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The management of severe infectious mononucleosis tonsillitis and upper airway obstruction

Published online by Cambridge University Press:  08 March 2006

S. C. S. Chan  and
P. J. D. Dawes
S. C. S. Chan
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
P. J. D. Dawes
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
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Abstract

Acute tonsillectomy has been advocated for severe infectious mononucleosis (IM) pharyngotonsillitis with upper airway obstruction (UAO) and not responding to corticosteroids. This paper reviews and rationalizes our management. A five-year chart review was carried out with a follow-up telephone survey. There were 36 admissions. Nine had UAO of whom 89 per cent (eight of nine patients) had a tonsillectomy. The diagnosis of UAO was not standardized. Twenty-seven patients did not have UAO and only a small proportion of these patients, 16 per cent (four of 25) went on to have an elective tonsillectomy. Corticosteroids made no significant difference to the tonsillectomy rate. UAO appears to identify patients with more severe disease who are likely to suffer recurrent tonsillitis. Acute tonsillectomy is an appropriate treatment option for this subgroup. The diagnosis of significant IM UAO is not defined and a schema is proposed. Recurrent tonsillitis is an uncommon sequela of severe IM pharyngotonsillitis without UAO.

Keywords

Infectious MononucleosisAirway ObstructionTonsillectomy
Type
Research Article
Information
The Journal of Laryngology & Otology , Volume 115 , Issue 12 , December 2001 , pp. 973 - 977
Copyright
© Royal Society of Medicine Press Limited 2001

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