Tonsillitis
Tonsillitis is an inflammatory condition of the tonsils that is most commonly caused by a viral infection, but it can be caused by a bacterial infection. The tonsils are two oval-shaped glands that sit on either side of the back of your throat. They are part of your immune system and the first line of defence against bacteria. Symptoms usually worsen over 2-3 days and patients feel better within a week. Tonsillitis can occur in people of all ages.
Types of tonsillitis
There are three types of tonsillitis:
Acute tonsillitis — symptoms that last anywhere between three days and two weeks
Recurrent tonsillitis — 7 or more episodes in one year, 5 or more episodes each year for 2 years or 3 or more episodes each year for 3 years
Chronic tonsillitis — a long-term infection of your tonsils.
Tonsillitis symptoms
The most common symptoms of tonsilitis include a sore throat that can make swallowing painful. Tonsillitis has several other symptoms, including:
red, swollen, painful tonsils
white patches or pus on the tonsils
a sore throat
trouble swallowing
hoarse voice
bad breath
swollen lymph nodes in your neck
stiff neck
fever
headache
pain in your ears
feeling generally unwell
abdominal pain
loss of appetite.
How do you get tonsillitis?
Most cases of tonsillitis are caused by viral infections like the common cold or flu. Around 15% of tonsil infections are caused by bacteria — usually, Streptococcus bacteria that causes strep throat.
Is tonsillitis contagious?
Tonsillitis itself isn’t contagious, but the viruses that cause it are. Viruses can be passed on through close contact with someone who is infected. When someone who is sick coughs or sneezes, they release droplets that contain the virus. If you breathe these in, you can become infected too. You can also become infected if you touch a surface with the virus on it, and then touch your nose or mouth.
Who gets tonsillitis?
Anyone can get tonsillitis, but it is more common in young children than adults. Children under seven have large tonsils and are and their immune system is not fully developed. As children grow older, bouts of tonsillitis become less frequent.
Risk factors for tonsillitis include:
Age
Children are more likely to develop tonsillitis, with bacterial tonsillitis most common in children aged 5 – 15. Elderly adults are also at a higher risk.
Exposure to pathogens
Those who are in close contact with others or frequently exposed to viruses or bacteria (e.g. school-aged children) are at higher risk.
How is tonsillitis diagnosed?
Tonsillitis is usually diagnosed with a physical examination by your doctor. They will check your throat and feel your glands. They may also do a throat swab to check if the infection is caused by bacteria, and they may suggest a blood test if they think the infection is caused by glandular fever (the Epstein-Barr virus).
Tonsillitis treatment
If your tonsillitis is caused by bacteria, you may need antibiotics to treat the infection. If it’s caused by a virus, treatment aims to relieve symptoms. You can:
get plenty of rest
use over-the-counter (OTC) pain relief medications such as paracetamol and ibuprofen (never give aspirin to a child under 12 years)
drink plenty of fluids
gargle with salt water or use lozenges to relieve a sore throat
eat cold foods such as cool drinks, ice cream, jelly or ice chips
avoid cigarette smoking
Your Pharmacist can provide advice on what products are suitable for you.
Surgery for tonsillitis
If you or your child suffer from recurrent tonsil infections, your doctor may recommend surgery to remove the tonsils. This is called a tonsillectomy. Surgery may be needed if:
there are recurrent bouts of tonsillitis that cause pain, discomfort and high temperatures
chronic tonsillitis doesn’t get better with antibiotics
frequent ear infections accompany tonsillitis infections
enlarged tonsils cause breathing difficulties
your child fails to thrive due to frequent infections.
Surgery is not the first line of treatment for tonsillitis.
Complications of tonsillitis
Tonsillitis can lead to complications which include:
chronic tonsillitis
infections that spread into the nose, sinus, ears or other tissues
an abscess behind a tonsil
disrupted breathing.
Can you prevent tonsillitis?
You can reduce the incidence of tonsillitis by practising good hygiene to prevent the spread of viruses and bacteria. This includes:
washing your hands thoroughly, especially after using the toilet, before eating and after you have coughed or sneezed
coughing and sneezing into tissues and throwing them away immediately
avoiding sharing food, crockery, cutlery and glassware and other personal items.
staying at home while you’re sick
changing your toothbrush after being diagnosed with tonsillitis.
When to see the doctor
You should visit your doctor if you suspect that your child has tonsillitis for the first time. You should also visit your doctor if your child has tonsillitis, and they:
have trouble breathing
are snoring more when they are asleep
have trouble swallowing
show signs of dehydration
have trouble opening their mouth.
If your child is very unwell, drooling or having trouble breathing, call an ambulance on 000. This could be due to inflammation of the epiglottis (a flap in the throat) which can be dangerous.
Your local MediADVICE Pharmacist is available to help with expert advice on managing coughs and sore throats and can recommend products that may be right for you. We can also refer you to a doctor if necessary.
Find your nearest store
Sources
1Better Health Channel, Tonsillitis,https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/tonsillitis
2Healthy WA, Tonsillitis,https://www.healthywa.wa.gov.au/Articles/S_T/Tonsillitis
3https://tgldcdp.tg.org.au/viewTopic?etgAccess=true&guidelinePage=Antibiotic&topicfile=sore-throat&guidelinename=Antibiotic§ionId=toc_d1e668#toc_d1e668
4Healthdirect, Tonsillitis,https://www.healthdirect.gov.au/tonsillitis
5Better Health Channel, Tonsillitis,https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/tonsillitis
6QLD Health, Tonsillitis, Emergency Department FactSheet,https://clinicalexcellence.qld.gov.au/sites/default/files/2018-02/tonsillitis.pdf
7SAHealth, Tonsillitis, https://www.sahealth.sa.gov.au/wps/wcm/connect/b5161a19-d4e0-4a1f-899d-cdc743ed94df/Tonsillitis+consumer+health+information+-+Paediatric+Unit+FMC.pdf?
8WebMD, Tonsillitis,https://www.webmd.com/oral-health/tonsillitis-symptoms-causes-and-treatments
9Healthdirect, Tonsillitis,https://www.healthdirect.gov.au/tonsillitis
10Better Health Channel, Tonsillitis,https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/tonsillitis
11Mayo Clinic, Tonsillitis,https://www.mayoclinic.org/diseases-conditions/tonsillitis/symptoms-causes/syc-20378479
12Mayo Clinic, Tonsillitis,https://www.mayoclinic.org/diseases-conditions/tonsillitis/symptoms-causes/syc-20378479
13Royal Children’s Hospital Melbourne, Tonsillitis,https://www.rch.org.au/kidsinfo/fact_sheets/Tonsillitis/
Disclaimer
General advice only – this information should not replace the information provided to you by your health care professional. If symptoms are severe or persist, please speak to your health care professional. Information current as of date of publishing.