[READ] Managing tonsillitis in children and adults

Last week’s column was on the management of abnormal breathing in children. We read about the story of Thaddeus my patient, a two-year-old male toddler born to Ethiopian parents. He had presented with history of catarrh, noisy breathing, mouth breathing, bad breath, cough and fever on and off, which the parents said started since birth.

Continue reading after the cut....

He had a successful surgery in his home country, done by the Ear Nose and Throat (ENT) surgeon after a diagnosis of Enlarged Adenoid. The toddler now has a reduced hospital visit, compared to the weekly visit before the surgery.

It was concluded that parents should release their wards for necessary surgery that may be beneficial to them in adulthood, the failure of which may present as regrets later in life. That is, some may snore heavily later in life and the speech may also be affected later in life.

It was finally said that adenoid enlargement is a major cause of abnormal breathing and that other causes of abnormal breathing include tonsillitis, asthma, poor dentition, pneumonia or abnormality in the mouth.

Today’s piece will be on the management of tonsillitis in children and adults

February 14 of each year is known all over the world as the day set aside to celebrate love in what is known as the St. Valentine’s Day. While some spend the day offering meticulous services to those in need, the majority get deeply engrossed in satisfying their orgies. It’s a day of maximum activity for all, especially the young generation and certainly not a day to fall sick.

“The last celebration was quite unique for me, as I got sick. I was down with tonsillitis — a mild inflammation of the tonsils that makes talking and swallowing extremely painful. For somebody like me that can’t keep the mouth shut, that’s like hell. I tried all I could — medications, counsels, advice and prayers, all to no avail. So I had to get professional help.”

Well, I’m not talking about myself here; rather, it’s a patient who had encounter with tonsillitis that was talking!

Tonsillitis is simply the inflammation or infection of the tonsils. The tonsils are the two oval-shaped tissues located at the back of the throat. Pharyngitis is the inflammation of the oropharynx, but not the tonsils. The tonsils tend to shrink in early adulthood. It is a very common childhood ailment but it also affects adults.

The tonsils act as a filter and prevent infections in the throat, mouth and sinuses from spreading to other parts of the body. Studies also show that the tonsils produce antibodies or cells that fight disease.

Some children seem to be more prone to developing tonsillitis than others. They may have tonsillitis attacks as often as five or six times in a year! Recurring tonsillitis may result in the enlargement of the tonsils, a condition labelled as chronic tonsillitis. In such a case, the tonsils remain infected despite antibiotic treatment.

Sore throats may also be due to tonsillitis. On the average, an individual has six or more episodes of sore throat per year. The episodes of sore throat are disabling and prevent normal functioning. Any person with sore throat that persists after two days should be seen by the doctor to rule out tonsillitis.

Causes

Bacterial or viral infections often cause tonsillitis. So also do food particles trapped in small in-foldings called crypts, which also results in prolonging the infection.

Symptoms

Symptoms of tonsillitis include pain in the throat, which can be severe sometimes and may last more than 48 hours; pain on swallowing; and redness of the tonsils. Others are painful blisters or ulcers on the throat, trouble with swallowing, stiff neck, inability to turn the neck left or right, ear pain, chills and fever, headache, hoarseness or loss of voice or changes in the voice.

The patient may also experience loss of appetite, difficulty swallowing; breathing through the mouth, swollen glands in the neck or jaw area, and bad breath. Children may complain of nausea, vomiting, and abdominal pain.

Doctors’ observation

The throat is reddened, the tonsils are swollen and may be coated or have white or yellow flecks of pus on them. The patient might have possibly a high temperature; he might present with swollen lymph nodes and glands around the chin or under the jaw.

Complications

Meningitis, throat abscess (called Quinsy), septicaemia, and febrile convulsion can happen in children suffering from tonsillitis.

Diagnosis

An ear, nose and throat examination is normally performed by the doctor. A light is shown in the throat to visualise the tonsils. A tongue depressor may be used to depress the tongue to see the tonsils clearly.

Parents can also use torchlight to see the throat of their children when ill. A simple technique is to tell the child to say “ah” aloud. This will enable the throat to be wide open; while adults can open their mouth wide in front of the mirror to see if the tonsils are enlarged.

It is usually recommended that throat swabs are taken and cultured. Rapid antigen tests are sometimes performed and blood tests are done to rule out infections.

To be concluded

 

-  Rotimi Adesanya

Share ypur thoughts...thanks!