Spontaneous tonsillar haemorrhage due to von Willebrand's disease.

OBJECTIVE: We report a case of spontaneous tonsillar haemorrhage due to underlying von Willebrand's disease, without symptoms or signs of infection.

METHOD: Case report and literature review of reported causes of spontaneous tonsillar haemorrhage.

CASE REPORT: Spontaneous tonsillar haemorrhage is uncommon. Acute bacterial tonsillitis, peri-tonsillar abscess, infectious mononucleosis and idiopathic causes have been reported. Two cases of tonsillitis with underlying bleeding disorders have been reported. We present the first reported case of spontaneous tonsillar haemorrhage secondary to von Willebrand's disease, without evidence of tonsillitis.

CONCLUSION: Spontaneous tonsillar haemorrhage is usually related to infection of the tonsils or peri-tonsillar space. An underlying bleeding disorder should be suspected if no evidence of infection is found.