How long do antibiotics typically take to work for tonsillitis. Are antibiotics always necessary for treating sore throats. What are the potential benefits and risks of using antibiotics for tonsillitis. How can you determine if your sore throat is caused by bacteria or a virus.

Understanding Tonsillitis and Its Causes

Tonsillitis, a common condition characterized by inflammation of the tonsils, often leads individuals to seek medical attention, especially during colder seasons. While many assume antibiotics are the go-to solution, it’s crucial to understand the underlying causes of this ailment.

Tonsillitis can be triggered by various factors, including:

• Viral infections (most common)
• Bacterial infections
• Allergies
• Environmental irritants

Distinguishing between viral and bacterial tonsillitis is essential for proper treatment. Viral tonsillitis, often associated with the common cold, does not respond to antibiotics. On the other hand, bacterial tonsillitis, frequently caused by streptococcus bacteria, may benefit from antibiotic treatment.

Identifying Bacterial Tonsillitis: Signs and Symptoms

Recognizing the symptoms of bacterial tonsillitis can help determine whether antibiotics might be necessary. Key indicators include:

• Fever (typically higher than 38째C or 100.4째F)
• Swollen tonsils with white or yellowish spots
• Absence of cough
• Swollen lymph nodes in the neck
• Severe throat pain

Can these symptoms definitively diagnose bacterial tonsillitis? While they provide strong indications, a throat swab test is the most accurate method for confirmation. Rapid tests can provide quick results, although they may not be as precise as laboratory cultures, which can take 2-3 days for conclusive results.

Antibiotic Effectiveness in Treating Tonsillitis

The efficacy of antibiotics in treating tonsillitis has been a subject of extensive research. A comprehensive analysis by the Cochrane Collaboration, involving 27 studies and over 12,800 participants, shed light on this matter.

How effective are antibiotics in reducing the duration of sore throats?

• After 3 days:
  • 80% of untreated individuals still experienced sore throat
  • 55% of those taking antibiotics continued to have symptoms
• After 1 week:
  • 40% of untreated individuals still had sore throat
  • 20% of those on antibiotics reported persistent symptoms

These findings suggest that antibiotics can accelerate recovery by approximately half a day to one day on average. It’s worth noting that the effectiveness was slightly higher in individuals with confirmed bacterial infections.

Potential Complications and Antibiotic Benefits

While the primary goal of antibiotic treatment is to alleviate symptoms and speed up recovery, they can also help prevent certain complications associated with tonsillitis.

What complications can antibiotics help prevent?

• Middle ear infections
• Quinsy (peritonsillar abscess) – a collection of pus beside a tonsil
• Rheumatic fever (in rare cases)
• Kidney inflammation (in rare cases)

However, it’s important to note that these complications are relatively rare in otherwise healthy individuals, even without antibiotic treatment. The incidence rate for such complications ranges from less than 1 to 10 out of 1,000 cases.

Side Effects and Risks of Antibiotic Use

While antibiotics can be beneficial in treating bacterial tonsillitis, they are not without risks. Understanding these potential side effects is crucial for making informed decisions about treatment.

What are the common side effects of antibiotics?

• Diarrhea
• Skin rashes
• Nausea
• Yeast infections
• Allergic reactions (in rare cases)

Studies have shown that approximately 10 out of 100 adults experience side effects while taking or after completing a course of antibiotics. These side effects can range from mild discomfort to more severe reactions in some cases.

Antibiotic Resistance: A Growing Concern

One of the most significant risks associated with frequent antibiotic use is the development of antibiotic-resistant bacteria. This occurs when bacteria evolve to withstand the effects of antibiotics, making infections harder to treat.

How does antibiotic resistance develop?

• Overuse of antibiotics for minor conditions
• Incomplete courses of prescribed antibiotics
• Use of broad-spectrum antibiotics when narrow-spectrum ones would suffice
• Presence of antibiotics in food and water sources

The consequences of antibiotic resistance are far-reaching, potentially making serious medical conditions more challenging to treat effectively. This underscores the importance of judicious antibiotic use, particularly for conditions like tonsillitis, where they may not always be necessary.

Alternative Treatments and Home Remedies for Tonsillitis

Given the potential risks associated with antibiotic use and the fact that many cases of tonsillitis are viral in nature, exploring alternative treatments and home remedies can be beneficial.

What are some effective home remedies for tonsillitis?

• Gargling with warm salt water
• Drinking plenty of fluids to stay hydrated
• Using over-the-counter pain relievers like ibuprofen or acetaminophen
• Consuming honey or warm herbal teas with honey
• Using a humidifier to keep the air moist
• Resting and getting adequate sleep

These remedies can help alleviate symptoms and support the body’s natural healing process. In many cases, tonsillitis will resolve on its own within a week, even without specific treatment.

When to Seek Medical Attention

While home remedies can be effective for many cases of tonsillitis, there are situations where medical intervention is necessary.

When should you consult a doctor for tonsillitis?

• Symptoms persist for more than a week
• Difficulty breathing or swallowing
• Severe pain that interferes with eating or drinking
• High fever (above 101째F or 38.3째C) that doesn’t respond to over-the-counter medications
• Signs of dehydration
• Recurrent episodes of tonsillitis

In these cases, a healthcare provider can assess the situation and determine whether antibiotics or other treatments are necessary.

Preventive Measures and Lifestyle Considerations

While tonsillitis can’t always be prevented, certain lifestyle choices and preventive measures can reduce the risk of infection and support overall throat health.

How can you reduce your risk of developing tonsillitis?

• Practice good hand hygiene
• Avoid sharing utensils, drinks, or personal items
• Quit smoking and avoid secondhand smoke
• Maintain a healthy diet rich in vitamins and minerals
• Get adequate sleep and manage stress
• Keep your immune system strong through regular exercise

These practices not only help prevent tonsillitis but also contribute to overall health and well-being. By adopting these habits, you can potentially reduce the frequency and severity of throat infections.

The Role of Tonsils in Immune Function

Understanding the importance of tonsils in the body’s immune system can provide context for their care and treatment. Tonsils are part of the lymphatic system and play a crucial role in defending the body against pathogens.

What functions do tonsils serve in the immune system?

• Act as a first line of defense against inhaled or ingested pathogens
• Produce antibodies to fight infections
• Help develop immunity in early childhood
• Filter out harmful bacteria and viruses

Given their important role, the decision to remove tonsils (tonsillectomy) is not taken lightly and is typically reserved for cases of chronic or recurrent tonsillitis that significantly impact quality of life.

