A Rare Cause of Nonresponsive Tonsillitis in the Primary Care Setting: Acute Myeloid Leukemia

Abstract

ore throat is among the most common causes of admission in primary care. A sore throat is predominantly a disease of adolescents and those in their early school years. 1 In adults, the most common reason for sore throat is an upper respiratory tract virus infection including rhinovirus, coronavirus and adenovirus with a ratio of 85% to 90%. 2 The bacterial cause of sore throat is mainly group A β-hemolytic streptococci (GAβHS), and can be cultured in 5% to 17% of adults with sore throat. 3 Acute tonsillitis is an acute inflammatory disorder of the tonsils manifested usually by swollen tonsillar structures associated with the symptoms of a sore throat. Tonsillitis may represent as an isolated disease or it can be associated with systemic diseases such as infections and neoplastic disorders. 4,5 A study exploring patients with tonsillitis showed that those whose tests were positive for GAβHS and treated with penicillin had relieved symptoms about 16 hours earlier than those whose tests were negative for GAβHS. 4 Treated or not, 85% of patients became completely free of symptoms after one week. 6 The host immunity and the aggressivity of the etiological agent effects the severity and course of acute tonsillitis. Herein we present an adult who had been complaining about a sore throat, headache, high fever, and weakness for two weeks and, after being suspected of having leukemia by the primary health care professionals, was

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“…In fact, the limited case reports of leukemia presenting as tonsillitis were of acute myeloid type as well; thus, adding to the uniqueness and significance of our patient's presentation. 5,6 ALL is more frequently diagnosed in children, whereas AML is the most prevalent acute leukemia in adults. Among ALL, T-ALL accounts for 15% of pediatric cases and 25% of cases in the adult population.…”