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Adenotonsillitis - diagnosis and treatment


What are adenoids and tonsils?

ADENOID A triangular-shaped mass of lymphoid tissue located on the posterior aspect of the nasopharynx (Bailey, 1998).

AMYGDALS A pair, usually ovoid-shaped masses located on the lateral walls of the oropharynx (Bailey, 1998).

What is adenotonsillitis?

Adenotonsillitis is inflammation of the tonsils and adenoids.

What causes adenotonsillitis?

Adenotonsillitis is caused by a viral or bacterial infection. Adenovirus, Influenza virus, Parainfluenza and Streptococcus species of bacteria are the most common organisms involved.

How is adenonsillitis transmitted to other people?

The virus and bacteria that cause adenotonsillitis are airborne and therefore easily transmitted to other people.

What are the signs and symptoms of adenotonsillitis?

Symptoms are fever, sore throat, swollen tonsils that are red and may have white patches. This is associated with cough, headache and swollen lymph nodes. Sometimes children may have nausea, vomiting, hoarseness and bad breath.

If adenoiditis is also present, children have nasal obstruction, runny nose, snoring and mouth breathing.

If the tonsils and adenoids are very large and block (obstruct) the airway, the child may have sudden difficulty breathing while asleep. This suddenly wakes her up. This is called obstructive sleep apnoea.

How is adenotonsillitis diagnosed?

Your child's ENT doctor will ask your child's symptoms and examine him/her to make a diagnosis and request a rhinopharyngeal X-ray to observe the degree of obstruction of the adenoids in the rhinopharynx, immunological tests such as ASTO (Streptolysin O is an extracellular haemolysin released into the tissues during infection with group A Streptococcus b -haemolyticus A. It causes the formation of antibodies capable of blocking its haemolytic effect. It causes the formation of antibodies capable of blocking its haemolytic effect. High ASTO titres are present in 90% of streptococcal pharyngitis).

How is adenotonsillitis treated?


Taking paracetamol or ibuprofen helps reduce fever and pain. Gargles and/or lozenges help reduce pain in older children. Encourage her to drink plenty of fluids and rest. Sometimes symptomatic treatment for cough, stuffy nose and runny nose may be necessary.

If a bacterial infection is suspected, a course of antibiotics is administered. If this treatment does not relieve the fever and sore throat, the child should be admitted to hospital for intravenous antibiotics.

Most of the time, adenotonsillitis gets better within a week. However, a small number of children have tonsillitis for longer or it keeps coming back. Therefore, surgical treatment may be necessary.


Adenotonsillectomy, which means removal of the adenoids by curettage technique in the rhinopharynx and agmidalectomy by electrocautery technique, is performed.

What are the complications of adenotonsillitis?

Complications sometimes arise as a result of adenotonsillitis and are mainly after bacterial infection and also in the surgical process although not as frequent as haemorrhage from the area.

Possible complications are:

Middle ear infection known as Otitis Media, where the fluid between the eardrum and the inner ear becomes infected by bacteria.

A collection of pus develops between one of the tonsils and the throat wall. This is called a peritonsillar abscess or Quinsy.

The rarest complications are:

Obstructive sleep apnoea (as explained above)

Glomerulonephritis 10-14 days after strep throat. This occurs as a result of the body's immune system reacting to the infection.


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