Diseases of Tonsil and Tonsillectomy (Acute Tonsillitis) by Dr. Vyshnavi | PrepLadder ENT Residency

Summary

This video script explains acute tonsillitis, detailing its four stages: superficial, follicular, parenchymal, and membranous. Acute tonsillitis involves inflammation of the tonsils, with symptoms ranging from redness to enlargement and the formation of a pearly white membrane. The disease is typically caused by group A beta-hemolytic streptococcus and can lead to complications like rheumatic fever or glomerulonephritis. Diagnosis is primarily clinical, based on patient history and examination, and is most common in children aged 3-15 years, presenting with sore throat, fever, and difficulty swallowing.

Takeaways

• 😀 Acute tonsilitis is an inflammation of the tonsils lasting less than 4 weeks, with different forms depending on the infection's progression.
• 😀 The four types of acute tonsilitis are superficial, follicular, parenchymal, and membranous.
• 😀 Superficial tonsilitis involves redness and congestion of the tonsil without enlargement, affecting only the surface.
• 😀 Follicular tonsilitis occurs when the infection spreads to the crypts of the tonsils, causing whitish-yellow spots on the surface.
• 😀 Parenchymal tonsilitis happens when the infection penetrates deeper into the tonsil's tissue, leading to redness and enlargement.
• 😀 Membranous tonsilitis occurs when the tonsil creates a membrane from dead tissue, which is avascular and pearly white in color.
• 😀 Membranous tonsilitis is localized to the tonsils, and the membrane does not bleed when peeled because it comes from dead tissue.
• 😀 Group A beta-hemolytic streptococcus is the primary organism responsible for acute tonsilitis and can lead to complications like rheumatic fever, glomerulonephritis, and endocarditis due to cross-reactivity.
• 😀 Acute tonsilitis is typically diagnosed clinically through history and physical examination, without the need for specific tests.
• 😀 Symptoms of acute tonsilitis in children include sore throat, fever, and pain when swallowing, most common in children aged 3-15 years.

Q & A

What are the two types of tonsilitis mentioned in the transcript?

The two types of tonsilitis mentioned are acute tonsilitis and chronic tonsilitis. Acute tonsilitis lasts less than four weeks, while chronic tonsilitis persists for a longer duration.

What are the four forms of acute tonsilitis described in the video?

The four forms of acute tonsilitis are: 1) Acute superficial tonsilitis, 2) Acute follicular tonsilitis, 3) Acute parenchymal tonsilitis, and 4) Acute membranous tonsilitis.

What is the difference between superficial tonsilitis and follicular tonsilitis?

In acute superficial tonsilitis, inflammation is limited to the surface of the tonsil, causing redness but no enlargement. In follicular tonsilitis, the infection moves to the crypts of the tonsils, causing blockage with pus, debris, and exudates, leading to whitish yellow dots on the surface of the tonsil.

How does parenchymal tonsilitis differ from other forms of acute tonsilitis?

Parenchymal tonsilitis occurs when the infection spreads deeper into the substance (parenchyma) of the tonsil, causing redness and enlargement of the tonsil. It marks the transition from superficial or follicular tonsilitis to a more severe form.

What is membranous tonsilitis and how does it develop?

Membranous tonsilitis occurs in the final stage of acute tonsilitis when the tonsil fights the infection. Dead tissue, bacteria, and debris form a pearly white membrane over the tonsil. This membrane is avascular and does not bleed when peeled off.

What organism is primarily responsible for causing acute tonsilitis?

Group A beta-hemolytic Streptococcus is the primary organism responsible for causing acute tonsilitis.

How can a tonsil infection lead to complications like glomerulonephritis or rheumatic fever?

Group A beta-hemolytic Streptococcus has cross-reactivity with other tissues, including myocardium, glomeruli, and joints. If the tonsil infection is prolonged, it can cause glomerulonephritis, arthritis, and even rheumatic fever due to this cross-reactivity.

How is acute tonsilitis diagnosed?

Acute tonsilitis is primarily diagnosed clinically based on history and examination. Specific investigations are usually not required unless necessary for further evaluation.

What symptoms are typically seen in children with acute tonsilitis?

In children, typical symptoms of acute tonsilitis include sore throat, fever, and pain while swallowing, which often worsens as the disease progresses. This is especially common in children aged 3-15 years.

Why does the membrane in membranous tonsilitis not cause bleeding when peeled?

The membrane in membranous tonsilitis is composed of dead tissue, dead bacteria, and debris. Since it comes from avascular (dead) tonsillar tissue, peeling it does not cause bleeding.