Virus and Viral Tonsillitis Differential

Topics: Inflammation, Virus, Infection Pages: 6 (1491 words) Published: February 8, 2013
Tonsillitis and Adenoiditis

Related Terms
* Adenoid Hypertrophy
* Adenotonsillitis
* Infective Adenoiditis
* Infective Tonsillitis
* Pharyngotonsillitis
* Septic Adenoiditis
* Septic Tonsillitis
* Suppurative Adenoiditis
* Suppurative Tonsillitis
* Tonsillar Hypertrophy
* Viral Tonsillitis
Differential Diagnoses
* Adenoid hypertrophy * Lymphoma * Pharyngitis * Strep throat|
* Family Physician * General Surgeon * Internal Medicine Physician * Otolaryngologist * Pediatrician|
Comorbid Conditions
* Chronic sinusitis * Pharyngitis * Severe nasal obstruction|
Factors Influencing Duration
Length of disability may be influenced by the underlying cause (bacterial or viral infection), method of treatment (antibiotics or surgery), response to treatment, or the presence of complications (presence of other infections).| Medical Codes

| ICD-9-CM:| 463, 474, 474.0, 474.00, 474.01, 474.02, 474.1, 474.11, 474.12, 474.9| Definition
Tonsillitis is an inflammation of the fleshy tissues that lie on either side of the back of the mouth at the top of the throat (pharyngeal or palatine tonsils). These tissues contain cells that are useful in fighting infection.

Inflammation of the tonsils can be caused by many contagious bacteria or viruses, including strains of streptococcus bacteria, adenovirus, influenza virus, Epstein-Barr virus, enterovirus, and the herpes simplex virus. One of the most frequent causes of tonsillitis is group A beta hemolytic Streptococcus pyogenes (GABHS), which is also the cause of strep throat; it is responsible for 30% of childhood tonsillitis and 10% of adult cases (Lauro).

Adenoiditis is an inflammation of the lymphoid tissue at the back of the roof of the mouth (the adenoids). Adenoiditis, or enlarged adenoids (adenoid hypertrophy), is unusual in adults because the adenoids normally shrink and almost disappear as the individual reaches adolescence. Hypertrophy of the adenoids occurs naturally or is caused by chronic inflammation. Chronic adenoid inflammation may cause nose-breathing problems due to their location.

Tonsillitis and adenoiditis may occur at the same time in children.Risk: Children are at a greater risk for both tonsillitis and adenoiditis. The risk is higher in those with a family history of tonsillectomy; in adults, the risk is variable and unspecified.Incidence and Prevalence: Tonsillitis is a common condition, with nearly all children becoming infected at least once (Shah). Carrier status of GABHS is found in 2.5% to 10.9% of school-age children (Shah).| Source: Medical Disability Advisor

History: Individuals with tonsillitis may report a sudden onset of a sore throat, painful swallowing, and fever. In addition, the individual may experience headache, loss of appetite, chills, malaise, and swollen lymph nodes in the neck and jaw area.

Individuals with adenoiditis may report chronic or acute pus-like nasal discharge and chronic mouth breathing due to nasal blockage (obstruction). The individual may also experience painful swallowing, snoring, sleep disturbances (sleep apnea and restlessness), and ear infections (otitis media). A history of prior bouts of tonsillitis may be reported (chronic tonsillitis).Physical exam: Examination of the neck and throat of an individual with tonsillitis reveals swollen, red tonsils, often coated with white areas of exudate if tonsillitis is caused by Streptococcus pyogenes. In some cases, grayish-white membranes and red spots (petechiae) may be seen if tonsillitis is caused by Epstein-Barr virus. The lymph nodes in the neck and jaw area may be swollen and tender, and the neck may be stiff. Signs of dehydration may be seen in the skin and mucosa. Ulcerated areas may be found on the tonsils, suggestive of herpes simplex virus.

A physical exam of an individual with adenoiditis reveals enlarged adenoids and nasal...
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