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Published on: March 30, 2018
Double trouble: Necrotizing tonsillitis in the setting of streptococcus pyogenes superinfection in a patient with
Joshua Mangerel1, Jessica Chung2, Yu S Lin2
1Department of Radiology, Maimonides Medical Center, 4802 10th Avenue, Brooklyn, NY 11219 USA.
Abstract:
Tonsillitis, the inflammation of the palatine tonsils, is a common cause of throat pain. It is most often due to viruses but can also be related to bacteria. Necrotizing tonsillitis is a rare complication of acute tonsillitis with relatively few cases reported in the literature. We present a case of necrotizing tonsillitis in a patient with mononucleosis related to infection by Epstein-Barr virus, with superinfection with Streptococcus pyogenes, or group A streptococcus. To our knowledge, this is the first case of this nature to be reported in the medical literature. While the role of radiologic imaging is generally of limited diagnostic utility in cases of uncomplicated tonsillitis, its use was invaluable in ascertaining the nature and scope of necrotizing tonsillitis in this case. Further research remains to determine whether viral or bacterial superinfection can be used to further stratify patients who present with sore throat.
Insights
Necrotizing tonsillitis, a rare complication, was observed in a patient with Epstein-Barr virus mononucleosis and a Streptococcus pyogenes superinfection. This case highlights the diagnostic value of imaging in rare tonsillitis complications.
Area of Science:
- Infectious Diseases
- Otolaryngology
- Pathology
Background:
- Tonsillitis is common, usually viral, but bacterial infections can occur.
- Necrotizing tonsillitis is a rare, severe complication of acute tonsillitis.
- Mononucleosis, caused by Epstein-Barr virus, can predispose to secondary infections.
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