Acute Tonsillitis

Tonsils are the two lymph nodes located on each side of the back of your throat. They function as a defense mechanism. They help prevent your body from infection. When the tonsils become infected, the condition is called tonsillitis.

Tonsillitis can occur at any age and is a common childhood infection. It is most often diagnosed in children from preschool age through their midteens. Symptoms include a sore throat, swollen tonsils, and fever.

This condition is contagious and can be caused by a variety of common viruses and bacteria, such as Streptococcal bacteria, which causes strep throat. Tonsillitis caused by strep throat can lead to serious complications if left untreated.

Tonsillitis is easily diagnosed. Symptoms usually go away within 7 to 10 days.

A set of large tonsils in the back of the throat covered in yellow exudate

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Tonsils are your first line of defense against illness. They produce white blood cells to help your body fight infection. The tonsils combat bacteria and viruses that enter your body through your mouth. However, tonsils are also vulnerable to infection from these invaders.

Tonsillitis can be caused by a virus, such as the common cold, or by a bacterial infection, such as strep throat. According to the American Academy of Family Physicians (AAFP), an estimated 15 to 30 percent of tonsillitis cases are due to bacteria. Most often it's strep bacteria.

Viruses are the most common cause of tonsillitis. The Epstein-Barr virus can cause tonsillitis, which can also cause mononucleosis.

Children come into close contact with others at school and play, exposing them to a variety of viruses and bacteria. This makes them particularly vulnerable to the germs that cause tonsillitis.

In rare cases, tonsillitis can cause the throat to swell so much that it causes trouble breathing. If this happens, seek immediate medical attention.

See a doctor if you experience the following symptoms:

  • fever that’s higher than 103˚F (39.5°C)
  • muscle weakness
  • neck stiffness
  • sore throat that doesn’t go away after two days

While some tonsillitis episodes go away on their own, some may require other treatments.

There are several types of tonsillitis, and there are many possible symptoms that include:

  • a very sore throat
  • difficulty swallowing or painful swallowing
  • a scratchy-sounding voice
  • bad breath
  • fever
  • chills
  • earaches
  • stomachaches
  • headaches
  • a stiff neck
  • jaw and neck tenderness due to swollen lymph nodes
  • tonsils that appear red and swollen
  • tonsils that have white or yellow spots

In very young children, you may also notice increased irritability, poor appetite, or excessive drooling.

There are two types of tonsillitis:

  • recurrent tonsillitis: multiple episodes of acute tonsillitis a year
  • chronic tonsillitis: episodes last longer than acute tonsillitis in addition to other symptoms that include:
    • chronic sore throat
    • bad breath, or halitosis
    • tender lymph nodes in the neck

Diagnosis is based on a physical examination of your throat. Your doctor may also take a throat culture by gently swabbing the back of your throat. The culture will be sent to a laboratory to identify the cause of your throat infection.

A mild case of tonsillitis does not necessarily require treatment, especially if a virus, such as a cold, causes it.

Treatments for more severe cases of tonsillitis may include antibiotics or a tonsillectomy.

Antibiotics will be prescribed to fight a bacterial infection. It’s important you complete the full course of antibiotics. Your doctor may want you to schedule a follow-up visit to ensure that the medication was effective.

Surgery to remove the tonsils is called a tonsillectomy. This was once a very common procedure. However, tonsillectomies today are only recommended for people who experience chronic or recurrent tonsillitis. Surgery is also recommend to treat tonsillitis that doesn’t respond to other treatment, or tonsillitis that causes complications.

If a person becomes dehydrated due to tonsillitis, they may need intravenous fluids. Pain medicines to relieve the sore throat can also help while the throat is healing.

Home care tips to ease a sore throat

  • drink plenty of fluids
  • get lots of rest
  • gargle with warm salt water several times a day
  • use throat lozenges
  • use a humidifier to moisten the air in your home
  • avoid smoke

Also, you may want to use over-the-counter (OTC) pain medications, such as acetaminophen and ibuprofen. Always check with your doctor before giving medications to children.

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