The complications of tonsillitis may be classified into suppurative
and nonsuppurative complications. The nonsuppurative complications
include scarlet fever, acute rheumatic fever, and post-streptococcal
glomerulonephritis. Suppurative complications include peritonsillar,
parapharyngeal and retropharyngeal abscess formation.
Scarlet fever is secondary to acute streptococcal tonsillitis or
pharyngitis with production of endotoxins by the bacteria. Clinical
signs include an erythematous rash, severe lymphadenopathy, fever,
tachycardia, and a yellow exudate overlying erythematous tonsils. Acute rheumatic
fever is a syndrome that follows Group A Streptococcal Pharyngitis for one
to four weeks. Certain proteins found in
heart muscle appear to be antigenetically
similar to protein found on the streptococcus.
This is believed to be the method of
infection of cardiac tissue. Post-streptococcal
glomerulonephritis may be seen after
both pharyngeal and skin infections. The
typical patient develops an acute nephritic
syndrome one to two weeks after a streptococcal
infection. The infection is secondary to the presence of a common antigen
in the glomerulus and in the streptococcus. Antibiotic therapy may not necessarily
alter the natural history of glomerulonephritis. A tonsillectomy may be necessary
to eliminate the source of infection.