Pharyngitis (Tonsillitis)

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Acute inflammation of the tonsils which usually has a rapid onset.

Causes

  • Mostly viral infection
  • Bacterial infection especially beta-haemolytic streptococcus

Signs and symptoms

  • Fever
  • Sore throat
  • Dysphagia
  • Enlargement of the tonsils
  • Painful swallowing
  • Tender cervical or submandibular lymph nodes
  • Body aches

Complications

  • Quinsy especially for young children aged 2-4 years

Differential diagnosis

  • Pharyngitis

Investigations

  • Culture and sensitivity of throat swab

Non-pharmacologic management

  • Bed rest
  • Drinks to soothe the throat

Pharmacological treatment

First Line

Amoxicillin oral

Adult: 500-875mg every 12 hours for 10 days

Child:

up to 5 years: 50 mg/kg/day in 2 or 3 divided doses for 10 days

AND

Paracetamol oral

Adult:

1gm every 8 hours until fever is controlled

Child:

10-20 mg/kg body weight every 6 hourly/PRN

 

Second line

Cephalexin oral

Adult:

500 mg every 12 hours for 10 days

Child:

Cephalexin 12.5 to 25 mg/kg every 12 hours

 

If allergic to penicillin

Azithromycin oral

Adult:

 500 mg daily for 5 days  

Child:

12 mg/kg once daily for 5 days