The Future of Tonsillitis Treatment: Research and Developments

As medical science advances, new approaches to diagnosing and treating tonsillitis are emerging. These developments aim to provide more targeted and effective treatments while minimizing the risk of antibiotic resistance.

What are some promising areas of research in tonsillitis treatment?

• Rapid diagnostic tests for more accurate bacterial identification
• Development of narrow-spectrum antibiotics
• Exploration of bacteriophage therapy as an alternative to antibiotics
• Investigation of immunomodulatory treatments
• Research into the role of probiotics in preventing and treating tonsillitis

These advancements hold the potential to revolutionize how we approach tonsillitis, potentially leading to more personalized and effective treatment strategies in the future.

The Importance of Antibiotic Stewardship

As research progresses, there’s an increasing emphasis on antibiotic stewardship – the responsible use of antibiotics to preserve their effectiveness for future generations. This approach involves careful consideration of when antibiotics are truly necessary and selecting the most appropriate antibiotic when they are needed.

How can healthcare providers practice antibiotic stewardship in treating tonsillitis?

• Accurately differentiating between viral and bacterial infections
• Prescribing antibiotics only when clearly indicated
• Choosing narrow-spectrum antibiotics when possible
• Educating patients about proper antibiotic use and potential risks
• Monitoring antibiotic resistance patterns in the community

By implementing these practices, healthcare providers can help ensure that antibiotics remain effective tools in fighting bacterial infections, including cases of bacterial tonsillitis.

In conclusion, while antibiotics can be effective in treating bacterial tonsillitis, their use should be carefully considered. Understanding the causes, symptoms, and treatment options for tonsillitis empowers individuals to make informed decisions about their health. By combining medical knowledge with responsible antibiotic use and preventive measures, we can effectively manage tonsillitis while preserving the efficacy of antibiotics for future generations.

Tonsillitis: Do antibiotics make sore throats go away quicker? – InformedHealth.org

Antibiotics can shorten the length of throat infections by between half a day and one day on average. But they can have side effects, and using antibiotics too much increases the risk of bacteria becoming resistant to them.

A lot of people go to the doctor because of a sore throat – particularly in the cold season. Sore throats are often caused by a common cold, and sometimes by a throat infection or a tonsil infection (tonsillitis). People may then wonder whether or not to take antibiotics. But antibiotics won’t help in most cases: Sore throats that are part of a common cold are usually caused by viruses, and antibiotics don’t fight viruses. Antibiotics only help in people who have a bacterial infection, such as bacterial tonsillitis. Most sore throats go away on their own within a week anyway, without any special treatment.

Certain symptoms suggest that the sore throat is being caused by a bacterial infection.  If you have a fever and swollen tonsils with a coating of white or yellowish spots on them, but you don’t have a cough, you could have bacterial tonsillitis. Doctors can find out whether it’s bacterial using a throat swab to get a sample of secretions from your throat or tonsils. The sample can be tested straight away in what is known as a rapid test, but the results aren’t very accurate. They are somewhat more accurate if the sample is sent to a lab and checked for bacteria there. This is hardly ever done, though, because it takes 2 to 3 days to get the results back. So antibiotics are usually prescribed based on symptoms alone, if the throat infection is suspected to be caused by bacteria. This means that a number of people who take antibiotics don’t benefit from them because their sore throat is caused by a viral infection.

Effectiveness of treatment with antibiotics

Because antibiotics are often used for sore throats even though it isn’t clear whether bacteria are really to blame, it would be interesting to known how effective this medication is. Researchers at the Cochrane Collaboration (an international network of researchers) analyzed a total of 27 studies including more than 12,800 people. In these studies one group of people took antibiotics and another group took a placebo (fake medicine). Most of the study participants had signs of a bacterial infection. The following results do not apply to people who have milder symptoms that are probably caused by a viral infection.

The studies showed that taking antibiotics can speed up recovery somewhat:

• About 80 out of 100 people who didn’t take antibiotics still had a sore throat after three days.
• About 55 out of 100 people who took antibiotics still had a sore throat after three days.

The results after one week:

• About 40 out of 100 people who didn’t use antibiotics still had a sore throat.
• About 20 out of 100 people who used antibiotics still had a sore throat.

In some of the participants a swab test detected certain bacteria that can cause bacterial tonsillitis. The antibiotics were a bit more effective in that group of people.

The studies also showed that antibiotics can prevent complications such as middle ear infections. People who take antibiotics are also less likely to develop a different complication called quinsy (also known as a peritonsillar abscess). This is a build-up of pus beside a tonsil. But these and other complications are rare in people who are otherwise healthy, even if they don’t take antibiotics. They occur in less than 1 to 10 out of 1,000 people who go to a doctor because of their symptoms.

Side effects of antibiotics

Antibiotics can have side effects too, though: Other studies have found that about 10 out of 100 adults experience side effects while taking, or after taking, antibiotics. The most common include diarrhea and rashes. What’s more, using antibiotics too much and even when treating less serious medical conditions can cause bacteria to become resistant. This means that the bacteria are no longer killed by the antibiotics. As a result, a lot of serious medical conditions can no longer be treated as successfully as before.

Sources

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  German health care system. The suitability of any of the described options in an individual
  case can be determined by talking to a doctor. We do not offer individual consultations.

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Tonsillitis – Diagnosis and treatment

Diagnosis

Your child’s doctor will start with a physical exam that will include:

• Using a lighted instrument to look at your child’s throat and likely his or her ears and nose, which also may be sites of infection
• Checking for a rash known as scarlatina, which is associated with some cases of strep throat
• Gently feeling (palpating) your child’s neck to check for swollen glands (lymph nodes)
• Listening to his or her breathing with a stethoscope
• Checking for enlargement of the spleen (for consideration of mononucleosis, which also inflames the tonsils)

Throat swab

With this simple test, the doctor rubs a sterile swab over the back of your child’s throat to get a sample of secretions. The sample will be checked in the clinic or in a lab for streptococcal bacteria.

Many clinics are equipped with a lab that can get a test result within a few minutes. However, a second more reliable test is usually sent out to a lab that can often return results within several hours or a couple of days.

If the rapid in-clinic test comes back positive, then your child almost certainly has a bacterial infection. If the test comes back negative, then your child likely has a viral infection. Your doctor will wait, however, for the more reliable out-of-clinic lab test to determine the cause of the infection.

