Streptococcal tonsillitis
Illness description
This is a bacterial inflammation of the tonsils and the lymphoid tissue of the back wall of the throat.
Causative agent
Tonsillitis is caused by Group A beta-hemolytic streptococcus. These bacteria are sensitive to high temperatures, dying at 60oC within 30 minutes.
Prevalence
Tonsillitis caused by Group A streptococcus is one of the most common bacterial human diseases. It mostly affects children aged 5-15 years. The source of infection is a sick person or carrier. The infection spreads through droplets in the air. The incidence increases during cold weather.
Symptoms
Symptoms appear 2-4 days after infection. The disease starts with acute throat pain, accompanied by difficulty swallowing, weakness, fever, and headache. Swollen and painful lymph nodes in the neck are characteristic. Tonsils and the back of the throat are red. Tonsil crypts are filled with pus, causing bad breath. The disease usually lasts shortly. Fever subsides within a few days, while throat pain and general symptoms may persist for more than a week. Complications of purulent streptococcal tonsillitis include peritonsillar abscess, otitis media, sinusitis, and others. Non-purulent complications include acute rheumatic fever, acute glomerulonephritis, and others.
Diagnosis
Acute streptococcal tonsillitis is diagnosed based on clinical and epidemiological data, and the diagnosis is confirmed by performing a throat culture or rapid antigen detection test.
Treatment
Bacterial tonsillitis is treated with antibiotics – penicillin and its derivatives, cephalosporins, macrolides, clindamycin. Due to effectiveness, safety, and cost, penicillin is the first-choice drug. It is important to complete the prescribed course of antibiotics, even if the condition improves significantly in the first few days, as short courses do not protect against systemic complications. It is recommended to drink plenty of warm fluids. Gargling with a potassium permanganate solution, chamomile tea is advised. Ibuprofen, paracetamol, nimesulide are given for fever. Surgical removal of the tonsils is performed only when the infection recurs.
Prevention
Important to treat contacts and carriers. Primary prevention of acute rheumatism includes treating streptococcal tonsillitis, while secondary prevention, in cases of rheumatism, involves monthly prophylactic penicillin use.
Source | Author Doctor Nikas Samuolis, reviewed by Prof. Virginijus Šapoka | Vilnius University | Faculty of Medicine | Head of the Department of Internal Medicine, Family Medicine, and Oncology