Tonsillitis – Causes, Symptoms and Treatment

Contents

• Tonsillitis in Children
• What Causes Tonsillitis?
• Symptoms of Tonsillitis
• Complications of Tonsillitis
• Who Is at Risk for Tonsillitis?
• Diagnosing Tonsillitis
• Home Remedies for Tonsillitis
• When to See a Doctor
• Treatment Options
• Preventing Tonsillitis

Tonsillitis in Children

Tonsillitis is most prevalent in children between the ages of 5 and 15. This is because children are frequently in close contact with peers at school and easily transmit viruses and bacteria that can cause tonsillitis. The tonsils also tend to be more active in childhood as they are an important part of the developing immune system. Tonsillitis can cause discomfort and interfere with eating and drinking. Parents should monitor symptoms and contact the child’s GP if they do not go away within one week. With rest and supportive care, most cases in otherwise healthy children resolve without issue.

What Causes Tonsillitis?

In most cases, tonsillitis is caused by a viral or bacterial infection. Viruses are the most common cause, especially in children. The viruses that commonly cause tonsillitis include influenza, parainfluenza, rhinovirus, coronavirus, adenovirus, respiratory syncytial virus, and Epstein-Barr virus.

Bacterial tonsillitis occurs less often and is typically caused by Group A streptococcus bacteria, also known as strep throat. Other bacteria like staphylococcus, pneumococcus, and haemophilus influenza can also sometimes cause bacterial tonsillitis.

Tonsillitis itself is not contagious, but the viral or bacterial infections that cause it can spread between people.

Symptoms of Tonsillitis

The most common symptoms of tonsillitis include:

• Sore throat
• Pain or difficulty swallowing
• Fever
• Headache
• Fatigue
• Swollen, red tonsils, sometimes with white patches
• Swollen lymph nodes in the neck
• Bad breath
• Loss of appetite

Symptoms usually start suddenly and tend to be worse in children and teenagers. Most cases of tonsillitis resolve within 3 to 4 days with proper rest and symptom management, although symptoms can last longer. Bacterial tonsillitis may sometimes need antibiotic treatment.

Complications of Tonsillitis

In most cases, tonsillitis is mild and self-limiting. However, some potential complications to watch for include:

• Dehydration from difficulty swallowing and drinking
• Chronic tonsillitis with frequent repeat infections
• Peritonsillar abscess, also known as quinsy (a collection of pus near the tonsils)
• Spread of infection to other parts of the body
• Breathing difficulty (rare)

Seek medical advice promptly if you experience signs of dehydration, intense throat pain, a stiff neck or changes in your voice. Call 999 or go to A&E if you have difficulty breathing or cannot swallow.

Who Is at Risk for Tonsillitis?

Tonsillitis is most common in school-aged children between 5 and 15 years old. This is due to increased exposure to viruses and bacteria in school environments. Adults can also develop tonsillitis, but it becomes less frequent with age as the tonsils shrink. Those with weakened immune systems are at higher risk for tonsillitis as well.

Diagnosing Tonsillitis

If symptoms of tonsillitis do not go away within one week, it is recommended that you see a GP. The GP will ask about symptoms and examine the throat. They may use a tongue depressor to inspect the tonsils for swelling, redness and white patches.

The GP may also take a throat swab and send it for laboratory testing to check whether bacteria are causing the tonsillitis. A blood test can sometimes be done to check for glandular fever (infectious mononucleosis).

Imaging scans are not normally needed but may be done if there are concerns about a peritonsillar abscess or other complications.

Home Remedies for Tonsillitis

Some home remedies can provide symptom relief:

• Drink cool or warm liquids
• Eat cool, soft foods such as ice cream, smoothies and chilled soups
• Gargle with warm salt water, but do not give this remedy to young children
• Ask a pharmacist about suitable medicated throat lozenges or other treatments
• Use a humidifier or steamy shower to moisten the air
• Rest your voice and avoid talking or whispering
• Get ample rest and sleep

These methods can help reduce throat pain and discomfort associated with tonsillitis. They are most helpful for mild viral cases alongside suitable over-the-counter medication.

When to See a Doctor

See your GP if the symptoms do not go away within one week or you keep getting throat infections. Contact NHS 111 if there are pus-filled spots on the tonsils or the sore throat is so painful that eating or drinking is difficult.

Call 999 or go to A&E if you or your child has difficulty breathing, cannot swallow, is drooling, makes a high-pitched sound when breathing, or has severe symptoms that are getting worse quickly.

Treatment Options

Rest and Symptom Relief

In mild viral cases, the main treatment is rest along with over-the-counter pain relievers such as paracetamol or ibuprofen. Do not give aspirin to children under 16, and always follow the instructions or ask a pharmacist if you are unsure whether a medicine is suitable. Staying hydrated and gargling warm salt water can also help soothe throat pain, although young children should not gargle with salt water.

Antibiotics

Most people with tonsillitis do not need antibiotics. If bacterial infection is considered likely, a GP may prescribe an antibiotic. Phenoxymethylpenicillin is usually the first-choice treatment in UK guidance, commonly for 5 to 10 days. Take the medicine exactly as prescribed and complete the course.

Surgery

For chronic, recurrent tonsillitis, surgery to remove the tonsils (tonsillectomy) may be recommended. This is usually only done when tonsillitis occurs frequently and severely affects normal functioning.

Tonsillectomy Recovery

Tonsillectomy is performed under general anaesthesia as a day-case procedure or with an overnight hospital stay. Recovery involves resting at home for 1 to 2 weeks. Pain and discomfort are common during recovery, so medication, soft foods and proper hydration are important. Most people can return to normal activity in about 2 weeks.

Preventing Tonsillitis

While tonsillitis cannot be completely prevented, good hygiene helps reduce the spread of infections that cause it. Thorough hand washing, covering coughs and sneezes, avoiding shared utensils, and disinfecting surfaces can help stop transmission. Getting adequate rest, eating a healthy diet and managing stress can also support the immune system.

In summary, tonsillitis is a common throat infection treatable with self-care and sometimes antibiotics. Severe, chronic cases may require tonsil removal, but this is rare. See a GP if symptoms do not go away within one week or keep returning, and seek urgent help for serious symptoms. With proper treatment and precautions, most cases of tonsillitis resolve without complications.

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