Complete blood cell count (CBC)

Your doctor may order a CBC with a small sample of your child’s blood. The result of this test, which can often be completed in a clinic, produces a count of the different types of blood cells. The profile of what’s elevated, what’s normal or what’s below normal can indicate whether an infection is more likely caused by a bacterial or viral agent. A CBC is not often needed to diagnose strep throat. However, if the strep throat lab test is negative, the CBC may be needed to help determine the cause of tonsillitis.

Treatment

At-home care

Whether tonsillitis is caused by a viral or bacterial infection, at-home care strategies can make your child more comfortable and promote better recovery.

If a virus is the expected cause of tonsillitis, these strategies are the only treatment. Your doctor won’t prescribe antibiotics. Your child will likely be better within seven to 10 days.

At-home care strategies to use during the recovery time include the following:

• Encourage rest. Encourage your child to get plenty of sleep.
• Provide adequate fluids. Give your child plenty of water to keep his or her throat moist and prevent dehydration.
• Provide comforting foods and beverage. Warm liquids — broth, caffeine-free tea or warm water with honey — and cold treats like ice pops can soothe a sore throat.
• Prepare a saltwater gargle. If your child can gargle, a saltwater gargle of 1/2 teaspoon (2.5 milliliters) of table salt to 8 ounces (237 milliliters) of warm water can help soothe a sore throat. Have your child gargle the solution and then spit it out.
• Humidify the air. Use a cool-air humidifier to eliminate dry air that may further irritate a sore throat, or sit with your child for several minutes in a steamy bathroom.
• Offer lozenges. Children older than age 4 can suck on lozenges to relieve a sore throat.
• Avoid irritants. Keep your home free from cigarette smoke and cleaning products that can irritate the throat.

• Treat pain and fever. Talk to your doctor about using ibuprofen (Advil, Children’s Motrin, others) or acetaminophen (Tylenol, others) to minimize throat pain and control a fever. Low fevers without pain do not require treatment.

  Unless aspirin is prescribed by a doctor to treat a particular disease, children and teenagers should not take aspirin. Aspirin use by children to treat symptoms of cold or flu-like illnesses has been linked to Reye’s syndrome, a rare but potentially life-threatening condition.

Antibiotics

If tonsillitis is caused by a bacterial infection, your doctor will prescribe a course of antibiotics. Penicillin taken by mouth for 10 days is the most common antibiotic treatment prescribed for tonsillitis caused by group A streptococcus. If your child is allergic to penicillin, your doctor will prescribe an alternative antibiotic.

Your child must take the full course of antibiotics as prescribed even if the symptoms go away completely. Failure to take all of the medication as directed may result in the infection worsening or spreading to other parts of the body. Not completing the full course of antibiotics can, in particular, increase your child’s risk of rheumatic fever and serious kidney inflammation.

Talk to your doctor or pharmacist about what to do if you forget to give your child a dose.

Surgery

Surgery to remove tonsils (tonsillectomy) may be used to treat frequently recurring tonsillitis, chronic tonsillitis or bacterial tonsillitis that doesn’t respond to antibiotic treatment. Frequent tonsillitis is generally defined as:

• At least seven episodes in the preceding year
• At least five episodes a year in the past two years
• At least three episodes a year in the past three years

A tonsillectomy may also be performed if tonsillitis results in difficult-to-manage complications, such as:

• Obstructive sleep apnea
• Breathing difficulty
• Swallowing difficulty, especially meats and other chunky foods
• An abscess that doesn’t improve with antibiotic treatment

A tonsillectomy is usually done as an outpatient procedure, unless your child is very young, has a complex medical condition or if complications arise during surgery. That means your child should be able to go home the day of the surgery. A complete recovery usually takes seven to 14 days.

Preparing for your appointment

If your child is experiencing a sore throat, difficulty swallowing or other symptoms that may indicate tonsillitis, you’ll likely start with a visit to your family doctor or your child’s pediatrician. You may be referred to a specialist in ear, nose and throat disorders.

Your doctor is likely to ask you a number of questions about your child’s condition. Be prepared to answer the following questions:

• When did the symptoms begin?
• If your child has had a fever, what was his or her temperature?
• Does he or she have difficulty swallowing foods, or does it hurt to swallow?
• Does anything improve symptoms, such as an over-the-counter pain reliever or warm liquids?
• Has your child been diagnosed with tonsillitis or strep throat before? If so, when?
• Do symptoms seem to affect his or her sleep?
• Has your child been exposed to anyone known to have strep throat?

Questions you may want to ask your doctor include the following:

• How long will it take to get test results?
• What is the best course of treatment?
• Should I be concerned with how frequently my child is getting tonsillitis?
• When can my child go back to school or resume other activities?

Nov. 07, 2020

Tonsillitis | Cigna

Condition Basics

What is tonsillitis?

Tonsillitis is an infection or inflammation of the tonsils. The tonsils are areas of lymph tissue on both sides of the throat, above and behind the tongue. They are part of the immune system, which helps the body fight infection. Tonsillitis often goes away on its own after 4 to 10 days.

What causes it?

Tonsillitis is usually caused by a virus. It can also be caused by the same bacteria that cause strep throat. In rare cases, a fungus or a parasite can cause tonsillitis.

What are the symptoms?

The main symptoms of tonsillitis are a sore throat and swollen tonsils. Symptoms may also include a fever, a congested or runny nose, swollen lymph nodes, a headache, and trouble swallowing.

How is it diagnosed?

Your doctor will look at your throat to see if you have red and swollen tonsils with spots or sores. These signs can mean that you have tonsillitis. Your doctor may do a rapid strep test along with a throat culture. These will show if the tonsillitis is caused by streptococcus bacteria.

How is tonsillitis treated?

If your tonsillitis is caused by strep bacteria, you may need treatment with antibiotics. Tonsillitis caused by a virus usually goes away on its own. Treatment includes self-care at home, such as over-the-counter pain medicine. Surgery to remove the tonsils is only used when there are serious problems with the tonsils.

Does your child need a tonsillectomy?

Tonsillectomy is surgery to remove the tonsils. It’s generally used for children who have serious complications. Or it may be done when there are repeated infections that don’t respond to other treatment, especially when they interfere with daily life. But it should only be done after you and your doctor carefully think about your child’s medical history and overall health.

Tonsillectomy for strep throat may be done when tonsillitis keeps coming back and isn’t helped by antibiotics. Or it may be done if an infection threatens the child’s well-being.

Diagnosis, Treatment, Medicines, and More

How Do I Know If My Child Has Tonsillitis?

