CONDITIONS
Tonsillitis
What is tonsillitis?
Tonsillitis is an inflammation of the tonsils that is caused by viral or bacterial infection. The tonsils are the two soft lumps of soft tissue located at the back of the throat, visible through the mouth. They are part of the immune system and help the body filter out bacteria and germs that can enter the body through the nose and mouth. When tonsils get infected, they get swollen and sore, and swallowing may hurt. It is the most common condition affecting children and adolescents.
What causes tonsillitis?
Tonsillitis is often caused by viral or bacterial infection.
Viral Tonsillitis: Viruses causing the common cold and the flu are responsible for up to 70% of tonsillitis cases. Individuals with viral tonsillitis have milder symptoms compared to those with bacterial tonsillitis.
Bacterial Tonsillitis (Strep Throat): Group A Streptococcus bacteria cause tonsillitis, commonly known as strep throat. Individuals without tonsils can still have strep throat, which affects their throat. Generally, bacterial tonsillitis tends to cause more severe symptoms than viral tonsillitis.
How does tonsillitis spread?
Like colds and strep throat, tonsillitis is spread when an infected person breathes, coughs, or sneezes and another person inhales the infected droplets in the air or comes into contact with them on the skin or an object that touches the eyes, nose, or mouth.
What are the symptoms of tonsillitis?
Common signs and symptoms of tonsillitis include:
- Sore and scratchy throat
- Red swollen tonsils and throat
- White spots on tonsils
- Fever above 100 degrees Fahrenheit
- Swollen glands on the sides of the neck and below the ear
- Difficult or painful swallowing
Peritonsillar abscess—Peritonsillar abscess is an advanced case of tonsillitis in which an abscess or pus pocket is formed around the tonsil. It is usually found in adolescents and adults but can occur occasionally in children.
Symptoms of peritonsillar tonsillitis include:
- Fever
- Intense throat pain
- Drooling
- Difficulty opening the mouth (trismus)
- Altered voice quality
- Asymmetrical appearing tonsils
How is tonsillitis diagnosed?
A doctor can diagnose tonsillitis by examining the individual’s throat, ears, and nose. Feel the sides of the neck to look for swollen glands or lymph nodes.
The doctor may also take a swab of the individual’s throat to check for streptococcal bacteria. If the test is positive, it is a bacterial infection; if it is negative, tonsillitis is viral.
How is tonsillitis treated?
If tonsillitis is caused by bacterial infection, the doctor will prescribe antibiotics. It is essential to complete the entire course of antibiotics as advised by the doctor, even if symptoms improve within a few days.
Home care strategies that can be used during the recovery time include:
- Pain and fever medication to minimize throat pain and control a fever as advised by the doctor
- Gargle with warm salt water
- Drink plenty of fluids. Fluids may help soothe an irritated throat.
- Drink warm liquids, like tea, soups
- Sucking on throat lozenges
- Do not smoke and avoid secondhand smoke
Surgery
Tonsillectomy, or the surgical removal of tonsils, may be recommended for various conditions, including recurrent tonsillitis, chronic tonsillitis, or bacterial tonsillitis that does not respond to antibiotic therapy. Recurrent tonsillitis is typically defined as:
- At least seven episodes within the previous year
- At least five episodes yearly over the past two years
- At least three episodes yearly over the past three years
Furthermore, tonsillectomy may be indicated if tonsillitis leads to complications that are challenging to manage, such as:
- Obstructive sleep apnea
- Difficulty breathing
- Difficulty swallowing, particularly solid foods
- Persistent abscess unresponsive to antibiotic treatment
How can tonsillitis be prevented?
While tonsillitis itself cannot be prevented, the following tips can help minimize the spread of illnesses:
- Avoid close contact with individuals suffering from tonsillitis or a sore throat.
- Refrain from sharing utensils, drinking glasses, toothbrushes, or any other personal items with individuals who have tonsillitis or a sore throat.
- Practice frequent handwashing.
- Cover your mouth when coughing or sneezing.
In conclusion, tonsillitis causes visibly red and inflamed tonsils. Both bacteria and viruses can cause tonsillitis. Most cases of viral tonsillitis resolve within a few days with adequate hydration and rest. Antibiotics are usually needed to eradicate bacterial tonsillitis. In case of recurrent tonsillitis and peritonsillar abscess, an ENT specialist may recommend surgery to remove tonsils.
References
1. American Academy of Otolaryngology–Head and Neck Surgery Foundation. Tonsillitis. Available from: https://www.enthealth.org/conditions/tonsillitis/ Accessed on 19th April 2024
2. Cleveland Clinic. Tonsillitis. Available from: https://my.clevelandclinic.org/health/diseases/21146-tonsillitis Accessed on 19th April 2024
3. Mayo Clinic. Tonsillitis. Diagnosis and Treatment. Available from: https://www.mayoclinic.org/diseases-conditions/tonsillitis/diagnosis-treatment/drc-20378483. Accessed on 19th April 2024
