Infections of the Tonsils Pharynx and Oropharynx Acute Tonsillitis see p196

This condition is characterized by sore throat, dysphagia, and pyrexia. The appearance of the tonsils varies. An obviously purulent exudate covering the tonsils is common, and is either diffuse or punctate (Fig. 4.52a, b). An apparently less severely infected throat with hyperemia of the tonsils only may, however, be associated with severe symptoms. The tonsillar lymph nodes near the angle of the mandible are large and tender.

With acute tonsillitis, the exudate and hyperemia are centered on the tonsils. In an acute pharyngitis, as may be associated with a head cold, the mucous membrane of the entire oropharynx is hyperemic.

The gonococcus may cause acute pharyngitis, and a throat swab must be placed in Stewart's medium for laboratory examination if this infection is suspected. The throat swab in acute tonsillitis commonly grows the hemolytic streptococcus, and a course of oral penicillin (often supplemented with an intramuscular injection) is invariably curative. An analgesic may also be needed, but lozenges and gargles are usually unnecessary.

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Fig. 4.52 Acute tonsillitis. The appearance of the tonsils in acute tonsillitis is either diffuse (a) or punctate (b).

Acute Tonsillitis

Fig. 4.52 Acute tonsillitis. The appearance of the tonsils in acute tonsillitis is either diffuse (a) or punctate (b).

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