To check your child’s tonsils, gently place the handle of a spoon, if possible, on their tongue and ask the child to say “aaahhh” while you shine a light on the back of the throat. If the tonsils look bright red and swollen, see your pediatrician or family doctor. Do not insist on doing this exam if you or the child is reluctant.

Often tonsillitis due to a virus looks no different than one caused by bacteria. Your pediatrician will examine your child’s tonsils and take a throat swab to check for strep throat. The test can be done with results available during the office visit. This is the rapid strep test. If this is negative a culture is done for confirmation which takes 24-48 hours. To check for a tonsillar abscess, the doctor will examine the tonsils and soft palate.

What Are the Treatments for Tonsillitis?

Since most of the time infection is due to a virus and not a bacteria, antibiotics are not routinely needed. For a bacterial infection such as strep, the doctor will prescribe an antibiotic, usually for 10 days. Be sure to give your child the full course; if unchecked, strep bacteria can cause serious conditions such as an abscess or rheumatic fever (a heart condition). If the infection is due to strep, the contagious period is over after the first 24 hours of using antibiotics.

If the throat culture is negative for bacteria, the infection is probably caused by a virus and requires only treatment for relief of symptoms. To ease pain, the doctor may also recommend acetaminophen (Tylenol) or ibuprofen (Advil). Do not give your child aspirin, which has been linked to Reye’s syndrome, a life-threatening condition. Gargling three times a day with warm salt water (1 teaspoon of salt in 8 ounces of warm water) may relieve some of the pain.

If your doctor discovers or suspects an abscess, you may need to be seen by an ear, nose, and throat doctor (called an ENT or otolaryngologist) to be evaluated for possible drainage of pus.

Frequent cases of tonsillitis that affect your child’s general health, interfere with school attendance, cause breathing problems (snoring), snoring, or difficulty swallowing may warrant surgical removal of the tonsils (tonsillectomy). This procedure is usually performed as outpatient surgery and your child can go home after a few hours of observation.

Recovery is usually helped by rest and avoiding vigorous activity. Try to get your child to drink plenty of fluids, but don’t force them to eat or drink. Older children should be given at least a pint of extra liquids per day. Although ice cream is usually the favorite food to cool the throat, it’s okay to offer your child any foods they desire if it will make your child more comfortable and help them eat. Do only what your doctor advises to lower your child’s fever.

How Can I Prevent Tonsillitis?

Hand washing remains crucial in preventing the spread of viruses and bacteria that cause tonsillitis. Avoid prolonged contact with anyone who has strep throat and has not been taking antibiotics for at least 24 hours. To be certain, avoid people who have been ill until such time as you are sure they no longer are.

Tonsillectomy, the surgical removal of the tonsils, is one of the most commonly performed operations in children. Newer surgical techniques and advances in anesthesia have made this 20-minute operation much more tolerable and safer than ever before. The reasons for tonsillectomy have also changed. Until the 1980s, the most common reason for tonsillectomy was because of recurrent infection. In the last 30 years, although tonsillectomy is frequently performed for recurrent infections, the most common reason for removing tonsils is tonsil-enlargement (hypertrophy) causing obstructive symptoms such as snoring, sleep apnea, and difficulty swallowing.

Tonsillitis | HealthLink BC

Topic Overview

What is tonsillitis?

Tonsillitis is an infection or inflammation of the tonsils. The tonsils are balls of lymph tissue on both sides of the throat, above and behind the tongue. They are part of the immune system, which helps the body fight infection.

Tonsillitis often goes away on its own after 4 to 10 days.

What causes tonsillitis?

Most often, tonsillitis is caused by a virus. Less often, it is caused by the same bacteria that cause strep throat. In rare cases, a fungus or a parasite can cause it.

Tonsillitis is spread through the air in droplets when an infected person breathes, coughs, or sneezes. You may then become infected after breathing in these droplets or getting them on your skin or on objects that come in contact with your mouth, nose, or eyes.

What are the symptoms?

The main symptom of tonsillitis is a sore throat. The throat and tonsils usually look red and swollen. The tonsils may have spots on them or pus that covers them completely or in patches. Fever is also common.

If you feel like you have a cold, with symptoms such as runny and stuffy nose, sneezing, and coughing, a virus is most likely the cause.

If you have a sore throat plus a sudden and severe fever and swollen lymph nodes, but you do not have symptoms of a cold, the infection is more likely caused by bacteria. This means you need to see a doctor and probably need a strep test.

How is tonsillitis diagnosed?

Your doctor will look at your throat to see if you have red and swollen tonsils with spots or sores. These signs can mean you have tonsillitis.

Your doctor may do a throat culture or rapid strep test. These will show whether the tonsillitis is caused by streptococcus bacteria.

Your doctor may also ask about past throat infections. If you get tonsillitis often, it may affect the choice of treatment.

You may have a test for mononucleosis if your doctor thinks that you have mono.

How is it treated?

Tonsillitis caused by a virus will usually go away on its own. Treatment focuses on helping you feel better. You may be able to ease throat pain if you drink warm tea, take over-the-counter pain medicine, and use other home treatments. Do not give aspirin to anyone age 18 or younger. It is linked to a serious disease called Reye syndrome.

If your tonsillitis is caused by strep, you need treatment with antibiotics. Antibiotics can help prevent rare but serious problems caused by strep and can control the spread of infection.

As a rule, doctors only advise surgery to remove tonsils (tonsillectomy) when there are serious problems with the tonsils. These include infections that happen again and again or long-lasting infections that do not get better after treatment and get in the way of daily activities. You and your doctor can decide if surgery is the right choice after a careful review of your or your child’s overall health.

Cause

Tonsillitis is usually caused by a virus. Bacteria can also cause tonsillitis. The most common bacterial cause of tonsillitis is group A beta-hemolytic streptococcus (GABHS), which also causes strep throat.

Tonsillitis can also be caused by fungi or parasites. But these causes are rare in people who have healthy immune systems.

How tonsillitis is spread

Tonsillitis is spread by close contact with an infected person. Droplets of disease-causing agents (pathogens) pass through the air when an infected person breathes, coughs, or sneezes. You may then become infected after you breathe in these droplets. Infection can also occur if pathogens get on your skin or on objects that come in contact with your mouth, nose, eyes, or other mucous membranes. Symptoms usually appear about 2 to 5 days after exposure.

A person with tonsillitis caused by strep bacteria is contagious early on and, without treatment, can remain so for up to 2 weeks. Antibiotics shorten the contagious period, and an infected person is no longer contagious about 24 to 48 hours after beginning antibiotic therapy.

