What is Tonsillitis?
Tonsillitis refers to the swelling and inflammation of the tonsils.
The tonsils are two masses that dangle above and behind the tongue - one on either side. On the surface of the tonsils are tiny crypts that may contain pus or stones. It is believed that the tonsils, in partnership with the adenoids located behind the nose and soft palate, are part of the body's defense mechanism against bacteria and viruses. Specifically, the tonsils produce white blood cells. After puberty, the tonsils' immunity role declines. This is why many adults who haven't had their tonsils removed as a child rarely experience tonsillitis.
Tonsillitis is contagious and can spread through air droplets containing the virus or bacteria.
Types of Tonsillitis
There are two kinds of tonsillitis: acute and chronic.
Acute tonsillitis refers to a sudden or gradual sore throat, which is usually associated with a fever. A patient may refrain from swallowing saliva, being drooling, report ear pain with swallowing, and have bad breath. The tonsils may appear bright red or show white spots. This condition can be caused by either bacteria or viruses.
One such type of bacteria is streptococcus. Streptococcus pyogenes (Group A streptococcus) causes most cases of strep throat, though "only about 30 percent of tonsillitis in children is caused by strep throat and only about 10 percent of tonsillitis in adults is caused by strep throat" (www.emedicinehealth.com). It is important that strep infections be treated promptly as it can damage the heart valves (rheumatic fever) and kidneys, and lead to scarlet fever, sinusitis, pneumonia, as well as ear infections.
When examining a patient for tonsillitis, in addition to a throat swab for strep, a doctor will also evaluate for acute mononucleosis caused by the Epstein-Barr virus. In this case the swelling of the tonsils, adenoids, and lymph nodes do not respond to the traditional antibiotics.
Chronic tonsillitis refers to recurring tonsillar infections, which include the development of tonsilloliths (tonsil stones), which cause bad breath.
Symptoms and Treatment for Tonsillitis
As with most conditions, there are a variety of symptoms reported by patients, but not every patient in every case will experience all of them. Possible symptoms include:
- sore throat
- pain with swallowing / difficulty feeding in infants
- drooling in young children
- fever
- headache
- bad breath
- stiff neck
- abdominal pain (in young children)
- nausea and vomiting
- cough
- hoarseness
- runny nose
- tonsils and throat are red
- swollen lymph nodes at the back of the neck
- tonsils have white patches
- eyes are red
- rash
- ear pain
Since viral tonsillitis usually goes away on its own in seven to 10 days, treatment will focus on managing and diminishing the discomfort of the symptoms. Simple at-home management methods can include:
- rest, both for the body overall and for the voice in particular
- drink plenty of fluids to keep the body hydrated
- comfort foods (warm liquids: broth, caffeine-free tea, or warm water with honey; cold foods: jello, ice cream, or popsicles)
- saltwater gargle: 1 tsp (5 mL) of table salt to 8 oz (237 mL) of warm water (spit out, do not swallow)
- use a cool-air humidifier, or sit with your child in a steamy bathroom
- lozenges are okay for children over the age of four
- avoid smoking or using cleaning products
- ibuprofen or acetaminophen can be used to manage the fever, headache, and general aches (Aspirin should not be used in children under two, and should only be used in older children under the direction of a family doctor because of the association with Reye's Syndrome.)
Antibiotics are used to treat tonsillitis (usually penicillin) caused by strep or other bacteria. There are alternatives for those allergic to penicillin. It is important that the full course of antibiotics be taken, and not cut short once symptoms subside. This will ensure that the bacteria is killed off. Not completing the course of antibiotics can increase a child's risk of developing rheumatic fever and inflammation of the kidneys.
A tonsillectomy to surgically remove the tonsils may be recommended if your child has experienced (from www.mayoclinic.com):
- more than six episodes in one year
- more than four episodes a year over two years
- more than three episodes a year over three years.
The surgery usually done on an out-patient basis. Recovery takes between 7 to 10 days.
Sources: www.medicinenet.com; www.mayoclinic.com; www.netdoctor.co.uk; www.emedicinehealth.com; www.webmd.com