Tonsillitis
Introduction
Open your mouth wide in front of a mirror. Do you see your tonsils? They're located on each side of your throat, just behind and above your tongue.
Years ago, many young children had their tonsils removed. In fact, surgery was once the standard treatment for recurrent tonsillitis — inflammation of the tonsils caused by a viral or bacterial infection.
Today, tonsils are recognized for their role in filtering harmful bacteria and viruses that could cause more serious infections. When tonsillitis strikes, the first line of treatment is typically self-care or antibiotics. Surgery is seldom necessary, unless tonsillitis recurs often or it interferes with breathing or swallowing.
Signs and symptoms
Tonsillitis is characterized by red, swollen tonsils. You may also notice white patches on the tonsils. Other signs and symptoms of tonsillitis include:
- Severe sore throat
- Difficult or painful swallowing
- Headache
- Fever and chills
- Enlarged, tender glands (lymph nodes) in the jaw and neck
- Loss of voice
Causes
When bacteria and viruses enter your body through your nose or mouth, your tonsils act as a filter — engulfing the offending organisms in white blood cells. This may cause a low-grade infection in your tonsils, which stimulates your immune system to form antibodies against future infections. But sometimes the tonsils are overwhelmed by a bacterial or viral infection. The result is tonsillitis.
Various viruses and bacteria can cause tonsillitis, including the virus that causes mononucleosis (the Epstein-Barr virus) and the bacterium that causes strep throat (Streptococcus pyogenes).
Treatment
Tonsillitis is typically treated with self-care or antibiotics. Although surgery is no longer the standard treatment for tonsillitis, it may be recommended in some cases.
Self-care
If tonsillitis is caused by a viral infection, you'll need to let the virus run its course. Recovery may take a week or two. In the meantime, get plenty of rest. Drink warm, soothing liquids — such as soup, broth and tea — and gargle with warm salt water. Acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others) can help reduce fever and decrease pain. Because of the risk of Reye's syndrome — a potentially life-threatening illness — don't give aspirin to children younger than age 12.
Antibiotics
If tonsillitis is caused by a bacterial infection, your doctor will prescribe antibiotics. Oral antibiotics typically need to be taken for at least 10 days. Although you'll probably feel better in a day or two, it's important to finish the full course of antibiotics. Stopping medication early may cause the infection to come back — which can lead to potentially serious complications.
If your child has a positive strep test, he or she needs to complete at least 24 hours of antibiotic treatment before returning to school or child care. If your child has difficulty swallowing, antibiotics may be given by injection.
Surgery
Surgical removal of the tonsils (tonsillectomy) is rarely needed for adults. During childhood, surgery may be recommended if:
- Your child has seven or more episodes of tonsillitis in one year
- Your child has five or more episodes of tonsillitis a year for two years
- Swollen tonsils interfere with your child's breathing or swallowing
- An abscess develops in the tonsils
After surgery, your child's throat will be sore. He or she may have ear pain as well. Encourage your child to suck on ice cubes or frozen fruit pops, eat ice cream or sherbet, and drink cold liquids. You may want to use a cool-mist humidifier in your child's bedroom. While your child is recovering, keep in mind that he or she will be more susceptible to infection than usual. Avoid crowds and exposure to anyone who may be ill. If your child begins to bleed from the mouth, report it to the doctor immediately.
Prevention
Frequent hand washing is the best way to prevent all kinds of infections, including tonsillitis. Wash your hands often, and encourage your children to do the same.
When you use soap and water:
- Wet your hands with warm, running water and apply liquid or clean bar soap. Lather well.
- Rub your hands vigorously for at least 15 seconds. Encourage your children to wash for as long as it takes to sing their ABCs, "Row, Row, Row Your Boat" or the "Happy Birthday" song.
- Scrub all surfaces, including the backs of your hands, wrists, between your fingers and under your fingernails.
- Rinse well.
- Dry your hands with a clean towel.
- Use a towel to turn off the faucet.
Other common-sense precautions apply, too. Cough or sneeze into your elbow or a tissue. Don't share drinking glasses or eating utensils. Avoid close contact with anyone who's sick. Look for a child care setting with sound hygiene practices and clear policies about keeping sick children at home.
Credit: National Institute of Health.