What is Acute Tonsillitis?
Written by Eli Smith
Sunday, 04 October 2009
Tonsillitis is an inflammation or infection of the tonsils.
What is going on in the body?
The body has two sets, or pairs, of tonsils. The palatine tonsils can be seen at the back of the throat. The lingual tonsils are at the back of the tongue and cannot be seen by looking in the mouth. Tonsillitis usually means the inflammation or infection of the palatine tonsils. But sometimes the infection can involve the lingual tonsils and lymph nodes in the back of the throat.
What are the causes and risks of the infection?
Common causes of acute tonsillitis may include:
- bacteria, such as streptoccal or hemophilus bacteria
- viruses such as adenovirus or Epstein-Barr virus, which also causes mononucleosis
- diphtheria, a serious disease that produces a false membrane in the throat. Diphtheria can be prevented by the DPT vaccine.
Subacute tonsillitis is most commonly caused by actinomyces, a normal mouth bacterium that can cause infection.
In chronic tonsillitis, there is a long-standing infection that is almost always bacterial.
What are the treatments for the infection?
Acute tonsillitis is usually treated with:
- pain medication
- oral fluids
- medications to lower fever
For acute tonsillitis caused by strep bacteria, antibiotics will usually cure the infection. Unfortunately, some strep bacteria are becoming resistant to penicillin. This means higher doses of amoxicillin or a different antibiotic need to be used.
Since antibiotics are not effective against viruses, the only treatment for tonsillitis caused by viral infection is medication to reduce fever and pain. Oral steroids may be given for a short period of time if symptoms are severe.
Oral steroids can lessen the symptoms of tonsiliitis caused by mononucleosis. Antibiotics can be helpful in preventing infection if material has collected on the surface of the tonsils.
In subacute tonsillitis caused by actinomyces, penicillin and clindamycin are effective. If these antibiotics do not work, the person can remove the infected material from the tonsil pits with a finger or special irrigating tool. Otherwise, the tonsils should be removed.
In cases of chronic tonsillitis, antibiotics combined with oral steroids may resolve the infection. If not, the tonsils should be removed.
Tonsillectomy may be recommended by the healthcare provider if the person has had:
- 3 to 5 bacterial infections of the tonsils within 3 to 5 years
- more than 6 episodes of tonsillitis in one year
- chronic tonsillitis, or infection of the tonsils, that does not respond to antibiotics
- enlargement of the tonsils that causes sleep apnea, a breathing disorder that occurs during sleep
- enlargement of the tonsils that causes difficulty swallowing, especially in children
What are the side effects of the treatments?
Side effects depend on the medications used, but may include allergic reactions and upset stomach. Surgery to remove the tonsils can cause bleeding, infection, or allergic reactions to anesthesia.
What happens after treatment for the infection?
Most viral episodes of tonsillitis will resolve without further problems. Antibiotics should clear up infections caused by strep or other bacteria. After recovery from tonsillectomy, the person should be free of symptoms.