1 child with high grade hyperpyrexia, bilat , bull swollen neck & inflamed lips. 2. With infection control & personnel protective equipment throat show thrush, severe acute inflammation, septic follicular tonsillitis & maybe diphtheria. & Septicemia and As per ECG changes percarditis, myocarditis. 3 ECG: sinustachy, St elevation ll , lll, avf, V5,6 . St depression in avr, V1,2 reciprocal changes . Urgent further evaluation and Rx Urgent Peaditrician, ENT & Cardiologist refrence. Need ICU isolation observation and monitoring, Maintain ABCDE and Vitals Oxygenation , Nebulisation - budecort, Duolin ENT Surgeon Maybe tracheostomy sos. Simultaneously Throat swab micro, c+s. Labtest cbc, clotting, RFT,LFT,Glucose. Cardiac enzymes, ECHO. Chest x-ray. Inj Parcetamol, Antibiotics, Antiemetics May need ionotropes Diphtheria antitoxin as per need. And as pt is responding to Rx, Continue further follow up, Evaluation and Rx...
Seviour sceptic follicular Tonsilitis. ECG. Sinus Mechanism. ST Elevated in inferior lead. ST Elevated in Latral lead to. ST flats depressed in V1 - V2 and AVR It is Reciprocal change . This is very critical condition of Pt. So Intensive menegment require. Starts Antibiotic and Do 2D.ECHO AND cardiac markers. And sent to interventional cardiologist .
A very rare case Acute follicular tonsillitis with Diphtheria, septicemia & Myocarditis. Intensive management is required in consultation with cardiologist.
Acute Follicular Tonsillitis with septicaemic Myocarditis.
Membranous tonsillitis leading to myocarditis and septicemia. What is the ASO titre???
A throat swab for gm stain & culture could have been done just before start of therapy
Acute inferior wall mi
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Friends today I am discussing about a very common problem occurs in change of weather known as tonsillitis. What is tonsillitis? Tonsils are the two lymph nodes located on each side of the back of your throat. They function as a defense mechanism. They help prevent your body from infection. When the tonsils become infected, the condition is called tonsillitis. Tonsillitis can occur at any age and is a common childhood infection. It is most often diagnosed in children from preschool age through their midteens. Symptoms include a sore throat, swollen tonsils, and fever. This condition is contagious and can be caused by a variety of common viruses and bacteria, such as Streptococcal bacteria, which causes strep throat. Tonsillitis caused by strep throat can lead to serious complications if left untreated. Tonsillitis is easily diagnosed. Symptoms usually go away within 7 to 10 days. Find a internist or a pediatrician or an ENT near you. Causes of tonsillitis Tonsils are your first line of defense against illness. They produce white blood cells to help your body fight infection. The tonsils combat bacteria and viruses that enter your body through your mouth. However, tonsils are also vulnerable to infection from these invaders. Tonsillitis can be caused by a virus, such as the common cold, or by a bacterial infection, such as strep throat. According to the American Academy of Family Physicians (AAFP), an estimated 15 to 30 percent of tonsillitis cases are due to bacteria. Most often it's strep bacteria. Viruses are the most common cause of tonsillitis. The Epstein-Barr virus can cause tonsillitis, which can also cause mononucleosis. Children come into close contact with others at school and play, exposing them to a variety of viruses and bacteria. This makes them particularly vulnerable to the germs that cause tonsillitis. Symptoms of tonsillitis There are several types of tonsillitis, and there are many possible symptoms that include: a very sore throat difficulty swallowing or painful swallowing a scratchy-sounding voice bad breath fever chills earaches stomachaches headaches a stiff neck jaw and neck tenderness due to swollen lymph nodes tonsils that appear red and swollen tonsils that have white or yellow spots In very young children, you may also notice increased irritability, poor appetite, or excessive drooling. There are two types of tonsillitis: recurrent tonsillitis: multiple episodes of acute tonsillitis a year chronic tonsillitis: episodes last longer than acute tonsillitis in addition to other symptoms that include: chronic sore throat bad breath, or halitosis tender lymph nodes in the neck When to see a doctor In rare cases, tonsillitis can cause the throat to swell so much that it causes trouble breathing. If this happens, seek immediate medical attention. See a doctor if you experience the following symptoms: fever that’s higher than 103˚F (39.5°C) muscle weakness neck stiffness sore throat that doesn’t go away after two days While some tonsillitis episodes go away on their own, some may require other treatments. How tonsillitis is diagnosed Diagnosis is based on a physical examination of your throat. Your doctor may also take a throat culture by gently swabbing the back of your throat. The culture will be sent to a laboratory to identify the cause of your throat infection. Treatment for tonsillitis A mild case of tonsillitis does not necessarily require treatment, especially if a virus, such as a cold, causes it. Treatments for more severe cases of tonsillitis may include antibiotics or a tonsillectomy. Antibiotics will be prescribed to fight a bacterial infection. It’s important you complete the full course of antibiotics. Your doctor may want you to schedule a follow-up visit to ensure that the medication was effective. Surgery to remove the tonsils is called a tonsillectomy. This was once a very common procedure. However, tonsillectomies today are only recommended for people who experience chronic or recurrent tonsillitis. Surgery is also recommend to treat tonsillitis that doesn’t respond to other treatment, or tonsillitis that causes complications. If a person becomes dehydrated due to tonsillitis, they may need intravenous fluids. Pain medicines to relieve the sore throat can also help while the throat is healing. Home care tips to ease a sore throat drink plenty of fluids get lots of rest gargle with warm salt water several times a day use throat lozenges use a humidifier to moisten the air in your home avoid smoke Also, you may want to use over-the-counter (OTC) pain medications, such as acetaminophen and ibuprofen. Always check with your doctor before giving medications to children. Tonsillitis complications People who experience chronic tonsillitis may start to experience obstructive sleep apnea. This happens when