Tonsillar Necrosis in a Diabetic Patient: A Case Report

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Introduction: Tonsillar necrosis is a rare manifestation, often associated with severe infections, vascular disorders or systemic pathologies. In diabetic patients, relative immunosuppression and microvascular disorders can promote the development of serious infectious complications. Through a case report and a review of the literature, we will study the diagnostic and therapeutic aspects of tonsillar necrosis in a diabetic setting. Patient and Method: This is a 40-year-old housewife, married in monogamy, residing in Bamako. She consults for sudden onset of febrile odynophagia, associated with high dyspnea, mouth breathing and reflex otalgia. The ENT examination, we note an ulcero-necrotic lesion of the right tonsillar lodge taking the veil and extending to the hard palate, and to the base of the tongue. A submental adenopathy is painful to palpation, and Anterior serous rhinorrhea. We performed a necrosectomy under local anesthesia and established the treatment of tonsillitis according to the national protocol by Amoxicillin at a rate of 2 g/day for 7 days; paracetamol in perfusion at a rate of 1 g every 8 hours for 3 days. Local care with antiseptic mouthwashes and local analgesics. Maintaining adequate hydration with an adapted diet. The patient was referred to the diabetology department and put on insulin therapy for diabetes. The evolution on the seventh day was favorable. Conclusion: Tonsillar necrosis is a rare pathology, often associated with severe infections, vascular disorders or underlying comorbidities. Diabetes mellitus, due to its immunosuppressive effects and microvascular complications, may promote this condition.