Tonsillitis

What is tonsillitis?

Your tonsils are two lymph nodes on each side at the back of your throat. They play a crucial role in defending your body against infections. When an infection develops specifically in the tonsils, it’s called tonsillitis. Tonsillitis can affect individuals of any age but is most common among children, typically diagnosed from preschool age through their mid-teens. Symptoms of tonsillitis include a sore throat, swollen tonsils, and fever.

The pathogens responsible for tonsillitis can be contagious, and several viruses and bacteria can cause the condition. Streptococcal bacteria are among the microorganisms that commonly cause tonsillitis. If tonsillitis is caused by strep throat, it can lead to serious complications if not treated promptly.

What are the causes of tonsillitis?

Your tonsils serve as your body’s initial defence against illness. They produce white blood cells that play a critical role in fighting infections. Tonsils combat bacteria and viruses that enter the body through the mouth and nose. Despite their protective function, tonsils can become infected by the pathogens they are designed to repel. Various pathogens, including viruses like the common cold and bacterial infections like strep throat, can trigger tonsillitis.

What are the Symptoms of tonsillitis?

Possible symptoms of tonsillitis include:

• Very sore throat
• Difficulty or pain while swallowing
• Scratchy-sounding voice
• Bad breath
• Fever
• Chills
• Earache
• Stomachache
• Headache
• Stiff neck
• Jaw and neck tenderness from swollen lymph nodes
• Red and swollen tonsils
• Tonsils with white or yellow spots

In very young children, additional symptoms may include increased irritability, poor appetite, or excessive drooling.

Can tonsillitis be prevented?

To reduce your risk of contracting tonsillitis:

• Avoid close contact with individuals displaying active symptoms of tonsillitis or other contagious illnesses. If you have tonsillitis, try to limit contact with others until the infection is no longer contagious.
• Practice good hygiene habits, such as frequent handwashing, especially after being around someone with a sore throat, cough, or sneeze.

How is tonsillitis diagnosed?

When diagnosing tonsillitis, your doctor will typically:

• Examine your throat to assess symptoms and signs of infection.
• Conduct a throat culture by gently swabbing the back of your throat. The swab is then sent to a laboratory to identify the specific cause of the throat infection.
• Take a blood sample to perform a complete blood count (CBC). This test helps determine whether the infection is viral or bacterial, influencing treatment decisions.

What is the treatment for tonsillitis?

Treatment options for tonsillitis vary depending on the severity and cause of the infection:

Mild Cases: A mild case of tonsillitis, often caused by a virus such as a cold, may not require specific treatment. Rest, fluids, and over-the-counter pain relievers like acetaminophen or ibuprofen can help manage symptoms until the infection resolves.

Severe Cases: For more severe cases, especially those caused by bacteria like streptococcus:

• Antibiotics may be prescribed to treat the bacterial infection. It’s crucial to complete the entire course of antibiotics as your doctor directs to prevent the infection from returning or worsening.
• If dehydration occurs, intravenous fluids may be necessary to maintain hydration.

Tonsillectomy: Surgery to remove the tonsils, known as a tonsillectomy, may be recommended in cases of:

• Chronic or recurrent tonsillitis.
• Complications from tonsillitis that do not improve with other treatments.
• Significant breathing or swallowing difficulties due to enlarged tonsils.

Research suggests that a tonsillectomy may reduce the frequency of throat infections in children during the first year post-surgery. However, long-term studies indicate potential risks, such as increased susceptibility to respiratory and infectious diseases in adulthood for those who underwent the procedure as children.

Home Remedies: Several home remedies can help alleviate throat pain and discomfort from tonsillitis:

• Drink plenty of fluids to stay hydrated.
• Get adequate rest to support recovery.
• Gargle with warm salt water multiple times a day to soothe the throat.
• Use throat lozenges or suck on frozen foods (such as popsicles) to numb the throat.
• Use a humidifier in your home to add moisture to the air.
• Avoid smoke and irritants that can worsen throat irritation.
• Take acetaminophen or ibuprofen to reduce pain and inflammation.

Use throat sprays instead of lozenges for young children, and always consult a doctor before giving medications.

Is tonsillitis contagious?

Tonsillitis itself is not directly contagious, but the infectious organisms that cause it can be transmitted to others under certain conditions:

• The pathogens responsible for tonsillitis can be contagious for 24 to 48 hours before symptoms appear. During this time, you may unknowingly spread the infection to others.
• The contagion continues until you are no longer symptomatic or after approximately 24 hours of starting antibiotic treatment, which helps eliminate the bacteria or virus.

You can contract tonsillitis by:

• Inhaling respiratory droplets containing infectious organisms when someone coughs or sneezes nearby.
• Touching surfaces contaminated with pathogens (like doorknobs) and then touching your nose or mouth allows the pathogens to enter your body and potentially cause tonsillitis.

What are the complications of tonsillitis?

Failure to complete an entire course of antibiotics or ineffective antibiotic treatment for tonsillitis can lead to potential complications, including:

• Rheumatic fever and poststreptococcal glomerulonephritis are serious conditions that can affect the heart and kidneys.
• Obstructive sleep apnea (OSA): Chronic tonsillitis can cause swelling in the airways, leading to sleep disturbances and potential long-term health issues if untreated.
• Tonsillar cellulitis: The infection may worsen and spread to surrounding tissues, resulting in tonsillar cellulitis.
• Peritonsillar abscess: In severe cases, tonsillitis can lead to a peritonsillar abscess, a collection of pus behind the tonsils that may require drainage and surgical intervention.

It’s essential to take prescribed medications as directed by your doctor to minimise the risk of these complications.