Throat Pain and Tonsillitis

Throat pain is one of the frequent complaints in children, most of which are caused by viruses like common cold viruses and less frequently by bacteria, the most common of which is streptococcus bacterium. Differentiating viral from bacterial cause is very important because of modality of treatment and is possible in most cases based on a good history and physical examination supported occasionally by doing some laboratory tests and waiting couple of days before blindly treating the child sore throat with antibiotic.
Tonsillitis is inflammation of tonsils, the two oval shaped tissues at the back of the throat one on each side. Bacterial type is usually caused by streptococcus pyogenes beta hemolytic, occurs rarely in less than 2 years of age and more common between 5-15 years. Patients suffer from fever, may look sick with swollen tonsils and in minority with some exudates on the tonsils. Throat pain is one of the prominent symptom as well as tender cervical adenopathy on the sides of the neck and occasionally abdominal pain. In old time we used to treat the patient with bacterial etiology immediately with antibiotics preferably using penicillin but nowadays in doubtful cases we can even wait 4 or 5 days before starting antibiotic depending on the case and the condition of the patient, this is in order to make sure of the cause viral or bacterial and even if it is bacterial this delay does not hurt the patient but it gives a better protection immunologically.
When we deal with tonsillitis at any age it is very important to consider the possibility of other causative agents meaning the differential diagnosis of the Acute Tonsillitis or Pharyngitis which are as followed:
1. Viral infection , which is the most common cause of tonsillitis
2. Bacterial, Streptococcus Group A Beta hemolytic which is the most common offending agent although other strain of strep like Group C and G beta hemolytic can also cause the same picture.
3. Mycoplasma Pneumonia ,is a small bacteria and common respiratory pathogen
4. Fusobacterium necrophorum which is anaerobic gram negative bacillus and the leading cause of peritonsillar abscess and also of the Lamierrre’s syndrome or suppurative internal jugular thrombophlebitis which is a potentially lethal form of sore throat.
5. Staphylococcus aureus, not that uncommon cause of tonsillitis
6. Diphtheria, very rare because of vaccination program
7. Tuleremia, very rare, a bacteria, need contact with infected animal like cat, deer or rabbit
Sometimes patient complains of chronic sore throat which can have anyone of the following causes (Differential diagnoses):
1. Tonsillitis
2. Allergy
3. Infectious Mononucleosis
4. Inhaling air pollutant
5. Smoking
6. Influenza
7. Inhaling through the mouth instead of nose

2019-03-26T07:36:20+00:00
en_USEN
arAR ru_RURU fa_IRFA en_USEN