Differential diagnosis of tonsillitis

Acute tonsillitis
(lat. tonsillitis acuta) can be caused by a diverse range of agents. It most often occurs in children and young adults. Etiology is determined primarily by the intensity, extent, involvement of the neck, soft palate, the presence of exudation, blisters, petechiae or enanthema u. Of the bacteria, it is the most common cause of Streptococcus pyogenes. In children under the age of three, it is usually of viral origin.

Clinical picture
Locally, in tonsillitis there is redness and swelling of the tonsils, they may be covered with pins. Sore throat, accompanied by difficulty swallowing (odynophagia), develops rapidly. The submandibular nodes are swollen and painful. To the local manifestations is added a general feeling of illness - malaise, fatigue, fever, lethargy.

According to the clinical picture, it is usually not possible to identify the causative agent.

Plaut-Vincent angina

 * rare, caused by a mixed flora of anaerobes and spirochetes;
 * the disability is one-sided - a disgusting feator ex ore is typical;
 * Lemierre's disease - a rare but fatal, infection fusobacterium necrophorum spreads to mediastina.

Infectious mononucleosis

 * significant swelling of the tonsils, thickening;
 * Holtzel's sign - small petechias on the soft floor;
 * Bass symptom - swelling of the eyelids.

Herpangina
Other forms
 * coxsackie viruses, mostly in children
 * fever, headache
 * redness of the oropharynx with small blisters (2-10), do not coalesce
 * on arches, pain during swallowing
 * within 2-4 days the fever subsides and the ulcers heal
 * dif.dg. - herpetic stomatitis - anterior ulcers in oral cavity
 * less common
 * gonococcus pharyngitis, secondary syphilis


 * Diagnosis
 * from the clinical picture;
 * laboratory examination - viral - normal sedimentation, rather leukopenia, predominance of mononuclear cells;
 * IM - atypical lymphocytes.
 * Therapy
 * viral - only symptomatically;
 * streptococcal - penicillin (erythromycin), cephalosporins I.g., abscess - lincosamides;
 * gonococcus, lues - also penicillin;
 * corynebacterium diphteriae - also penicillin;
 * In IM, on the other hand, aminopenicillins are completely inappropriate!.

Source

 * BENEŠ, Jiří. Studijní materiály [online]. ©2007. [cit. 2009]. .

Used literature

 * KLOZAR, Jan, et al. Speciální otorinolaryngologie. 1. vydání. Praha : Galén, 2005. 224 s.  ISBN 80-7262-346-X.


 * HAVLÍK, Jiří, et al. Infektologie. 2. vydání. Praha : Avicenum, 1990. 393 s.  ISBN 80-201-0062-8.


 * LOBOVSKÁ, Alena. Infekční nemoci. 1. vydání. Praha : Karolinum, 2001. 263 s.  ISBN 80-246-0116-8.