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Tonsillitis – causes, symptoms and treatment


TL;DR:

  • Tonsillitis: Inflammation of the palatine tonsils caused by viruses (adenoviruses, rhinoviruses) or bacteria (primarily Group A Streptococcus). Common symptoms: sore throat, difficulty swallowing, fever, swollen/red tonsils, pus (in bacterial cases), and enlarged neck lymph nodes.
  • Diagnosis: Based on symptoms, physical exam, and throat swabs for bacterial infections.
  • Treatment: Viral tonsillitis—symptomatic relief (painkillers, sprays). Bacterial tonsillitis—antibiotics to avoid complications (rheumatic fever, nephritis). Chronic/recurrent cases or complications (e.g., abscess) may require tonsillectomy (tonsil removal).
  • Tonsillectomy: Performed under general anesthesia; removes tonsils entirely or partially (tonsillotomy in children). Post-op recovery takes ~2 weeks.
  • Effects: Reduces infections, improves breathing (sleep issues like sleep apnea), speech, and swallowing.
  • Contraindications: Includes clotting disorders, respiratory failure, cleft palate, active tuberculosis, and others.

Tonsillitis is a common problem that affects the palatine tonsils, which are part of the lymphatic system responsible for protecting against infection. Although the tonsils play an important role in the body's defense, they can become infected with bacteria or viruses, leading to painful symptoms, discomfort and decreased well-being. Find out how modern treatments can provide relief and improve quality of life, just what!

What exactly is tonsillitis?

The palatine tonsils are a cluster of lymphoid tissue located in the depression of the throat between the palatine arches. Their function is to protect the body from pathogens found in the food we eat and in the inhaled air. When capturing a variety of microorganisms, healthy tonsils become larger due to the influx of immune cells. During the first years of life, the tonsils in the throat play an important role in the immune system's adaptation to the environment. [read more url="https://otcoclinic.com/blog/trzeci-migdal-powiekszony-migdal-u-dzieci-kiedy-usunac/" text="Third tonsil – enlarged tonsil, in children – when to remove"]. Enlarged tonsils are a very common reason for visits to the ENT, affecting both children and adults. Symptoms can include a sore throat, difficulty swallowing, fever and enlarged and bloody tonsils. The infection is caused by both viruses and bacteria, the most common pathogen being group A beta-hemolytic streptococcus (GABHS). In some cases, tonsillitis can be complicated by peri-tonsillar abscesses or lead to chronic inflammation.

Sick tonsils – causes.

Inflammation of the tonsils is most often the result of a viral or bacterial infection. Inflammation can also be caused by fungi (tonsillitis), as well as protozoa. In general, the most common causes include:

  • viral infections – including primarily adenoviruses, rhinoviruses, coronaviruses. Much less common causes are Epstein-Barr virus (which causes mononucleosis), cytomegalovirus, rubella, HIV or hepatitis A. In the latter cases, the pathogens cause the underlying conditions, while tonsillar hypertrophy is a concurrent symptom. Tonsils – inflammation of viral origin is characterized by congestion and swelling of the structures, while no white coating is observed directly on their surface,
  • Bacterial infections – are less common than viral infections and cause purulent inflammation of the tonsil. The cause is usually group A beta-hemolytic streptococci (S. pyogenes), S.aureus, S. pneumoniae and H.influenza, which can lead to serious complications if not properly treated. Purulent tonsils have a typical white infiltrate on the surface, which makes it easy to differentiate the cause of inflammation,
  • systemic diseases – diabetes, hyperthyroidism, allergies, gastroesophageal reflux, cancer,
  • environmental factors – being in crowded places, exposure to cigarette smoke or polluted air, weakened immunity, a foreign body in the throat area, improper temperature and humidity.

Symptoms and diagnosis

Typical symptoms of tonsillitis include:

  • sore throat and difficulty swallowing,
  • reddened and swollen tonsils,
  • white or yellowish plaques on the tonsils,
  • fever and chills,
  • enlarged lymph nodes in the neck,
  • general weakness of the body, headache, chills,
  • change in tone of voice,
  • sneezing, coughing.

