What is tonsillitis?

Causes and Symptoms

Four small pairs of lymphatic tissue called tonsils
together form a ring that circles the nasal cavity and mouth. In children, these tonsils help filter and protect the respiratory and alimentary tracts from infection. As children grow, however, this function dwindles and the tonsils shrink. Tonsillitis, or an infection of these tissues, can be either viral or bacterial in origin. Viral infections are more common in children under three, while older children usually suffer from bacterial infections. A throat culture can determine whether bacteria are present, thus indicating antibiotic treatment.

The two pairs of tonsils most often infected and inflamed are the palatine tonsils, which are those removed in a tonsillectomy, and the adenoids. Symptoms of infected and enlarged tonsils include a sore throat, difficulty swallowing, fever, chills, bad breath, and breathing exclusively through the mouth.

Treatment and Therapy

Viral tonsillitis is self-limiting and typically lasts for five days or less. In these cases, treatment should be symptomatic and includes a soft or liquid diet, warm saltwater or mild antiseptic gargles, throat lozenges, rest, and an analgesic drug such as acetaminophen. If a throat culture indicates bacterial causes, treatment should also include a ten-day course of penicillin or other appropriate drug and a second culture to determine the effectiveness of the treatment.

Occasionally, tonsillectomy (removal of the palatine tonsils) and adenoidectomy (removal of the adenoids) may also be indicated. Because the tonsils play an important role in the development of the immune system, children under three should not be surgically treated. Before the discovery of penicillin and other antibiotics, a tonsillectomy was the treatment of choice for children who suffered recurrent tonsillitis. Because of the inherent risks of even minor surgery, however, tonsillectomies are now performed only if infected and enlarged tonsils are so problematic that they threaten to obstruct breathing.

Bibliography

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