Tonsillitis is an inflammation of the tonsils. The tonsils are a group of tissues located at the back of the mouth, with one on each side of the throat.
What Are Tonsils For?
The tonsils are glands that are part of the immune system and therefore work to prevent infection by potential bacterial or viral organisms that enter through the mouth and nose1.
However, sometimes the tonsils themselves can become infected, leading to swelling and inflammation of this tissue. Tonsillitis can be caused by viruses or bacteria, although most cases are viral in origin and therefore resolve without the need for antibiotics.
Acute and Chronic Tonsillitis
Acute tonsillitis usually resolves within 7 to 10 days. However, some individuals with chronic tonsillitis may have recurrent or ongoing symptoms of tonsillitis.
Tonsillitis is more common in children and teenagers, although adults of any age can develop this condition.
Causes of Tonsillitis
Tonsillitis is caused by a viral or bacterial infection. Most cases of tonsillitis are caused by viruses. Some of the viruses that can cause tonsillitis include:
- Adenovirus
- Enterovirus
- Flu virus
- Parainfluenza virus
- Epstein-Barr virus (mononucleosis)
- Cytomegalovirus
- Measles virus
- Herpes simplex virus.
Bacterial tonsillitis is often caused by Streptococcus pyogenes, the organism that causes strep throat.
Important: It is very important to know that Bacterial Tonsillitis (which requires antibiotics) does not occur in children younger than 2 years and rarely in those under 3 years of age.
Symptoms of Tonsillitis
There are many symptoms of tonsillitis2, some more recurrent, common, and easy to diagnose:
Symptoms of tonsillitis may include:
- Sore throat;
- Difficulty or pain when swallowing;
- Fever;
- Feeding difficulties (in infants);
- Headache;
- Nausea and vomiting;
- Cough;
- Hoarseness;
- Redness and swelling of the tonsils
Other symptoms such as runny nose, swollen glands in the neck (swollen lymph nodes), spots or white patches on the tonsils, bad breath, red eyes, skin rash, and ear pain (caused by nerves that go to the back of the throat and also to the ear) may also occur.
Is Tonsillitis Contagious?
Tonsillitis is indeed contagious, and the disease is usually transmitted through direct contact with infected individuals. The infectious organisms are typically spread through airborne droplets released
during coughing or sneezing, or indirectly by contact with contaminated surfaces (such as glasses, tissues, or utensils).
Tonsillitis caused by a virus is often contagious for about 7-10 days.
Untreated bacterial tonsillitis may be contagious for about 2 weeks. However, people with bacterial tonsillitis who are treated with antibiotics generally become non-contagious 24 hours after starting treatment.
When Should I See a Doctor?
Most people who develop tonsillitis will recover completely without medical assistance. People who may have bacterial tonsillitis that requires antibiotics should seek medical care, especially because it is often difficult to tell the difference between viral and bacterial tonsillitis based only on symptoms. Therefore, always seek medical attention to help differentiate and receive proper treatment3.
Complications of Tonsillitis
In some cases, people with tonsillitis may experience complications such as:
- Airway blockage due to severely swollen tonsils
- Spread of infection from the tonsils into the neck, known as peritonsillar abscess. In this case, it is necessary to drain the pus that develops on the outside of the throat. This procedure is performed surgically, requiring hospitalization and administration of intravenous antibiotic medication.
- In rare cases, patients with tonsillitis caused by streptococcus may develop rheumatic fever
Diagnosis of Tonsillitis
In general, the doctor will perform a physical exam, paying special attention to the throat and neck area. Tonsillitis caused by viruses can look very similar to bacterial tonsillitis, so diagnostic tests (for example, throat culture, rapid strep test) may be needed to differentiate between the two potential causes.
They may also request a rapid strep test, which involves swabbing the back of the throat. Rapid strep test results are usually available within 30 minutes.
Sometimes, a strep culture is sent to a lab to confirm a strep infection, although this result may take 24 to 48 hours.
In rare cases of severe or complicated tonsillitis, blood tests or imaging tests may be requested. Additionally, if other causes of sore throat are suspected, additional tests may be needed.
Treatment of Tonsillitis
As most cases of tonsillitis are caused by viruses, the body will fight the infection and the disease will run its course. In these people, antibiotics are not necessary.
However, in people with bacterial tonsillitis, antibiotics are generally prescribed. The penicillin class of antibiotics is the most commonly prescribed.
- Penicillin can be given as a single dose injection or may be prescribed orally (tablets or solution in the case of children).
- If the patient is allergic to penicillin, alternative antibiotics will be prescribed.
- Treatment with oral antibiotics is typically prescribed for 10 days.
- It is important to take all prescribed medication, even if symptoms go away and you feel better before finishing the full course of antibiotics.
Steroids may be prescribed for certain people with tonsillitis to help reduce inflammation.
What is Tonsillitis Recovery Like?
In general, recovery from tonsillitis is excellent and most people recover without complications or long-term problems. Most cases of viral tonsillitis resolve within 7 to 10 days, following medical recommendations.
When treated with antibiotics, tonsillitis can be cured in a shorter time. People usually begin to feel better within 24 to 48 hours after starting treatment.
The prognosis for those who develop complications from tonsillitis depends on the severity and extent of the complication. Death from tonsillitis or its complications is very rare.
See Also: Is Cold Water Bad for Children? Myth or Truth
Photos: Pbeck at English Wikipedia