Diagnosis is made on the basis of a physical examination and medical history. In some cases, laboratory tests are performed, such as a throat swab to detect the presence of bacteria.
Illustration showing inflamed tonsils with redness and swelling.

Treatment of tonsillitis

Treatment of tonsillitis depends on the cause of the infection. For viral infections, symptomatic treatment is used to relieve discomfort such as sore throat and fever. Lozenges, painkillers and antipyretics or sprays to reduce inflammation are used. Bacterial infections require individual antibiotic therapy to prevent complications such as rheumatic fever and nephritis. Recurrent and chronic tonsillitis in adults and children often requires surgical intervention. In this case it is tonsillectomy, or surgical removal of the tonsils. The procedure is also used in cases complicated by periglottal abscesses.

Indications for the procedure

Overgrown tonsils affect people of all ages. An absolute indication for tonsil removal is excessive hypertrophy of the tonsils, which causes difficulty in breathing, swallowing, speech impediment, and can also lead to obstructive sleep apnea. Enlarged tonsils in children, can affect craniofacial development and sleep quality, which can have further health consequences. Another indication for surgery is recurrent inflammation of the tonsils, which can lead to chronic tonsillitis or sinusitis. Recurrent infections significantly reduce quality of life, causing sore throat, fever, general weakness and increased risk of complications such as rheumatic fever and nephritis. Ongoing cancer, primary tuberculosis of the tonsils or carrying diphtheria are also grounds for removal of the tonsils. A peri-tonsillar abscess, or accumulation of pus around the tonsils, is a serious indication for tonsillectomy. The abscess leads to severe pain, difficulty swallowing, breathing problems and in some cases even septicemia, which requires immediate surgical intervention. Tonsillectomy is most commonly performed in adults and older children (around 8-10 years of age). In younger children, because of their immune function, the tonsils are usually removed partially in a procedure called tonsillotomy to preserve their protective immune properties.

Contraindications

Adult tonsil excision is contraindicated in the following situations:

Course of treatment

Before tonsillectomy, a consultation with an ENT specialist and an anesthesiologist must be held. It is necessary to have a detailed interview with the patient, as part of which the specialist qualifies the patient for the procedure and excludes any contraindications. One week before the operation, one should not take non-steroidal anti-inflammatory drugs, while immediately 6h before the procedure one must not drink or eat. The tonsillectomy procedure is performed under general anesthesia. The surgeon completely removes the tonsils using a scalpel or the alternative method BIZact. Innovative electrosurgical equipment allows precise separation of the tonsil from adjacent tissues. Surgery using the BIZact technique is virtually bloodless, relatively quick, and also ensures smooth wound healing and minimal pain. The procedure takes about an hour, and the patient can return home the same day. After surgery, the patient is advised to avoid heavy physical labor and eat soft foods for a few days. **After tonsillectomy, the patient may experience a sore throat, which subsides after a few days. Full recovery usually takes about two weeks.

Effects of the procedure

The noticeable effects of tonsillectomy in adults are primarily the cessation of recurrent infections. Patients experience a reduction in the frequency of throat infections, tonsillitis and other upper respiratory infections. The treatment significantly improves breathing, especially at night, which helps treat obstructive sleep apnea. Improved sleep quality often leads to an overall increase in energy levels and a better daytime mood. A tonsillectomy also results in a reduction in sore throat, as well as improved speech and swallowing. Tonsillitis is a common infection that can lead to serious complications if not treated properly. Early diagnosis and appropriate treatment, including antibiotic therapy or tonsillectomy, can effectively prevent complications and improve quality of life. If you suffer from recurrent tonsillitis, it's worth consulting an ENT specialist to discuss the best treatment options and enjoy life to the fullest without infection, that's what!

Conclusion

Tonsillitis may cause pain and discomfort, but effective treatments are available. From understanding symptoms to diagnosing and treating infections, knowing your options makes a big difference. Whether using antibiotics for bacterial cases or considering tonsil removal for chronic issues, timely action improves health and life quality. If throat issues often disrupt your life, seek help from a trusted ENT specialist. Don’t let recurrent tonsillitis hold you back—modern solutions exist to relieve symptoms and prevent complications. Your health and comfort are worth prioritizing!