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tonsillitis

 
American Heritage Dictionary:

ton·sil·li·tis

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(tŏn'sə-lī'tĭs) pronunciation
n.
Inflammation of the tonsils.

tonsillitic ton'sil·lit'ic (-lĭt'ĭk) adj.

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Britannica Concise Encyclopedia:

tonsillitis

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Inflammatory infection of the tonsils, usually with hemolytic streptococci (see streptococcus) or viruses. The symptoms are sore throat, trouble in swallowing, fever, and enlarged lymph nodes on the neck. The infection, which usually lasts about five days, is treated with bed rest and antiseptic gargling. Sulfa drugs or other antibiotics are prescribed in severe bacterial infections to prevent complications. Streptococcal infection can spread to nearby structures. Complications may include abscess, nephritis, and rheumatic fever. Tonsils that become chronically inflamed and enlarged require surgical removal (tonsillectomy).

For more information on tonsillitis, visit Britannica.com.

McGraw-Hill Science & Technology Encyclopedia:

Tonsillitis

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An inflammation of the tonsil. Tonsillitis is a nonspecific term usually referring to bacterial or viral infection involving all or part of Waldeyer's ring, a collection of lymphatic tissue encircling the pharynx. It consists primarily of the tonsils (palatine tonsils), adenoids (pharyngeal tonsils), and lingual tonsils.

The complication of tonsillitis depend on which tonsil is involved. Recurrent adenoiditis with adenoid hypertrophy is frequently associated with recurrent otitis media, middle-ear fluid, and at times nasal obstruction with mouth breathing and snoring. Acute palatine tonsillitis may be complicated by peritonsillar abscess which may develop lateral to the tonsillar capsule. Removal of the adenoids is considered when there is residual middle-ear fluid. Palatine tonsils must be removed after peritonsillar abscess, but otherwise their removal depends upon the frequency of recurrent attacks of bacterial pharyngotonsillitis in relation to the patient's age. See also Tonsil.

Gale Encyclopedia of Children's Health:

Tonsillitis

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Definition

Tonsillitis is an infection and swelling of the tonsils, which are oval-shaped masses of lymph gland tissue located on both sides of the back of the throat.

Description

The tonsils normally help to prevent infections. They act like filters to trap bacteria and viruses entering the body through the mouth and sinuses. The tonsils also stimulate the immune system to produce antibodies that help fight infections. Anyone of any age can have tonsillitis; however, it is most common in children between the ages of five and 15 years.

Transmission

Tonsillitis is transmitted from one person to another in the same way that many common diseases are, such as by coughing and sneezing. It can also spread when a child touches his or her nose and then other children's toys or by children eating or drinking with the same utensils. Children with bacterial tonsillitis are usually no longer contagious 24 hours after beginning a course of antibiotics.

Demographics

Tonsillitis is very common among children. Nearly all children will have some form of tonsillitis at least once.

Causes and Symptoms

Tonsillitis is caused by viruses or bacteria that make the tonsils swell and become inflamed. Most cases of tonsillitis are caused by viruses, which cannot be treated with antibiotics. A mild or severe sore throat is one of the first symptoms of tonsillitis. Symptoms can also include fever, chills, tiredness, muscle aches, earache, pain or discomfort when swallowing, and swollen glands in the neck. Very young children may be fussy and stop eating. When a doctor or nurse looks into the mouth with a flashlight, the tonsils may appear swollen and red. Sometimes, the tonsils will have white or yellow spots or flecks. Symptoms usually last four to six days.

When to Call the Doctor

If the child is displaying the symptoms of tonsillitis and has had a sore throat for more than 48 hours, especially when accompanied by a fever, a doctor should be called. The doctor can determine if the child has tonsillitis, if it is bacterial or viral, and treat the problem accordingly. If the child cannot breathe or cannot swallow emergency medical attention should be sought.

