Tonsillitis

Tonsillitis occurs when the tonsils become inflamed or swollen, often due to an infection caused by either a virus or bacteria. While it's frequently observed in childhood, it can affect individuals of all ages

Is tonsillitis contagious?

Tonsillitis itself, characterized by tonsil swelling, is not contagious. However, the bacteria and viruses responsible for causing tonsillitis can be contagious. These germs can spread through infected air or direct contact.

Children frequently encounter these germs at school or daycare, emphasizing the importance of frequent handwashing for both you and your children, particularly before meals or touching the mouth.

Is it tonsillitis or something else?

Tonsillitis can resemble various other health conditions at times. To accurately identify your condition, it's important to consult your doctor.

Symptoms of tonsillitis

• Enlarged or inflamed tonsils, often accompanied by redness (might occur on one side)

• Presence of white or yellow spots on the tonsils or at the back of the throat

• Sudden onset of a sore throat

• Pain or discomfort while swallowing

• Swollen and tender lymph nodes on the sides of the throat

• Hoarseness or a scratchy throat

Other symptoms

If you have chronic tonsillitis, you may also experience:

• Halitosis (bad breath)

• Tonsil stones

In young children, who may not articulate their symptoms clearly, watch for:

• Loss of appetite

• Increased irritability

• Excessive drooling due to difficulty swallowing

• Appearance of blisters, sores, or ulcers in the throat

• Headaches

• Ear pain

• Loss of appetite

• Fever

• Chills

• Fatigue

• Snoring

When to seek medical attention

Tonsillitis symptoms can resemble those of other health issues. It's important to consult your healthcare provider for an accurate diagnosis. Seek urgent medical attention if you or your child:

• Develop a fever exceeding 103°F

• Experience bleeding

• Encounter significant difficulty breathing

• Begin to excessively drool

Tonsillitis: causes and types

Tonsillitis can be triggered by both bacteria and viruses, with viral infections being more prevalent. Common culprits include:

• Epstein-Barr virus, known for causing infectious mononucleosis (mono), which can lead to secondary tonsillitis

• Herpes simplex virus

• Rhinovirus (responsible for the common cold)

• Streptococcus bacterium: often associated with strep throat and a common cause of bacterial tonsillitis (accounts for 15% to 30% of cases)

Numerous other bacteria and viruses can also provoke tonsillitis.

There are three types of tonsillitis:

• Acute tonsillitis: This type involves swollen and infected tonsils for a brief period, typically lasting a few days to two weeks. It can often be resolved with antibiotics and home remedies.

• Recurrent tonsillitis: Individuals experience multiple episodes of tonsillitis throughout the year. If it occurs more than 7 times annually, surgical removal of the tonsils may be recommended.

• Chronic tonsillitis: In this form, tonsil inflammation and infection persist for a month or longer. It can lead to cryptic tonsils, characterized by small holes where bacteria, old cells, and food particles accumulate, forming tonsil stones. These stones may dislodge naturally or require removal.

Diagnosis

If you're experiencing symptoms of tonsillitis, it's important to schedule an appointment with your doctor. During the visit, your doctor will inquire about your symptoms, medical history, and family history.

Additionally, they will conduct a physical examination, which may include:

• Examining the back of your throat using a light

• Palpating the lymph nodes on the sides of your neck

• Listening to your lung sounds

You will also get tested for strep bacteria. Strep bacteria can cause tonsillitis, and can lead to serious complications. There are two ways to test for it:

• Rapid strep test: Your doctor will swab the back of your throat and conduct the test in the clinic to detect strep bacteria. This test typically yields results within 15 minutes. If the rapid test is negative, your doctor may also perform a throat culture since rapid tests may not be entirely accurate.

• Throat culture: A swab from the back of your throat is sent to a laboratory, where any bacteria present in the sample are cultured and examined under a microscope to provide a definitive diagnosis.

In some cases, your doctor may recommend a complete blood cell count (CBC). This test examines a blood sample to determine if you have elevated levels of white blood cells, which are immune cells. Elevated levels of white blood cells may indicate a non-strep-related cause of tonsillitis. However, a CBC is not always necessary.

Treatments for tonsillitis

Tonsillitis home remedies

If you have a mild case of tonsillitis, you may be able to treat it at home. This is especially the case if your tonsillitis is caused by a virus, like the common cold. Try the following home remedies:

• Rest and avoid strenuous activities. Consider taking time off work or keeping your child home from school, as tonsillitis can be contagious.

• Stay hydrated by drinking plenty of clear fluids such as tea and water.

• Soothe your throat with warm tea with honey or popsicles.

• Gargle warm salt water by mixing half a teaspoon of salt in a cup of warm water. Gargle for a minute or longer and then spit it out to reduce swelling and alleviate soreness.

• Use over-the-counter medications like acetaminophen (Tylenol) to manage pain and low-grade fevers.

• Consider sucking on throat lozenges to ease throat discomfort, but avoid giving them to children under four years old.

• Steer clear of cigarettes and other throat irritants like cleaning products.

• Use a humidifier to add moisture to the air, which can help alleviate throat irritation.

Medications

If your tonsillitis is caused by strep bacteria, antibiotic treatment is necessary. These medications work by inhibiting the bacteria's vital functions, ultimately killing them.

Typically, your doctor will prescribe a 10-day course of penicillin. If you're allergic to penicillin, an alternative antibiotic will be prescribed. It's crucial to strictly adhere to your doctor's instructions and complete the entire course of medication. Even if symptoms improve, finishing all prescribed antibiotics is essential to eradicate any lingering bacteria. Incomplete antibiotic courses heighten the risk of complications such as rheumatic fever and kidney inflammation, particularly in children.

Surgery

Tonsils play a vital role in the immune system, so doctors typically avoid recommending tonsil removal (tonsillectomy). However, if you experience recurrent, severe, or chronic tonsillitis, your doctor may suggest a tonsillectomy. You may be considered a candidate for this procedure if you:

• Have had tonsillitis 7 times in the past year, or 5 times a year for two consecutive years

• Suffer from chronic tonsillitis that is challenging to manage

• Experience severe tonsillitis resulting in complications such as an abscess or significant breathing difficulties

A tonsillectomy is often conducted as an outpatient surgery, allowing you to leave the hospital on the same day. Typically, full recovery takes between seven to 14 days. During this period, your doctor may advise dietary adjustments and provide instructions for wound care.

Complications of tonsillitis

Complications of tonsillitis may arise if the condition is left untreated. These complications can include:

Peritonsillar abscess: Untreated bacterial tonsillitis can lead to the formation of a peritonsillar abscess, resulting in severe throat pain and difficulty in opening the mouth.

Tonsillar cellulitis: When untreated tonsillitis spreads deeply into the surrounding tissues, it can cause tonsillar cellulitis and additional complications.

Obstructive sleep apnea: Swelling of the tonsils can obstruct airflow during sleep, leading to obstructive sleep apnea. Symptoms may include waking up gasping or choking and experiencing difficulty in obtaining sufficient sleep.

If untreated, tonsillitis caused by strep bacteria can lead to more severe infections, such as:

• Scarlet fever: This condition is characterized by a prominent red rash accompanying a strep infection

• Rheumatic fever: An infection that can cause swelling in the joints and heart

• Kidney inflammation (also known as post-streptococcal glomerulonephritis)