TONSILLITIS

General Information

DEFINITION--Inflammation of the tonsils (lymph glands located at the back of the throat). Tonsils are small at birth, enlarge during childhood, and become smaller at puberty. Tonsils normally help prevent infection in the sinuses, mouth and throat from spreading to other body parts. Tonsillitis is contagious.

BODY PARTS INVOLVED--Tonsils; pharynx.

SEX OR AGE MOST AFFECTED--All ages, but most common in children between ages 5 and 10.

SIGNS & SYMPTOMS

• Throat pain, either mild or severe.
• Swallowing difficulty.
• Chills and fever as high as 104F (40C) or more.
• Swollen lymph glands on either side of the jaw.
• Headache.
• Ear pain.
• Cough (sometimes).
• Vomiting (sometimes).
• Very young child refuses to eat.

CAUSES--Bacterial (usually streptococcal) or viral infection of the tonsils.

RISK INCREASES WITH

• Crowded or unsanitary living conditions.
• Exposure to others in public places.

HOW TO PREVENT--Avoid exposure to people with upper-respiratory infections.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory throat culture. Family members should be cultured also, so that carriers can be treated at the same time.

APPROPRIATE HEALTH CARE

• Home care.
• Treatment is usually with antibiotics and self-care. Surgery to remove the tonsils for repeated acute tonsillitis or for chronic tonsillitis. (See Tonsil & Adenoid Removal in Surgery section.)

POSSIBLE COMPLICATIONS

• Abscess of the tonsils and nearby throat area, requiring surgery to drain.
• Chronic tonsillitis, with a recurrent sore throat and greatly enlarged tonsils, caused by repeated attacks.
• Rheumatic fever, if the bacterial infection is streptococcal and it is not treated with antibiotics, or if antibiotics are discontinued before 10 days.

PROBABLE OUTCOME--Usually spontaneous recovery. Symptoms generally begin to improve in 2 to 3 days, but treatment may last longer. If attacks of tonsillitis are so severe and frequent that they affect one's general health or interfere with schooling, hearing or breathing, your doctor may recommend surgery to remove the tonsils. A tonsillectomy involves small risk, but the risk increases with age.

How To Treat

GENERAL MEASURES--

• Use a cool-mist, ultrasonic humidifier to relieve throat irritation and cough. Clean humidifier daily.
• Prepare a soothing tea or other gargle. Double the usual strength of tea. This may be gargled warm or cold as often as is soothing.

MEDICATION--

• If the tonsillitis is caused by a streptococcal infection, your doctor will prescribe penicillin or other antibiotics for at least 10 days.
• To relieve pain, you may use acetaminophen.

ACTIVITY--

• Keep the patient away from others until fever, pain and other symptoms disappear.
• Bed rest, except to use the bathroom, is necessary until fever subsides. Normal activity may be resumed when temperature has been normal for 2 or 3 days.

DIET--Increase all fluid intake. While the throat is very sore, use liquid nourishment, such as milk shakes, soups, and high-protein fluids (diet or instant-breakfast milk drinks).

Call Your Doctor If

• You have symptoms of tonsillitis. If tonsils cover the opening of the throat (hold down the tongue with a spoon and look with a flashlight), call your doctor immediately.
• Symptoms worsen or the following occurs during treatment: Temperature is normal for 1 or 2 days, then fever returns. New symptoms begin, such as: nausea; vomiting; skin rash; thick nasal drainage; chest pain; or shortness of breath. There is a convulsion. Joints become red or painful. Cough produces a discolored (green, yellow, brown or bloody) sputum.