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A Study on Acute Membranous Tonsillitis, Its Different Etiologies and Its Clinical Presentation in a Tertiary
Kalpana Sharma1, Sunita Das1, Abhilasha Goswami1
1Department of Otorhinolaryngology and Head & Neck Surgery, Gauhati Medical College & Hospital, Guwahati, 781032 Assam India.
Abstract:
Membranous tonsillitis is the infection of the palatine tonsils where the exudation from the crypts coalesce to form a membrane over the tonsillar surface. It is a stage ahead of the acute follicular tonsillitis. There are different etiologies for membrane formation over the tonsils. The commonest cause in the present scenario is still Corynebacterium diphtheriae. A one year prospective study was conducted on patients presenting with membranous tonsillitis in a tertiary referral centre in North-East India. Proper history was taken, clinical examination and all the necessary investigations were done. The patients were managed conservatively, while a few patients required tracheostomy. In our one year study, we found that majority of the patients presenting with acute membranous tonsillitis were males (65%) and 35% were females. Most of the cases were seen in 6-12 years of age and belonged to the lower socioeconomic group, and also to the lower Assam belt. Most of the cases were seen in the months of November to January. This prospective study gives a view of the different etiologies of acute membranous tonsillitis, its presentation and how its management affects the outcome of the patients and also affects the mortality and morbidity. This study also shows that diphtheria is still prevalent in the current Indian scenario and thus, proper implementation of the vaccination programs and prompt reporting of the cases should be done to prevent outbreaks.
Insights
Membranous tonsillitis, often caused by Corynebacterium diphtheriae, remains prevalent in India. This study highlights the need for continued vaccination and prompt case reporting to prevent outbreaks.
Area of Science:
- Infectious Diseases
- Otolaryngology
- Public Health
Background:
- Membranous tonsillitis involves exudate forming a membrane on tonsils, progressing from acute follicular tonsillitis.
- Etiologies for tonsillar membrane formation vary, with Corynebacterium diphtheriae being a common cause.
Purpose of the Study:
- To investigate the etiologies, clinical presentation, and management outcomes of acute membranous tonsillitis.
- To assess the current prevalence of diphtheria as a cause of membranous tonsillitis in North-East India.
Main Methods:
- A one-year prospective study was conducted at a tertiary referral center in North-East India.
- Data collection included patient history, clinical examination, and necessary investigations.
- Management strategies ranged from conservative treatment to tracheostomy.
Main Results:
- The majority of patients were male (65%), aged 6-12 years, from lower socioeconomic groups, and residing in the lower Assam belt.
- Most cases occurred between November and January.
- Diphtheria was identified as a significant etiological agent, indicating its continued prevalence.
Conclusions:
- Acute membranous tonsillitis presents distinct demographic and seasonal patterns in North-East India.
- Diphtheria remains a relevant public health concern in the region.
- Effective vaccination programs and timely case reporting are crucial for preventing diphtheria outbreaks.
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