Tonsillitis Health Article

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.

Causes and 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, 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 or a thin 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 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 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—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 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 10-14 days. If the patient 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 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.