Tonsillitis
Tonsillitis is the inflammation and infection of the palatine tonsils, which are small masses of lymphoid tissue located on either side of the throat, and can also involve the adenoids. This condition can arise from either bacterial or viral infections, with children under three years old more commonly experiencing viral tonsillitis, while older children are often affected by bacterial infections such as strep throat. Common symptoms include a sore throat, difficulty swallowing, fever, chills, and bad breath. The duration of viral tonsillitis is typically short, lasting five days or less, and treatment is generally supportive, focusing on symptom relief with soft diets and analgesics.
For bacterial tonsillitis, antibiotic treatment is required, with penicillin being a common choice. In severe or recurrent cases, surgical options like tonsillectomy may be considered, particularly if the tonsils threaten to obstruct breathing. While tonsils play an essential role in the immune system during childhood, surgical removal is approached with caution, especially in younger children. Understanding the nature of tonsillitis, its symptoms, and treatment options can help individuals make informed decisions about their health or that of their children.
Tonsillitis
ANATOMY OR SYSTEM AFFECTED: Ears, lymphatic system, throat
DEFINITION: Inflammation, infection, and enlargement of the palatine tonsils, two small masses of lymphoid tissue located on either side of the back of the throat, and frequently of the pharyngeal tonsils, or adenoids, which are located high in the throat above the soft palate
CAUSES: Bacterial or viral infection
SYMPTOMS: Sore throat, difficulty swallowing, fever, chills, bad breath
DURATION: Acute
TREATMENTS: Alleviation of symptoms (soft or liquid diet, warm saltwater or mild antiseptic gargles, throat lozenges, rest, analgesics); antibiotics; tonsillectomy if needed
Causes and Symptoms
Four small pairs of lymphatic tissue called tonsils together form a ring that circles the nasal cavity and mouth. In children, these tonsils help filter and protect the respiratory and alimentary tracts from infection. As children grow, however, this function dwindles and the tonsils shrink. Tonsillitis, or an infection of these tissues, can be either viral or bacterial in origin. Viral infections are more common in children under three, while older children usually contract bacterial infections. Strep throat, a bacterial infection, is a common cause of tonsillitis. A throat culture can determine whether bacteria are present, thus indicating antibiotic treatment.
The two pairs of tonsils most often infected and inflamed are the palatine tonsils, which are those removed in a tonsillectomy, and the adenoids. Symptoms of infected and enlarged tonsils include a sore throat, difficulty swallowing, fever, chills, bad breath, and breathing exclusively through the mouth. Potential complications of strep throat include abscess in the area of the tonsils, kidney disease, and heart problems.
Treatment and Therapy
Viral tonsillitis is self-limiting and typically lasts for five days or less. In these cases, treatment should be symptomatic and includes a soft or liquid diet, warm saltwater or mild antiseptic gargles, throat lozenges, rest, and an analgesic drug such as acetaminophen. If a throat culture indicates bacterial causes, treatment should also include a ten-day course of penicillin or other appropriate drug and a second culture to determine the effectiveness of the treatment.
Occasionally, tonsillectomy (removal of the palatine tonsils) and adenoidectomy (removal of the adenoids) may also be indicated. Because the tonsils play an important role in the development of the immune system, children younger than three should not be surgically treated. Before the discovery of penicillin and other antibiotics, a tonsillectomy was the treatment of choice for children who suffered recurrent tonsillitis. Because of the inherent risks of even minor surgery, however, tonsillectomies are now performed only if infected and enlarged tonsils are so problematic that they threaten to obstruct breathing.
Bibliography
Beers, Mark H., et al., eds. The Merck Manual of Diagnosis and Therapy. 19th ed. Whitehouse Station: Merck, 2011. Print.
"The Difference between a Sore Throat, Strep, and Tonsillitis." HealthyChildren.org. American Academy of Pediatrics, 26 Feb. 2016. Web. 10 May 2016.
Kemper, Kathi J. The Holistic Pediatrician: A Pediatrician’s Comprehensive Guide to Safe and Effective Therapies for the Twenty-five Most Common Ailments of Infants, Children, and Adolescents. 2nd. ed. New York: Quill, 2007. Print.
Lewy, Jennifer. "Sore Throat." Health Library. EBSCO Information Services, 30 Sept. 2014. Web. 10 May 2016.
Litin, Scott C., ed. Mayo Clinic Family Health Book. 4th ed. New York: HarperResource, 2009. Print.
Parker, James N., and Philip M. Parker. Tonsillitis: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References. San Diego: Icon, 2004. Print.
Silverstein, Alvin, Virginia B. Silverstein, and Laura Silverstein Nunn. Sore Throats and Tonsillitis. New York: Franklin Watts, 2000. Print.
"Strep Throat: All You Need to Know." Centers for Disease Control and Prevention, 19 Jan. 2024, www.cdc.gov/groupastrep/diseases-public/strep-throat.html. Web. Accessed 8 Apr. 2024.
"Tonsillitus." HealthyChildren.org. American Academy of Pediatrics, 21 Nov. 2015. Web. 10 May 2016.
"Tonsillitis." KidsHealth. Nemours Foundation, Dec. 2015. Web. 10 May 2016.
"Tonsils and Adenoids." MedlinePlus. National Library of Medicine, 31 Oct. 2022, medlineplus.gov/ency/article/001043.htm. Web. Accessed 8 Apr. 2024.
"Tonsils and Adenoids." MedlinePlus. National Library of Medicine, 15 Mar. 2016. Web. 10 May 2016.
Woolf, Alan D., et al., eds. The Children’s Hospital Guide to Your Child’s Health and Development. Cambridge: Perseus, 2002. Print.