Tonsillitis (recurrent) or tonsillar enlargement

ADULT

  • If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.

    • Acute tonsillitis with airway obstruction and/or unable to tolerate oral intake and/or uncontrolled fever
    • Tonsillar haemorrhage
    • Abscess or haematoma, (e.g., peritonsillar abscess/quinsy, salivary abscess,) with or without associated cellulitis

  • Medical management

    • Manage acute episodes
    • Analgesia
    • Antibiotics
    • Fluids
    • Throat gargle
    • Rest
    • Consider Monospot or Epstein Barr virus serology
Minimum Referral Criteria
Category 1
(appointment within 30 calendar days)
  • No category 1 criteria
Category 2
(appointment within 90 calendar days)
  • No category 2 criteria
Category 3
(appointment within 365 calendar days)
  • Chronic or recurrent infection with fever/malaise and decreased PO intake and any of the following:
    • 4 or more episodes in the last 12 months
    • 6 or more episodes in the last 24 months
    • sleep apnoea or sleep disordered breathing due to tonsillar hypertrophy
    • tonsillar concretions with halitosis
    • absent from work/school/university/college for 4 weeks in a year

Please insert the below information and minimum referral criteria into referral

1. Reason for request Indicate on the referral

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can't order, or the patient can't afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

2. Essential referral information Referral will be returned without this

  • The number and timeframe of previous episodes
  • Degree of systemic symptoms and time off work/school/university/college
  • Previous antibiotic prescriptions
  • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
  • Please advise if taking any anticoagulant medication, including aspirin and fish oil, and any family history of coagulation disorder in referral

3. Additional referral information Useful for processing the referral

  • Has tonsillitis caused an admission to hospital in the previous 12 months?

4. Request

  • Patient's Demographic Details

    • Full name (including aliases)
    • Date of birth
    • Residential and postal address
    • Telephone contact number/s – home, mobile and alternative
    • Medicare number (where eligible)
    • Name of the parent or caregiver (if appropriate)
    • Preferred language and interpreter requirements
    • Identifies as Aboriginal and/or Torres Strait Islander

    Referring Practitioner Details

    • Full name
    • Full address
    • Contact details – telephone, fax, email
    • Provider number
    • Date of referral
    • Signature

    Relevant clinical information about the condition

    • Presenting symptoms (evolution and duration)
    • Physical findings
    • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
    • Body mass index (BMI)
    • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
    • Current medications and dosages
    • Drug allergies
    • Alcohol, tobacco and other drugs use

    Reason for request

    • To establish a diagnosis
    • For treatment or intervention
    • For advice and management
    • For specialist to take over management
    • Reassurance for GP/second opinion
    • For a specified test/investigation the GP can't order, or the patient can't afford or access
    • Reassurance for the patient/family
    • For other reason (e.g. rapidly accelerating disease progression)
    • Clinical judgement indicates a referral for specialist review is necessary

    Clinical modifiers

    • Impact on employment
    • Impact on education
    • Impact on home
    • Impact on activities of daily living
    • Impact on ability to care for others
    • Impact on personal frailty or safety
    • Identifies as Aboriginal and/or Torres Strait Islander

    Other relevant information

    • Willingness to have surgery (where surgery is a likely intervention)
    • Choice to be treated as a public or private patient
    • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

  • If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.

    • Please note that where appropriate and where available, the referral may be streamed to an associated public allied health and/or nursing service.  Access to some specific services may include initial assessment and management by associated public allied health and/or nursing, which may either facilitate or negate the need to see the public medical specialist.

    • A change in patient circumstance (such as condition deteriorating, or becoming pregnant) may affect the urgency categorisation and should be communicated as soon as possible.

    • Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

Last updated: 16 January 2025

© State of Queensland (Queensland Health) 2023

Except as permitted under the Copyright Act 1968, no part of this work may be reproduced, communicated or adapted without permission from Queensland Health. To request permission email ip_officer@health.qld.gov.au1.