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What causes chronic tonsillitis and quinsy?

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General & Family Physician
Practicing since : 2009
Answered : 3094 Questions
I have had chronic tonsillitis and 10 bouts of quinsy over the past year. I have just had a tonsillectomy. I am worried that there is a problem with my immune system. What could cause this? I have also had tooth abcesses, im not diabetic or anaemic. I also suffer from migrains and take sumatriptins for this and I have viltiligo. I have also contracted MRSA twice in hospital. I am beggining to worry that I may have a more serious underlying problem with my immune system. Can you give any advice or information as to what this could be and what tests I can suggest to my GP. Thank you XXXX
Posted Wed, 26 Feb 2014 in Medicines and Side Effects
Answered by Dr. Luchuo Engelbert Bain 2 hours later
Brief Answer: Complete review, cultures, infectiologist opinion Detailed Answer: Hi and thanks for the query, I very much understand how disturbing this could be. It is reasonable to think of a possible immune system dysfunction in the face of multiple and recurrent bacterial infections. However, a few things should be taken into consideration first. It is important to know if you are diabetic or have had any cancer in the past. These are common conditions that cause immune depression. In case you have been exposed to prolonged steroid therapy, this could also explain immune depression. Knowing your HIV status is also important. It is a bit difficult to attribute this to an immune system dysfunction in case you do not have any of the above conditions. Again, if you actually have never been having such recurrent infections since you were young, and lack the above cited conditions, this would also be unlikely. it is possible that poorly treated tonsillitis, could predispose to abscesses as such. I have afraid migraines and sumitriptans would really have nothing to do with this state of recurrent infections. It is good if your fasting blood glucose keeps you clear of diabetes already. A complete blood count you be done to appreciate the various blood cell parameters. This would be important to suspect in blood cancer, and also to monitor therapeutic success as treatment unfolds. doing a C reactive protein measure shall help in monitoring success as far as treatment of the infectious agent is concerned. Its levels are a direct function of bacterial presence and inflammation. I strongly suggest that a blood culture, and possibly culture of any pus collection (abscess) be done. This shall help in identification of the causative germ and specific antibiotic to use to ensure therapeutic success. In case germ is not identified, broad spectrum antibiotics, including at least drugs active against anaerobic organisms (Quinolones, Metronidazole) could be good options. The opinion at some point of an infectiologist could be helpful. Thanks and kind regards as I wish you just the best of health. Dr Bain
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