the airway swells and prevents a person from sleeping well. It’s also possible the infection will worsen and spread to other areas of the body. This is known as tonsillar cellulitis. The infection can also cause a person to develop a buildup of pus behind the tonsils, which is known as peritonsillar abscess. This can require drainage and more surgery. If a person doesn’t take a full course of antibiotics or the antibiotics don’t kill off the bacteria, it’s possible a person could develop complications. These include rheumatic fever and poststreptococcal glomerulonephritis. Preventing tonsillitis Tonsillitis is highly contagious. To decrease your risk of getting tonsillitis, stay away from people who have active infections. Wash your hands often, especially after coming into contact with someone who has a sore throat, or is coughing or sneezing. If you have tonsillitis, try to stay away from others until you are no longer contagious. Outlook for tonsillitis Swollen tonsils may cause difficulty breathing, which can lead to disturbed sleep. Tonsillitis left untreated can result in the infection spreading to the area behind the tonsils or to the surrounding tissue. Symptoms of tonsillitis caused by a bacterial infection usually improve a few days after you begin taking antibiotics. Strep throat is considered contagious until you have been taking antibiotics for a 24-hour period. Strep Throat Strep throat is a bacterial infection that causes inflammation and pain in the throat. This common condition is caused by group A Streptococcus… Diphtheria Diphtheria is a bacterial infection that affects the throat and nose. Get the facts on causes, symptoms, treatment, and prevention. What’s the Difference Between Tonsillitis and Strep Throat? Tonsillitis can be caused by various viruses or bacteria. Strep throat is only caused by group A Streptococcus bacteria. Tonsillectomy A tonsillectomy is a surgical procedure to remove the tonsils, which are located in the back of your throat. Sometimes they can become infected. Here there are some common homeopathic medicines given for tonsillitis Belladonna – belladonna is the most common and hugely prescribed homeopathic medicines for tonsillitis. Belladonna has the best anti inflammatory action and thus helps a lot to relief the symptoms both in acute and chronic condition. The key symptoms by which belladonna is prescribes are – pain in throat at the time of wallowing, red congested and swelling of tonsils, mild to moderate fever associates with tonsillitis, headache and malaise also present. The tonsils are been affected by taking any cold things like chilled drink or ice cream or cold drink or exposing to cold air etc. The throat pain is slightly relieved after taking any sort of warm drink. If all those symptoms are prominently found in a tonsillitis patient then belladonna is the suitable medicine for that person. Mercurius Solubis- Here is another best hoemopathy medicine for tonsillitis. The key symptoms to prescribe tonsillitis are – pain in throat, congestion of tonsils and unable to drink or eat anything. There is more salivation from mouth. The pain is worse in the night time in compare to day time. There is swelling of tonsils and also swelling of other lymph nodes in neck and sub mandibular regions. There is mild to moderate fever and the person feels thirsty though there is more salivation. If the above symptoms are prominent in any tonsillitis patient this medicine is most suitable medicine for that person Phytolacca- it is also one of the important homeopathic medicine for tonsillitis. The tonsils are dark red or bluish red in colour. There is much pain at the root of tongue, soft palate. The tonsils are swollen. There is a sensation of a lump in throat. While taking any food the throat feels rough, narrow, and hot. The Tonsils are swollen, especially of right side. There is a sharp shooting pain into ears on swallowing anything. There is much pain when swallow anything hot. The pain of phytolacca is burning type of pain. The person cannot swallow anything even water. Hepar Sulphur- Hepar Sulphur is one of the best Homeopathic medicines for tonsillitis. The tendency to suppuration is most marked, and has been a strong guiding symptom in tonsillitis. When swallowing, sensations as if a plug and of a splinter like sensation in throat. There is quinsy with suppuration of tonsils. When swallowing there is stitching type of pain in throat extending to the ear. There is mild to moderate fever and chilliness is feeling during the tonsillitis affection. The person is very chill and cannot tolerate any cold air or cold water. Calcarea Carb –It is a medicine for chronic tonsillitis problem.The person is bulky, obese, gaining weight easily. He is though fatty but very weak in stamina. Exhausted or tired on slightest physical activity. He/she sweats a lot on slightest physical exertion. He is very susceptible to catch cold. the tonsils are large, swelled and get acutely affected on slightest exposure to cold. The throat appearance itself is not always sufficient to prescribe on, but the complaints in the throat are those that come on in persons taking cold so frequently. On every cold he will have cough, tonsil affection, appetite lost. The calcarea carb child is very lazy and lethargic in nature. he takes cold from every, draft, from very exposure, and from damp weather. There are little red patches in the throat, this extends to the roof of the mouth, a sore tongue, and a constant dry, choking feeling in the pharynx, covering the tonsils. The throat is very painful on swallowing. Baryta Carb – it is one of the 1st grade medicine for chronic tonsillitis. The tonsils are inflamed, swelled and very painful in acute condition. After the acute attack passed on the tonsils looks larger than with the last cold. The child is weak, not fatty like calcarea carb. Physically and also mentally he is week. He/she has a tendency to catch cold very easily. But the most important symptom is whenever he catch cold first it attack to the tonsil or throat. So it is written in allens materia medica that every cold settles in the throat. The person sweats more from the feet. Every cold change inflames the tonsils, and in children they very soon enlarge. Children with enlarged tonsils, and with enlarged glands in other places, somewhat weak intellectually, slow to learn.The throat is very painful on swallowing.On every cold change of the weather, and on every exposure to the cold, he gets rattling respiration.Dr. Rajesh Gupta21 Likes36 Answers