Tonsillitis - Symptoms, Causes, and Treatment

Tonsillitis is a painful condition involving infection or inflammation of the tonsils. It occurs most often in children and adolescents, with symptoms that can be quite uncomfortable and mildly alarming. Although treatment of tonsillitis is usually straightforward, it may take some time before the sore throat, swollen tonsils, and fever subside. But what is tonsillitis? Read on to find out.

Tonsillitis is a bacterial or viral infection of the tonsils, masses of tissue located at the back of the throat. The tonsils play an essential role in protecting people from infection by trapping bacteria and viruses that could cause respiratory infections if they enter the airways. When viruses or bacteria over-run the tonsils, they become swollen and lose the ability to carry out their immunity functions and protect a person from infection.

There are three types of tonsils. They are as follows -

• Acute Tonsillitis - Symptoms usually last 3 to 4 days but, in rare cases, can persist for a week or more.
• Recurrent Tonsillitis - A bacterial infection that strikes several times within a single year.
• Chronic Tonsillitis - A long-term tonsil infection, also known as chronic tonsillitis, is characterised by a sore throat and difficulty swallowing.

The common symptoms of tonsillitis are as follows –

• Difficulty swallowing along with pain and sore throat.
• Tonsils look red and swollen with some pus-filled spots.
• Mild fever
• Headache
• Coughing
• Chills
• Pain in neck and ears
• Tiredness
• Difficulty sleeping
• Swollen lymph glands

Some symptoms that develop with the severity of this disorder include –

• Fatigue
• Stomach pain with vomiting
• Nausea
• Furry tongue
• Vocal sound changes
• Bad breath
• Difficulty in opening the mouth

The primary cause of tonsillitis is bacteria and viruses. Further, a specific bacterium named Streptococcus can also give rise to strep throat symptoms. Other common causes of tonsillitis are as follows -

• Adenoviruses
• Influenza virus
• Epstein-Barr virus
• Parainfluenza viruses
• Enteroviruses
• Herpes simplex virus

Further, being a contagious disease, one can also acquire the tonsillitis germs from other carriers in following ways -

• Sharing food and other things.
• Coming in close contact with an affected person.
• Touching contaminated surfaces and subsequently nose and mouth.
• Inhaling airborne germs spread out from sneezing and coughing.

Here is a list of factors that can make individuals more likely to develop this disease.

• Young age - Tonsillitis is most common in children aged 5 to 15, and it is usually caused by bacterial infection.
• Exposure to germs - The close contact between school-age children and their peers means that they are at a higher risk of catching bugs or viruses that can cause tonsillitis.

Frequent cases of tonsillitis can give rise to further adverse conditions. These include the following:

• Obstructive Sleep Apnea - Disrupted or irregular breathing during sleep
• Tonsillar Cellulitis - Infection that spreads and affects the surrounding tissue
• Peritonsillar Abscess – Pus formation behind the tonsil occurs after prolonged infection.
• Rheumatic Fever - It results from a streptococcal infection and can affect the heart, joints, nervous system and skin.
• Scarlet Fever - A streptococcal infectious disease marked by a distinctive rash.
• Poststreptococcal Glomerulonephritis – It is characterised by inflammation in the kidney.
• Poststreptococcal Reactive Arthritis - An inflammation of the joints that can occur after infection by some strains of strep bacteria.

To prevent the rise of such complications, proper diagnosis is highly advisable, along with treatments.

The physicians will begin with a physical exam in the following ways -

• Doctors and nurses may use a lighted instrument called an otoscope to examine the patient’s throat, ears and nose.
• To determine whether a sore throat is caused by strep, doctors perform a simple test for scarlet fever, which is a rash associated with some cases of strep.
• Gently feeling an individual's neck for swollen glands and enlarged lymph nodes.
• Using a stethoscope to listen to the breathing patterns.
• A doctor may check for an enlarged spleen, which indicates that mononucleosis might be present.

Further, tests may be prescribed by the physician to understand the severity of the disorder.

• Throat Swab - Tests will be used to identify the cause of tonsillitis. Saliva and cells from an individual's throat will be examined to see if strep bacteria are present. If not, the doctor may order a lab test that takes two days to complete. If these tests are negative, a virus likely caused tonsillitis.
• Blood Test - The doctor may order a complete blood cell count, which counts the number of red blood cells, white blood cells, and platelets in your blood. This test determines if the infection is viral or bacterial.

Tonsillitis treatment depends on whether it occurred due to a virus or bacteria. Some cases can be treated with simple medication and home treatment. But in severe scenarios, one has to undergo surgery to remove the affected part altogether. The treatment methods are as follows –

1. Medication

If tonsillitis is caused by group A streptococcus, doctors often prescribe a 10-day course of penicillin. If someone has a penicillin allergy, the doctor may recommend an alternative antibiotic. It's important to take the entire duration of antibiotics, even if symptoms subside entirely. Otherwise, the infection may come back with more severity or spread to other body parts.

2. Home Remedies

Antibiotics do not cure tonsillitis caused by viruses as one's body fights independently. In addition, one can try some home remedies to help curb the symptoms of tonsil infection in following ways –

• Get adequate rest.
• To help with throat pain, drink warm fluids.
• Resort to warm liquids like soups, tea, warm water with honey or some cold treats to help soothe the sore throat.
• Use a humidifier in the room to get rid of the dry air that can further irritate the sore throat.
• Gargle with salt water 2 to 3 times a day.
• Suck on lozenges that can help relieve sore throat.
• Avoid smoking and some cleaning products that can irritate one's throat.
• In high fever and pain cases, talk to a physician about using painkillers and fever controlling drugs.

3. Tonsillectomy

Surgery to remove tonsils (tonsillectomy) is sometimes performed to treat chronically inflamed tonsils or recurring tonsillitis when the underlying cause cannot be determined or when it has not responded to antibiotic treatment. Individuals generally undergo surgery in the following circumstances –

• Seven tonsillitis cases in a year.
• Five tonsillitis cases per year in the past two years.
• Three cases of tonsillitis per year in the past three years

When experiencing tonsillitis symptoms, some steps can be taken to prevent such scenarios before medications.

• Regular hand washing after the toilet, sneezing or coughing can reduce the likelihood of contracting diseases.
• Do not share food, water or drinks with anyone who may be infected or contagious.
• Someone with tonsillitis should replace the toothbrush after being diagnosed.
• It is safe to stay inside when an individual is ill.
• Take advice from the doctor on when a child can rejoin school after being diagnosed with tonsillitis.
• Take the initiative to teach a child to sneeze or cough into their elbow or a tissue.

Tonsillitis can be caused by pathogens and is usually characterised by swollen tonsils. Untreated tonsillitis can spread to other parts of the body and last for weeks, so it is important to get treatment from a doctor. Most bacterial and viral tonsillitis cases clear up after seven days when treated with antibiotics or rest.