Diagnosis

The diagnosis of tonsillitis is made from the visible symptoms and a physical examination of the patient. The doctor examines the eyes, ears, nose, and throat, looking at the tonsils for signs of swelling, redness, or discharge. A careful examination of the throat is necessary to rule out diphtheria and other conditions that may cause a sore throat. Since most sore throats in children are caused by viruses rather than bacteria, the doctor may take a throat culture in order to test for the presence of streptococcal bacteria. A throat culture is performed by wiping a cotton swab across the tonsils and back of the throat and sending the swab to a laboratory for culturing. Streptococcus pyogenes, the bacterium that causes "strep" throat, is the most common bacterial agent responsible for tonsillitis. Depending on what type of test is used for strep, the doctor may be able to determine within a few minutes if S. pyogenes is present. The quick tests for strep are not as reliable as a laboratory culture, which can take 24 to 48 hours. If the results of a quick test are positive, however, the doctor can prescribe antibiotics right away. If the quick test results are negative, the doctor can do a throat culture to verify the results and wait for the laboratory report before prescribing antibiotics. A blood test may also be done to rule out a more serious infection or condition and to check the white blood cell count to see if the body is responding to the infection. In some cases, the doctor may order blood tests for mononucleosis, since about one third of patients with mononucleosis develop streptococcal infections of the tonsils.

Treatment

Treatment of tonsillitis usually involves keeping the patient comfortable while the illness runs its course. This supportive care includes bed rest, drinking extra fluids, gargling with warm salt water, and taking pain relievers. Children under the age of 12 should not be given aspirin as a pain reliever because of the threat of Reye's syndrome. Frozen juice bars and cold fruit drinks can bring some temporary relief of sore throat pain. Drinking warm tea or broth can also be soothing. If the throat culture shows that S. pyogenes is present, penicillin or other antibiotics will be prescribed. An injection of benzathine or procaine penicillin may be most effective in treating the infection, but it is also painful. If an oral antibiotic is prescribed, it must be taken for the full course of treatment, usually 10 to 14 days, even if the symptoms are no longer present. If the child has several episodes of severe tonsillitis, the doctor may recommend a tonsillectomy, which is the surgical removal of the tonsils.

Alternative Treatment

Strengthening the immune system is important whether tonsillitis is caused by bacteria or viruses. Naturopaths often recommend dietary supplements of vitamin C, bioflavonoids, and beta-carotenes, found naturally in fruits and vegetables, to ease inflammation and fight infection. A variety of herbal remedies also may be helpful in treating tonsillitis. Calendula (Calendula officinalis) and cleavers (Galium aparine) target the lymphatic system, while echinacea (Echinacea spp.) and astragalus (Astragalus membranaceus)stimulate the immune system. Goldenseal (Hydrastis canadensis), myrrh (Commiphora molmol), and bitter orange act as antibacterials. Lomatium dissectum and ligusticum porteri have an antiviral action. Some of the homeopathic medicines that may be used to treat symptoms of tonsillitis include:

  • arsenicum
  • belladonna
  • hepar sulphuris
  • lachesis
  • lycopodium
  • mercurius
  • phytolacca
  • rhus toxicodendron

As with any condition, the treatment and dosage should be appropriate for the particular symptoms and age of the patient.

Prognosis

Tonsillitis usually resolves within a few days with rest and supportive care. Treating the symptoms of sore throat and fever will make the child more comfortable. If fever persists for more than 48 hours, however, or is higher than 102°F (38.9°C) the child should be seen by a doctor. If antibiotics are prescribed to treat an infection, they should be taken as directed for the complete course of treatment, even if the child starts to feel better in a few days. Prolonged symptoms may indicate that the child has other upper respiratory infections, most commonly in the ears or sinuses. An abscess behind the tonsil (a peritonsillar abscess) may also occur. In rare cases, a persistent sore throat may point to more serious conditions, such as rheumatic fever or pneumonia.

Prevention

The bacteria and viruses that cause tonsillitis are easily spread from person to person. It is not unusual for an entire family or several students in the same classroom to come down with similar symptoms, especially if S. pyogenes is the cause. The risk of transmission can be lowered by avoiding exposure to anyone who already has tonsillitis or a sore throat. Drinking glasses and eating utensils should not be shared and should be washed in hot, soapy water before reuse. Old toothbrushes should be replaced to prevent reinfection. People who are caring for someone with tonsillitis should wash their hands frequently to prevent spreading the infection to others.

Parental Concerns

Tonsillitis usually has no long term effects if it is detected and treated promptly. If it is not treated it can lead to other medical conditions such as rheumatic fever, kidney inflammation, or abscesses that could block a child's breathing passage.

Resources

Books

Silverstien, Alvin, Virginia Silverstein, and Laura S. Nunn. Sore Throats and Tonsillitis. Danbury, CT: Franklin Watts, 2000.

"Tonsillitis." In Professional Guide to Diseases, 7th ed. Springhouse, PA: Springhouse Corporation, 2001.

Periodicals

"Sore Throat." Journal of the American Medical Association 291, no. 13 (April 7, 2004): 1664.

