Tonsilitis

The symptoms of tonsillitis generally occur suddenly and may include:

• Fever (≤ 38℃)
• Lymph node swellings
• Swelling and redness of the tonsils
• White or yellow coating on the tonsils
• Sore throat
• Mouth ulcers
• Difficulty in swallowing
• Rashes on the roof of the mouth
• Strawberry tongue
• Bad breath
• Decreased appetite
• Fatigue

Note: Typically, there is an absence of symptoms associated with a viral upper respiratory infection, such as conjunctivitis, runny nose, or cough.

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Tonsillitis can be caused by both bacteria and viruses. Common bacteria that cause tonsillitis include:

• Beta-hemolytic streptococci
• Other streptococci

Though the role of viruses is uncertain, the most common infective agent in causing tonsillitis is the Epstein–Barr virus, which is present in:

• 50% of children
• 90% of adults

Cytomegalovirus is another virus that can cause tonsillitis.

Want to understand better how respiratory viruses spread? Watch this video now.

Tonsillitis affects the younger age group and is mainly caused by infections with bacteria or viruses. Risk factors that can increase your chances of developing tonsillitis include:

• Frequent exposure to viruses or bacteria: School-age children are usually in close contact with their friends and peers, which increases their exposure to viruses or bacteria that can cause tonsillitis.
• Young age: Studies show that the peak incidence of acute tonsillitis is observed in young children, especially those of school-going age, but it can occur at any age.
• Being immunocompromised: A decrease in immunity can be a major risk factor for inflammation of the tonsils, leading to tonsillitis.
• Environmental pollution: Air pollution can significantly increase the incidence of swollen adenoids and tonsillitis in children. Additionally, sore throat is a common side effect of exposure to polluted air.
• Colder climates: Cold weather can impact your tonsils, as tonsillitis is more likely to recur during seasonal changes, especially in winter.
• Genetics: Research suggests that genetic inheritance may determine the severity of tonsillar damage in pediatric patients with a history of recurrent chronic tonsillitis in both parents.
• Diabetes: Studies indicate that individuals with diabetes have a higher risk of infections. Infections and issues with the ears, nose, and throat, such as tonsillitis, can be symptoms of diabetes.
• Prolonged use of corticosteroids: Corticosteroids can increase the risk of infections due to their wide-ranging effects on the immune system, potentially leading to tonsillitis.
• Obesity: Research suggests a possible link between being overweight or obese and ear infections, which can also affect the throat, such as tonsillitis.

Accurately diagnosing tonsillitis is important to reduce the further spread of infection and to limit complications. Diagnosis includes:

1. History: A complete history provides important information to determine whether the patient has a sore throat or deeper pain in the throat or neck.

2. Physical Examination: Diagnosis of tonsillitis is mainly clinical and is performed by:

   • Carefully examining the throat at the infection site with light instruments
   • Checking for any rash in the throat
   • Observing for a 'toxic' appearance and signs of dehydration
   • Palpating the neck to check for swollen lymph nodes
   • Listening to the patient's voice
   • Checking for any enlargement of the spleen (which can be a symptom of tonsillitis)

3. Laboratory Tests:

   • Throat Swab: This is a simple test in which doctors rub a sterile swab over the back of the throat to collect samples of secretions. The samples are later checked in the lab or clinic.
   • Rapid Antigen Test: Although it may have low sensitivity in diagnosing bacterial tonsillitis, the results for the presence of infection (positive or negative) are obtained very quickly.
   • Complete Blood Count (CBC): If the strep throat lab test is negative, a CBC is performed to determine the cause of tonsillitis. This test counts the number of different cells by taking small amounts of blood samples from patients.

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It can be a little difficult to prevent tonsillitis completely, but there are things you can do to reduce your risk. They include:

• Always wash your hands often, especially before touching your nose or mouth.
• Avoid sharing food, drink, or utensils with someone who is sick.
• Replace your toothbrush regularly, especially after an infection.
• Practice good oral care.
• Keep a safe distance from tonsillitis patients.
• Cover your mouth with a tissue or your hand when you cough or sneeze.
• Wash your hands after coughing or sneezing.
• Keep your child at home if they are sick.

