Tonsillitis classification

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Luke Rusowicz-Orazem, B.S., Usama Talib, BSc, MD [2]

Overview[edit | edit source]

Tonsillitis can be classified into acute, and recurrent forms. Acute tonsillitis is primarily caused by viral or bacterial infection; the former of which is usually self-limited. Bacterial acute tonsillitis will usually resolve with antimicrobial therapy. Recurrent tonsillitis is primarily caused by bacterial infection - usually group A streptococcus. Systemic symptoms, including fever, are usually absent due to their association with viral acute manifestations of tonsillitis. Tonsillectomy may be indicated for patients with recurrent tonsillitis if antimicrobial therapy is ineffective.

Classification[edit | edit source]

Tonsillitis can be classified into^[1][2]

• Acute tonsillitis, either bacterial or viral
• Subacute tonsillitis, mostly caused by a bacteria actinomyces
• Chronic tonsillitis, mostly bacterial
• Recurrent tonsillitis

Acute Tonsillitis[edit | edit source]

• Primarily caused by bacterial or viral infection.^[1]
• Presents with tonsillar erythema, edema, odynophagia, dysphonia, fever, rhinorrea, cough and headache.^[3][4]
• Tonsillectomy is not usually indicated to treat acute tonsillitis; viral tonsillitis is self-limited and bacterial tonsillitis will resolve with antimicrobial therapy.^[4]

Recurrent Tonsillitis[edit | edit source]

• Tonsillitis that is recurrent is primarily caused by bacterial infection - usually group A streptococcus.^[4]
• Presents primarily with tonsillar erythema and edema, along with odynophagia, dysphonia, dyspnea, and dysphagia.
  • Systemic symptoms, including fever, are usually absent due to their association with viral acute manifestations of tonsillitis.
• Tonsillectomy is indicated for patients with recurrent tonsillitis if the following criteria are met:^[5]
  • 7 episodes of tonsillitis in a single year OR
  • 5 episodes in each of 2 consecutive years OR
  • 3 episodes in each of 3 consecutive years

Chronic Tonsillitis[edit | edit source]

Persistence of the infection for a duration over 3 months is known as chronic tonsillitis. The viruses usually stay and lead to chronic inflammation or it results from repeated allergies or GERD.^[6][7][8]

References[edit | edit source]

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