What Is Tonsillitis? Who Gets Tonsillitis?

The tonsils are fleshy pieces of lymphatic tissue that rest in the back of the throat above and below the tongue. As part of the immune system, the tonsils help fight infections. However, if bacteria or viruses contaminate the tonsils, the result is an infectious inflammation and swelling of the tonsils - or tonsillitis.

Tonsillitis is often labeled as acute, subacute, or chronic. Acute tonsillitis tends to be bacterial or viral in nature, while subacute tonsillitis is caused by the bacterium Actinomyces. Chronic tonsillitis generally lasts for a long time and is caused by bacteria.

Who gets tonsillitis?

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Although tonsillitis can occur at any age, children are much more likely to suffer from the condition. In fact, tonsillitis is more common in anyone who spends time in a school, child care facility, or other environment where people are in close contact and germs can be easily spread.

What causes tonsillitis?

Tonsillitis has both viral and bacterial causes, though most cases are caused by viruses such as Epstein-Barr (associated with mononucleosis) and adenovirus. When tonsillitis is caused by the Group A streptococcal bacteria, the condition is more commonly termed "strep throat". There have also been fungal and parasitic causes of tonsillitis.

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Most infections begin when a person breathes in bacteria- or virus-infected droplets that another person has breathed, coughed, or sneezed out. Other types of contact, though, can also spread the infection. As a first line of defense, the tonsils filter much of what is inhaled through the mouth and nose. The tonsils may swell and become infected themselves as they are collecting white blood cells to fight off bacteria and viruses.

What are the symptoms of tonsillitis?

Common tonsillitis symptoms include sore throat, visibly red and swollen tonsils, white patches on the tonsils, fever, headache, difficulty swallowing, stomach pain, loss of voice, enlarged lymph nodes in the neck and jaw, runny or stuffy nose, sneezing, and coughing. Viral tonsillitis will usually result in cold-like symptoms, whereas bacterial tonsillitis usually results in sudden and severe fever along with swollen lymph nodes and without cold-like symptoms.

How is tonsillitis diagnosed?

A physical examination will allow a doctor to find red and swollen tonsils, white patches on the tonsils, and other key indicators of tonsillitis. A complete blood cell count (CBC) can help determine the origin of the infection. A strep test (throat swab) may be employed to determine if the case of tonsillitis is the bacterial infection known as strep throat. If it is determined that the cause is viral, a physician may order a test for mononucleosis. A common blood test can help distinguish between mononucleosis and tonsillitis.

How is tonsillitis treated?

Treatments for tonsillitis vary from doing nothing to surgically removing the tonsils. When caused by a virus, tonsillitis often goes away in a few days and treatments are designed to manage symptoms. This includes gargling salt water, drinking warm liquids such as tea and broth, sucking on lozenges, and taking over-the-counter pain killers such as acetaminophen. For bacterial tonsillitis and strep throat, treatment generally consists of antibiotics such as penicillin or erythromycin.

The most serious and invasive treatment is removal of the tonsils, or tonsillectomy. This is only recommended when a doctor finds something seriously wrong with the tonsils such as long-lasting recurring infections that do not respond to other treatments. Adults with recurrent sore throats may benefit from having a tonsillectomy in the short term, but the overall longer term benefit is still unclear, a study revealed. An adenotonsillectomy, which provides improvement in the upper airway of children, may in turn lead to improvement of the lower airways of children, especially those with bronchial asthma, this study found.

How can tonsillitis be prevented?

The best way to prevent tonsillitis is to avoid contact with the germs, bacteria, and viruses that cause the condition. Experts recommend to wash hands frequently, to avoid sharing glasses or utensils with sick individuals, and to cough and sneeze into a tissue or elbow.


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