Tonsillitis refers to the inflammation of the tonsils. The tonsils are two oval-shaped tissue masses at the rear of the throat – one tonsil on each side. They are part of the body’s immune system that keeps you safe from infections.
Tonsillitis is commonly caused by viral or bacterial infection and affects the respiratory system. A number of viruses, such as the common flu, adenovirus, and Epstein-Barr virus (mononucleosis), are known to lead to tonsillitis. From the bacteria group, strep throat (streptococcus) is the most likely cause of tonsillitis.
While there are more cases of tonsillitis caused by viruses, children whose tonsillitis is caused by bacterial infections tend to experience more severe symptoms and hence, require more medical attention.
Tonsillitis is in itself not contagious but the bacteria or viruses that result in tonsillitis may be contagious, or lead to more severe complications if not properly treated.
The main symptoms of tonsillitis are swollen and red tonsils, sometimes severe enough that it becomes hard to breathe. A child suffering from tonsillitis may also present with:
These symptoms usually subside after 3 to 4 days. If these symptoms do not subside after 4 days and/or you begin developing more serious symptoms, such as swollen glands (lymph nodes) on the sides of your neck, white-pus filled spots on your tonsils, and bad breath, you should consult a doctor.
Tonsillitis generally causes some degree of discomfort and pain, especially more for children who may not be able to express themselves. Some children also experience chronic tonsillitis that is characterised by frequent episodes of sore throat and swollen tonsils or even near-constant throat discomfort.
Tonsillitis is more commonly found in children, affecting those from the age of two onwards. This is because children are more exposed to viruses and bacteria that cause tonsillitis in school, where they are in close contact with each other. While it is more prevalent in children aged 5 to 16, teenages and adults can contract tonsillitis as well.
To check for tonsillitis, doctors will typically examine your tonsils for any signs of inflammation. They will also check for fever and swollen lymph nodes on the sides of the neck.
As tonsillitis can be caused by either viral or bacterial infections, doctors will carry out checks to determine and address the cause directly. To check for the cause of tonsillitis, you may undergo a rapid strep test – a 10-15 minute test that will determine if you have strep throat. Sometimes, your doctor may send your saliva sample for a lab test that takes a couple of days. Your doctor may also check for scarlatina – a rash linked to strep throat infection. If these tests come back negative, a virus is what caused your tonsillitis.
Your doctor may also call for a complete blood cell count, to look for high and low numbers of blood cells. This indicates whether a virus or bacteria caused your tonsillitis.
Treatment would depend on whether the tonsillitis was caused by a virus or bacteria. For viruses, your body will naturally recover from the infection on its own and you may apply home remedies to expedite the recovery. For bacteria, however, the doctor will prescribe an antibiotic. Antibiotics will help to alleviate the symptoms.
It's important to finish the entire prescription to prevent reinfection. This would also prevent more severe health complications that streptococcus can cause, like rheumatic fever that can damage the heart.
Rarely would a doctor recommend removing your tonsils (tonsillectomy) as they are part of your natural immune system. However, a tonsillectomy may be recommended for children whose tonsils get infected very frequently and severely, making it hard for them to breathe. While tonsillectomy was carried out rather commonly in the past, the surgery would only be recommended for children who experience:
Tonsillectomy may also be considered for children who experience multiple peritonsillar abscess. Peritonsillar abscess is a condition where the bacteria spreads to the space around the tonsil and fills it with pus. In addition to the symptoms of tonsillitis, other signs of an abscess include earache or a muffled voice. Treating an abscess has to be done at a hospital where a healthcare expert will help to drain the infection.