Tonsillitis and Peritonsillar Abscess Questions & Answers

Updated: Apr 06, 2020
  • Author: Udayan K Shah, MD, FACS, FAAP; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Questions & Answers

Overview

What is tonsillitis?

What are the signs and symptoms of acute tonsillitis?

What are the clinical manifestations of tonsillitis?

What are the signs and symptoms of peritonsillar abscess (PTA)?

How are tonsillitis and peritonsillar abscess (PTA) diagnosed?

What are the treatment approaches for acute tonsillitis?

What pharmacologic treatments are used for tonsillitis?

When is tonsillectomy indicated for the treatment of tonsillitis?

When is an adenoidectomy indicated for the treatment of tonsillitis?

What is the treatment options for peritonsillar abscess (PTA)?

What is the history of tonsillitis?

How is the carrier state of tonsillitis defined?

What is tonsillitis?

Which viruses cause acute tonsillitis?

How frequently is Epstein-Barr virus (EBV) the cause of tonsillitis?

What role does bacteria play in the pathophysiology of tonsillitis?

Which bacteria are involved in recurrent tonsillitis?

What are the differences in etiologies of recurrent tonsillitis between children and adults?

Which bacteria are involved in the pathophysiology of chronic tonsillitis?

What is the importance of local immunologic mechanisms in the pathophysiology of tonsillitis?

What is the role of radiation exposure in the etiology of chronic tonsillitis?

What is the pathophysiology of peritonsillar abscess (PTA)?

How does the prevalence of tonsillitis vary by age?

How does the prevalence of peritonsillar abscess (PTA) vary by age?

What is the incidence of peritonsillar abscess (PTA)?

What is the prognosis of tonsillitis?

Presentation

What is the role of the medical history in the diagnosis of tonsillitis?

What are the signs and symptoms of acute tonsillitis?

How is recurrent streptococcal tonsillitis diagnosed?

What are the signs and symptoms of peritonsillar abscess (PTA)?

What is included in the oral exam for suspected tonsillitis and/or peritonsillar abscess (PTA)?

Which physical findings are characteristic of acute tonsillitis?

Which tonsillitis etiology is suggested by the presence of palatal petechiae?

How is the voice affected by acute tonsillitis?

Which physical finds of acute tonsillitis suggest infectious mononucleosis?

Which physical findings in the evaluation of tonsillitis suggest herpes simplex virus (HSV) pharyngitis?

Which physical findings are characteristic of peritonsillar abscess (PTA)?

What are the signs and symptoms of scarlet fever in tonsillitis?

How frequently does rheumatic fever complicate tonsillitis and peritonsillar abscess (PTA)?

What are the symptoms of septic arthritis in tonsillitis and peritonsillar abscess (PTA)?

What actions should be taken in patients with signs of impending complications of tonsillitis?

What are possible complications of the treatment of streptococcal pharyngitis?

What are possible complications of untreated or incompletely treated tonsillitis?

What is the most common complication of tonsillitis?

What are the signs of thrombophlebitis of the internal jugular vein in tonsillitis?

What are the complications of group A beta-hemolytic Streptococcus pyogenes (GABHS) pharyngitis?

What is acute poststreptococcal glomerulonephritis (AGN) in tonsillitis?

DDX

What are the diagnostic considerations for tonsillitis and peritonsillar abscess (PTA)?

What are the differential diagnoses for Tonsillitis and Peritonsillar Abscess?

Workup

How are tonsillitis and peritonsillar abscess (PTA) diagnosed?

What is the role of throat culture in the diagnosis of tonsillitis?

What is the role of rapid antigen detection test (RADT) in the diagnosis of tonsillitis and peritonsillar abscess (PTA)?

What is the role of antibody testing in the diagnosis of tonsillitis and peritonsillar abscess (PTA)?

What is needed for the lab evaluation of chronic tonsillitis?

What is the role of radiologic imaging in the diagnosis of acute tonsillitis?

What is the role of CT scanning in the diagnosis of peritonsillar abscess (PTA)?

What is the role of ultrasonography in the diagnosis of peritonsillar abscess (PTA)?

Treatment

What are the goals of treatment for acute tonsillitis?

How is airway obstruction managed in tonsillitis?

