Tonsillitis and Tonsillectomy

What are the tonsils?

Tonsils are a pair of soft tissue masses located at the back of the throat.

Tonsils are also found behind the nose where they are called adenoids. Tonsil tissue is also found behind the tongue.

Tonsils help the body to fight infections.

What is tonsillitis?

Tonsillitis is an infection of the tonsils. The infection usually also involves the back of the throat (pharyngitis).Tonsil infections are most frequently seen in children older than 3 years. They are uncommon in those who are younger than 2 years.

What problems do infections in the tonsils cause?

Tonsillitis usually results in a sore throat and difficulty in swallowing. Younger children may refuse to eat and complain of tummy ache. Other problems include fever, headache, swollen and tender neck glands. The tonsils will look red and swollen when infected. Sometimes a white or yellow coating or patches will cover the tonsils. Tonsil infection can cause a foul breath.

What causes tonsil and throat infections?

Infection of the throat and tonsils is most often caused by viruses but sometimes bacteria are responsible. Older children between 5 and 15 years more commonly  get bacterial infection while  the younger ones mainly suffer viral infections.

Children who are regularly in contact with their peers whether at school or in a play group get frequently exposed to the viruses and bacteria that cause tonsillitis.

What are the complications of throat and tonsil infections?

Tonsils can swell and cause blocked airways making it difficult to breath.

Infection in the tonsils can spread to the surrounding soft tissues in the neck causing serious problems that might be life threatening if not treated promptly.

Bacteria and debris can accumulate in the pits on the surface of the tonsils. This leads to the production of white or yellow stones called tonsilloliths. They produce foul smell.

A pocket of pus can form behind a tonsil following tonsil infection. This is called a peritonsillar abscess.

Some children get tonsil infections very frequently. This is called recurrent tonsillitis. This can affect school attendance, interfere with daily activities , and reduce the quality of life.

Rarely a child can get complications affecting the heart or kidneys following infection with a specific bacteria called group A streptococcus. Rheumatic fever affects the heart valves and joint. Glomerulonephritis causes injury to the kidneys.

Are tests necessary?

Your doctor will usually know that your child has a throat or tonsil infection by taking a history and finding characteristic changes in the throat on examination. However, a test may be needed to tell if the infection is caused by bacteria or viruses. This is important because antibiotic treatment is not required for the majority of throat and tonsil infections that are caused by viruses. Tests may include:

A throat swab. This is done to check for the bacteria group A streptococcus.

Blood test may be done to see if a virus called Eppstein Barr virus is the cause of the tonsil infection.

How are tonsil and throat infections treated?

Symptoms of throat infections usually resolve within a week.

Treatment will depend on whether the infection is caused by bacteria or viruses and whether any complications are present.

Medications like paracetamol or ibuprofen help relieve pain and discomfort associated with fever.

Gargling a solution of warm water and salt can help reduced swelling and pain.

Having a good rest and taking lots of fluids help one feel better.

Viral infections do not require antibiotics. Antibiotics do not treat viral infections.

If a bacterial tonsil infection is strongly suspected or confirmed with tests an antibiotic will be recommended.

Why would my child be referred to the ENT clinic?

When tonsil infections become recurrent or complications like difficulty in breathing, spread of infection to surrounding neck tissues and abscess is formed you will need evaluation at the ENT clinic for possible surgical removal of tonsils (tonsillectomy). A collection of pus behind the tonsil will require drainage.

How can I prevent tonsil and throat infections?

Practice good hand hygiene. Teach the child to:

  • Wash his or her hands thoroughly and frequently
  • Avoid touching his mouth, nose or eyes with hands that are not washed well.
  • Avoid sharing sweets, gum, food, water bottles and utensils
  • Replace the toothbrush after a tonsil infection
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