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Tonsillitis

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23 views

Tonsillitis

Uploaded by

rosejoseph0777
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Tonsillitis

Tonsillitis
The tonsils are masses of lymphoid tissue located in the pharyngeal
cavity.
They protect the respiratory and alimentary tracts from invasion by
pathogenic organisms and play a role in antibody formation.
Although their size varies, children generally have much larger
tonsils than adolescents or adults.
Tonsillitis is inflammation of the tonsils, two oval-shaped pads of
tissue at the back of the throat.
Definition
It is the inflammation of palatine tonsils,
palatine arches, walls of the pharynx
caused by viruses and Streptococcus
pyogenes.

Incidence:
Up to 20% of the population is affected
by acute tonsillitis.
Etiology:

 The usual causative organism is beta-hemolytic group A –


streptococcus.
 The viral infection of upper respiratory tract such as adeno virus
and entero virus.
 Mycoplasma pneumoniae and candida albicans.
 Irritant fumes and smoke.
Types of Acute Tonsillitis
Catarrhal tonsillitis: It is usually present with URI and measles. It is
least severe form and manifested as redness and sore throat.
Follicular tonsillitis: There is involvement of crypts with discrete
yellow patches of exudate on tonsils and enlargement of regional
glands.
Parenchymatous tonsillitis: There is congestion and swelling of the
entire organ.
Peritonsillar abscess (quinsy) : It may
develop in bacterial tonsillitis. The child
may present with trismus and muffled voice
with poor oral intake, severe pain on
swallowing and opening of the mouth, high
fever, offensive breath, enlarged cervical
lymph glands and otalgia.
Pathophysiology
Tonsils are lymphoid tissue located in the oropharynx that serves to
protect the body from invading organisms. Children are prone to
tonsillitis because they have a large amount of lymphoid tissue in
the pharyngeal cavity tend to have frequent upper respiratory tract
infection and are around other children who may be infected
Clinical Manifestations

The manifestations of tonsillitis are caused by inflammation.


As the palatine tonsils enlarge from oedema, they may meet in the midline ,
obstructing the passage of air or food.
Difficulty swallowing and breathing.
Difficult passage of air to pass from the nose to the throat. As a result, the
child breathes through the mouth.
Tonsils become swollen , red and covered with exudate

White or yellow coating or patches on the tonsils

Sore throat, Pain

Difficult or painful swallowing

Fever , Headache

Bad breath

Stiff neck
Diagnostic Method

• Physical examination – On visual


inspection of the throat, it reveal the
pharyngeal mucosa and tonsils to be
inflamed and red in colour. Puss may be
seen coming out of crypts of the tonsil.
Tonsils and lymph nodes are enlarged and
tender.
• Culture of the throat swab help in
the definitive diagnosis. Neutrophil count in
the peripheral blood is elevated in
streptococcal infection
Management
Medical Management
If a Virus is the suspected cause of infection, the child is managed
with supportive care
• Warm saline gargles may be used to sooth the inflamed mucous
membranes
• Analgesic and Antipyretics may be used to reduce pain and
fever
If a Bacterial source is identified as the etiological agent, the child
needs to be treated with an antibiotic such as penicillin and
amoxicillin
Surgical Management

Tonsillectomy – Surgical removal of tonsil. It may be indicated for


recurrent streptococcal tonsillitis or when hypertrophied tonsils
interfere with eating or breathing.
Nursing Management
Gather information about the course of child’s illness and complete physical
examination
Pre operative Nursing Management
 Children requiring a tonsillectomy need baseline assessments prior to surgery.
 Assess for signs of active infection.
 Assess bleeding and clotting studies because the throat is vascular.
 Inform the child he / she will need to drink liquids post operatively.
 Assess for any loose teeth to decrease the risk of aspiration during surgery.
Post operative Nursing Management

Position the child prone or side lying to facilitate drainage.


Have suction equipment available, but do not suction unless there is
an airway obstruction.
Monitor for signs of bleeding (frequent swallowing may indicate
bleeding). If bleeding occurs, turn the child to the side and notify the
physician.
Discourage coughing, clearing the throat or nose blowing to prevent
bleeding.
Provide analgesics for pain.
Provide clear cool, non citrus and non carbonated fluids.
Avoid red, purple or brown liquids which simulate the appearance of blood if the
child vomits.
Avoid milk products such as milk, ice cream and pudding initially because they
coat the throat causing the child to cough or clear the throat.
 Instruct the parents not to give the child any straws, forks or sharp objects that
can be put into the mouth.
Parents should be instructed to notify the physician , if bleeding , persistent
earache or fever occurs.
 Keep the child away from the crowds until healing as occurred.

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