[Article by: Tish Davidson, A.M.]


Dictionary of Cultural Literacy: Health:

tonsillitis

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(ton-suh-leye-tis)

An inflammation of the tonsils, sometimes the result of a bacterial infection.

Saunders Veterinary Dictionary:

tonsillitis

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Inflammation and enlargement of a tonsil, especially the palatine tonsils.

  • follicular t. — tonsillitis especially affecting the crypts.
  • parenchymatous t. — that affecting the whole substance of the tonsil.
  • pustular t. — a variety characterized by formation of pustules.
Mosby's Dental Dictionary:

tonsillitis

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Home > Library > Health > Dental Dictionary
(ton′silī′tis)
n

Inflammation of the tonsils.

Tonsillitis. (Neville/Damm/Allen/Bouquot, 2002)

Tonsillitis. (Neville/Damm/Allen/Bouquot, 2002)

Random House Word Menu:

categories related to 'tonsillitis'

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Random House Word Menu by Stephen Glazier
For a list of words related to tonsillitis, see:
  • Diseases and Infestations - tonsillitis: inflammation of tonsils, due to bacterial or viral infection, causing sore throat and fever

Wikipedia on Answers.com:

Tonsillitis

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Tonsilitis
Classification and external resources
A set of large tonsils in the back of the throat covered in white exudate
A culture positive case of Streptococcal pharyngitis with typical tonsillar exudate
ICD-10 J03, J35.0
ICD-9 463
DiseasesDB 13165
MedlinePlus 001043
eMedicine article/871977
MeSH D014069

Tonsillitis is inflammation of the tonsils most commonly caused by a viral or bacterial infection. Symptoms of tonsillitis include sore throat and fever. While no treatment has been found to shorten the duration of viral tonsillitis otherwise known as the common cold, bacterial causes such as streptococcal pharyngitis are treatable with antibiotics. It usually takes one to three weeks to recover.

Contents

Symptoms

Common symptoms of tonsillitis include:[1][2][3][4]

  • red and/or swollen tonsils
  • white or yellow patches on the tonsils
  • tender, stiff, and/or swollen neck
  • swollen lymph nodes
  • sore throat
  • painful or difficult swallowing
  • cough
  • headache
  • sore eyes
  • body aches
  • earache
  • fever
  • chills
  • nasal congestions
  • ulceration

In cases of acute tonsillitis, the surface of the tonsil may be bright red and with visible white areas or streaks of pus.[5]

Tonsilloliths occur in up to 10% of the population frequently due to episodes of tonsillitis.[6]

Causes

The most common causes of tonsillitis are the common cold viruses (adenovirus, rhinovirus, influenza, coronavirus, respiratory syncytial virus).[1][2][3][4] It can also be caused by Epstein-Barr virus, herpes simplex virus, cytomegalovirus, or HIV.[1][2][3][4] The second most common causes are bacterial. The most common bacterial cause is Group A β-hemolytic streptococcus (GABHS), which causes strep throat.[1][2][3][4] Less common bacterial causes include: Staphylococcus aureus, Streptococcus pneumoniae, Mycoplasma pneumoniae, Chlamydia pneumoniae, pertussis, Fusobacterium, diphtheria, syphilis, and gonorrhea.[1][2][3][4]

Under normal circumstances, as viruses and bacteria enter the body through the nose and mouth, they are filtered in the tonsils.[7][8] Within the tonsils, white blood cells of the immune system mount an attack that helps destroy the viruses or bacteria, and also causes inflammation and fever.[7][8] The infection may also be present in the throat and surrounding areas, causing inflammation of the pharynx.[9] This is the area in the back of the throat that lies between the voice box and the tonsils.

Tonsillitis may be caused by Group A streptococcal bacteria,[10] resulting in strep throat.[10] Viral tonsillitis may be caused by numerous viruses[10] such as the Epstein-Barr virus[10] (the cause of infectious mononucleosis)[11] or adenovirus.[10]

Sometimes, tonsillitis is caused by an infection of spirochaeta and treponema, in this case called Vincent's angina or Plaut-Vincent angina.[12]

Treatment

Treatments to reduce the discomfort from tonsillitis symptoms include:[1][2][3][4][9][13][14]

  • pain relief, anti-inflammatory, fever reducing medications (acetaminophen/paracetamol and/or ibuprofen)
  • sore throat relief (salt water gargle, lozenges, warm liquids)

