Tonsillitis is an inflammation or infection of the tonsils.
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.
Common causes of acute tonsillitis may include:
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.
There are three forms of tonsillitis:
Symptoms of acute tonsillitis include:
Symptoms of subacute tonsillitis can last from 3 weeks to 3 months, and include:
Symptoms of chronic tonsillitis include:
A healthcare provider can diagnose acute tonsillitis based on the person's health history and a physical exam. A throat culture can help identify the organism causing the infection. A complete blood count, or CBC, can also help determine if the infection is caused by a virus or bacteria.
If mononucleosis is involved, the lymph nodes in the neck, armpit, or groin will be enlarged. An antibody titer may be done to check for antibodies to the Epstein-Barr virus.
A healthcare provider can diagnose subacute tonsillitis and chronic tonsillitis based on a person's health record and a physical exam.
The best way to prevent acute tonsillitis is to avoid people who have strep throat or any of the bacterial or viral infections that can lead to acute tonsillitis.
A person can get acute tonsillitis by:
There is no way to prevent subacute or chronic tonsillitis.
Usually, no significant long-term effects result from any of the three forms of tonsillitis. However, difficulty swallowing or breathing during sleep can result if the chronic infection causes enlargement of the tonsils. The healthcare provider may recommend a tonsillectomy, or removal of the tonsils, if there are recurrent infections or difficulties with swallowing and breathing.
Strep, diphtheria, and Epstein-Barr infections are all contagious.
Acute tonsillitis is usually treated with:
For acute tonsillitis caused by strep bacteria, antibiotics will usually
cure the infection. Unfortunately, some strep bacteria are becoming resistant
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
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:
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.
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.
Any new or worsening symptoms should be reported to the healthcare provider.
Author:William Stevens, MD
Editor:Ballenberg, Sally, BS
Reviewer:Eileen McLaughlin, RN, BSN