tonsillitis

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More about Tonsillitis: Causes and symptoms Diagnosis Treatment Alternative treatment Prognosis Prevention Resources

Definition

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.

Description

The tonsils normally help to prevent infections. They act like filters to trap 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 most common in children between the ages of five and 10 years.

— Altha Roberts Edgren

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n.

Inflammation of the tonsils.

tonsillitic ton'sil·lit'ic (-lĭt'ĭk) adj.

An inflammation of the tonsil. Tonsillitis is a nonspecific term usually referring to bacterial or viral infection involving all or part of Waldeyer's ring, a collection of lymphatic tissue encircling the pharynx. It consists primarily of the tonsils (palatine tonsils), adenoids (pharyngeal tonsils), and lingual tonsils.

The complication of tonsillitis depend on which tonsil is involved. Recurrent adenoiditis with adenoid hypertrophy is frequently associated with recurrent otitis media, middle-ear fluid, and at times nasal obstruction with mouth breathing and snoring. Acute palatine tonsillitis may be complicated by peritonsillar abscess which may develop lateral to the tonsillar capsule. Removal of the adenoids is considered when there is residual middle-ear fluid. Palatine tonsils must be removed after peritonsillar abscess, but otherwise their removal depends upon the frequency of recurrent attacks of bacterial pharyngotonsillitis in relation to the patient's age. See also Tonsil.

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(ton′silī′tis)
n

Inflammation of the tonsils.

Tonsillitis. (Neville/Damm/Allen/Bouquot, 2002)

Definition

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.

Description

The tonsils normally help to prevent infections. They act like filters to trap bacteria and viruses entering the body through the mouth and sinuses. The tonsils also stimulate the immune system to produce antibodies which fight off infections. Anyone can have tonsillitis; however, it is most common in children between the ages of five and 10 years.

Causes & Symptoms

Tonsillitis is caused by viruses or bacteria that cause the tonsils to swell and become inflamed. A mild or severe sore throat is one of the first symptoms of tonsillitis. Symptoms can also include fever, chills, lethargy, muscle aches, earache, pain or discomfort when swallowing, and swollen glands in the neck. Young children may be fussy and stop eating. When a doctor or nurse looks into the mouth with a otoscope, the tonsils may appear swollen and red. Sometimes they will have white or yellow spots and a thin mucous coating. Symptoms usually last four to six days.

Diagnosis

The diagnosis of tonsillitis is made from the visible symptoms and a physical examination of the patient. The doctor will examine the eyes, ears, nose, and throat, looking at the tonsils for signs of swelling, redness, or a discharge. A careful examination of the throat 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 or rapid diagnostic test in order to test for the presence of streptococcal bacteria. A throat culture is performed by wiping a cotton swab across the tonsils and back of the throat and sending the swab to a laboratory for culturing. Streptococcus pyogenes, the bacterium that causes strep throat, is the most common disease agent responsible for tonsillitis. Depending on what type of test is used for strep, the doctor may be able to determine within a few minutes if S. pyogenes is present. The quick tests for strep are not as reliable as a laboratory culture, which can take 24-48 hours. If the results of a quick test are positive, however, the doctor can prescribe antibiotics right away. If the quick test results are negative, the doctor can do a throat culture to verify the results and wait for the laboratory report before prescribing antibiotics. A blood test may also be done to rule out a more serious infection or condition, and to check the white blood cell count to see if the body is responding to the infection. In some cases, the doctor may order blood tests for mononucleosis, since about a third of patients with mononucleosis develop infections in the tonsils.

Treatment

Treatment of tonsillitis usually involves keeping the patient comfortable while the illness runs its course. This supportive care includes bed rest, drinking extra fluids, gargling with warm salt water, and taking pain relievers to reduce fever. Frozen juice bars and cold fruit drinks can bring some temporary relief of sore throat pain and drinking warm tea or broth can be soothing.

Strengthening the immune system is important whether tonsillitis is caused by bacteria 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 remedies also may be helpful in treating tonsillitis. Calendula (Calendula officinalis) and cleavers (Galium aparine) target the lymphatic system, while echinacea (Echinacea spp.) and astragalus (Astragalus embranaceus) stimulate the immune system. Goldenseal (Hydrastis canadensis), myrrh (Commiphora molmol), and bitter orange (Citrus aurantium) act as antibacterials. Lomatium dissectum and Ligusticum porteri have an antiviral action.

