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recurring tonsillitis
Sent to Health Experts July 31 01:30 AM

my 13 year old son suffered from recurring "viral" tonsillitis from april to november 2004. numerous strep tests were taken. he also had a mono test all were negative. now it has started again this april. he is suffering with it for the 3rd time in 2005. what could be the cause of this illness? he gets swollen glands. fever, and pus pockets on his tonsils. it lasts 3 to 5 days and then he is fine. 5 to 6 weeks later it starts again

Customer (name blocked for privacy)
Answer
July 31 2:21 AM (51 minutes and 13 seconds later)
         
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As you probably know, primary function of tonsils is to fight infection. However, recurrent infections are generally an indication that the tonsils need to be removed.

According to this reference, general guidelines for tonsil removal are:

  • Five or more episodes in one year
  • Three or more episodes per year for two years
  • Infections that do not respond to treatment
If you have not already done so, you should discuss this option with your son's physician.

Let me know if you need more input. If not, thanks for the opportunity to assist you... I would really appreciate your honoring my efforts by 'pushing the button' and Accepting this answer. Adding a bonus -- should you wish to do so -- is always warmly welcomed.

Good Luck!

Steve



Edited by Oreport on July 31 2005 at 2:24 AM



Counselor /listener/collaborative problem solver. Thanks!
Answer
July 31 2:24 AM (2 minutes and 33 seconds later)
         
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Tonsillitis refers to inflammation of the pharyngeal tonsils. The inflammation may involve other areas of the back of the throat including the adenoids and the lingual tonsils (areas of tonsil tissue at the back of the tongue). There are several variations of tonsillitis: acute, recurrent, and chronic tonsillitis and peritonsillar abscess.
Viral or bacterial infections and immunologic factors lead to tonsillitis and its complications. Nearly all children in the United States experience at least one episode of tonsillitis. Because of improvements in medical and surgical treatments, complications associated with tonsillitis, including mortality, are rare.
Tonsillitis most often occurs in children; however, the condition rarely occurs in children younger than two years. Tonsillitis caused by Streptococcus species typically occurs in children aged five to 15 years, while viral tonsillitis is more common in younger children. A peritonsillar abscess is usually found in young adults but can occur occasionally in children. The patient's history often helps identify the type of tonsillitis (i.e., acute, recurrent, chronic) that is present.
Tonsillitis is...
The herpes simplex virus, Streptococcus pyogenes (GABHS) and Epstein-Barr virus (EBV), cytomegalovirus, adenovirus, and the measles virus cause most cases of acute pharyngitis and acute tonsillitis. Bacteria cause 15-30 percent of pharyngotonsillitis cases; GABHS is the cause for most bacterial tonsillitis.
The symptoms are
The type of tonsillitis determines what symptoms will occur.
Acute tonsillitis: Patients have a fever, sore throat, foul breath, dysphagia (difficulty swallowing), odynophagia (painful swallowing), and tender cervical lymph nodes. Airway obstruction due to swollen tonsils may cause mouth breathing, snoring, nocturnal breathing pauses, or sleep apnea. Lethargy and malaise are common. These symptoms usually resolve in three to four days but may last up to two weeks despite therapy.
Recurrent tonsillitis: This diagnosis is made when an individual has multiple episodes of acute tonsillitis in a year.
Chronic tonsillitis: Individuals often have chronic sore throat, halitosis, tonsillitis, and persistently tender cervical nodes.
Peritonsillar abscess: Individuals often have severe throat pain, fever, drooling, foul breath, trismus (difficulty opening the mouth), and muffled voice quality, such as the “hot potato” voice (as if talking with a hot potato in his or her mouth).
What happens during the physician visit?
Your child will undergo a general ear, nose, and throat examination as well as a review of the patient’s medical history.
A physical examination of a young patient with tonsillitis may find:
Fever and enlarged inflamed tonsils covered by pus.
Group A beta-hemolytic Streptococcus pyogenes (GABHS) can cause tonsillitis associated with the presence of palatal petechiae (minute hemorrhagic spots, of pinpoint to pinhead size, on the soft palate). Neck nodes may be enlarged. A fine red rash over the body suggests scarlet fever. GABHS pharyngitis usually occurs in children aged 5-15 years.
Open-mouth breathing and muffled voice resulting from obstructive tonsillar enlargement. The voice change with acute tonsillitis usually is not as severe as that associated with peritonsillar abscess.
Tender cervical lymph nodes and neck stiffness (often found in acute tonsillitis).
Signs of dehydration (found by examination of skin and mucosa).
The possibility of infectious mononucleosis due to EBV in an adolescent or younger child with acute tonsillitis, particularly when cervical, axillary, and/or groin nodes are tender. Severe lethargy, malaise and low-grade fever accompany acute tonsillitis.
A grey membrane covering tonsils that are inflamed from an EBV infection. (This membrane can be removed without bleeding.) Palatal petechiae (pinpoint spots on the soft palate) may also be seen with an EBV infection.
Red swollen tonsils that may have small ulcers on their surfaces in individuals with herpes simplex virus (HSV) tonsillitis.
Unilateral bulging above and to the side of one of the tonsils when peritonsillar abscess exists. A stiff jaw may be present in varying severity.
Treatment
Tonsillitis is usually treated with a regimen of antibiotics. Fluid replacement and pain control are important. Hospitalization may be required in severe cases, particularly when there is airway obstruction. When the condition is chronic or recurrent, a surgical procedure to remove the tonsils is often recommended.
Good Luck with your son if he is having severe & repeated syymptoms the relativly simple surgery maybe your answer.
Hope this was a help
God Bless
Kath














   

   












Reply
July 31 9:48 AM (7 hours and 24 minutes later)
         
thank you so much. my son does not meet the criteria for a tonsilectomy since he doesn't have any symptoms during the months of Dec. and March.
I would just like to know why this is happening. i thought maybe it was from allergys. thank you again
Reply
July 31 9:59 AM (10 minutes and 44 seconds later)
         
my son is experiencing chronic tonsilitis from April to Nov.. Symptoms are swollen glands under jaw,pus pockets on tonsils,sore throat,fever. this has been going on for the last 2 years. But he is perfectly fine during Dec. through Mar.
Before this stated happening my so had severe bout of allergies sometime ending with an asthma attack. Since this tonsilitis has start, my son hasn't had an allergy attack. Could it be that the sinuses are draining into the throat during allergy season and causing this tonsilitis, instead of a full blown allergy attack.
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