Symptoms

The main symptom of tonsillitis is a sore throat. More symptoms occur in most cases. Some or all of the following may be present:

• Fever
• Bad breath
• Nasal congestion and runny nose
• Swollen lymph nodes
• Red, swollen tonsils covered completely or in patches by pus
• Difficulty swallowing
• Headache
• Abdominal (belly) pain
• Raw, bleeding patches on the tonsils

When you have sore throat plus cold symptoms such as nasal congestion, runny nose, sneezing, and coughing, the cause is most likely a virus. Viral infection of the tonsils usually goes away without treatment within 2 weeks.

Sore throat with, swollen glands, a sudden fever above 38.3°C (101°F), and without symptoms of an upper respiratory tract infection may point to a bacterial infection like strep that needs to be treated with antibiotics.

What Happens

Tonsillitis, in most cases, lasts 4 to 10 days. A bacterial sore throat may last slightly longer but usually gets better with antibiotics.

In some cases, tonsillitis can become chronic. Surgical removal of the tonsils (tonsillectomy) may be recommended for you or your child based on past health and results of physical examinations.

Complications of tonsillitis

Tonsillitis caused by strep bacteria that is not treated with antibiotics may result in complications, such as ear and sinus infections or pockets of infection outside the tonsils (peritonsillar abscess). More serious complications, such as rheumatic fever, are rare.

Recurrent and ongoing (chronic) tonsillitis may obstruct the upper airway and cause problems, such as snoring, nasal congestion, and mouth breathing. Sometimes chronic tonsillitis can lead to more severe conditions, including obstructive sleep apnea and heart and lung problems. But most children who have sleep apnea and enlarged tonsils do not have a history of tonsillitis.

What Increases Your Risk

Close contact with an infected person is the main risk factor for tonsillitis. Droplets of disease-causing agents (pathogens) pass through the air when an infected person breathes, coughs, or sneezes. You may then become infected after breathing in these droplets. Infection can also occur if pathogens get on your skin or on objects that come in contact with the mouth, nose, eyes, or other mucous membranes.

Nasal obstruction causes you to breathe through your mouth, which increases the risk of tonsillitis.

When should you call your doctor?

Call your doctor if any of the following occur.

• Sore throat, along with any two of these signs of bacterial infection:
  • Fever of 38.3°C (101°F) or higher
  • White or yellow coating on the tonsils
  • Swollen, tender tonsils
  • Swollen lymph nodes in the neck
  • Rash
  • Abdominal (belly) pain and headache
  • Severe pain
  • Severe difficulty swallowing
  • Pain on only one side of the throat
• Tonsillitis or sore throat that starts after being exposed to someone who has strep throat.
• 6 episodes of tonsillitis in 1 year despite treatment.
• Persistent mouth-breathing, snoring, or a very nasal- or muffled-sounding voice.
• Signs of dehydration, such as a dry mouth and tongue and urinating less than normal.

Watchful waiting

Watchful waiting is a period of time during which you and your doctor observe your or your child’s symptoms or condition without using medical treatment. Watchful waiting is appropriate if tonsillitis occurs along with cold symptoms such as runny nose, nasal congestion, sneezing, and coughing. Tonsillitis with these symptoms is most often caused by a virus. Viral infection of the tonsils can be treated at home and in most cases goes away without treatment within 2 weeks. In general, the more like a cold the condition is, the less likely it is that the condition is caused by strep bacteria.

Watchful waiting is not appropriate if tonsillitis occurs with a fever of 38.3°C (101°F) or higher or with swollen lymph nodes in the neck, and without symptoms of an upper respiratory tract infection. If these symptoms occur together, see a doctor. You may have strep throat, which should be treated promptly.

Who to see

Your family doctor or general practitioner can evaluate tonsillitis, perform quick tests or throat cultures, and prescribe antibiotic treatment if needed.

If surgery to remove the tonsils (tonsillectomy) is indicated, your doctor may refer you to an otolaryngologist (ear, nose, and throat, or ENT, doctor).

Examinations and Tests

Diagnosis of tonsillitis is based on a medical history and a physical examination of the throat. An accurate medical history is needed to find out whether tonsillitis is recurrent, which may affect treatment choices.

If your symptoms suggest strep throat, your doctor may want to confirm this diagnosis by doing a throat culture. Strep throat is more likely if 3 or 4 of the following signs or symptoms are present:

• Fever
• White or yellow spots or coating on the throat and/or tonsils (tonsillar exudates)
• Swollen or tender lymph nodes on the neck
• Absence of coughing or sneezing

If a strep infection is suspected, your doctor may do a throat culture or a rapid strep test or both. Both of these tests can be done in a doctor’s office. You may want to discuss the advantages and disadvantages of each test to see which test is appropriate.

The results of these tests will determine whether antibiotic treatment is needed. These results combined with an accurate medical history will be considered in deciding whether surgery to remove the tonsils (tonsillectomy) is recommended.

If the Epstein-Barr virus, which can cause mononucleosis, is suspected as a cause for the tonsillitis, a test for mononucleosis may be done.

Treatment Overview

Tonsillitis is most often caused by a virus, which resolves on its own. But tonsillitis can be caused by strep bacteria, which requires treatment with antibiotics. Watch for signs of dehydration, such as a dry mouth and tongue. Also, watch for signs of complications, such as ear pain, from tonsillitis caused by strep bacteria.

Tonsillitis caused by a virus

Tonsillitis caused by a virus will usually go away on its own. Antibiotics are not effective treatment for viral tonsillitis.

The virus that causes mononucleosis (mono) can lead to tonsillitis that is as severe as tonsillitis caused by bacteria and can take several weeks or more before it goes away.

Home treatments such as drinking warm tea, and taking over-the-counter pain medicine (such as acetaminophen or ibuprofen) may help relieve discomfort. Do not give aspirin to anyone younger than 18 because of its link to Reye syndrome, a serious but rare problem.

Many non-prescription remedies such as antiseptic mouthwashes, decongestants, and antihistamines contain extra ingredients that don’t relieve discomfort. These remedies are not recommended for children, because they have not been proved to have any benefits in the treatment of acute tonsillitis.^{footnote 1}

Be safe with medicines. Read and follow all instruction on the label.

Tonsillitis caused by bacteria

Antibiotics are prescribed for tonsillitis caused by strep bacteria. A strep infection will usually go away on its own, but antibiotic treatment is needed because untreated strep throat can cause serious complications. For more information, see the topic Strep Throat.

