Tonsillitis

The tonsils are oval-shaped pieces of tissue located at the back of the throat. They filter what we eat and inhale and help protect against infection. Tonsillitis occurs when the tonsils become inflamed due to viral or bacterial infection.

Tonsillitis is most common in young children and teenagers. This is most likely because the tonsils lose their immune function after puberty. Common symptoms of tonsillitis include:

• Red or swollen tonsils
• A stiff neck
• Visible white or yellow spots on the tonsils
• A low-grade fever
• A sore throat
• Difficult or painful swallowing
• Tender or enlarged lymph nodes in the neck

Young children who are unable to verbally express themselves may become irritable and fussy, refuse to eat, and drool excessively because of the pain associated with swallowing. Most cases of tonsillitis are mild and easily treated; however, in rare instances, patients may experience difficulty breathing.

The infection may also spread to surrounding tissue or develop into a pus pocket, or abscess, behind the tonsils.

Most cases of tonsillitis are diagnosed through a simple physical exam. The physician will examine the ears, nose, and throat for signs of infection and gently palpate the neck to check for enlarged lymph nodes. The doctor will also check for an enlarged spleen. This could indicate mononucleosis, another condition that can cause inflamed tonsils.

Most doctors will also perform a throat swab to obtain a sample of the secretions. This will help determine if the infection is caused by streptococcal bacteria or a virus. In some cases, a streptococcal infection may be diagnosed if the patient has a fever and a red skin rash called scarletina.

If tonsillitis is caused by bacterial infections, then the primary treatment is antibiotics. Patients should take the full course of antibiotics even if they start to feel better. Prematurely halting treatment with antibiotics can cause the infection to worsen or even spread to other parts of the body.

If the infection is viral, the only course of action is to manage the symptoms until they resolve; this can take anywhere between a week and 10 days. Patients can take the following steps to help speed up recovery and alleviate symptoms:

• Get plenty of rest
• Drink warm liquids
• Use non-aspirin pain relievers to treat fever and pain
• Eat cool foods, such as popsicles, to soothe the throat
• Use a humidifier to eliminate dry air
• Gargle with salt water

Patients with chronic or recurrent tonsillitis may need a tonsillectomy, a procedure performed to remove the tonsils. Tonsillitis is considered frequent if:

• Patients have more than seven episodes in a year
• Patients have had more than three episodes in each of the last three years
• Patients have had more than four or five episodes in each of the past two years

A tonsillectomy may also be necessary if the condition is causing complications, such as difficulty swallowing or breathing. A tonsillectomy is an outpatient procedure with a short recovery period of one to two weeks.