Some of the homeopathic medicines that may be used to treat symptoms of tonsillitis include Belladonna, Phytolacca, Mercurius, Lycopodium, Lachesis, Hepar sulphuris, Arsenicum, or Rhus toxicodendron. As with any condition, the treatment and dosage should be appropriate for the particular symptoms and age of the patient. Other demulcent herbs include teas made with slippery elm bark, wild cherry, and licorice.

Allopathic Treatment

If the throat culture shows that S. pyogenes is present, penicillin or other antibiotics will be prescribed. An injection of benzathine or procaine penicillin may be most effective in treating the infection, but it is also painful. If an oral antibiotic is prescribed, it must be taken for the full course of treatment, which is usually 10-14 days.

Expected Results

Tonsillitis is usually resolved 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 (39°C), 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.

Prevention

The bacteria and viruses that cause tonsillitis are easily spread from person to person. It is not unusual for an entire family or several students in the same 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, soapy water 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.

Resources

Books

Berkow, Robert. "Tonsillitis." In The Merck Manual of Diagnosis and Therapy. Rahway, NJ: Merck Research Laboratories, 1992.

Eckman, Margaret, and Nancy Priff. "Ear, Nose, and Throat Disorders: Tonsillitis." In Diseases. Springhouse, PA: Springhouse Corporation, 1997.

Inlander, Charles B., ed., et al. "Tonsillitis." The Consumer's Medical Desk Reference. New York: A Stonesong Press Book, 1995.

Norris, June. "Tonsillitis." In Professional Guide to Diseases. Springhouse, PA: Springhouse Corporation, 1995.

Shaw, Michael. "Tonsillitis." In Everything You Need to Know about Diseases. Springhouse, PA: Springhouse Corporation, 1996.

[Article by: Kathleen D. Wright]

Definition

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.

Description

The tonsils normally help to prevent infections. They act like filters to trap bacteria and viruses entering the body through the mouth and sinuses. The tonsils also stimulate the immune system to produce antibodies that help fight infections. Anyone of any age can have tonsillitis; however, it is most common in children between the ages of five and 15 years.

Transmission

Tonsillitis is transmitted from one person to another in the same way that many common diseases are, such as by coughing and sneezing. It can also spread when a child touches his or her nose and then other children's toys or by children eating or drinking with the same utensils. Children with bacterial tonsillitis are usually no longer contagious 24 hours after beginning a course of antibiotics.

Demographics

Tonsillitis is very common among children. Nearly all children will have some form of tonsillitis at least once.

Causes and Symptoms

Tonsillitis is caused by viruses or bacteria that make the tonsils swell and become inflamed. Most cases of tonsillitis are caused by viruses, which cannot be treated with antibiotics. A mild or severe sore throat is one of the first symptoms of tonsillitis. Symptoms can also include fever, chills, tiredness, muscle aches, earache, pain or 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, the tonsils will have white or yellow spots or flecks. Symptoms usually last four to six days.

When to Call the Doctor

If the child is displaying the symptoms of tonsillitis and has had a sore throat for more than 48 hours, especially when accompanied by a fever, a doctor should be called. The doctor can determine if the child has tonsillitis, if it is bacterial or viral, and treat the problem accordingly. If the child cannot breathe or cannot swallow emergency medical attention should be sought.

Diagnosis

The diagnosis of tonsillitis is made from the visible symptoms and a physical examination of the patient. The doctor examines the eyes, ears, nose, and throat, looking at the tonsils for signs of swelling, redness, or discharge. A careful examination of the throat 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. A throat culture is performed by wiping a cotton swab across the tonsils and back of the throat and sending the swab to a laboratory for culturing. Streptococcus pyogenes, the bacterium that causes "strep" throat, is the most common bacterial agent responsible for tonsillitis. Depending on what type of test is used for strep, the doctor may be able to determine within a few minutes if S. pyogenes is present. The quick tests for strep are not as reliable as a laboratory culture, which can take 24 to 48 hours. If the results of a quick test are positive, however, the doctor can prescribe antibiotics right away. If the quick test results are negative, the doctor can do a throat culture to verify the results and wait for the laboratory report before prescribing antibiotics. A blood test may also be done to rule out a more serious infection or condition and to check the white blood cell count to see if the body is responding to the infection. In some cases, the doctor may order blood tests for mononucleosis, since about one third of patients with mononucleosis develop streptococcal infections of the tonsils.