If antibiotics are prescribed, be sure you take them exactly as directed by your doctor. Antibiotics should be taken for the entire duration of the prescription, even if the symptoms disappear completely before the prescription is gone. If antibiotics used to treat tonsillitis are not taken as directed, bacteria can become resistant to them (antibiotic resistance). In these cases, antibiotic treatment of future infections may not work.

Surgery

Surgical removal of the tonsils (tonsillectomy) is still a common procedure, particularly for children. But it is not done nearly as often as it was in the past. Tonsillectomy may be considered to treat tonsillitis when a child has serious complications, recurrent infections, or chronic infections that do not respond to treatment and interfere with daily functioning. But the risks and benefits of surgery need to be weighed carefully. Tonsillectomy should only be done after you and your doctor carefully consider your or your child’s overall health.

Prevention

A wide variety of viruses and bacteria can cause tonsillitis, so the best prevention is to follow basic health and hygiene precautions. These steps are especially helpful for children:

• Avoid close contact with others who are sick. If possible, keep your child away from children who are known to have tonsillitis or a sore throat.
• Often remind your child about the importance of proper handwashing, especially when around people who appear to be sick. Also tell your child not to share toothbrushes or eating utensils with other children.
• Wash and disinfect surfaces and toys.
• Teach children to cover their mouths when coughing or sneezing, preferably using a tissue so that germs do not get on their hands. Also show them how to use tissues to wipe their noses.
• Carry disposable wipes and a hand sanitizer to clean hands and to wipe off shopping carts or other shared items in public places.
• Do not smoke around your child.

Home Treatment

The goal of home treatment of tonsillitis caused by a virus is to manage symptoms as the body fights off the infection. Home treatment eases the discomfort of sore throat and symptoms such as runny nose, nasal congestion, sneezing, and coughing.

Things that may help you or your child feel better include:

• Gargling often with warm salt water if your child is age 8 or older. You can make your own salt water by mixing 1 tsp (5 g) salt with 240 mL (8 fl oz) warm water.
• Drinking warm or cool liquids (whichever feels better). These include tea, soup, juice, and rehydration drinks.
• Eating flavoured ice pops, such as Popsicles.
• Getting plenty of rest.
• Using a vaporizer or humidifier in the bedroom.
• Using throat lozenges to help relieve sore throat symptoms. But lozenges should not be given to young children because of the risk of choking. Also, many lozenges contain unneeded ingredients that can be potentially harmful.

Ask your doctor if you can take over-the-counter pain medicines (such as acetaminophen or ibuprofen) to help relieve sore throat pain. Be safe with medicines. Read and follow all instructions on the label. If you give medicine to your baby, follow your doctor’s advice about what amount to give. Do not give aspirin to anyone younger than 18 because of its link to Reye syndrome, a serious but rare problem.

Cough and cold medicines may not be safe for young children or for people who have certain health problems. Before you use these medicines, check the label. Many over-the-counter remedies, including antiseptic mouthwashes, decongestants, and antihistamines, contain extra ingredients that don’t relieve discomfort. These remedies are not recommended for children, since these ingredients have not been proved to have any benefits in the treatment of acute tonsillitis.^{footnote 2}

A sore throat along with sudden fever and swollen lymph nodes, and without symptoms of an upper respiratory tract infection, may point to a bacterial infection. Anyone with these symptoms should see a doctor to be tested for strep throat, which requires treatment with antibiotics. It is important to get plenty of rest and take all the prescribed antibiotics exactly as directed. Keep your child home from school for the first 1 to 2 days of antibiotic treatment. He or she is still contagious during this time and might pass the infection to others.

Medications

Tonsillitis is usually caused by a virus and does not require prescription medicine. For information on over-the-counter pain medicine and other self-care options, see Home Treatment.

An antibiotic, usually amoxicillin or penicillin, is used to treat tonsillitis caused by strep bacteria.

Although tonsillitis caused by strep bacteria usually will go away on its own, antibiotics are used to prevent the complications, such as rheumatic fever, that can result from untreated strep throat.

What to think about

If antibiotics are prescribed, be sure you take them exactly as directed by your doctor until the medicine is gone. Even if the symptoms go away completely before the prescription is gone, all pills should be taken as directed to make sure the infection is completely destroyed. Bacteria can become resistant to the antibiotics used to treat tonsillitis (antibiotic resistance) if prescriptions aren’t taken as directed or if they are prescribed when they aren’t needed.

Surgery

Tonsillectomy for tonsillitis is generally used for children who have serious complications or recurrent infections that do not respond to other treatment, especially when they interfere with daily life. But tonsillectomy should only be done after you and your doctor carefully consider your child’s medical history and overall health.

Researchers in a recent study concluded that tonsillectomy may be no better than watchful waiting for children who have mild symptoms, which was defined as tonsillitis occurring fewer than 3 times a year.^{footnote 3}

But for some children, tonsillectomy can greatly improve their quality of life. Children who are most likely to benefit from tonsillectomy are those who have:

• 6 or more episodes of tonsillitis in 1 year. Tonsillectomy is more likely to be considered as treatment when some of these episodes result in missing school, trouble sleeping, or having other problems with normal daily life.
• Tonsillitis lasting longer than 3 months, despite medicine.
• Obstructed air passages.
• Difficulty swallowing.
• Difficulty talking because of nasal obstruction.
• Tonsils that bleed heavily.

Surgery choices

Tonsillectomy for strep throat may be done in cases of recurring tonsillitis that do not respond to antibiotics or if an infection threatens the child’s well-being.

What to think about

Tonsillectomy is still the most common major surgical procedure done on children in Canada. But it is not done as often as it was in the past.

Upper respiratory infections and tonsillitis usually occur less frequently as a child gets older. Consider whether your child’s tonsillitis infections are manageable until you can wait to see if he or she outgrows them.

A child who has tonsillectomy will need special care and close monitoring for at least a week after the surgery. Consider your ability to provide this care for your child before deciding on tonsillectomy.

References

Citations

1. Cherry JD (2009). Pharyngitis (pharyngitis, tonsillitis, tonsillopharyngitis, and nasopharyngitis). In RD Feigin et al., eds., Feigin and Cherry’s Textbook of Pediatric Infectious Diseases, 6th ed., vol. 2, pp. 160–169. Philadelphia: Saunders.
2. Cherry JD (2009). Pharyngitis (pharyngitis, tonsillitis, tonsillopharyngitis, and nasopharyngitis). In RD Feigin et al., eds., Feigin and Cherry’s Textbook of Pediatric Infectious Diseases, 6th ed., vol. 2, pp. 160–169. Philadelphia: Saunders.
3. Baugh RF, et al. (2011). Clinical practice guideline: Tonsillectomy in children. Otolaryngology–Head and Neck Surgery, 144(IS): S1–S30.

