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Tonsillitis

Última revisão: 18 Jun 2025
Última atualização: 30 Apr 2024

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • pain on swallowing
  • fever (>100.5°F [>38°C])
  • tonsillar exudate
Detalhes completos

Outros fatores diagnósticos

  • sudden onset of sore throat
  • headache
  • abdominal pain
  • nausea and vomiting
  • presence of cough or runny nose
  • tonsillar erythema
  • tonsillar enlargement
  • enlarged anterior cervical lymph nodes
Detalhes completos

Fatores de risco

  • age between 5 and 15 years
  • contact with infected people in enclosed spaces (e.g., child care centers, schools, prison)
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • throat culture
  • rapid streptococcal antigen test
Detalhes completos

Investigações a serem consideradas

  • serologic testing for streptococci
  • WBC count and differential
  • heterophile antibodies
  • vaginal and cervical, or penile, and rectal cultures
  • HIV viral load assay
  • lateral cervical view x-ray, exposed for soft tissue
Detalhes completos

Algoritmo de tratamento

AGUDA

acute tonsillitis not due to group A beta-hemolytic streptococcal infection

acute tonsillitis due to group A beta-hemolytic streptococcal infection

CONTÍNUA

recurrent episodes of tonsillitis

Colaboradores

Autores

Christos Georgalas, PhD, DLO, FRCS (ORL-HNS)
Christos Georgalas

Professor of Surgery - Head and Neck

University of Nicosia

Cyprus

Declarações

CG declares that he has no competing interests.

Eleftherios Margaritis, PhD, MSc, MD
Eleftherios Margaritis

Otolaryngologist - Head and Neck Surgeon

Collaborator in Otolaryngology

ENT Department

Hippokration University Hospital

Athens

Greece

Declarações

EM declares that he has no competing interests.

Revisores

Itzhak Brook, MD, MSc

Professor of Pediatrics and Medicine

Georgetown University

Washington

DC

Declarações

IB declares that he has no competing interests.

Chris Del Mar, MB BChir, FRACGP MD, MA, FAFPHM

Dean

Faculty of Health Sciences and Medicine

Bond University

Gold Coast

Queensland

Australia

Declarações

CDM is an author of a number of references cited in this topic.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

Shaikh N, Swaminathan N, Hooper EG, et al. Accuracy and precision of the signs and symptoms of streptococcal pharyngitis in children: a systematic review. J Pediatr. 2012 Mar;160(3):487-93. Resumo

Aalbers J, O'Brien KK, Chan WS, et al. Predicting streptococcal pharyngitis in adults in primary care: a systematic review of the diagnostic accuracy of symptoms and signs and validation of the Centor score. BMC Med. 2011 Jun 1;9:67.Texto completo  Resumo

Spinks A, Glasziou PP, Del Mar CB. Antibiotics for sore throat. Cochrane Database Syst Rev. 2013;(11):CD000023.Texto completo  Resumo

Shulman ST, Bisno AL, Clegg HW, et al. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. Clin Infect Dis. 2012 Nov 15;55(10):e86-102.Texto completo  Resumo

de Cassan S, Thompson MJ, Perera R, et al. Corticosteroids as standalone or add-on treatment for sore throat. Cochrane Database Syst Rev. 2020 May 1;5(5):CD008268.Texto completo  Resumo

Burton MJ, Glasziou PP, Chong LY, et al. Tonsillectomy or adenotonsillectomy versus non-surgical treatment for chronic/recurrent acute tonsillitis. Cochrane Database Syst Rev. 2014 Nov 19;(11):CD001802.Texto completo  Resumo

Windfuhr JP, Toepfner N, Steffen G, et al. Clinical practice guideline: tonsillitis II. Surgical management. Eur Arch Otorhinolaryngol. 2016 Apr;273(4):989-1009. Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Tonsillitis images
  • Diagnósticos diferenciais

    • Infectious mononucleosis
    • Epiglottitis
    • Peritonsillar abscess (quinsy)
    Mais Diagnósticos diferenciais
  • Diretrizes

    • Clinical practice guideline: tonsillectomy in children (update)
    • A guide to utilization of the microbiology laboratory for diagnosis of infectious diseases: 2018 update
    Mais Diretrizes
  • Folhetos informativos para os pacientes

    Sore throat

    Tonsillitis

    Mais Folhetos informativos para os pacientes
  • Calculadoras

    Sore Throat (Pharyngitis) Evaluation and Treatment Criteria (McIsaac)

    Mais Calculadoras
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