Published November 19, 2019.
Dr Rotimi Adesanya
A young man developed a sore throat , a cough , high temperature ( fever ) and headache . He felt sick, found swallowing painful and had swollen neck glands.
His symptoms typically got worse over two to three days and refused to go for a whole week . He started anti -malaria treatment with marked improvement . His symptoms later resurfaced within few days . This prompted him to visit hospital. Upon a thorough examination and laboratory tests , he was diagnosed with acute tonsillitis.
Tonsillitis is inflammation of the pharyngeal tonsils . The inflammation usually extends to the adenoid and other parts of the throat . Therefore , the term pharyngitis may also be used. The tonsils are glands at both sides of the back of the throat that help protect against infection. Pharyngitis and tonsillitis are infections in the throat that cause inflammation. If the tonsils are primarily affected , it is called tonsillitis. If the throat is primarily affected , it is called pharyngitis . One might even have inflammation and infection of both the tonsils and the throat or inflammation and infection of both the tonsils and the adenoid . These would be called pharyngotonsillitis and adenotonsilitis respectively . These infections are spread by close contact with other individuals .
The main types of tonsillitis are acute and chronic. In acute , the symptoms of tonsilitis happens suddenly while in chronic the symptoms are constantly present , even after treatment .
Tonsillitis is usually caused by a virus, or occasionally by bacteria , and often follows a cold. Most cases of bacterial tonsillitis are caused by group A beta -hemolytic Streptococcus . Bacterial infections are more common during the cold season . Viral infections are more common in dry season . Other causes include fungi such as in those that cause a yeast infection, allergies like hay fever or allergies affecting, the nose; sinus infection ; cancers , injuries , irritants like cigarette smoke or air pollution , and stomach acids in the throat .
People with tonsillitis often feel unwell and they may have a sore throat , red , swollen and painful tonsils , sometimes with white patches or pus , fever, difficulty or pain on swallowing , headache , swollen lymph nodes in the neck , bad breath , stiff neck , and pain in the ears.
There may be other cold symptoms such as a runny nose, cough or sore eyes . Young children may have nausea , vomiting or stomach pain . They may be unusually fussy and drool a lot because they can ’t swallow, have sore throat , trouble or painful swallowing , enlarged , painful neck glands, hoarseness or change in voice, fever or chills , headache , ear pain , nausea and vomiting , belly pain , feeling achy and tired , red or swollen throat , red or enlarged tonsils , throat or tonsils may have a whitish discharge, trouble breathing or snoring .
Analgesics can reduce discomfort, fever or headache . People with tonsillitis should rest , drink plenty of fluids to prevent dehydration and avoid cigarette smoke. One should gargle with warm salt water and use throat lozenges to reduce discomfort. Ice cream , jelly and other soft , cool foods can soothe a sore throat .
Hospital treatment of acute tonsillitis is largely supportive and focuses on maintaining adequate hydration and caloric intake and controlling pain and fever. Inability to maintain adequate oral caloric and fluid intake may require intravenous hydration , antibiotics , and pain control . Intravenous corticosteroids may be administered to reduce pharyngeal oedema .
Airway obstruction may require management by placing a nasal airway device , using intravenous corticosteroids , and administering humidified oxygen . Observe the patient in a monitored setting until the airway obstruction is clearly resolving
Some people who have recurring bouts of tonsillitis will be offered surgery to remove their tonsils . The operation is known as a tonsillectomy. People who have a tonsillectomy need a general anaesthetic , and often stay in hospital overnight . It doesn ’t prevent sore throats coming back. Some people may have pain afterwards , and it can take up to a week in most cases for the throats to be less painful . An ear, nose and throat surgeon should be contacted to know whether a tonsillectomy is likely to help or not.
Good hygiene reduces the chance of passing infections to others. Good hygiene includes regularly hand washing , not sharing cups or cutlery, not letting toothbrushes touch , encouraging children to cough or sneeze into their elbow and using tissues instead of hankies. One can ’t be immunised against tonsillitis.