Acta Scientific Otolaryngology (ASOL) (ISSN: 2582-5550)

Case Report Volume 5 Issue 8

Acute Tonsillitis in COVID-19 Patients: Case Report

Diaa El Din Mohamed El Hennawi1, Mohamed Rifaat Ahmed1*, Mohamed T El Tabbakh1 and Mahmoud Hassan Eid2

1Professor of Otolaryngology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
2Assistant Lecturer of Otorhinolaryngology, Faculty of medicine, Suez Canal University, Ismailia, Egypt

*Corresponding Author: Mohamed Rifaat Ahmed, Professor of Otolaryngology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.

Received: May 25, 2023; Published: July 11, 2023


Background: Coronavirus and tonsillitis can have similar symptoms, such as fever and sore throat, digestive discomfort, and headache. However diagnosis could be little confused.

Case Presentation: A 33-year- old female patient presented with severe odynophagia last 3 days with generalized arthralgia and bone aches. On examination there was bilateral whitish pseudo-membranous follicullar tonsillitis. tonsillar swab reported no bacterial growth or any evidence of fungal infection, superficial pseudo-membranous examined biopsy revealed acute inflammatory exudate. Real-time reverse transcription-polymerase chain reaction (rRT-PCR) proved SARS-CoV-2.

Conclusions: Our findings demonstrate that viral exposure to COVID‐19 is possibly a key factor in the pathophysiology pseudo-membranous follicullar tonsillitis and uses of antiviral and steroids maybe helps in control the infection.

 Keywords: Acute; Tonsillitis; COVID-19; PCR


  1. Windfuhr JP., et al. “Clinical practice guideline: Tonsillitis I. Diagnostics and nonsurgical management”. European Archives of Oto-Rhino-Laryngology4 (2016): 973-987.
  2. Zahran AM., et al. “Differential alterations in peripheral lymphocyte subsets in COVID-19 patients: upregulation of double-positive and double-negative T cells”. Multidisciplinary Respiratory Medicine 2 (2021): 758.
  3. Abdelmaksoud AA., et al. “Olfactory Disturbances as Presenting Manifestation Among Egyptian Patients with COVID-19: Possible Role of Zinc”. Biological Trace Element Research 11 (2021): 4101-4108.
  4. Pohl MO., et al. “SARS-CoV-2 variants reveal features critical for replication in primary human cells”. PLoS Biology3 (2021): e3001006.
  5. Struyf T., et al. “Signs and symptoms to determine if a patient presenting in primary care or hospital outpatient settings has COVID-19 disease”. Cochrane Database System Review7 (2020): CD013665.
  6. Safiabadi Tali SH., et al. “Tools and Techniques for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)/COVID-19 Detection”. Clinical Microbiology Review3 (2021): e00228-320.
  7. Edwards MJ., et al. “ENT UK coronavirus disease 2019 adult tonsillitis and quinsy guidelines: translating guidance into practice”. Journal of Laryngology and Otology 7 (2021): 579-583.
  8. Al-Jabir A., et al. “Impact of the Coronavirus (COVID-19) pandemic on surgical practice - Part 1”. International Journal of Surgery 79 (2020): 168-179.
  9. Kaur S., et al. “The looming storm: Blood and cytokines in COVID-19”. Blood Review 46 (2021): 100743.
  10. Nagura-Ikeda M., et al. “Clinical Evaluation of Self-Collected Saliva by Quantitative Reverse Transcription-PCR (RT-qPCR), Direct RT-qPCR, Reverse Transcription-Loop-Mediated Isothermal Amplification, and a Rapid Antigen Test To Diagnose COVID-19”. Journal of Clinical Microbiology9 (2020): e01438-20.
  11. El-Anwar MW., et al. “Analysis of Ear, Nose and Throat Manifestations in COVID-19 Patients”. International Archives of Otorhinolaryngology3 (2021): e343-e348.
  12. Lima CMAO. “Information about the new coronavirus disease (COVID-19)”. Radiologia Brasileira2 (2020): V-VI.
  13. Zhang J., et al. “Risk factors for disease severity, unimprovement, and mortality in COVID-19 patients in Wuhan, China”. Clinical Microbiology and Infection6 (2020): 767-772.
  14. Kadriyan H., et al. “COVID-19 infection in the palatine tonsil tissue and detritus: the detection of the virus compartment with RT-PCR”. BMJ Case Report2 (2021): e239108.
  15. Baig AM., et al. “Evidence of the COVID-19 virus targeting the CNS: tissue distribution, host-virus interaction, and proposed neurotropic mechanisms”. ACS Chemical Neuroscience 11 (2020): 995-998.
  16. Ziegler CGK., et al. “SARS-CoV-2 receptor ACE2 is an interferon-stimulated gene in human airway epithelial cells and is detected in specific cell subsets across tissues”. Cell 181 (2020): 1016-1035.
  17. Proenca‐Modena JL., et al. “High rates of detection of respiratory viruses in tonsillar tissues from children with chronic adenotonsillar disease”. PLoS One 7 (2012): e42136.
  18. INTEGRATE, The UK ENT Trainee Research Collaborative. “Admission avoidance in tonsillitis and peritonsillar abscess: A prospective national audit during the initial peak of the COVID-19 pandemic”. Clinical Otolaryngology2 (2021): 363-372.
  19. Wollina U. “Schamberg-like purpuric eruptions and tonsillitis in mild COVID-19”. Dermatologic Therapy4 (2020): e13766.
  20. H Mulchandani., et al. “Tonsillitis based Early Diagnosis of COVID-19 for Mass-Screening using One-Shot Learning Framework". 2020 IEEE 17th India Council International Conference (INDICON) (2020): 1-6.
  21. Torretta S., et al. “ENT management of children with adenotonsillar disease during COVID-19 pandemic. Ready to start again?” International Journal of Pediatric Otorhinolaryngology 138 (2020): 110145.
  22. Malih N., et al. “Unexpected Presentation of COVID-19 in a 38-Year-Old Male Patient: A Case Report”. Case Report on Dermatology 12 (2020): 124-131.


Citation: Mohamed Rifaat Ahmed., et al. “Acute Tonsillitis in COVID-19 Patients: Case Report".Acta Scientific Otolaryngology 5.8 (2023): 13-16.


Copyright: © 2023 Mohamed Rifaat Ahmed., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Acceptance rate34%
Acceptance to publication20-30 days
Impact Factor0.871

Indexed In

News and Events

  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is July 30, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US