Tonsillitis is an inflammation of the tonsils, the two pads of lymphoid tissue at the back of the throat. The tonsils are part of the immune system, functioning as the first line of defense against pathogens entering the body through the nose or mouth. Because of their role is protecting the body against infections, they can easily become infected or inflamed themselves. The immune function of the tonsils diminishes after puberty, so tonsillitis, a common ailment in children, is not usually found in adults. Tonsillitis is most often caused by a virus or a bacteria, usually a type of Streptococcus, but may also result from a fungal or parasitic infection. Although usually not considered a serious disorder, severe or untreated tonsillitis may result in complications.

Symptoms of Tonsillitis

Many of the symptoms of tonsillitis are similar to those of a strep throat or a common cold. Symptoms of tonsillitis may include:

  • Sore throat
  • Nasal congestion
  • Red, swollen tonsils with white or yellow spots
  • Fever
  • Headache
  • Laryngitis
  • Tender, swollen lymph nodes
  • Mouth breathing or bad breath
  • Stiff neck
  • Difficult or painful swallowing

Young children with tonsillitis may also experience stomach pain.

Diagnosis of Tonsillitis

Tonsillitis is typically diagnosed easily by physical examination since the tonsils are visibly red, swollen and covered with spots or sores. Tests for strep or cultures for other bacteria may be taken to ensure that the appropriate antibiotic is prescribed. If mononucleosis is suspected, a diagnostic test for that illness may also be administered.

Treatment of Tonsillitis

Tonsillitis caused by a virus can usually be treated at home through rest, gargling salt water and drinking plenty of warm liquids. Throat pain can be alleviated with over-the-counter pain medication and sucking on lozenges. When tonsillitis is caused by a bacterial infection, usually Streptococcus, antibiotics are prescribed.

In the past, it was common to surgically remove the tonsils as a treatment for tonsillitis. At present, a tonsillectomy, is only considered necessary if the patient has had several infections in a short period of time, or is suffering an ongoing case of tonsillitis that does not respond to treatment with medication. A tonsillectomy may be performed in a variety of ways and is often combined with the removal of the adenoids. The surgical method chosen is dependent on the patient’s overall medical condition and the severity of the infection.

Complications of Tonsillitis

Left untreated, tonsillitis can result in serious medical problems, either from the obstructive enlargement of the tonsils or from the systemic spread of bacteria. These may include:

  • Respiratory difficulty
  • Sleep apnea
  • Tonsillar cellulitis
  • Tonsillar abscess

If tonsillitis caused by a strep infection is left untreated, the following complications may occur:

  • Rheumatic fever
  • Kidney disorders

Because of the dangerous consequences of untreated tonsillitis, it is important to have severe sore throats examined, diagnosed and treated promptly.

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