Tonsillitis: An Updated Review Article for Healthcare Professionals.

Abstract

Background: Tonsillitis, an inflammatory condition of the palatine tonsils, accounts for 1.3% of outpatient visits and is primarily caused by viral or bacterial infections. As part of Waldeyer’s ring, the tonsils serve as immunological barriers, but their inflammation can lead to complications such as peritonsillar abscess, rheumatic fever, and post-streptococcal glomerulonephritis. Accurate diagnosis and management are critical to prevent unnecessary antibiotic use and mitigate complications.

Aim: This review synthesizes current evidence on the etiology, diagnosis, treatment, and complications of tonsillitis to guide healthcare professionals in evidence-based decision-making.

Methods: A comprehensive analysis of peer-reviewed literature, clinical guidelines, and Cochrane reviews was conducted, focusing on etiology (viral vs. bacterial), diagnostic tools (Centor criteria, rapid antigen testing), treatment modalities (supportive care, antibiotics, surgery), and complications.

Results: Viral etiologies (e.g., rhinovirus, EBV) dominate, but GABHS requires prompt antibiotic therapy to prevent sequelae. The Centor criteria effectively stratify risk, with scores ≥4 warranting antibiotics. Penicillin remains first-line for GABHS, while macrolides or cephalosporins are alternatives for allergic patients. Complications like peritonsillar abscess (managed with drainage and antibiotics) and rheumatic fever (preventable with timely antibiotics) underscore the need for judicious treatment. Recurrent cases (>5 episodes/year) may benefit from tonsillectomy, though shared decision-making is essential.

Conclusion: Tonsillitis management hinges on accurate diagnosis, antibiotic stewardship, and awareness of complications. Interprofessional collaboration optimizes outcomes, balancing symptomatic relief with prevention of long-term sequelae.