THIS SECTION

PEDIATRIC OTORHINOLARYNGOLOGY

SORE THROAT

A sore throat is a symptom of many medical pathologies. Infections cause the majority of sore throats and these are contagious. Throat infections can be caused by viruses such as influenza, cold or mononucleosis viruses, or by bacteria like the streptococcus, haemophilus and moraxella.

TONSILLITIS

What is Tonsillitis?
Tonsillitis refers to an inflammation or infection of the tonsils. This inflammation can involve other areas at the back of the throat including the adenoids and the lingual tonsils (the area of tonsils behind the tongue). Several kinds of tonsillitis exist: acute, recurrent, chronic and peritonsillar abscess.

Viral or bacterial infections and immunological factors of the patient lead to tonsillitis and its complications. Almost all children experience at least one episode of tonsillitis up to adult life. Due to improvement in medicamental and surgical treatment, complications due to tonsillitis are rare nowadays.

Who can have tonsillitis?
Tonsillitis occurs with greater frequency in children: however, this condition rarely occurs in children less than two years old. Tonsillitis caused by streptococcus typically occurs between the ages of 5 to 15, while viral tonsillitis is more common in younger children. A peritonsillar abscess is generally found in young adults, however occasionally it occurs in children. The history of the patient illnesses normally helps to identify the type of tonsillitis (acute, recurring, and chronic).

Which microorganisms cause tonsillitis?
The bacteria streptococcus pyogenes and haemophilus, among others; and the Epstein-Barr virus (EBV), Herpes simplex, cytomegalovirus and adenovirus can cause acute pharyngitis and tonsillitis. Bacteria are responsible for 15 to 30% of all tonsillitis and pharyngotonsillitis, streptococcus being the most common bacteria.

WHAT ARE THE SYMPTOMS OF TONSILLITIS
The types of tonsillitis determine which are the most frequent symptoms:

ACUTE TONSILLITIS: The patient has fever, sore throat, Dysphagia (difficulty to swallow), Odinophagia (pain to swallow), neck pain from lymph nodes. Obstruction of the airways can occur due to the increase of the tonsils, causing mouth breathing, snoring and nocturnal respiratory pauses or sleep apnea. Lethargy and depression can also occur. These symptoms improve in two or three days, however can last up to two weeks despite treatment.

RECURRENT TONSILLITIS: This diagnosis is made when the individual has had several episodes of tonsillitis in a year.

CHRONIC TONSILLITIS: The individuals have sore throat, halitosis, tonsillitis and cervical lymph nodes which are persistently aching.

PERITONSILLAR ABSCESS: The patient has severe cervical pain, high fever, absence of air, trismus (difficulty to open the mouth), muted voice

TREATMENT

Viral tonsillitis is normally treated with painkillers and anti-inflammatory medicines and bacterial with a regime of antibiotics, painkillers and anti-inflammatory medicines. Children should drink plenty of liquid and eat despite the pain. Hospitalization may be necessary in more serious cases (lack of air and abscesses) or in the cases where intense pain does not cease with common analgesic medicines.
When the condition is chronic or recurrent, tonsillectomy surgery is normally the recommended treatment.

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