What is tonsillitis?

Tonsillitis is an inflammation (swelling) of the tonsils. Sometimes along with tonsillitis, the adenoids are also swollen.

What are tonsils?

Tonsils are lumps of tissue at the back of the throat. There are two of them, one on each side. Along with the adenoids, tonsils are part of the lymphatic system. The lymphatic system clears away infection and keeps body fluids in balance. Tonsils and adenoids work by trapping the germs coming in through the mouth and nose.

Tonsillitis is inflammation of the tonsils. The tonsils are oval shape masses of tissue or lymph nodes in each side of the back of your mouth and on top of your throat. The tonsils are part of your body’s immune system and their job is to catch bacteria and viruses that come through the upper respiratory airways via the nose and mouth before these germs cause an infection in the body. The tonsils also produce antibodies to fight the infection. The tonsils themselves can at times become infected with viruses and bacteria. A common bacterial infection of the tonsils is with Streptococcus bacteria. This is also known as strep throat and is treated with antibiotics.

Viral infections ARE NOT treated with antibiotics. Over the counter medications will just give you relief from the symptoms. Your body’s immune response is the best line of the defense to clear the virus from your body. Some common viral infections of the tonsils are:

• Adenoviruses – another type of common cold
• Influenza virus - Flu
• Epstein-Barr virus
• Parainfluenza viruses
• Enteroviruses
• Herpes simplex virus

Common symptoms include swollen tonsils, sore throat, difficulty swallowing and tender lymph nodes on the sides of the neck. If the swelling is severe enough, it can block the airways and you may have problems drinking and eating.

Types of Upper Respiratory Infections.

Who gets tonsillitis?

Tonsillitis is most common in children over age two. Almost every child in the United States gets it at least once. Tonsillitis caused by bacteria is more common in kids ages 5-15. Tonsillitis caused by a virus is more common in younger children.

Adults can get tonsillitis, but it is not very common.

Is tonsillitis contagious?

Although tonsillitis is not contagious, the viruses and bacteria that cause it are contagious. Frequent handwashing can help prevent spreading or catching the infections

The cause of tonsillitis is usually a viral infection. Bacterial infections such as strep throat can also cause tonsillitis.

The symptoms of tonsillitis include:

• A sore throat, which may be severe
• Red, swollen tonsils
• Trouble swallowing
• A white or yellow coating on the tonsils
• Swollen glands in the neck
• Fever
• Bad breath

You should call your health care provider if your child

• Has a sore throat for more than two days
• Has trouble or pain when swallowing
• Feels very sick or very weak

You should get emergency care right away if your child

• Has trouble breathing
• Starts drooling
• Has a lot of trouble swallowing

To diagnose tonsillitis, your child's health care provider will first ask you about your child's symptoms and medical history. The provider will look at your child's throat and neck, checking for things such as redness or white spots on the tonsils and swollen lymph nodes.

Your child will probably also have one or more tests to check for strep throat, since it can cause tonsillitis and it requires treatment. It could be a rapid strep test, a throat culture, or both. For both tests, the provider uses a cotton swab to collect a sample of fluids from your child's tonsils and the back of the throat. With the rapid strep test, testing is done in the office, and you get the results within minutes. The throat culture is done in a lab, and it usually takes a few days to get the results. The throat culture is a more reliable test. So sometimes if the rapid strep test is negative (meaning that it does not show any strep bacteria), the provider will also do a throat culture just to make sure that your child does not have strep.

Treatment for tonsillitis depends on the cause. If the cause is a virus, there is no medicine to treat it. If the cause is a bacterial infection, such as strep throat, your child will need to take antibiotics. It is important for your child to finish the antibiotics even if he or she feels better. If treatment stops too soon, some bacteria may survive and re-infect your child.

No matter what is causing the tonsillitis, there are some things you can do to help your child feel better. Make sure that your child

• Gets a lot of rest
• Drinks plenty of fluids
• Tries eating soft foods if it hurts to swallow
• Tries eating warm liquids or cold foods like popsicles to soothe the throat
• Isn't around cigarette smoke or do anything else that could irritate the throat
• Sleeps in a room with a humidifier
• Gargles with saltwater
• Sucks on a lozenge (but do not give them to children under four; they can choke on them)
• Takes an over-the-counter pain reliever such as acetaminophen. Children and teenagers should not take aspirin.

In some cases, your child may need a tonsillectomy.

A tonsillectomy is surgery to remove the tonsils. Your child might need it if he or she

• Keeps getting tonsillitis
• Has bacterial tonsillitis that does not get better with antibiotics
• Has tonsils are too big, and are causing trouble breathing or swallowing

Your child usually gets the surgery and goes home later that day. Very young children and people who have complications may need to stay in the hospital overnight. It can take a week or two before your child completely recovers from the surgery.

Some kids get tonsillitis, or infected tonsils, again and again. A new study found that strep, a germ that causes tonsillitis, can trick the body’s immune system. Because of the trick, the body’s immune cells kill each other, rather than the germ. But this only happens in certain people who are vulnerable.

Your tonsils are the bumps of tissue at the back of your throat. They help prevent infections in the body by trapping germs that come in through your nose and mouth. When tonsils get infected, they can swell and become painful. Children who get tonsillitis over and over may need to have their tonsils removed.

Researchers compared tonsils removed from children who had repeated bouts of tonsillitis with those from children who had them removed for other reasons, such as a sleep disorder.

Kids with repeated tonsillitis had more of certain immune cells (a type of TFH cell). These cells help another immune cell, called B cells, make antibodies to fight the germ. But the kids with repeated tonsillitis had fewer B cells and antibodies that guard against strep.

The team found that strep makes a certain toxin that, in kids with repeated tonsillitis, causes certain TFH cells to destroy B cells instead of helping them. These kids had genetic differences that made them more vulnerable to this effect.

The results suggest there may be a way to make a vaccine that trains the immune system to prevent recurring bouts of tonsillitis, says Dr. Shane Crotty, who led the study at the La Jolla Institute for Immunology