It is essential to establish the diagnosis of recurrent tonsillitis in patients undergoing tonsillectomy. This is based mainly on history which itself can be inaccurate and is supported by clinical findings which are not truly specific. There seems to be room for further selection criteria if these can be properly established. This retrospective study comprises 30 patients, 16 with tonsillitis and 14 with peri-tonsillar abscess, the diagnosis being supported also by CT scans. The imaging was done with a view to determine precise location of infection, differentiate between cellulitis and abscess, identify secondary complications and occasionally suggest the infection source. Patients with tonsillitis and peri-tonsillar abscess had significantly lower platelet volume and raised neutrophil/lymphocyte ratio compared to a control group. It is explained that inflammation causes and initial increase in platelet size but subsequently the platelet volume decreases because of utilisation and depletion of activated platelets and/or defective thrombopoiesis. The results differ from another study and this has been attributed to the timing of sample collection. The study has limitations but does evoke some thoughts. Future research on similar lines may be a helpful tool in diagnosing and treating recurrent tonsillitis.

Diagnostic role of mean platelet volume in tonsillitis with and without peritonsillar abscess.
Nakao Y, Tanigawa T, Kano F, et al.
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Madhup K Chaurasia

Mid and South Essex NHS Foundation Trust, UK.

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