#microbiology
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Tonsillitis is inflammation of the pharyngeal tonsils.
- Inflammationusually extends to the adenoid and the lingual tonsils
- Most commonly viral
- Most cases of bacterial tonsillitis are caused by group A beta-hemolytic Streptococcus pyogenes (GABHS) - strep throat.
- Spread through the air.
Symptoms may include sore throat, fever, enlargement of the tonsils, trouble swallowing, and large lymph nodes around the neck. Complications include peritonsillar abscess.
Recurrent tonsillitis
- A polymicrobial flora consisting of both aerobic and anaerobic bacteria
- Other competing bacteria are reduced - less interference to GABHS infection.
- Streptococcus pneumoniae, Staphylococcus aureus, and Haemophilus influenzae are the most common bacteria isolated in recurrent tonsillitis, and Bacteroides fragilis is the most common anaerobic bacterium isolated in recurrent tonsillitis.
- The microbiologies of recurrent tonsillitis in children and adults are different; adults show more bacterial isolates, with a higher recovery rate of Prevotella species, Porphyromonas species, and B fragilis organisms , whereas children show more GABHS. Also, adults more often have bacteria that produce beta-lactamase.
Chronic tonsillitis
- Polymicrobial bacterial population present
- There is likely a relationship between tonsillar size and chronic bacterial tonsillitis based on both the aerobic bacterial load and the absolute number of B and T lymphocytes.
- Fewer dendritic cells on the surface epithelium and more in the crypts and extrafollicular areas during chronic tonsillitis.
- Radiation exposure may relate to the development of chronic tonsillitis. A high prevalence of chronic tonsillitis was noted following the Chernobyl nuclear reactor accident in the former Soviet Union.
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