Tonsillitis

Excerpt

Tonsillitis is inflammation of the palatine tonsils and typically presents with sore throat, odynophagia, fever, and erythematous or exudative tonsils. This condition causes frequent healthcare visits worldwide, comprising approximately 1.3% of outpatient encounters. The palatine tonsils in the lateral oropharynx between the palatoglossal and palatopharyngeal arches comprise lymphoid tissue and are a key component of the Waldeyer ring. These structures serve as a first-line immunologic barrier against inhaled or ingested pathogens. See Image. Tonsillitis.

Acute tonsillitis is typically infectious in origin and diagnosed clinically. Viral pathogens are responsible for 70% to 95% of cases, while bacterial pathogens—particularly Streptococcus pyogenes (group A Streptococcus [GAS])—account for 5% to 15% of adult cases and 15% to 30% of pediatric cases, especially in children aged 5 to 15. Timely differentiation between viral and bacterial tonsillitis is essential to guide appropriate antimicrobial use and reduce unnecessary antibiotic prescriptions. This distinction is crucial, as streptococcal tonsillitis can lead to complications such as peritonsillar abscess, acute rheumatic fever, and poststreptococcal glomerulonephritis.