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Lymphatic system
Lymphatic system
Throat anatomy
Throat anatomy

Tonsillitis
Definition:
A disorder involving inflammation of the tonsils (also see sore throat).

Causes, incidence, and risk factors:
The tonsils are lymph nodes in the back of the mouth/top of the throat. They normally help to filter out bacteria and other microorganisms to prevent infection in the body. They may become so overwhelmed by bacterial or viral infection that they swell and become inflamed, causing tonsillitis. The infection may also be present in the throat and surrounding areas, causing pharyngitis.

Tonsillitis is extremely common, particularly in children.
Symptoms:
Signs and tests:
Inspection of the mouth and throat shows enlarged, visible tonsils. They are usually reddened and may have white spots on them. The lymph nodes of the jaw and neck may be enlarged and tender to the touch (palpation).

A culture of the tonsils may show bacterial infection. A culture for the streptococcus bacteria (strep) may be taken because it is the most common and most dangerous form of tonsillitis. A rapid Strep test may also be performed by your physician by taking a throat swab for a quick diagnosis.
Treatment:

If the cause of the tonsillitis is bacteria such as strep, antibiotics are given to cure the infection. The antibiotics may be given by one-time intramuscular injection, or by a 10 day course of oral antibiotics.

If oral antibiotics are used, they must continue for the full course and must not be discontinued just because the discomfort stops, or the infection will not be cured. Some health care providers will treat all tonsillitis with antibiotics to prevent the chance of strep-related complications. Others treat only known bacterial and strep infections to minimize the chance of reaction to the antibiotic.

Rest to allow the body to heal. Fluids, especially warm (not hot), bland fluids or very cold fluids may soothe the throat. Gargle with warm salt water or suck on lozenges (containing benzocaine or similar ingredients) to reduce pain.

Over-the-counter medications may be used to reduce pain and fever. Do not use aspirin in children if the infection could be viral, because this may be associated with Reye's syndrome.

Surgery to remove the tonsils (tonsillectomy) may be necessary for some people.
Expectations (prognosis):
Tonsillitis symptoms usually lessen in 2 or 3 days after treatment is initiated. The infection usually is cured by then, but may require more than one course of antibiotics. Complications of untreated strep tonsillitis may be severe. A tonsillectomy may be recommended if tonsillitis is severe, recurs often, or does not respond to antibiotics.
Complications:
Calling your health care provider:
Call your health care provider if sore throat persists longer than 48 hours, is accompanied by other symptoms of tonsillitis, if symptoms worsen, or new symptoms develop.
Prevention:
Avoid people with known tonsillitis or bacterial sore throats, if susceptible to tonsillitis.
Review Date: 10/31/2001
Reviewed By: Ashutosh Kacker, Department of Otolaryngology, New York Presbyterian Hospital, New York, NY. Review provided by VeriMed Healthcare Network.
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