What is Tonsillitis?

Tonsillitis is the inflammation of the tonsils, usually due to infection. The tonsils are part of the body’s lymphatic system and act as the first line of defense against pathogens. When they become infected, they swell, turn red, and may develop white or yellow patches.

Tonsillitis can occur as:

Acute tonsillitis – short-term infection, usually lasting 7–10 days.

Chronic tonsillitis – long-term or recurrent inflammation that happens multiple times a year.

Recurrent tonsillitis – repeated episodes of acute tonsillitis.

Tonsillitis is a common infection of the tonsils, which are two oval-shaped masses of lymphoid tissue located at the back of the throat. The tonsils play an important role in the immune system by trapping germs that enter through the mouth and nose. However, when these tissues themselves become infected, the condition is known as tonsillitis.https://en.wikipedia.org/wiki/Tonsillitis

Causes of Tonsillitis

Tonsillitis can result from viral or bacterial infections.

Viral Causes

Viruses are the most common cause of tonsillitis. Some common viruses include:

• Adenovirus
• Influenza virus
• Parainfluenza virus
• Enteroviruses
• Herpes simplex virus
• Epstein-Barr virus (EBV), which causes mononucleosis

Bacterial Causes

The most common bacterial cause is Group A Streptococcus (Streptococcus pyogenes), which also causes strep throat. Other bacteria include:

• Staphylococcus aureus
• Haemophilus influenzae
• Mycoplasma pneumoniae

Risk Factors

• Children between 5–15 years
• Exposure to crowded environments (schools, hostels)
• Weakened immune system
• Seasonal infections (cold and flu season)

Symptoms of Tonsillitis

The symptoms of tonsillitis may vary depending on the cause, severity, and age of the patient.

Common Symptoms:

• Severe sore throat
• Red, swollen tonsils
• White or yellow coating on tonsils
• Painful swallowing (odynophagia)
• Fever and chills
• Bad breath (halitosis)
• Swollen lymph nodes in the neck
• Headache and earache
• Fatigue and body aches

In Children:

• Irritability
• Poor appetite
• Excessive drooling (in younger children)

Types of Tonsillitis

1. Acute Tonsillitis – Sudden onset, lasts less than 2 weeks.
2. Chronic Tonsillitis – Persistent inflammation, can last for months.
3. Recurrent Tonsillitis – Several episodes per year, requiring further evaluation.
4. Peritonsillar Abscess (Quinsy) – Complication where pus collects around the tonsils.

Diagnosis of Tonsillitis

A healthcare provider may diagnose tonsillitis based on medical history, symptoms, and physical examination.

Diagnostic Steps:

1. Physical Examination

• Red, swollen tonsils
• White/yellow patches (exudates)
• Swollen neck lymph nodes

2. Throat Swab Test

• Rapid strep test (detects Streptococcus bacteria)
• Throat culture (for detailed analysis)

3. Blood Tests

• Complete blood count (CBC) to check for viral vs bacterial infection
• Monospot test (for mononucleosis)

Treatment of Tonsillitis

Treatment depends on whether the cause is viral or bacterial.

1. Home Remedies and Supportive Care (for Viral Tonsillitis)

• Drinking warm fluids (tea, soup)
• Gargling with warm salt water
• Using throat lozenges
• Taking over-the-counter pain relievers (acetaminophen, ibuprofen)
• Using a humidifier to moisten the air

2. Medical Treatment (for Bacterial Tonsillitis)

• Antibiotics – Penicillin or amoxicillin is usually prescribed. In case of penicillin allergy, azithromycin or clindamycin may be used.
• Pain relievers – Paracetamol or ibuprofen to reduce fever and throat pain.

⚠️ Important: Complete the full antibiotic course to prevent resistance and complications.

3. Surgical Treatment – Tonsillectomy

If tonsillitis is recurrent, chronic, or causes complications, surgery may be recommended.

Indications for Tonsillectomy:

• 7 or more episodes in 1 year
• 5 episodes per year for 2 consecutive years
• 3 episodes per year for 3 consecutive years
• Difficulty breathing or swallowing due to enlarged tonsils
• Sleep apnea caused by enlarged tonsils
• Abscess formation

Tonsillectomy can be done using:

• Cold knife (scalpel)
• Electrocautery
• Laser
• Coblation (radiofrequency energy)

Complications of Tonsillitis

• If untreated, tonsillitis may lead to complications such as:
• Peritonsillar abscess (Quinsy) – collection of pus near tonsil
• Rheumatic fever – inflammation affecting heart, joints, and skin
• Post-streptococcal glomerulonephritis – kidney inflammation
• Obstructive sleep apnea – due to enlarged tonsils
• Spread of infection – to chest, sinuses, or bloodstream (sepsis)

Prevention of Tonsillitis

• While it may not always be preventable, certain measures reduce the risk:
• Maintain good hand hygiene
• Avoid close contact with sick individuals
• Do not share utensils, food, or drinks
• Keep surroundings clean and well-ventilated
• Strengthen immunity with a healthy diet, exercise, and proper sleep
• Cover mouth and nose when coughing or sneezing

Frequently Asked Questions (FAQs)

Q1. Is tonsillitis contagious?
Yes, viral and bacterial tonsillitis are contagious and can spread through coughing, sneezing, and close contact.

Q2. How long does tonsillitis last?
Acute tonsillitis usually lasts 7–10 days, but chronic cases may persist or recur.

Q3. Can tonsillitis go away without antibiotics?
Yes, if caused by a virus, it usually resolves on its own with supportive care. Antibiotics are only needed for bacterial cases.

Q4. Does removing tonsils weaken the immune system?
No, other lymphoid tissues in the throat take over the immune functions, so removal does not significantly affect immunity.

Q5. What foods should be avoided during tonsillitis?
Avoid spicy, acidic, or hard foods. Stick to soft, warm, and soothing foods like soups, mashed potatoes, and yogurt.

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