Chronic Tonsillitis - Symptoms & Treatment

Inflammation of the tonsils, or tonsillitis, can be acute or chronic. The uncomplicated acute form usually lasts 4 to 6 days and commonly affects children between ages 5 and 10. The presence of proven chronic tonsillitis justifies tonsillectomy, the only effective treatment. Tonsils tend to hypertrophy during childhood and atrophy after puberty.

Causes

There are many possible, highly contagious bacterial and viral causes of tonsillitis. Causes of tonsillitis include the following:

Streptococcus (commonly referred to as "strep") bacteria (the most common cause of tonsillitis)
adenoviruses
the influenza virus
the Epstein-Barr virus
parainfluenza viruses
enteroviruses
the herpes simplex virus

Signs and symptoms

The symptoms of tonsillitis include:

sore throat
difficulty swallowing
fever
headache
tiredness
swollen, painful lymph nodes in the neck

Younger children may also complain of tummy ache (probably due to swelling of lymph glands in the abdomen).

Diagnosis

Tonsillitis can be diagnosed by performing a rapid strep test, also called a throat culture. To perform the throat culture, the doctor will use a long cotton swab to swipe off some of the stuff on the surface of the back of your throat. The doctor will then test the "stuff" on the cotton swab. This test will determine whether you have tonsillitis and whether it is caused by a bacteria or a virus.

Treatment

Effective treatment of acute tonsillitis requires rest, adequate fluid intake, administration of aspirin or acetaminophen and, for bacterial infection, antibiotics.

When the causative organism is group A beta-hemolytic streptococcus, penicillin is the drug of choice (another broad-spectrum antibiotic may be substituted.). Most oral anaerobes will also respond to penicillin. To prevent complications, antibiotic therapy should continue for 10 to 14 days.

Chronic tonsillitis or the development of complications (obstructions from tonsillar hypertrophy, peritonsillar abscess) may require a tonsillectomy, but only after the patient has been free of tonsillar Or respiratory tract infections for 3 to 4 Weeks.

Prevention

To prevent tonsillitis, avoid letting your child near anyone who already has tonsillitis or a sore throat. Make sure to practice good hand-washing habits, and teach your child to do the same. If you are concerned that your child has the symptoms of tonsillitis, or has been exposed to someone who has been infected, talk with your child's doctor.

Other common-sense precautions apply, too. Cough or sneeze into your elbow or a tissue. Don't share drinking glasses or eating utensils. Avoid close contact with anyone who's sick. Look for a child care setting with sound hygiene practices and clear policies about keeping sick children at home.

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