When is tonsillectomy indicated for the treatment of tonsillitis?

What is the role of antibiotics in the treatment of tonsillitis?

When is transfer indicated in the management of tonsillitis?

How is clinical improvement confirmed following treatment for tonsillitis?

Which specialist consultations may be helpful in the management of tonsillitis?

Is surgical drainage necessary in the ED treatment of uncomplicated peritonsillar abscess?

What is the role of corticosteroids in the treatment of tonsillitis and peritonsillar abscess (PTA)?

Which antibiotics are used to treat tonsillitis and peritonsillar abscess (PTA)?

When are antibiotics indicated for the treatment of tonsillitis and peritonsillar abscess (PTA)?

What are the goals of treatment for group A beta-hemolytic Streptococcus pyogenes (GABHS) pharyngitis?

What is the treatment for group A beta-hemolytic Streptococcus pyogenes (GABHS) pharyngitis?

Which antibiotics are used in the treatment of group A beta-hemolytic Streptococcus pyogenes (GABHS) pharyngitis?

When should antibiotics be administered for the treatment of tonsillitis?

Which antibiotics are used for the management of recurrent tonsillitis?

What are the indications for treatment of carrier state tonsillitis?

Which antibiotics are used for the treatment of peritonsillar abscess (PTA)?

What is the prevalence of beta-lactamase resistance in the treatment of tonsillitis and peritonsillar abscess (PTA)?

When is tonsillectomy indicated for the treatment of tonsillitis?

What are important considerations in the decision to treat tonsillitis with tonsillectomy?

When is an adenoidectomy indicated for the treatment of tonsillitis?

What are the benefits of tonsillectomy for the treatment of tonsillitis?

What are the surgical options for treatment for tonsillitis?

What is the role of surgery in the treatment of acute lingual tonsillitis?

What are the benefits of tonsillectomy for treatment of tonsillitis?

What are the risks of tonsillectomy for the treatment of tonsillitis?

What is the role of steroids in the surgical treatment of tonsillitis?

What can increase the risk of postoperative bleeding following tonsillectomy?

What is the most frequent complication of tonsillectomy in children?

What is the most common complication of tonsillectomy in adults?

What are the surgical options for treatment of peritonsillar abscess (PTA)?

What is the role of needle aspiration in the management of peritonsillar abscess (PTA)?

When is tonsillectomy indicated in patients with peritonsillar abscess (PTA)?

What is done if the abscess cannot be located during surgery for peritonsillar abscess (PTA)?

What indicates a neoplasm in patients with peritonsillar abscess (PTA)?

How is aspiration performed in the treatment of peritonsillar abscess (PTA)?

How is incision and drainage performed in the treatment of peritonsillar abscess (PTA)?

What is the role of sedation and anesthesia in the surgical treatment of peritonsillar abscess (PTA)?

How is exposure of the posterior oropharynx for aspiration and incision and drainage achieved during treatment of peritonsillar abscess (PTA), and what are the benefits of incisional drainage of PTA?

What consideration should be given to coronavirus disease 2019 (COVID-19) in pediatric procedures?

What are the dietary and activity restrictions during treatment of tonsillitis and/or peritonsillar abscess (PTA)?

How are tonsillitis and peritonsillar abscess (PTA) prevented?

Guidelines

What are the IDSA diagnostic guidelines for tonsillitis and peritonsillar abscess (PTA)?

What are the IDSA treatment guidelines for tonsillitis and peritonsillar abscess (PTA)?

What are the ACP/CDC guidelines for antibiotic treatment of tonsillitis and/or peritonsillar abscess (PTA)?

What are the AAO-HNSF guidelines on tonsillectomy for tonsillitis and peritonsillar abscess (PTA)?

Medications

What medications are used in the treatment of tonsillitis and peritonsillar abscess (PTA)?

Which medications in the drug class Analgesics, Other are used in the treatment of Tonsillitis and Peritonsillar Abscess?

Which medications in the drug class Immune Globulins are used in the treatment of Tonsillitis and Peritonsillar Abscess?

Which medications in the drug class Antibiotics, Other are used in the treatment of Tonsillitis and Peritonsillar Abscess?

Which medications in the drug class Corticosteroids are used in the treatment of Tonsillitis and Peritonsillar Abscess?