pathology (What happens?)

Repeated infection →

• Fibrosis of tonsillar tissue

• Crypt obstruction

• Collection of debris (tonsilloliths)

• Chronic inflammation

Indications for Tonsillectomy (Very Important for Viva)

• Recurrent tonsillitis (≥7 episodes/year or frequent episodes over 2–3 years)

• Peritonsillar abscess history

• Obstructive symptoms

• Suspicion of malignancy