Tonsillitis | |
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A culture-positive case of streptococcal pharyngitis with typical tonsillar exudate in a 16-year-old | |
Pronunciation | |
Specialty | Infectious disease |
Symptoms | Sore throat, fever, enlargement of the tonsils, trouble swallowing, large lymph nodes around the neck[1][2] |
Complications | Peritonsillar abscess[1][3] |
Duration | ~ 1 week[4] |
Causes | Viral infection, bacterial infection[1][5][6] |
Diagnostic method | Based on symptoms, throat swab, rapid strep test[1][5] |
Medication | Paracetamol (acetaminophen), ibuprofen, penicillin[1][5] |
Frequency | 7.5% (in any given 3 months)[7] |
Tonsillitis is inflammation of the tonsils in the upper part of the throat. It can be acute or chronic.[8][9][2] Acute tonsillitis typically has a rapid onset.[10] Symptoms may include sore throat, fever, enlargement of the tonsils, trouble swallowing, and enlarged lymph nodes around the neck.[1][2] Complications include peritonsillar abscess (quinsy).[1][3]
Tonsillitis is most commonly caused by a viral infection and about 5% to 40% of cases are caused by a bacterial infection.[1][5][6] When caused by the bacterium group A streptococcus, it is classed as streptococcal tonsillitis[11] also referred to as strep throat.[12] Rarely bacteria such as Neisseria gonorrhoeae, Corynebacterium diphtheriae, or Haemophilus influenzae may be the cause.[5] Typically the infection is spread between people through the air.[6] A scoring system, such as the Centor score, may help separate possible causes.[1][5] Confirmation may be by a throat swab or rapid strep test.[1][5]
Treatment efforts involve improving symptoms and decreasing complications.[5] Paracetamol (acetaminophen) and ibuprofen may be used to help with pain.[1][5] If strep throat is present the antibiotic penicillin by mouth is generally recommended.[1][5] In those who are allergic to penicillin, cephalosporins or macrolides may be used.[1][5] In children with frequent episodes of tonsillitis, tonsillectomy modestly decreases the risk of future episodes.[13]
About 7.5% of people have a sore throat in any three-month period and 2% of people visit a doctor for tonsillitis each year.[7] It is most common in school-aged children and typically occurs in the colder months of autumn and winter.[5][6] The majority of people recover with or without medication.[1][5] In 82% of people, symptoms resolve within one week, regardless if bacteria or viruses were present.[4] Antibiotics probably reduce the number of people experiencing sore throat or headache, but the balance between modest symptom reduction and the potential hazards of antimicrobial resistance must be recognised.[4]
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