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 (
- Siedek S.
- Reichel O.
- Harreus U.
Spontaneous intratonsillar haemorrhage with acute dysphagia.
Eur Arch Otorhinolaryngol. 2008; 265: 721-723
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 (
- Griffies S.
- Wotowic P.
- Wildes T.
Spontaneous tonsillar hemorrhage.
Laryngoscope. 1988; 98: 365-368
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.
- Salem A.
- Healy S.
- Pau H.
Management of spontaneous tonsillar bleeding: review.
J Laryngol Otol. 2010; 124: 470-473
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Published online: July 31, 2019
Accepted: May 6, 2019
Received in revised form: May 5, 2019
Received: January 4, 2019
Published by Elsevier Inc.