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Tonsillitis: Treatment, symptoms, advice and help

About tonsillitis

Tonsillitis is an inflammatory condition of the tonsils which are masses of lymphoid tissue in the throat.

Tonsillitis: Incidence, age and sex

The incidence in general practice is 100 per 1000 population a year. Acute tonsillitis is more common in childhood. No gender predilection has been noted.

Signs & symptoms of tonsillitis: Diagnosis

The onset of tonsillitis is usually acute with fever and sore throat. Affected children also may have headache, nausea, vomiting and occasionally, abdominal pain. Usually, physical examination reveals pharyngeal erythema and tonsillar enlargement and enlargement of the nodes in the neck. The erythema can be associated with follicular lesions with areas of exudates. The presence of exudates has been thought in the past to be characteristic of group A streptococcal infection or infectious mononucleosis.

Causes & prevention of tonsillitis

In normal, healthy children, more than 90% of all cases of tonsillitis are caused by the following organisms, listed in order of decreasing frequency of occurrence: group A beta-hemolytic streptococci; adenoviruses; influenza viruses A and B; parainfluenza viruses 1, 2, and 3; Epstein-Barr virus; enteroviruses; and Mycoplasma pneumoniae.

Tonsillitis: Complications

Streptococcal tonsillitis can have significant suppurative complications, including peritonsillar abscess and bacteremia. After a latency period of several days, contiguous or lymphatic spread of local infection, septicemia, and septic metastases may occur.

Infection with group A streptococci can have significant non-suppurative complications like acute rheumatic fever and acute glomerulonephritis.

Tonsillitis: Treatment

The majority of tonsillitis episodes are viral and self-limiting, lasting from 4 to 10 days, depending on the cause.

Palliative treatments to reduce the discomfort from tonsillitis symptoms include pain relief with anti-inflammatory drugs, fever-reducing medications (acetaminophen, ibuprofen, aspirin),sore throat relief (salt water gargle, lozenges, and warm liquids), hydration and rest

Specific therapy is indicated for streptococcal pharyngitis. Intramuscular benzathine penicillin or a 10-day course of oral penicillin remains the treatment of choice because of the proven efficacy (>90%), safely, narrow spectrum, and low cost. Erythromycin is a suitable alternative for patients sensitive to penicillin. Certain cephalosporins and macrolides have been reported to achieve comparable cure rates when these drugs were given for 5 days or less. Where the palatine tonsils become so swollen that swallowing is impaired, a tonsillectomy may be performed to remove the tonsils.