Tonsillitis is an infection of the tonsils that causes inflammation. It is most common in children aged 5 to 15. The tonsils are made of lymphatic tissue. Their job is to produce antibodies that fight infection. Ironically, such tissue is quite prone to becoming infected itself. Tonsillitis can be caused by viral or bacterial infections.
Many cases of tonsillitis never reach the doctor’s office, but it is estimated that 15% of all visits to family doctors are because of tonsillitis.
Tonsillectomy (tonsil removal) has always been the most common childhood operation, but it is considered a last resort for tonsillitis these days.
There are three common causes of tonsillitis:
Group A streptococcus, which are common bacteria that cause throat infections in about 1 in 5 people, including adults. Many people have no symptoms but they can still transmit the bacteria. Group A streptococcus can also cause strep throat. It’s also capable under some circumstances of causing more serious illness, such as rheumatic fever. Bacterial infection accounts for around 30% of tonsillitis cases.
Various respiratory viruses, especially cold and flu viruses, account for most cases of tonsillitis. These infections can be sometimes milder than bacterial infections, but it is often difficult to tell the difference between a viral and bacterial infection.
Infectious mononucleosis, caused by the Epstein-Barr virus, can also produce symptoms of tonsillitis, especially in children.
If you have tonsillitis, you should rest and stay well hydrated. You can take acetaminophen* or ibuprofen to ease symptoms, but acetylsalicylic acid (ASA) should be avoided in children with viral infections, as it can lead to Reye’s syndrome, a very dangerous condition that affects many organs, particularly the brain and liver.
Warm saltwater gargles may temporarily relieve pain. Throat lozenges that contain benzocaine or lidocaine are also available to reduce pain, but they have to be used repeatedly and often affect taste. Throat pain can also be relieved through sucking on ice chips or hard candies.
When bacteria are causing the infection, your doctor will likely prescribe an antibiotic. Most doctors will not prescribe antibiotics until tests confirm that bacteria are the cause. However, people with 3 out of following 4 characteristic symptoms may be treated with antibiotics "up-front" (before culture results are known): fever, discharge from the tonsils, no cough, and tender lymph nodes.
Few children get chronic or recurring infections. In some cases, when a child has recurring tonsillitis, family members may be tested to see if they’re asymptomatic (without symptoms) carriers of group A streptococcus. If so, they may be given antibiotics to ensure that the whole family is streptococcus-free, and to protect the child from reinfection.
If children don’t respond to antibiotics and have recurring infections (over 6 episodes in 1 year, over 4 episodes per year for 2 years, or over 3 episodes a year for 3 years), tonsillectomy may be considered.
Quinsy is usually treated by draining the abscess and antibiotics. Sometimes removing the tonsils is needed to treat quinsy.
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For information on a given medication, check our Drug Information database. For more information on brand names, speak with your doctor or pharmacist.
All material copyright MediResource Inc. 1996 – 2026. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/condition/getcondition/Tonsillitis
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