Tonsillitis: Symptoms, Causes, and Treatments

At the back of your throat, two masses of tissue called tonsils act as filters, trapping germs that could otherwise enter your airways and cause infection. They also produce antibodies to fight infection. But sometimes the tonsils themselves become infected. Overwhelmed by bacteria or viruses, they swell and become inflamed, a condition known as tonsillitis.

Tonsillitis is common, especially in children. The condition can occur occasionally or recur frequently.

Causes and Symptoms of Tonsillitis

Bacterial and viral infections can cause tonsillitis. A common cause is Streptococcus (strep) bacteria. Other common causes include:

The main symptoms of tonsillitis are inflammation and swelling of the tonsils, sometimes severe enough to block the airways. Other symptoms include:

In children, symptoms may also include:

Treatments for Tonsillitis

Treatment for tonsillitis will depend in part on the cause. To determine the cause, your doctor may perform a rapid strep test or throat swab culture. Both tests involve gently swabbing the back of the throat close to the tonsils with a cotton swab. A lab test can detect a bacterial infection. A viral infection will not show on the test, but may be assumed if the test for bacteria is negative. In some cases, the physical findings are convincing enough to diagnose a probable bacterial infection. In these cases, antibiotics may be prescribed without performing a rapid strep test

If tests reveal bacteria, treatment will consist of antibiotics to cure the infection. Antibiotics may be given as a single shot or taken 10 days by mouth. Although symptoms will likely improve within two or three days after starting the antibiotic, it's important to take all of the medication your doctor prescribes to make sure the bacteria are gone. Some people need to take a second course of antibiotics to cure the infection.

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If the tonsillitis is caused by a virus, antibiotics won't work and your body will fight off the infection on its own. In the meantime, there are things you can do to feel better, regardless of the cause. They include:

  • Get enough rest
  • Drink warm or very cold fluids to ease throat pain
  • Eat smooth foods, such as flavored gelatins, ice cream, or applesauce
  • Use a cool-mist vaporizer or humidifier in your room
  • Gargle with warm salt water
  • Suck on lozenges containing benzocaine or other anesthetics
  • Take over-the-counter pain relievers such as acetaminophen or ibuprofen.

When Tonsillectomy Is Needed

Tonsils are an important part of the immune system throughout life, so it is best to avoid removing them. However, if tonsillitis is recurrent or persistent, or if enlarged tonsils cause upper airway obstruction or difficulty eating, surgical removal of the tonsils, called tonsillectomy, may be necessary. Most tonsillectomies involve using a conventional scalpel to remove the tonsils; however there are many alternatives to this traditional method. Increasingly doctors are using techniques such as lasers, radio waves, ultrasonic energy, or electrocautery to cut, burn, or evaporate away enlarged tonsils.

As with all surgeries, each of these has benefits and drawbacks. When considering the procedure, it's important to discuss your options with the surgeon to select the most appropriate one for your child.

What to Expect After Surgery

Tonsillectomy is an outpatient procedure performed under general anesthesia and typically lasting between 30 minutes and 45 minutes. It is most commonly performed in children.

Most children go home about four hours after surgery and require a week to 10 days to recover from it. Almost all children will have throat pain, ranging from mild to severe, after surgery. Some may experience pain in the ears, jaw, and neck. Your child's doctor will prescribe or recommend medication to ease the pain.

During the recovery period, it's important for your child to get enough rest. It's also important to make sure your child gets plenty of fluids; however, you should avoid giving your child milk products for the first 24 hours after surgery. Although throat pain may make your child reluctant to eat, the sooner your child eats, the sooner he or she will recover.

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For several days after surgery, your child may experience a low-grade fever and small specks of blood from the nose or saliva. If the fever is greater than 102 degrees Fahrenheit or if you see bright red blood, call your child's doctor right away. Prompt medical attention may be necessary.

WebMD Medical Reference Reviewed by Carol DerSarkissian on September 17, 2016

Sources

SOURCES:

Kliegman R.M., Behrman R.E., Jenson H.B., Stanton B.F., eds., Nelson Textbook of Pediatrics, 18th ed., Philadelphia, Saunders Elsevier, 2007.

American Academy of Otolaryngology -- Head and Neck Surgery: "Tonsils and Adenoids."

Nemours Foundation: "Tonsillitis."

University of Virginia Health System: "Tonsillitis."

WebMD Medical Reference from Healthwise: "Rapid strep test for strep throat," "Throat culture."

American Academy of Otolaryngology -- Head and Neck Surgery: "Fact Sheet: Tonsillectomy Procedures," "Fact Sheet: Fact Sheet: Tonsils and Adenoids PostOp."

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