When do tonsils atrophy

Specimens were compared for their apoptotic cell count. Conclusions: In the light of these findings, it was concluded that apoptosis played a role in the tonsillar hypertrophy and atrophy.

Apoptosis functioned to balance lymphocyte proliferation in tonsil tissue. The association of apoptosis with tonsillar hypertrophy seemed to be age-dependent.

Keywords: Apoptosis; In situ nick-end labeling; Palatine tonsil; Tonsillitis. What are the symptoms? What causes tonsillar hypertrophy? How is it diagnosed? How is it treated? Possible complications. What to expect.

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The tonsils tend to atrophy in early adulthood. In laryngitis there are few visible signs of infection but with soreness lower down the throat often associated with a hoarse voice. Urgent blood tests, including FBC, should be arranged for any patient that has any suspicion of immunodeficiency. Check that the patient is not taking a drug that may cause agranulocytosis. Culture of Group A beta-haemolytic streptococcus GABS is inefficient as a diagnostic criterion, as it is too slow and it fails to differentiate between infection and carriage.

There are four Centor Criteria that may be used [ 2 ] :. Patients with one or none of these criteria are unlikely to have GABS. Consideration of antibiotic prescription should be limited to patients with three or four criteria [ 1 ]. Reviews of the literature concur that antibiotics confer no benefit in the majority of patients with sore throat, that the 'numbers needed to treat' warrant a conservative approach in developed countries and that they should be reserved for specific clinical scenarios.

Antibiotics confer relative benefits in the treatment of sore throat. However, the absolute benefits are modest. Protecting sore throat sufferers against suppurative and non-suppurative complications in high-income countries requires treating many patients with antibiotics for one patient to benefit.

This number needed to treat to benefit may be lower in low-income countries. Antibiotics shorten the duration of symptoms by about 16 hours overall [ 5 ]. The antibiotic of choice is a day course of phenoxymethylpenicillin. Alternative first choices for penicillin allergy or intolerance are clarithromycin or erythromycin [ 4 ].

Amoxicillin should be avoided if there is a possibility of glandular fever. If penicillin-allergic, a day course of clarithromycin is recommended [ 6 ]. Tonsillectomy remains a very common ENT operation.

Two thirds of tonsillectomies in the UK are performed on children [ 7 ]. Tonsils are important lymph tissue which protects the upper airways. Recurrent infection, however, does alter this situation and chronic tonsillitis can turn tonsillar tissue into a nidus for anaerobic bacteria.