The treatment of tonsillitis depends on whether the infection is viral or bacterial. Tonsillitis is very common and can be managed with proper rest and medications. The management consists of the following:

I. Medications

• Antibiotics: This therapy is indicated for patients with signs and symptoms of sore throat along with tonsillitis and laboratory confirmation of bacteria as the pathogen. The drugs include:
  • Penicillin V
  • Amoxicillin
  • Cephalexin
  • Clindamycin
  • Azithromycin
• Nonsteroidal anti-inflammatory drugs (NSAIDs): These medications are given to decrease inflammation and reduce fever. The commonly used drugs include:
  • Paracetamol
  • Ibuprofen
• Analgesics: These are a group of medications used to relieve pain. The most commonly used drugs to manage pain include:
  • Paracetamol
  • Naproxen
  • Ibuprofen

Note: Certain studies in adults and children show that corticosteroids in combination with antibiotic treatment provide symptomatic relief of pain and faster recovery. Get your medications online from India’s largest online pharmacy. Order Now.

II. Surgery

Tonsillectomy is the surgical removal of the tonsils. Tonsillectomy may be considered after careful consideration of the risks and benefits and a thorough discussion of the options with the patient. It is usually performed when tonsillitis occurs frequently or doesn't respond to other treatments.

The management of tonsillitis mainly depends on providing symptomatic relief along with a lot of rest. Some home remedies that can help relieve the symptoms include:

• Gargling with salt water: Rinsing or gargling your mouth with warm salt water can help soothe pain caused by tonsillitis. It can also reduce inflammation and may even help treat infections. Just add ½ a tablespoon of salt to a glass of warm water and gargle to see the difference.
• Using throat lozenges: Lozenges containing licorice have anti-inflammatory properties that can help soothe the discomfort and swelling in the tonsils and throat.
• Drinking warm tea with honey: Studies suggest that raw honey has flavonoids and anti-inflammatory effects. Warm beverages like tea can help reduce discomfort, and adding raw honey may help treat the infections causing tonsillitis.
• Trying cold therapy: Cold can be highly effective in treating pain, inflammation, and swelling. Popsicles, frozen drinks, ice chips, and ice cream can be particularly helpful for young children who can’t use other home remedies safely.
• Getting humidifiers: Humidifiers can help if you are experiencing dry mouth as a result of tonsillitis. Dry air can irritate the throat, and humidifiers can help decrease discomfort in the throat and tonsils by adding moisture back into the air.
• Drinking a lot of warm liquids: Drinking warm liquids, including soups, broths, and teas, can help soothe a sore throat. Herbal teas containing ingredients such as honey, pectin, or glycerine may help soothe irritation in the throat.
• Eating softer food items: For people with tonsillitis, eating hard or sharp foods can be uncomfortable and even painful. Individuals with tonsillitis should try eating softer foods that are easier to swallow.
• Not straining your voice: Swelling in the throat can cause the voice to become muffled. See a doctor immediately if you have too much pain while talking, as it can indicate a complication.

Tonsillitis, if left untreated, can lead to complications such as:

• Peritonsillar abscess/quinsy: This is the spread of infection beyond the tonsil that may lead to a collection of pus (abscess) within the space between the tonsils.
• Airway obstruction: This is a rare complication that requires immediate care, where surgical intervention may be considered an emergency.
• Post-Streptococcal glomerulonephritis: This is an inflammatory disorder of the kidneys that can manifest 1–2 weeks after a streptococcal throat infection.
• Rheumatic fever: Rheumatic fever is a rare but serious complication of untreated or partially treated tonsillitis caused by streptococcus bacteria.
• Scarlet fever: This is an infection caused by group A streptococci bacteria that affects the throat. This is the same bacteria that can cause tonsillitis.

Mild cases of tonsillitis can be managed with certain home remedies and plenty of rest. Some of the alternative therapies that have shown promising results include:

• Homeopathy: Tonsillitis is common among children, and homeopathy is very safe and highly effective in treating most cases of tonsillitis. Studies have shown that homeopathy can be quite effective in managing acute viral tonsillitis. Belladonna is the most commonly prescribed homeopathic medicine for tonsillitis.
• Acupuncture: This treatment can help reduce inflammation and provide analgesic pain relief for a sore throat. Studies demonstrate that certain acupoints are used to treat the common cold, influenza, acute tonsillitis, and other respiratory tract infections.

Recurrent and acute tonsillitis is very common among children. Managing kids can be quite a task, especially when they are sick. Some tips that can help parents manage their children with tonsillitis include:

• Treat their pain and fever.
• Give them soft and warm foods.
• Encourage them to drink plenty of fluids.
• Have them gargle with salt water.
• Provide throat sprays instead of lozenges.
• Make them as comfortable as possible.
• Be patient with them.

Note: Talk to your doctor to understand the reason behind the recurrent infections and get the appropriate treatment.

Read more about 10 things you need to do if your child has a fever.