Other Works Consulted

• Georgalas CC, et al. (2014). Tonsillitis. BMJ Clinical Evidence. http://clinicalevidence.bmj.com/x/systematic-review/0503/overview.html. Accessed April 14, 2016.
• Isaacson G (2012). Tonsillectomy care for the pediatrician. Pediatrics, 130(2): 324–334.
• Simon HB (2006). Bacterial infections of the upper respiratory tract. In DC Dale, DD Federman, eds., ACP Medicine, section 7, chap. 19. New York: WebMD.
• Suurna MV (2012). Management of adenotonsillar disease. In AK Lalwani, ed., Current Diagnosis and Treatment: Otolaryngology—Head and Neck Surgery, 3rd ed., pp. 362–368. New York: McGraw-Hill.
• Wetmore RF (2011). Tonsils and adenoids. In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 19th ed., pp. 1442–1445. Philadelphia: Saunders.

Credits

Current as of:
April 15, 2020

Author: Healthwise Staff
Medical Review:
Adam Husney MD – Family Medicine
Brian D. O’Brien MD – Internal Medicine
E. Gregory Thompson MD – Internal Medicine
Kathleen Romito MD – Family Medicine
Charles M. Myer III MD – Otolaryngology

Kids Health Information : Tonsillitis

An infection of the tonsils is called tonsillitis. Tonsils are glands at the back of the throat. Tonsils are part of the immune system and help to fight germs in the mouth.

It is common for tonsils to get infected by viruses or bacteria (bacterial tonsillitis is sometimes called strep throat). Tonsillitis is common in children of all ages and often occurs when children have a cold, with a runny nose and a cough. In teenagers, glandular fever can cause severe
tonsillitis.

Signs and symptoms of tonsillitis

If your child has tonsillitis, they may have some of the following symptoms:

• a sore throat
• difficulty swallowing
• tender lymph nodes (glands under the jaw)
• pain in their ears (usually referred pain, but the ears should be checked by your GP as there may also be a middle ear infection)
• a fever
• bad breath
• loss of appetite
• lethargy and generally being unwell.

Older children may also complain of headache or abdominal pain.

When to see a doctor

If you think your child has tonsillitis for the first time, take them to the GP. If your child has had tonsillitis before and they usually improve with care at home, you don’t always need to see a doctor.

As tonsillitis is often caused by a virus, your doctor may not prescribe antibiotics as these will not help your child. 

Some children are likely to need antibiotics, including:

• Aboriginal and Torres Strait Islander children and those from the Pacific Islands
• those who have previously had rheumatic heart disease (which is rare in Australia)
• children with severe forms of tonsillitis, especially if there is a rash (this is known as scarlet fever)
• children who have a complication, such as an abscess behind the tonsil or in the glands in the neck.

If there is difficulty with swallowing, some children are prescribed prednisolone (an anti-inflammatory corticosteroid medication) as well as or instead of antibiotics. Prednisolone reduces the swelling of the tonsils.

If your child is extremely unwell, drooling and having difficulty breathing, call an ambulance immediately. This may represent a dangerous inflammation of the epiglottis (a flap in the throat).

Care at home

Most children with tonsillitis can be cared for at home after seeing a doctor (if necessary).

You can care for your child in the following ways:

• Make sure they have plenty of rest.
• Give them pain relief such as paracetamol or ibuprofen. See our fact sheet Pain relief for children.
• Give them extra fluids to drink. This will prevent your child from becoming dehydrated and will help their throat feel less dry and painful. Icy poles are a good option as they provide extra fluids as well as soothing and numbing the sore throat.
• There are no restrictions on what your child can have to eat or drink; however, they may prefer softer foods if they have a sore throat.

Your child should stay at home until their fever is gone and they are able to swallow again. This will usually be three to four days.

If antibiotics are prescribed, give these to your child as directed, and make sure you complete the full course of antibiotics.

You should go back to see your GP if your child has tonsillitis and:

• difficulty breathing with an increase in snoring when asleep
• difficulty swallowing and shows signs of dehydration (see our fact sheet
  Dehydration)
• difficulty opening their mouth
• you are worried for any reason.

Key points to remember

• Tonsillitis an infection of the tonsils, which can be caused by viruses or bacteria.
  
• Most children recover with rest at home, pain relief and plenty of fluids.
  
• Many children do not require treatment with antibiotics. Antibiotics don’t treat viruses.
  
• If antibiotics are prescribed, make sure you complete the course of antibiotics.

For more information

Common questions our doctors are asked

Why isn’t my child being treated with antibiotics?

Even when tonsillitis is caused by bacteria (strep throat),
this is usually an infection that the child can recover from without the need
for antibiotics. Antibiotics do not improve the symptoms of tonsillitis, and
most children have a sore throat for three to four days even if they do have
treatment with antibiotics.

Waiting to see if children will get better without
antibiotics is helpful as it builds up immunity to the infection and makes it
less likely that your child will get tonsillitis from that type of infection
again. If your child is having recurrent infections it may be helpful to change
the toothbrush after each infection, so that the tonsils will not be
reinfected.

How can I prevent tonsillitis spreading to the other
children in the family?

Good hygiene reduces the
chance of passing infections onto others. Good hygiene includes: regularly
washing hands thoroughly, not sharing cups or cutlery, not letting toothbrushes
touch, encouraging children to cough or sneeze into their elbow and using
tissues instead of hankies. Teach your child to throw tissues into the bin as
soon as they have used them and to wash their hands afterwards.

Developed by The Royal Children’s Hospital. We acknowledge the input of RCH consumers and carers.

Developed July 2018.

Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit

www.rchfoundation.org.au. 

Which antibiotics are used for the management of recurrent tonsillitis?

Author

Udayan K Shah, MD, FACS, FAAP Professor of Otolaryngology-Head and Neck Surgery and Pediatrics, Sidney Kimmel Medical College of Thomas Jefferson University; Chief of Credentialing, Nemours Children’s Health System; Chief of Otolaryngology, Nemours Delaware Valley

Udayan K Shah, MD, FACS, FAAP is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Academy of Pediatrics, American College of Surgeons, American Society of Pediatric Otolaryngology, Phi Beta Kappa, Society for Ear, Nose and Throat Advances in Children

Disclosure: Nothing to disclose.

