Tonsillar Conditions

Primary tonsil pathology, distinct from the infective pharyngitides (see Pharyngitis) and suppurative complications (see Deep Neck Space Infections).

Tonsilloliths

Microbial biofilms that form within the tonsillar crypts. Associated with halitosis and chronic cryptic tonsillitis. Patients may report a foreign-body sensation in the throat, or have expressible hard, white masses on their tonsils.

Treatment: tonsillectomy.

Recurrent / chronic tonsillitis

Recurrent acute tonsillitis

Tonsillectomy is indicated for patients with: 6–7 episodes of tonsillitis in 1 year; 5 episodes/year over 2 years; or 3 episodes/year over 3 years.

Chronic tonsillitis

A single episode lasting 3 months or more.

Symptoms: sore throat; halitosis; persistent lymphadenopathy; tonsillar enlargement.

Management: consider treatment with a beta-lactamase-resistant antibiotic (e.g. amoxicillin/clavulanate) — not covered by eTG, sourced from a US textbook. Will likely need tonsillectomy — refer to ENT.