Pediatria pre prax 2/2013

Diagnosis and treatment of tonsillitis in children

The pharynx is the site of first contact of the body with the environment; therefore, a lot of inflammatory processes occur here. If an inflammation is mainly confined to the area of the tonsils, it is referred to as tonsillitis. Pharyngitides are most frequently of viral etiology, with group A Streptococcus pyogenes being the most common bacterial agent. They are diagnosed based on clinical examination and, if necessary, laboratory investigations (CRP, microbiological examination, etc.). Non-serious inflammatory processes are treated symptomatically and those caused by bacteria with antibiotics. Penicillin is the drug of choice in streptococcal infections and has to be taken for ten days. By contrast, penicillin is not suitable in recurrent inflammations in which broad-spectrum antibiotics are indicated. Tonsillectomy may be considered in recurrent tonsillitis and is indicated if there are seven episodes of tonsillitis in one year, five episodes for two consecutive years, or three episodes per year for three consecutive years. When considering tonsillectomy, however, an individual approach is always required depending on the complaints, age, and other factors.

Keywords: tonsillitis, diagnosis, microbiology, treatment.