Treatment

Treatment of tonsillitis usually involves keeping the patient comfortable while the illness runs its course. This supportive care includes bed rest, drinking extra fluids, gargling with warm salt water, and taking pain relievers. Children under the age of 12 should not be given aspirin as a pain reliever because of the threat of Reye's syndrome. Frozen juice bars and cold fruit drinks can bring some temporary relief of sore throat pain. Drinking warm tea or broth can also be soothing. If the throat culture shows that S. pyogenes is present, penicillin or other antibiotics will be prescribed. An injection of benzathine or procaine penicillin may be most effective in treating the infection, but it is also painful. If an oral antibiotic is prescribed, it must be taken for the full course of treatment, usually 10 to 14 days, even if the symptoms are no longer present. If the child has several episodes of severe tonsillitis, the doctor may recommend a tonsillectomy, which is the surgical removal of the tonsils.

Alternative Treatment

Strengthening the immune system is important whether tonsillitis is caused by bacteria 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 remedies also may be helpful in treating tonsillitis. Calendula (Calendula officinalis) and cleavers (Galium aparine) target the lymphatic system, while echinacea (Echinacea spp.) and astragalus (Astragalus membranaceus)stimulate the immune system. Goldenseal (Hydrastis canadensis), myrrh (Commiphora molmol), and bitter orange act as antibacterials. Lomatium dissectum and ligusticum porteri have an antiviral action. Some of the homeopathic medicines that may be used to treat symptoms of tonsillitis include:

• arsenicum
• belladonna
• hepar sulphuris
• lachesis
• lycopodium
• mercurius
• phytolacca
• rhus toxicodendron

As with any condition, the treatment and dosage should be appropriate for the particular symptoms and age of the patient.

Prognosis

Tonsillitis usually resolves within a few days with rest and supportive care. Treating the symptoms of sore throat and fever will make the child more comfortable. If fever persists for more than 48 hours, however, or is higher than 102°F (38.9°C) the child 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 child starts to feel better in a few days. Prolonged symptoms may indicate that the child 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.

Prevention

The bacteria and viruses that cause tonsillitis are easily spread from person to person. It is not unusual for an entire family or several students in the same 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, soapy water 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.

Parental Concerns

Tonsillitis usually has no long term effects if it is detected and treated promptly. If it is not treated it can lead to other medical conditions such as rheumatic fever, kidney inflammation, or abscesses that could block a child's breathing passage.

Resources

Books

Silverstien, Alvin, Virginia Silverstein, and Laura S. Nunn. Sore Throats and Tonsillitis. Danbury, CT: Franklin Watts, 2000.

"Tonsillitis." In Professional Guide to Diseases, 7th ed. Springhouse, PA: Springhouse Corporation, 2001.

Periodicals

"Sore Throat." Journal of the American Medical Association 291, no. 13 (April 7, 2004): 1664.

[Article by: Tish Davidson, A.M.]

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For more information on tonsillitis, visit Britannica.com.

(ton-suh-leye-tis)

An inflammation of the tonsils, sometimes the result of a bacterial infection.

Inflammation and enlargement of a tonsil, especially the palatine tonsils.

• follicular t. — tonsillitis especially affecting the crypts.
• parenchymatous t. — that affecting the whole substance of the tonsil.
• pustular t. — a variety characterized by formation of pustules.

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Dansk (Danish)
n. - betændelse i mandlerne

Nederlands (Dutch)
angina

Français (French)
n. - amygdalite

Deutsch (German)
n. - Mandelentzündung, Angina

Ελληνική (Greek)
n. - (παθολ.) αμυγδαλίτιδα

Italiano (Italian)
tonsillite

Português (Portuguese)
n. - amigdalite (f), tonsilite (f)

Русский (Russian)
тозиллит, воспаление миндалевидной железы

Español (Spanish)
n. - amigdalitis, inflamación de las amígdalas

Svenska (Swedish)
n. - halsfluss

中文（简体）(Chinese (Simplified))
扁桃腺炎

中文（繁體）(Chinese (Traditional))
n. - 扁桃腺炎

한국어 (Korean)
n. - 편도선염

日本語 (Japanese)
n. - 扁桃炎, 扁桃腺炎

العربيه (Arabic)
‏(الاسم) ألتهاب أللوزتين‏

עברית (Hebrew)
n. - ‮דלקת-שקדים‬

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