If the tonsillitis is caused by group A streptococus, then antibiotics are useful with penicillin or amoxicillin being first line.[15] A macrolide such as erythromycin is used for people allergic to penicillin. People who fail penicillin therapy may respond to treatment effective against beta-lactamase producing bacteria[16] such as clindamycin or amoxicillin-clavulanate. Aerobic and anaerobic beta lactamase producing bacteria that reside in the tonsillar tissues can "shield" group A streptococcus from penicillins.[17] When tonsillitis is caused by a virus, the length of illness depends on which virus is involved. Usually, a complete recovery is made within one week; however may last for up to two weeks. Chronic cases may be treated with tonsillectomy (surgical removal of tonsils) as a choice for treatment.[18]

Complications

Complications may rarely include dehydration and kidney failure due to difficulty swallowing, blocked airways due to inflammation, and pharyngitis due to the spread of infection.[1][2][3][4][9]

An abscess may develop lateral to the tonsil during an infection, typically several days after the onset of tonsillitis. This is termed a peritonsillar abscess (or quinsy). Rarely, the infection may spread beyond the tonsil resulting in inflammation and infection of the internal jugular vein giving rise to a spreading septicaemia infection (Lemierre's syndrome).

In chronic/recurrent cases (generally defined as seven episodes of tonsillitis in the preceding year, five episodes in each of the preceding two years or three episodes in each of the preceding three years),[19][20][21] or in acute cases where the palatine tonsils become so swollen that swallowing is impaired, a tonsillectomy can be performed to remove the tonsils. Patients whose tonsils have been removed are still protected from infection by the rest of their immune system.

In very rare cases of strep throat, diseases like rheumatic fever[22] or glomerulonephritis[23] can occur. These complications are extremely rare in developed nations but remain a significant problem in poorer nations.[24][25] Tonsillitis associated with strep throat, if untreated, is hypothesized to lead to pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS).[26]

