What Is Tonsillitis?
Tonsillitis is an infection of your tonsils, two masses of tissue at the back of your throat.
Your tonsils act as filters, trapping germs that could otherwise enter your airways and cause infection. They also make antibodies to fight infection. But sometimes, they get overwhelmed by bacteria or viruses. This can make them swollen and inflamed.
Tonsillitis is common, especially in children. It can happen once in a while or come back again and again in a short period.
There are three types:
- Acute tonsillitis. These symptoms usually last 3 or 4 days but can last up to 2 weeks.
- Recurrent tonsillitis. This is when you get tonsillitis several times in a year.
- Chronic tonsillitis. This is when you have a long-term tonsil infection.
The main symptoms of tonsillitis are inflamed and swollen tonsils, sometimes severe enough to make it hard to breathe through your mouth. Other symptoms include:
- Throat pain or tenderness
- Red tonsils
- A white or yellow coating on your tonsils
- Painful blisters or ulcers on your throat
- Loss of appetite
- Ear pain
- Trouble swallowing
- Swollen glands in your neck or jaw
- Fever and chills
- Bad breath
- A scratchy or muffled voice
- Stiff neck
Tonsillitis Symptoms in Children
In children, symptoms may also include:
- Upset stomach
- Stomach pain
- Not wanting to eat or swallow
Tonsillitis Causes and Risk Factors
Bacterial and viral infections cause tonsillitis. A common cause is Streptococcus (strep) bacteria, which can also cause strep throat. Other common causes include:
- Influenza virus
- Epstein-Barr virus
- Parainfluenza viruses
- Herpes simplex virus
Some things may put you at greater risk of getting tonsillitis:
- Age.Children tend to get tonsillitis more than adults. Kids who are between the ages of 5 and 15 are more likely to get tonsillitis caused by bacterial infections. Tonsillitis from viral infections are more common in very young children. Elderly adults are at higher risk for tonsillitis too.
- Germ exposure.Children also spend more time with other kids their age in school or camp, so they can easily spread infections that lead to tonsillitis. Adults who spend a lot of time around young children, such as teachers, may also be more likely to pick up infections and get tonsillitis.
Your doctor will do a physical exam. They’ll look at your tonsils to see if they’re red or swollen or have pus on them. They’ll also check for a fever. They may look in your ears and nose for signs of infection and feel the sides of your neck for swelling and pain.
You might need tests to find the cause of your tonsillitis. They include:
- A throat swab. Your doctor will test saliva and cells from your throat for strep bacteria. They’ll run a cotton swab along the back of your throat. This might be uncomfortable but won’t hurt. Results are usually ready in 10 or 15 minutes. Sometimes, your doctor will also want a lab test that takes a couple of days. If these tests are negative, a virus is what caused your tonsillitis.
- A blood test. Your doctor may call this a complete blood cell count (CBC). It looks for high and low numbers of blood cells to show whether a virus or bacteria caused your tonsillitis.
- Rash.Your doctor will check for scarlatina, a rash linked to strep throat infection.
Complications usually happen only if bacteria caused your infection. They include:
- A collection of pus around your tonsil (peritonsillar abscess)
- Middle ear infection
- Breathing problems or breathing that stops and starts while you sleep (obstructive sleep apnea)
- Tonsillar cellulitis, or infection that spreads and deeply penetrates nearby tissues
Tonsillitis and Strep Infection
If you have strep bacteria and don’t get treatment, your illness could lead to a more serious problem, including:
- Rheumatic fever
- Scarlet fever
- A kidney infection called glomerulonephritis
Your treatment will depend in part on what caused your illness.
If your tests find bacteria, you’ll get antibiotics. Your doctor might give you these drugs in a one-time injection or in pills that you’ll swallow for several days. You’ll start to feel better within 2 or 3 days, but it’s important to take all of your medication.
If you have a virus, antibiotics won't help, and your body will fight the infection on its own. In the meantime, you can try some home remedies:
- Get lots of rest
- Drink warm or very cold fluids to help with throat pain
- Eat smooth foods, such as flavored gelatins, ice cream, and applesauce
- Use a cool-mist vaporizer or humidifier in your room
- Gargle with warm salt water
- Suck on lozenges with benzocaine or other medications to numb your throat
- Take over-the-counter pain relievers such as acetaminophen or ibuprofen
Tonsils are an important part of your immune system, so your doctor will try to help you keep them. But if your tonsillitis keeps coming back or won’t go away, or if swollen tonsils make it hard for you to breathe or eat, you might need to have your tonsils taken out. This surgery is called tonsillectomy.
Tonsillectomy used to be a very common treatment. But now, doctors only recommend it if tonsillitis keeps coming back. That means you or your child has tonsillitis more than seven times in one year, more than four or five times a year for the past two years, or more than three times a year for the past three years.
Usually, your doctor uses a sharp tool called a scalpel to take out your tonsils. But other options are available, including lasers, radio waves, ultrasonic energy, or electrocautery to remove enlarged tonsils.
Discuss your options with your doctor to decide the best treatment for you.
Tonsillectomy is an outpatient procedure, meaning you won’t need to stay in the hospital. It usually lasts less than an hour. You can probably go home a few hours after surgery.
Recovery usually takes 7 to 10 days. You may have some pain in your throat, ears, jaw, or neck after the surgery. Your doctor can tell you what drugs to take to help with this.
Get plenty of rest and drink lots of fluids while you’re recovering. But don’t eat or drink any dairy products for the first 24 hours.
You might have a low fever and see a little blood in your nose or mouth for several days after the surgery. If your fever is over 102 or you have bright red blood in your nose or mouth, call your doctor right away.
The best way to prevent tonsillitis is through good hygiene, including:
- Washing your hands often
- Not sharing food, drink, utensils, or personal items like toothbrushes with anyone
- Staying away from someone who has a sore throat or tonsillitis