A 6-year-old has recurrent acute tonsillitis documented by a physician each time. According to the Paradise criteria, tonsillectomy is indicated when episodes number at least seven in the preceding year, five per year in each of two years, or:

• A Six per year in each of two years
• B Four per year in each of two years
• C Three per year in each of three years ✓
• D Three per year in each of four years

Explanation

The Paradise criteria define documented recurrent throat infection warranting tonsillectomy as seven or more episodes in one year, five or more per year in two consecutive years, or three or more per year in three consecutive years. The pattern deliberately trades episode frequency against duration of observation so that transient clustering of infections does not trigger surgery. Four per year for two years falls short of any arm of the criterion.

Reference: Cummings Otolaryngology: Head and Neck Surgery, 7th ed.

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Written and medically reviewed by the StethoPrep medical team.