A Simple Guide to Tonsillitis
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What is Tonsillitis?
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Tonsillitis is inflammation (swelling) of the tonsils.
The tonsils are lymph nodes in the back of the mouth and top of the throat.
They normally help to filter out bacteria and other germs 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. The inflammation may involve other areas of the back of the throat including the adenoids and the lingual tonsils (areas of tonsil tissue at the back of the tongue).
What causes Tonsillitis?
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Viral or bacterial infections and low immunity lead to tonsillitis and its complications.
Viral:
The herpes simplex virus, Epstein-Barr virus (EBV), cytomegalovirus, adenovirus, and the measles virus cause most cases of acute pharyngitis and acute tonsillitis.
Bacteria:
Bacteria cause 15-30 percent of pharyngotonsillitis cases.
Streptococcus pyogenes is the most common bacteria causing acute Tonsillitis
Who gets tonsillitis?
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Tonsillitis most often occurs in children but rarely in children younger than 2 years.
Tonsillitis caused by Streptococcus species typically occurs in children aged 5-15 years.
Viral tonsillitis is more common in younger children.
A peritonsillar abscess is usually found in young adults but occur occasionally in children.
What are types of Tonsillitis?
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There are several variations of tonsillitis:
1.acute
2.recurrent
3.chronic tonsillitis and
4.peritonsillar abscess.
What are the symptoms of tonsillitis?
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The type of tonsillitis determines what symptoms will occur.
Acute tonsillitis:
Patients have a
Ear pain
Fever, chills
Headache
Sore throat - severe, lasts longer than 48 hours
Tenderness of the jaw and throat
Voice changes, loss of voice
Foul breath
dysphagia (difficulty swallowing)
Odynophagia (painful swallowing) and
tender cervical lymph nodes.
Airway obstruction due to swollen tonsils may cause mouth breathing, snoring, nocturnal breathing pauses, or sleep apnea.
Lethargy and malaise are common.
These symptoms usually resolve in three to four days but may last up to two weeks despite therapy.
Recurrent tonsillitis:
This diagnosis is made when an individual has multiple episodes of acute tonsillitis in a year.
Chronic tonsillitis:
Individuals often have
Chronic sore throat,
Foul breath,
Enlarged tonsils, and
Persistently tender cervical nodes.
Peritonsillar abscess:
Individuals often have
Severe throat pain,
fever, Drooling,
Foul breath,
Trismus (difficulty opening the mouth), and
Muffled voice quality (as if talking with a hot potato in his or her mouth).
What are the signs of Tonsillitis?
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The health care provider will look in the mouth and throat for signs of:
1.enlarged, visible tonsils that are usually reddened with white spots (pus) on them.
2.enlarged and tender lymph nodes of the jaw and neck.
3.Fever and chills.
4.Open-mouth breathing and muffled voice resulting from obstructive enlarged tonsils.
5.neck and jaw stiffness (often found in acute tonsillitis).
6.Signs of dehydration (found by examination of skin and mucosa).
7.Palatal petechiae (pinpoint bleeding spots on the soft palate).
8.Unilateral bulging above and to the side of one of the tonsils in peritonsillar abscess .
A culture of the tonsils may show bacterial infection.
A culture for the streptococcus bacteria (strep) may be taken using a throat swab because it is the most common and most dangerous form of tonsillitis.
What is the treatment of Tonsillitis?
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1.If the cause of the tonsillitis is bacteria such as strep, antibiotics are given to cure the infection.
The antibiotics may need to be taken for 10 days by mouth.
They must not be stopped 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.
2.Rest to allow the body to heal.
3. 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.Fluid replacement and pain control are important.
4.Hospitalization may be required in severe cases and when there is airway obstruction.
5. When the condition is chronic or recurrent, a surgical procedure to remove the tonsils (tonsillectomy) is often recommended.
What is the Prognosis of Tonsillitis?
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Tonsillitis symptoms usually lessen in 2 or 3 days after treatment starts.
The infection usually is cured by then, but may require more than one course of antibiotics.
A tonsillectomy may be recommended if tonsillitis is severe, recurrent, or does not respond to antibiotics.
What are the Complications of Tonsillitis?
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1.Complications of untreated strep tonsillitis may be severe:
Rheumatic fever and subsequent cardiovascular disorders
Post-streptococcal glomerulonephritis followed by kidney failure
2.Dehydration from difficulty swallowing fluids
3.Blocked airway from enlarged tonsils
4.Peritonsillar abscess or abscess in other parts of the throat
