An overview of tonsillitis
The tonsils are two oval-shaped glands situated at the back of the throat, one on each side that fight germs and protect your body from infections. In young children typically up until the age of 6, tonsils are hyperplastic (fairly large) and tend to regress (decrease in size) by 12 years old.1 Tonsillitis is the inflammation of these glands. It can occur at any age, however, it is typically common in children, teenagers and young adults. Tonsillitis can often feel like a bad cold or flu.
Causes of tonsillitis
The main role of tonsils' is to fight off bacteria and viruses, however, there are instances where they can become infected by the same bugs they are trying to fight off. This is what generally causes tonsillitis.
A simple virus such as the common cold or flu can trigger tonsillitis and the symptoms of viral tonsillitis are often similar to those of a cold or flu.
Tonsillitis can also be caused by the following strains of bacteria:
- Group A Streptococcus bacteria
- Streptococcus pneumoniae
- Staphylococcus Aureus
Symptoms of tonsillitis
Symptoms of tonsillitis include:
- Sore throat
- Difficulty swallowing
- High fever, a temperature of 38 degrees or above
- Ear ache
- Headache
- Swollen and painful glands in your neck (feels like a lump on the side of your neck).
Differences between viral and bacterial tonsillitis
So what is the difference between viral and bacterial tonsillitis?
As mentioned earlier, viral tonsillitis involves tonsillitis caused by viruses. Symptoms often manifest as a common cold and usually lasts for 3 to 4 days. It is easier to treat viral tonsillitis at home than bacterial tonsillitis. Like all viral infections, antibiotics will not work to treat tonsillitis, therefore simple home remedies and over-the-counter medications can be used to manage the symptoms.
Bacterial tonsillitis on the other hand usually requires a short course of antibiotics to get rid of the infection.
Diagnosis of tonsillitis
There are several ways to test for the presence of tonsillitis. Generally, your doctor will examine your throat and look for inflamed glands which is a primary indicator of tonsillitis. Your doctor may also notice if the glands are pus-filled and red sore. A throat swab may also be taken to determine the cause of the infection.2
If a bacterial infection is suspected, a blood test (blood culture) will be taken to determine whether it is bacterial tonsillitis or not.
Treatment for tonsillitis
Treatment for tonsillitis is also dependent on the type of tonsillitis. As antibiotics have no effect on the treatment of viral tonsillitis, most viral tonsillitis can be treated at home with plenty of fluid and rest.3
In the case that it is bacterial tonsillitis, then you may require treatment with antibiotics prescribed by your doctor.
In severe cases, you may have to undergo a surgery known as Tonsillectomy which involves the removal of your tonsils. This is usually seen in chronic tonsillitis cases where the infection is recurrent or just won’t go away despite remedies and or antibiotics. The symptoms of chronic tonsillitis last longer and usually include sore throat, swollen glands at the sides of the neck and bad breath for a long period of time. The main cause for chronic tonsillitis is when the bacteria begin to create a biofilm on the tonsils, almost like a shield which protects the bacteria from being killed by antibiotics (antibiotic resistance). This makes it difficult to treat tonsillitis.2
Home Remedies without Antibiotics
- Over-the-counter medications such as paracetamol and ibuprofen can be used to alleviate symptoms such as headaches, and cold-like symptoms.
- A recent indicated that the use of phytomedicines (medicines extracted from plants) can also be effective in the management of the symptoms of tonsillitis in particular symptoms such as sore throat and common cold-like symptoms.4 The main plants found in the drug were chamomile flowers, marshmallow root, horsetail herb, walnut leaves, yarrow herb, oak bark and dandelion herb. All of these are easily accessible and can be found at your local health store.4
- Drinking plenty of water.
- Gargling with warm salt water
- Humidifier to help moisten your airways.
Prevention
You can reduce the risk of you developing tonsillitis by practising good hygiene, in particular, effective handwashing and keeping your surroundings clean and tidy, especially after coming into contact with someone that has been coughing and sneezing.
Also, try to avoid coming in contact with people that you know or suspect to have tonsillitis.
When to seek medical attention?
Seek medical advice when you experience the following:
- Temperature of 38 degrees and above
- A sore throat that lasts longer than 2 days
- Stiffness to your neck
- Muscle weakness and fatigue
Summary
Tonsillitis occurs as a result of your tonsils coming into contact with a virus or bacteria. The tonsils' main function is to protect your body from bacteria and viruses, however, there are cases where they become infected by the said bugs. Tonsillitis is the inflammation of your tonsils. Tonsillitis can be either viral (caused by viruses) or bacterial (caused by bacteria). Treatment is dependent on the type of tonsillitis that you have developed. Most viral tonsillitis can be treated with home remedies and may disappear after a few days of rest and plenty of fluids. Bacterial tonsillitis on the other hand may require treatment with antibiotics. In severe cases, where tonsillitis has become chronic, your tonsils may be removed following a surgery known as tonsillectomy. Seek medical attention if you experience a high temperature above 38 degrees, a stiff neck, and muscle weakness
References
- Arambula A, Brown J, Neff L. Anatomy and physiology of the palatine tonsils, adenoids, and lingual tonsils. World Journal of Otorhinolaryngology - Head and Neck Surgery. 2021;7(3):155-160.
- Norton L, Myers A. The treatment of streptococcal tonsillitis/pharyngitis in young children. World Journal of Otorhinolaryngology - Head and Neck Surgery. 2021;7(3):161-165.
- bin Abu Bakar M, McKimm J, Haque S, Majumder A, Haque M. Chronic tonsillitis and biofilms: a brief overview of treatment modalities. Journal of Inflammation Research. 2018;Volume 11:329-337.
- Popovych V, Koshel I, Malofiichuk A, Pyletska L, Semeniuk A, Filippova O et al. A randomized, open-label, multicenter, comparative study of therapeutic efficacy, safety and tolerability of BNO 1030 extract, containing marshmallow root, chamomile flowers, horsetail herb, walnut leaves, yarrow herb, oak bark, dandelion herb in the treatment of acute non-bacterial tonsillitis in children aged 6 to 18 years. American Journal of Otolaryngology. 2019;40(2):265-273.