What is Tonsillitis?

Tonsillitis is inflammation of the tonsils, two oval-shaped pads of tissue at the back of the throat — one tonsil on each side. Signs and symptoms of tonsillitis include swollen tonsils, sore throat and difficulty swallowing.

Most cases of tonsillitis are caused by infection with a common virus, but a bacterial infection also may cause tonsillitis.

Because appropriate treatment for tonsillitis depends on the cause, it's important to get a prompt and accurate diagnosis. Surgery to remove tonsils, once a common procedure to treat tonsillitis, is usually performed only when tonsillitis occurs frequently, does not respond to other treatments or causes serious complications.

Symptoms

Tonsillitis most commonly affects children between preschool ages and the mid-teenage years. Common signs and symptoms of tonsillitis include:

1) Red, swollen tonsils
2) White or yellow coating or patches on the tonsils
3) Sore throat
4) Difficult or painful swallowing
5) Fever
6) Enlarged, tender glands (lymph nodes) in the neck
7) A scratchy, muffled or throaty voice
8) Bad breath
9) Stomachache, particularly in younger children
10) Stiff neck
11) Headache

In young children who are unable to describe how they feel, signs of tonsillitis may include:

1) Drooling due to difficult or painful swallowing
2) Refusal to eat
3) Unusual fussiness
4) A sore throat that doesn't go away with the first drink or two in the morning
5) Painful or difficult swallowing
6) Extreme weakness, fatigue or fussiness
7) Has difficulty breathing
8) Has extreme difficulty swallowing
9) Is drooling

Causes

Tonsillitis is most often caused by a common cold virus, but other viral and bacterial infections can also be the cause.

The most common bacterium causing tonsillitis is Streptococcus pyogenes, or group A streptococcus, the bacterium that causes most cases of strep throat.

Western Medicine Treatment

At-home care

Whether tonsillitis is caused by a viral or bacterial infection, at-home care strategies can make your child more comfortable and promote better recovery.

If a virus is the expected cause of tonsillitis, these strategies are the only treatment. Your doctor will not prescribe antibiotics. Your child will likely be better within seven to 10 days. At-home care strategies to use during the recovery time include the following:

1) Encourage rest. Encourage your child to get plenty of sleep and to rest his or her voice.
2) Provide adequate fluids. Give your child plenty of water to keep the throat moist and prevent dehydration.
3) Provide comforting foods and beverage. Warm liquids like broth, caffeine-free tea or warm water with honey, and cold treats like ice pops can soothe a sore throat.
4) Prepare a saltwater gargle. If your child can gargle, a saltwater gargle of 1 teaspoon (5 milliliters) of table salt to 8 ounces (237 milliliters) of warm water can help soothe a sore throat. Have your child gargle the solution and then spit it out.
5) Humidify the air. Use a cool-air humidifier to eliminate dry air that may further irritate a sore throat, or sit with your child for several minutes in a steamy bathroom.
6) Offer lozenges. Children older than age 4 can suck on lozenges to relieve a sore throat.
7) Avoid irritants. Keep your home free from cigarette smoke and cleaning products that can irritate the throat.
8) Treat pain and fever. Talk to your doctor about using ibuprofen (Advil, Motrin, others) or acetaminophen (Tylenol, others) to minimize throat pain and control a fever. Aspirin has been linked with Reyes syndrome, so use caution when giving aspirin to children or teenagers. Though aspirin is approved for use in children older than age 2, children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. Talk to your doctor if you have concerns.

Antibiotics

If tonsillitis is caused by a bacterial infection, your doctor will prescribe a course of antibiotics. Penicillin taken by mouth for 10 days is the most common antibiotic treatment prescribed for tonsillitis caused by group A streptococcus. If your child is allergic to penicillin, your doctor will prescribe an alternative antibiotic.

Your child must take the full course of antibiotics as prescribed even if the symptoms go away completely. Failure to take all of the medication as directed may result in the infection worsening or spreading to other parts of the body. Not completing the full course of antibiotics can, in particular, increase your childs risk of rheumatic fever and serious kidney inflammation. Talk to your doctor or pharmacist about what to do if you forget to give your child a dose.

Surgery

Surgery to remove tonsils (tonsillectomy) may be used to treat frequently recurring tonsillitis, chronic tonsillitis, or bacterial tonsillitis that does not respond to antibiotic treatment. Frequent tonsillitis is generally defined as:

1) More than six episodes in one year
2) More than four episodes a year over two years
3) More than three episodes a year over three years

A tonsillectomy may also be performed if tonsillitis results in difficult to manage complications, such as:

1) Obstructed sleep apnea
2) Breathing difficulty
3) A peritonsillar abscess that doesn't improve with antibiotic treatment

Tonsillectomy is usually done as a one-day surgery. That means your child should be able to go home the day of the surgery. A complete recovery usually takes seven to 10 days.

Adopted From mayoclinic.com