Acute tonsilliti in pediatric age: diagnostics and treatment


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In childhood beta-hemolytic streptococcus group A is causative agent of acute tonsillitis only in one-third of children, same frequency is observed in diseases caused by Epstein-Barr virus and respiratory viruses (most adenoviruses). Clinical differences between these forms of tonsillitis are almost exclusively absence catarrhal symptoms in streptococcal tonsillitis and the presence of nasopharyngitis in patients with viral forms, as well as conjunctivitis in adenovirus. Laboratory markers of bacterial inflammation show minor aid in the differential diagnosis of bacterial and viral forms, dramatize the importance of streptococci identification by microbiological and serological methods. Antibacterial therapy is justified only in streptococcal forms, in which it gives immediate effect. The lack of effect suggests a viral tonsillitis, and stop treatment with antibiotics. The deta-lactams use in streptococcal tonsillitis requires a 10-day course of therapy. Azithromycin or better - jozamycin (less often develops resistance) use allows the 5-day course of therapy.

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