References

  1. ^ a b c d e f g Tonsillopharyngitis at Merck Manual of Diagnosis and Therapy Professional Edition
  2. ^ a b c d e f g Wetmore RF. (2007). "Tonsils and adenoids". In Bonita F. Stanton; Kliegman, Robert; Nelson, Waldo E.; Behrman, Richard E.; Jenson, Hal B.. Nelson textbook of pediatrics. Philadelphia: Saunders. ISBN 1-4160-2450-6. 
  3. ^ a b c d e f g Thuma P. (2001). "Pharyngitis and tonsillitis". In Hoekelman, Robert A.. Primary pediatric care. St. Louis: Mosby. ISBN 0-323-00831-3. 
  4. ^ a b c d e f g Simon HB (2005). "Bacterial infections of the upper respiratory tract". In Dale, David. ACP Medicine, 2006 Edition (Two Volume Set) (Webmd Acp Medicine). WebMD Professional Publishing. ISBN 0-9748327-6-6. 
  5. ^ Tonsillitis and Adenoid Infection MedicineNet. Retrieved on 2010-01-25
  6. ^ S. G. Nour; Mafee, Mahmood F.; Valvassori, Galdino E.; Galdino E. Valbasson; Minerva Becker (2005). Imaging of the head and neck. Stuttgart: Thieme. pp. 716. ISBN 1-58890-009-6. 
  7. ^ a b van Kempen MJ, Rijkers GT, Van Cauwenberge PB (May 2000). "The immune response in adenoids and tonsils". Int. Arch. Allergy Immunol. 122 (1): 8–19. doi:10.1159/000024354. PMID 10859465. 
  8. ^ a b Perry M, Whyte A (September 1998). "Immunology of the tonsils". Immunology Today 19 (9): 414–21. doi:10.1016/S0167-5699(98)01307-3. PMID 9745205. 
  9. ^ a b c MedlinePlus Encyclopedia Tonsillitis
  10. ^ a b c d e Putto A (1987). "Febrile exudative tonsillitis: viral or streptococcal?". Pediatrics 80 (1): 6–12. PMID 3601520. 
  11. ^ Renn CN, Straff W, Dorfmüller A, Al-Masaoudi T, Merk HF, Sachs B (2002). "Amoxicillin-induced exanthema in young adults with infectious mononucleosis: demonstration of drug-specific lymphocyte reactivity". Br. J. Dermatol. 147 (6): 1166–70. doi:10.1046/j.1365-2133.2002.05021.x. PMID 12452866.  -Renn studied 4 patients who were treated amoxicillin for throat infection and lymphadenopathy. Infectious mononucleosis was present in the patient’s blood due to trace of Epstein-Barr antibodies. The three tests performed where the patched test, intracutaneous test, and lymphocyte transformation test. The results of the patched test assas the caused of their rash were 1 out of 4 patients. The intracutaneous showed 2 out of 4 patients with positive results that pointed to amoxicillin. The LTT results showed 3 out of 4 that pointed to amoxicillin
  12. ^ Van Cauwenberge P (1976). "[Significance of the fusospirillum complex (Plaut-Vincent angina)]" (in Dutch; Flemish). Acta Otorhinolaryngol Belg 30 (3): 334–45. PMID 1015288.  — fusospirillum complex (Plaut-Vincent angina) Van Cauwenberge studied the tonsils of 126 patients using direct microscope observation. The results showed that 40% of acute tonsillitis was caused by Vincent's angina and 27% of chronic tonsillitis was caused by Spirochaeta
  13. ^ Boureau, F. et al. (1999). "Evaluation of Ibuprofen vs Paracetamol Analgesic Activity Using a Sore Throat Pain Model". Clinical Drug Investigation 17: 1–8. doi:10.2165/00044011-199917010-00001. 
  14. ^ Praskash, T. et al. (2001). "Koflet lozenges in the Treatment of Sore Throat". The Antiseptic 98: 124–7. 
  15. ^ Touw-Otten FW, Johansen KS (1992). "Diagnosis, antibiotic treatment and outcome of acute tonsillitis: report of a WHO Regional Office for Europe study in 17 European countries". Fam Pract 9 (3): 255–62. doi:10.1093/fampra/9.3.255. PMID 1459378. 
  16. ^ Brook I (2009). "The role of beta-lactamase-producing-bacteria in mixed infections". BMC Infect Dis 9: 202. doi:10.1186/1471-2334-9-202. PMC 2804585. PMID 20003454. http://www.biomedcentral.com/1471-2334/9/202. 
  17. ^ Brook I (2007). "Microbiology and principles of antimicrobial therapy for head and neck infections". Infect Dis Clin North Am 21 (2): 355–91. doi:10.1016/j.idc.2007.03.014. PMID 17561074. http://linkinghub.elsevier.com/retrieve/pii/S0891-5520(07)00026-8. 
  18. ^ Paradise JL, Bluestone CD, Bachman RZ, et al. (1984). "Efficacy of tonsillectomy for recurrent throat infection in severely affected children. Results of parallel randomized and nonrandomized clinical trials". N. Engl. J. Med. 310 (11): 674–83. doi:10.1056/NEJM198403153101102. PMID 6700642. 
  19. ^ Scottish Intercollegiate Guidelines Network. (January 1999). "6.3 Referral Criteria for Tonsillectomy". Management of Sore Throat and Indications for Tonsillectomy. Scottish Intercollegiate Guidelines Network. ISBN 1-899893-66-0. http://www.sign.ac.uk/guidelines/fulltext/34/section6.html.  — notes though that these criteria "have been arrived at arbitrarily" from:
    Paradise JL, Bluestone CD, Bachman RZ, et al. (1984). "Efficacy of tonsillectomy for recurrent throat infection in severely affected children. Results of parallel randomized and nonrandomized clinical trials". N. Engl. J. Med. 310 (11): 674–83. doi:10.1056/NEJM198403153101102. PMID 6700642. 
  20. ^ Paradise JL, Bluestone CD, Colborn DK, Bernard BS, Rockette HE, Kurs-Lasky M (2002). "Tonsillectomy and adenotonsillectomy for recurrent throat infection in moderately affected children". Pediatrics 110 (1 Pt 1): 7–15. doi:10.1542/peds.110.1.7. PMID 12093941.  — this later study by the same team looked at less severely affected children and concluded "modest benefit conferred by tonsillectomy or adenotonsillectomy in children moderately affected with recurrent throat infection seems not to justify the inherent risks, morbidity, and cost of the operations"
  21. ^ Wolfensberger M, Mund MT (2004). "[Evidence based indications for tonsillectomy]" (in German). Ther Umsch 61 (5): 325–8. PMID 15195718.  — review of literature of the past 25 years concludes "No consensus has yet been reached, however, about the number of annual episodes that justify tonsillectomy"
  22. ^ Del Mar CB, Glasziou PP, Spinks AB (2004). Del Mar, Chris. ed. "Antibiotics for sore throat". Cochrane Database Syst Rev (2): CD000023. doi:10.1002/14651858.CD000023.pub2. PMID 15106140. http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD000023/frame.html.  — Meta-analysis of published research
  23. ^ Zoch-Zwierz W, Wasilewska A, Biernacka A, et al. (2001). "[The course of post-streptococcal glomerulonephritis depending on methods of treatment for the preceding respiratory tract infection]" (in Polish). Wiad. Lek. 54 (1–2): 56–63. PMID 11344703. 
  24. ^ Ohlsson, A.; Clark, K (September 28 2004). "Antibiotics for sore throat to prevent rheumatic fever: Yes or No? How the Cochrane Library can help". CMAJ 171 (7): 721–3. doi:10.1503/cmaj.1041275. PMC 517851. PMID 15451830. http://www.cmaj.ca/cgi/content/full/171/7/721.  — Canadian Medical Association Journal commentary on Cochrane analysis
  25. ^ Danchin, MH; Curtis, N; Nolan, TM; Carapetis, JR (2002). "Treatment of sore throat in light of the Cochrane verdict: is the jury still out?". MJA 177 (9): 512–5. PMID 12405896. http://www.mja.com.au/public/issues/177_09_041102/dan10028_fm.html.  — Medical Journal of Australia commentary on Cochrane analysis
  26. ^ Pickering, Larry K., ed. (2006). "Group A streptococcal infections". Red Book: 2006 Report of the Committee on Infectious Diseases (Red Book Report of the Committee on Infectious Diseases). Amer Academy of Pediatrics. ISBN 1-58110-194-5. 

