Recurrent tonsillitis is a tonsil infection that returns frequently, even with treatment. There may be a genetic component to why some people experience recurrent or chronic infections.

Tonsillitis occurs when the two glands that sit in the back of your throat, called the tonsils, become swollen and painful due to an infection.

Most often, a viral infection, such as the common cold, is responsible for tonsillitis. But bacterial infections, particularly from Streptococcus pyogenes, can also be the cause.

Recurrent tonsillitis doesn’t have a clearly defined number of episodes. It generally means that the infection returns frequently, three to five times or more per year, even with treatment such as antibiotics.

Read on to learn about the potential causes of recurrent tonsillitis and treatment options.

What’s the difference between recurrent tonsillitis and chronic tonsillitis?

While these terms are sometimes confused and used interchangeably, recurrent tonsillitis means that the tonsil infection returns frequently, even with treatment. Chronic means that the infection and symptoms are ever-present.

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When it comes to recurrent bacterial tonsillitis, researchers have found some clues as to why some people are more likely to keep getting infections. Their research centers on genetic components that affect the immune system.

A 2019 study looked at tissue samples from 66 children who had their tonsils removed after having recurrent strep infections. Researchers found an unusual immune response to the strep bacteria. Essentially, the strep bacteria tricked the children’s immune systems into attacking immune cells that would normally fight off the infection.

Researchers also found that there was a genetic connection to this immune response, as many of the children had a family history of recurrent tonsillitis.

Both children and adults can have recurrent tonsillitis, but children are often exposed to more germs, which makes them more susceptible to infections. In addition, a 2018 study found that recurrent tonsillitis most often affects people assigned female at birth.

Recurrent tonsillitis may also occur in children with:

Similar to recurrent tonsillitis, genetic and immune factors may also play a role in who gets PFAPA.

If you’re someone who gets recurrent tonsillitis, you likely want to prevent a repeat infection. Prevention recommendations include:

  • practicing good oral hygiene
  • not sharing drinks, utensils, and toothbrushes
  • washing your hands frequently, particularly:
    • before eating
    • after using the bathroom
    • before touching your face, nose, or mouth
  • avoiding people who may be ill

As research draws more connections between genetics and the immune response to strep, it may become even more clear why some people are more likely to get recurrent infections despite their best prevention efforts.

Future research may also find new treatments and prevention strategies for those who are prone to recurrent tonsillitis. For example, scientists are currently looking to develop a vaccine that can prevent strep infections.

How tonsillitis is treated depends on a couple of factors: whether it’s caused by a viral or bacterial infection and whether it’s a recurrent infection.

  • Viral infections: These have no specific treatment and will generally run their course in about a week.
  • Bacterial infections: These are treated with antibiotics to kill the bacteria causing the infection.

A tonsillectomy, surgical removal of the tonsils, is typically recommended for people with recurrent tonsillitis.

According to Texas Children’s Hospital, frequent or recurrent tonsillitis is typically defined as:

  • more than seven infections in 1 year
  • more than five infections a year during a 2-year period
  • more than three infections a year during a 3-year period

Tonsillectomies are also typically recommended for those with:

Learn more about tonsillectomy here.

Recurrent tonsillitis means you frequently get infections that cause your tonsils to become red, swollen, and painful.

Researchers are beginning to understand why certain people are more susceptible to repeat infections, and it has something to do with an abnormal immune response tied to certain genes.

When recurrent tonsillitis starts to affect your quality of life, surgery to remove the tonsils — called a tonsillectomy — is usually recommended.