Tonsillitis

Acute Tonsillitis

a. Viral TonsillitisSymptoms of sore throat. Epstein Barr virus is the

most common cause. Hemophilus influenzae is a cause of acute
suppurative tonsillitis. If there is a coxschakie virus infection, then on
examination of the oral cavity will appear minor injuries to the palate
and tonsils are very painful perceived clients.
b. Bacterial toxicitygroup A germs Streptococcus β hemolytic,
pneumococcus, viridan Streptococcus, Streptococcus piogenes.
Infiltration of bacteria in the epitheliuminflammatory reaction of
leucocytes of polymorphonuclear leukocytes to form detritus.
• Tonsillitis is an inflammation of the palatine tonsils that are part of
the Waldeyer ring. The Waldeyer Ring consists of the lymph glands
arranged in the oral cavity of the pharyngeal tonsillary (adenoid),
tonsil palatine (tonsil faucial), lingual tonsils (tonsil base of tongue),
Eustachian tube tonsils (lateral band of the pharyngeal wall or
Gerlach's tonsils)
• Acute tonsillitis is an acute inflammation caused by the bacteria
Streptococcus β hemolyticus, streptococcus viridans and
streptococcus pyogenes, can also be caused by a virus
Etiology
• Causes of tonsillitis are infection with the bacteria Streptococcus beta
hemolyticus, Streptococcus viridans, and Streptococcus pyogenes,
can also be caused by viral infections
Pathophysiology and pathogenesis
• Bacteria or virusesenter the body through the nose or
mouthmild infection of the tonsils.
• The body's responseforms antibodies but too many infections of
tired tonsillitis withstand infection or virus. Bacterial infection of the
virus is what causes tonsillitis.
• Germs infiltrate epithelial layereroded epitheliumsuperficial
lymphoid reactsinflammatory inflammation with
polymorphonuclear leukocyte infiltration. This process is clinically
seen in the corpus of tonsils containing yellow spotsDetritus
• Tonsillitis begins a symptom of a mild sore throat until it becomes
severe difficulty swallowing, heat, swelling, and lymph nodes
weakening in the sub-mandibular region, pain in joints and muscles,
cold, whole body aches, headaches and usually pain in the ears.
• When spotted enlarged false membrane (Pseudomembrane),
whereas in chronic tonsillitis occurs due to recurrent inflammatory
process, the epithelial mucosa and lymphoid tissue eroded. So in the
healing process, lymphoid tissue replaced scar tissue. This tissue will
shrink so that the space between the widened (crypts) group will be
filled by the detritus, this process extends to penetrate the capsule
and eventually arises adhesions with the tissue around the tonsillar
fossa.
Clinical Manifestation
• Sudden fever
• Throat pain
• Snoring
• Difficulty swallowing
• Itchiness or dryness in the throat
• Sluggish
• Joint pain
• Odinofagia (painful swallowing)
• Anorexia
• Otalgia (earache)
• When the larynx is exposed the sound will become hoarse
• On examination appears pharyngeal hyperemisis, tonsils swell, hyperemisis.
Management
1. If the cause of bacteria, given oral antibiotics (by mouth) for 10 days,
if having difficulty swallowing, can be given in the form of injections.
2. Tonsillectomy removal (Tonsillectomy) is performed if:
a. Tonsillitis occurs as much as 7 times or more / year.
b. Tonsillitis occurs 5 or more times a year within 2 years.
c. Tonsillitis occurs 3 or more times a year within 3 years.
d. Tonsillitis does not respond to antibiotics.
Treatment of tonsillitis patients according to
Mansjoer (2000)
• Management of acute tonsillitis:
a. Penicillin or sulfanamid group antibiotics for 5 days and mouthwash
or swabs with disinfectant, if allergic with erythromycin or
clidomycin.
b. Antibiotics are adequate to prevent secondary infections,
corticosteroids to reduce edema of the larynx and symptomatic
drugs.
c. Patients are isolated for infectious, bed rest, to avoid complication
of the sac for 2 to 3 weeks or until the throat is 3 times negative.
d. Giving antipyretics
Complication
1. Peritonsil abscess Occurred over tonsils in anterior pillar tissue and palate mole,
this abscess occurs several days after acute infection and is usually caused by
streptococcus group A (Soepardi, 2007)
2. Acute otitis media Infection can spread to the middle ear through auditory tubes
(eustochi) and may lead to otitis media that may lead to spontaneous rupture of
the eardrum (Soepardi, 2007)
3. Acute mastoiditis The spontaneous ruptures of the eardrum further spread the
infection into mastoid cells (Soepardi, 2007)
4. Laryngitis Is an inflammatory process of the mucous membranes that form
larynx. This inflammation may be acute or chronic caused due to virus, bacteria,
environment, or allergies (Reeves, 2001)
5. Sinusitis Is an inflammatory or inflammatory disease in one or more of the
paranasal sinuses. The sinus is a cavity or a room filled with air from a wall
consisting of mucous membranes (Reeves, 2001)