Acute tonsillitis is an inflammation of the tonsils that frequently occurs with pharyngitis, inflammation of the pharynx

Aetiology

• Majority of cases are viral - EBV, rhinovirus, influenza, parainfluenza, enterovirus, adenovirus
• 5-30% bacterial, most commonly Strep. pyrogenes (Group A strep)
  • Others include H. influenza, S. aureus and streptococcus pneumonia
  • 'Strep throat' - inflamed tonsils and surrounding part of throat caused by Streptococcus
  • ~40% are beta-lactamase-producing
• Non-infectious causes of pharyngitis are uncommon and can include physical irritation e.g. from GORD, chronic irritation from cigarette smoke

Clinical presentation

Viral tonsillitis

• Malaise
• Sore throat, mild analgesia requirement
• Temperature
• Able to undertake near normal activity
• Possible lymphadenopathy
• Lasts 3-4 days

Bacterial tonsillitis

• Dysphagia, odynophagia, dysphonia
• Systemic upset
• Fever
• Halitosis
• Unable to work/school