Spontaneous tonsillar hemorrhage (STH) is a rare but known complication of acute and
chronic tonsillitis. It occurs in both bacterial and viral tonsillitis, and can also
be associated with coagulopathy and malignancy (
1
). The incidence of STH is estimated to occur in 1.1% of infectious tonsillitis cases
(
2
). STH can be dangerous if measures are not taken to control the bleeding, protect
the airway, and investigate fatal sequelae, including carotid artery erosion and deep
neck infections (
3
). We describe a case of a 22-year-old male with STH during acute mononucleosis infection
that presented with active bleeding from the right tonsil. Bleeding was controlled
with local interventions, and the patient remained stable throughout evaluation. Head
and Neck Surgery was consulted, and the patient was discharged home from the emergency
department (ED). The patient later underwent tonsillectomy for chronic tonsillitis.
STH is a rare complication that clinicians must be familiar with in order to diagnosis,
treat, and determine appropriate disposition.To read this article in full you will need to make a payment
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References
- Spontaneous intratonsillar haemorrhage with acute dysphagia.Eur Arch Otorhinolaryngol. 2008; 265: 721-723
- Spontaneous tonsillar hemorrhage.Laryngoscope. 1988; 98: 365-368
- Management of spontaneous tonsillar bleeding: review.J Laryngol Otol. 2010; 124: 470-473
- Spontaneous tonsillar hemorrhage and post-tonsillectomy hemorrhage.Clin Exp Otorhinolaryngol. 2010; 3: 56-58
- Spontaneous tonsillar hemorrhage: an underdiagnosed condition.J Otolaryngol. 1998; 27: 270-274
- Hemorrhagic tonsillitis.Laryngoscope. 1989; 99: 15-18
- An unusual presentation of an unusual complication of infectious mononucleosis: haematemsis and melena.J Laryngol Otol. 1995; 109: 335-336
- Review of literature for stepwise management of post tonsillectomy hemorrhage.J Otolaryngol ENT Res. 2016; 5: 00142
- AAO-HNS guidelines for tonsillectomy in children and adolescents.Otolaryngol Head Neck Surg. 2011; 84: 566-573
- Current indications for the use of clindamycin: a critical review.Can J Infect Dis. 1998; 9: 22-28
- Corticosteroids for a sore throat?.J Fam Pract. 2013; 62: 372-374
Article info
Publication history
Published online: July 31, 2019
Accepted:
May 6,
2019
Received in revised form:
May 5,
2019
Received:
January 4,
2019
Identification
Copyright
Published by Elsevier Inc.
