Tonsillitis involves inflammation of the tonsils. It's usually caused by a viral infection or, less commonly, a bacterial infection. Tonsillitis is a common condition in children but teenagers and adults can get it too.
Where are the tonsils located?
Tonsils are located at the back of the throat. (See photo 1)
What are they made of? Are tonsils important?
Tonsils are made of lymphoid tissues. They offer some immunity to body during the initial 12 months of life. After that period they do not offer any function to the body.
What are the symptoms of tonsillitis?
Fever, sore throat, swallowing difficulty, feeling sick, earache, flu like symptoms, feeling tired, swollen painful glands in the neck whitish spots on tonsils & bad breath. Usually symptoms last for 3-4 days. Tonsils at the back of throat look red and swollen with spots on it
What are the investigations for tonsillitis?
- Throat Swab
- Blood test to check for glandular fever ( A viral infection (Ebstein Barr virus) which makes you very tired and tonsils swell up with dense thick whitish coating of the throat)
What is the treatment for tonsillitis?
- Get plenty of rest
- Keep well hydrated
- Take paracetamol or ibuprofen
- Gargle with warm salty water (children shouldn’t try this)
- Difflam sprays, lozenges etc
Symptoms will usually go away after 3 to 4 days. You might require antibiotics if sore throat persists for more than 4 days with white spots on the tonsils and has difficulty in eating or drinking.
What is quinsy? (see photo 2)
Quinsy is a tonsil abscess which can occur as a result of very bad tonsil infection. This is associated with the following:
- Severe sore throat getting rapidly worse
- Difficulty in speaking and breathing
- Unable to swallow
- Change in voice (Hot potato voice)
- Trismus (difficulty in mouth opening)
What is the treatment for quinsy?
- Drainage of the pus (usually under local anaesthetic)
- Hospital admission for antibiotics administered through vein (Intravenous)
When is surgery considered for tonsillitis?
Surgery is recommended if any of below:
- 7 episodes of tonsillitis in 12 months
- 5 episodes of tonsillitis every year for 2 consecutive years
- 3 episodes of tonsillitis every year for 3 consecutive years
- 2 episodes of quinsy
What does Tonsillectomy involve?
For details regarding tonsillectomy please check
What is Coblation tonsillotomy?
Coblation tonsillotomy is performed in children with large tonsils causing obstructive sleep apnoea. This is not the preferred treatment in adults and also in children suffering from tonsil infections. In the latter groups, it is better to remove the tonsil tissue completely.
What other problems can arise due to tonsils
- Sleep apnoea and snoring - Due to enlarged tonsils
- Tonsil stones (Tonsilloliths) - The tonsil has a lot of dips on the surface called crypts. Food and bacteria can get collected here and form stone like material. This causes throat irritation and bad breath (Haliptosis)
- Tonsil cancers-These are rare in children. They are suspected if only one tonsil is enlarged.