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Translations:

Tonsillitis

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Dansk (Danish)
n. - betændelse i mandlerne

Nederlands (Dutch)
angina

Français (French)
n. - amygdalite

Deutsch (German)
n. - Mandelentzündung, Angina

Ελληνική (Greek)
n. - (παθολ.) αμυγδαλίτιδα

Italiano (Italian)
tonsillite

Português (Portuguese)
n. - amigdalite (f), tonsilite (f)

Русский (Russian)
тозиллит, воспаление миндалевидной железы

Español (Spanish)
n. - amigdalitis, inflamación de las amígdalas

Svenska (Swedish)
n. - halsfluss

中文（简体）(Chinese (Simplified))
扁桃腺炎

中文（繁體）(Chinese (Traditional))
n. - 扁桃腺炎

한국어 (Korean)
n. - 편도선염

日本語 (Japanese)
n. - 扁桃炎, 扁桃腺炎

العربيه (Arabic)
‏(الاسم) ألتهاب أللوزتين‏

עברית (Hebrew)
n. - ‮דלקת-שקדים‬

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American Heritage Dictionary. The American Heritage® Dictionary of the English Language, Fourth Edition Copyright © 2007, 2000 by Houghton Mifflin Company. Updated in 2009. Published by Houghton Mifflin Company. All rights reserved.  Read more
Britannica Concise Encyclopedia. Britannica Concise Encyclopedia. © 1994-2012 Encyclopædia Britannica, Inc. All rights reserved.  Read more
McGraw-Hill Science & Technology Encyclopedia. McGraw-Hill Encyclopedia of Science and Technology. Copyright © 2005 by The McGraw-Hill Companies, Inc. All rights reserved.  Read more
$copyright.smallImage.alttext Gale Encyclopedia of Children's Health. © 2006 by The Gale Group, Inc. All rights reserved.  Read more
Dictionary of Cultural Literacy: Health. The New Dictionary of Cultural Literacy, Third Edition Edited by E.D. Hirsch, Jr., Joseph F. Kett, and James Trefil. Copyright © 2002 by Houghton Mifflin Company. Published by Houghton Mifflin. All rights reserved.  Read more
Saunders Veterinary Dictionary. Saunders Comprehensive Veterinary Dictionary 3rd Edition. Copyright © 2007 by D.C. Blood, V.P. Studdert and C.C. Gay, Elsevier. All rights reserved.  Read more
Mosby's Dental Dictionary. Mosby's Dental Dictionary. Copyright © 2004 by Elsevier, Inc. All rights reserved.  Read more
Random House Word Menu. © 2010 Write Brothers Inc. Word Menu is a registered trademark of the Estate of Stephen Glazier. Write Brothers Inc. All rights reserved.  Read more
 Rhymes. Oxford University Press. © 2006, 2007 All rights reserved.  Read more
Wikipedia on Answers.com. This article is licensed under the Creative Commons Attribution/Share-Alike License. It uses material from the Wikipedia article Tonsillitis.  Read more
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