Tonsillitis is an infection of the tonsils, which are two fleshy masses at the back of the throat. The tonsils work to trap germs to prevent them from entering the airways and creating an infection in the lungs or sinuses. Plus, they produce antibodies to fight off infections. However, sometimes the tonsils themselves become overwhelmed with viral or bacterial infection and they become inflamed and sore.

There are three types of tonsillitis. Acute tonsillitis is where an infection lasts for a short period, usually no longer than two weeks but often just three or four days. Recurrent tonsillitis is when repeated acute infections occur multiple times within a year. Chronic tonsillitis is where an infection of the tonsils lasts for a long period – several weeks or more.

What are the symptoms of tonsillitis?

The tonsils become swollen and inflamed with tonsillitis and in very severe cases this can make it difficult to breathe. The tonsils often look red and there may a yellow or white coating on them. Most people experience pain or soreness in the throat and it’s also common to have difficulty swallowing.

Some people experience a headache, fever, chills, ear pain and stiff neck when they have tonsillitis. The glands in the neck and jaw might be swollen, and there could be ulcers on blisters in the throat. Loss of appetite, bad breath, and a scratchy voice are also common symptoms.

When children experience tonsillitis, they may display additional symptoms such as an upset stomach, stomach pain, vomiting, drooling, and a reluctance to eat or swallow.

What causes tonsillitis?

There are several different types of bacteria and viruses that could lead to an infection of the tonsils. Streptococcus bacteria is one of the most common. Influenza virus, parainfluenza virus, adenovirus, Epstein-Barr virus, herpes simplex virus and enterovirus are also common causes of tonsillitis.

Some people are more susceptible to tonsillitis than others. Children aged between five and fifteen are particularly susceptible to tonsillitis caused by bacterial infection, whereas children younger than five are more likely to get viral infections that lead to tonsillitis. Children spend lots of time in close contact with each other at school and infections tend to spread quickly between them. Adults who work with children are also at higher risk of getting tonsillitis.

Elderly adults are at a higher risk of tonsillitis than other adults. As the body gets older its immune system becomes weaker and has a harder time fighting off infections. As a result, elderly people are more likely to contract the viral or bacterial infections that cause tonsillitis.

How is tonsillitis diagnosed?

A physical examination is the first step in diagnosing tonsillitis. A doctor will look at your throat to see if the tonsils appear inflamed, swollen, red, or coated with pus. They might take your temperature to check for a fever, feel the sides of the neck for signs of pain and swelling of the glands, and look in the nose and ears for signs of infection.

Sometimes it is necessary to determine the cause of tonsillitis to choose the best way to treat it. This might involve a throat swab, in which a cotton swab is run along the back of the throat to collect saliva and cells. The swab is tested for the presence of streptococcus bacteria. If none is found, the cause of the infection must be viral. Blood tests can also be used to determine the cause of the infection.

Are there any complications of tonsillitis?

When tonsillitis is caused by a bacterial infection several complications can occur. The infection could develop into a middle ear infection, or it could spread to other nearby tissues and cause cellulitis, a serious condition in which deep layers of tissue become infected. When tonsils become very swollen the ability to breathe soundly can be affected and this can cause obstructive sleep apnoea in which breathing stops and starts during sleep. If pus collects around the tonsils this can create what is known as a peritonsillar abscess which in severe cases can block the throat and inhibit speaking, swallowing and breathing.

When a streptococcus infection is left untreated, it can develop into more serious problems such as:

– Sinusitis which causes inflammation of the tissues lining the sinuses;
– Rheumatic fever which can damage the joints, heart and nervous system;
– Scarlet fever which causes a bright red bumpy rash on the skin;
– Glomerulonephritis which is a serious infection of the kidneys.

How is tonsillitis treated?

Medication is the most common treatment method for bacterial tonsillitis. Antibiotics, commonly administered via pills, usually helps symptoms to improve within a few days. However, it’s important to complete the full course of prescribed antibiotics to ensure the infection is properly treated, even if your symptoms go away.

When tonsillitis is caused by a virus, antibiotics do not help and the body must fight off the virus itself. In these cases, home remedies can help to manage symptoms and relieve discomfort. The following tips are useful:

– Get plenty of rest
– Drink warm or very cold fluids to alleviate pain in the throat
– Eat smooth foods that are easy to swallow such as jelly, ice cream and soup
– Gargle with warm saltwater
– Take paracetamol or ibuprofen to manage the pain
– Suck throat lozenges

When tonsillitis is chronic or recurring, it might be helpful to remove the tonsils in a procedure called a tonsillectomy. However, since the tonsils are an integral part of the immune system, tonsillectomy is not performed without very good reason. If a patient has had multiple episodes of debilitating tonsillitis in a relatively short period, or their tonsils are so enlarged that it is making it difficult to breathe or swallow, tonsillectomy may be warranted.

If you have suffered from repeated or serious tonsillitis and are interested in tonsillectomy surgery, contact us to arrange a consultation with one of our throat specialists to learn if the procedure is right for you.