Tonsillitis

Tonsillitis is an infection and swelling of the tonsils, which are oval-shaped masses of lymph gland tissue located on both sides of the back of the throat. The tonsils normally help to prevent infections. They act like filters totrap bacteria and viruses entering the body through the mouth and sinuses. The tonsils also stimulate the immune system to produce antibodies to help fight off infections. Anyone of any age can have tonsillitis; however, it is mostcommon in children between the ages of five and 10 years.

A mild or severe sore throat is one of the first symptoms of tonsillitis. Symptoms can also include fever, chills, tiredness, muscle aches, earache, painor discomfort when swallowing, and swollen glands in the neck. Very young children may be fussy and stop eating. When a doctor or nurse looks into the mouth with a flashlight, the tonsils may appear swollen and red. Sometimes, thetonsils will have white or yellow spots or flecks or a thin coating. The doctor will also examine the eyes, ears, nose, and throat, looking at the tonsilsfor signs of swelling, redness, or a discharge. A careful examination of thethroat is necessary to rule out diphtheria and other conditions that may cause a sore throat. Since most sore throats in children are caused by viruses rather than bacteria, the doctor may take a throat culture in order to test for the presence of streptococcal bacteria verify the results and wait for thelaboratory report before prescribing antibiotics. A blood test may also be done to rule out a more serious infection or condition, and to check thewhite blood cell count to see if the body is responding to the infection. Insome cases, the doctor may order blood tests for mononucleosis, since abouta third of patients with mononucleosis develop streptococcal infections of the tonsils.

Treatment of tonsillitis also involves keeping the patient comfortable whilethe illness runs its course. This supportive care includes bed rest, drinkingextra fluids, gargling with warm salt water, and taking pain relievers--usually NSAIDs--to reduce fever. Frozen juice bars and cold fruit drinks can bring some temporary relief of sore throat pain; drinking warm tea or broth can be soothing. If the patient has several episodes of severe tonsillitis, the doctor may recommend a tonsillectomy, which is the surgical removal of the tonsils.

Strengthening the immune system is important whether tonsillitis is caused bybacteria or viruses. Naturopaths often recommend dietary supplements of vitamin C, bioflavonoids, and beta-carotenes--found naturally in fruits and vegetables--to ease inflammation and fight infection. A variety of herbal remediesalso may be helpful in treating tonsillitis. As with any condition, the treatment and dosage should be appropriate for the particular symptoms and age ofthe patient.

Tonsillitis usually resolves within a few days with rest and supportive care.Treating the symptoms of sore throat and fever will make the patient more comfortable. If fever persists for more than 48 hours, however, or is higher than 102°F, the patient should be seen by a doctor. If antibiotics are prescribed to treat an infection, they should be taken as directed for the complete course of treatment, even if the patient starts to feel better in a few days. Prolonged symptoms may indicate that the patient has other upper respiratory infections, most commonly in the ears or sinuses. An abscess behind the tonsil (a peritonsillar abscess) may also occur. In rare cases, a persistent sore throat may point to more serious conditions, such as rheumatic fever or pneumonia.

The bacteria and viruses that cause tonsillitis are easily spread from personto person. It is not unusual for an entire family or several students in thesame classroom to come down with similar symptoms, especially if S. pyogenes is the cause. The risk of transmission can be lowered by avoiding exposure to anyone who already has tonsillitis or a sore throat. Drinking glasses and eating utensils should not be shared and should be washed in hot, soapywater before reuse. Old toothbrushes should be replaced to prevent reinfection. People who are caring for someone with tonsillitis should wash their hands frequently, to prevent spreading the infection to others.

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