Specialty Editor Board

Ted L Tewfik, MD Professor of Otolaryngology-Head and Neck Surgery, Professor of Pediatric Surgery, McGill University Faculty of Medicine; Senior Staff, Montreal Children’s Hospital, Montreal General Hospital, and Royal Victoria Hospital

Ted L Tewfik, MD is a member of the following medical societies: American Society of Pediatric Otolaryngology, Canadian Society of Otolaryngology-Head & Neck Surgery

Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA Professor of Otolaryngology, Dentistry, and Engineering, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American Head and Neck Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Cerescan;Cliexa, eMedevents, Neosoma, MI10<br/>Received income in an amount equal to or greater than $250 from: , Cliexa;;Neosoma<br/> Received stock from RxRevu; Received ownership interest from Cerescan for consulting; for: Neosoma, eMedevents, MI10.

Acknowledgements

Ari J Goldsmith, MD Chief of Pediatric Otolaryngology, Long Island College Hospital; Associate Professor, Department of Otolaryngology, Division of Pediatric Otolaryngology, State University of New York Downstate Medical Center

Ari J Goldsmith, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Medical Association, and Medical Society of the State of New York

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

90,000 Angina – How to Treat | Throat Encyclopedia HEXORAL®

08/25/2021

236 774

15 minutes

Contents:

Angina, or tonsillitis, is usually called an acute inflammation of one or even several tonsils of the pharyngeal ring. This pathology is extremely common, therefore, drugs for the treatment of angina are usually snapped up in pharmacies. Read more about the disease, about how to recover faster and not get sick again, in our article.

The pharyngeal lymphoid ring consists of six large tonsils:

• two palatine tonsils, which are located in the depressions on both sides of the entrance to the pharynx,
• two tubes located in the area of ​​the auditory tubes in the nasopharynx,
• one lingual – on the root of the tongue ,
• one pharyngeal – in the upper part of the pharynx ⁵ .

Small lymphoid formations form lateral ridges and single tubercles on the posterior wall of the pharynx ⁵ .

The lymphoid ring serves as a barrier to the penetration of microbes into the respiratory and digestive tract, participates in the formation of immunity. The tonsils have many depressions (lacunae) and crypts, into which various microorganisms constantly penetrate. They activate immune cells, which trigger the production of immune antibody proteins that provide protection against infections. With a decrease in immunity and a high degree of aggressiveness of pathogens, the tonsils become inflamed – tonsillitis develops.

Adenoiditis is more common in children ¹ , or an infectious lesion of the pharyngeal accumulations of lymphoid tissue – adenoids. In adults seeking treatment, angina is more often palatine. Therefore, the term “angina” is often understood as inflammation of the palatine tonsils – tonsils ² .

Dangerous in terms of disease is considered the winter-spring period ³ . During this time, tonsillitis usually develops as a complication of acute respiratory viral infections. This is facilitated by ^1.2 :

• a decrease in the body’s defenses,
• unfavorable environmental conditions (temperature fluctuations, high or low humidity, lack of vitamins, etc.)etc.) ¹ .

In addition, factors such as:

1. trauma to the glands (for example, fish bone),
2. genetic predisposition,
3. the presence of foci of chronic infection in the mouth, nose and its paranasal sinuses ^1.2 …

A variety of microorganisms can be the culprit. In children, beta-hemolytic streptococcus ^1.3 is in the first place among all infectious agents – this important fact is taken into account by the doctor when choosing an antibiotic for the treatment of angina.In adults, tonsillitis caused by adenoviruses, rhinoviruses, coronaviruses, influenza viruses and parainfluenza prevails. Streptococci join at the second stage of the development of the disease ^1.3 .

Infection occurs through airborne droplets, when kissing, when using common dishes, towels, household items. In the presence of foci of chronic infection and carriage, endogenous pathogens ^1.2 are activated, those that already live in the body. So, in 75% of cases, beta-hemolytic streptococci inhabiting the crypts of tonsils ¹ become the culprits of exacerbation of chronic tonsillitis.

An inflammatory process in the glands can be a consequence of some systemic diseases:

1. Infectious mononucleosis,
2. Agranulocytosis,
3. Leukemia ⁴ .

Damage to the lymphoid tissue of the pharyngeal ring is one of the first symptoms of these ailments. Therefore, treating a sore throat with home remedies without consulting a doctor is always a risky undertaking.

Up to the table of contents

Types and symptoms of angina

Effective treatment of angina is impossible ¹ without taking into account the nature of its causative agent and the form of the disease.The most common clinical types of tonsil inflammation ¹ :

• catarrhal,
• follicular,
• lacunar.

Catarrhal

The disease begins acutely. Against the background of general malaise, weakness and weakness, there are sensations of burning, perspiration and dryness in the throat and pain when swallowing. Body temperature in the range of 37-37.9 ⁰ C. Examination reveals diffuse redness and slight swelling of the glands and arches of the soft palate.Tongue dry, coated with white bloom. The cervical and submandibular lymph nodes are enlarged.

With the development of adenoiditis, a nasal voice is possible, which often happens in children – the treatment of angina in such cases is often postponed due to the ignorance of the parents ² . In this case, the general symptoms of intoxication will be more pronounced than in adults, and the child may complain of pain in the ear when swallowing ^1.2 .

Depending on the type of pathogen, the clinical picture of inflammation of the tonsils may vary.So, with adenovirus sore throat, in addition to reddening of the glands, there are other signs of infection, in particular, redness extends to the entire surface of the pharynx, nasopharynx and nose, symptoms of conjunctivitis develop – redness, tearing and discharge from the eyes ² . In the treatment of viral catarrhal sore throat, a special place is occupied by antiseptic preparations for gargling – antibiotics do not work on viruses ^3.4 .

If the process is caused by Coxsackie viruses, tonsillitis is complemented by various manifestations of gastrointestinal disorder.On the surface of the tonsils and the soft palate, rashes appear in the form of small vesicles resembling herpes; the treatment of such a sore throat requires a special approach due to the possibility of meningitis development ² .

Usually catarrhal inflammation lasts 3-5 days, then it either disappears or goes into the next stage – follicular or lacunar tonsillitis ² .

Follicular

If with catarrhal inflammation the process captures only the surface of the tonsils, then with follicular it spreads to the deep layers and the follicular apparatus.This is expressed in fever (up to 40 ⁰ C), chills, severe weakness, aches and pains in muscles and joints ¹ . A sharp sore throat makes it difficult to swallow, makes you refuse to eat.

In children, inflammation of the lymphoid tissue is accompanied by its pronounced edema, which can lead to difficulty breathing. Therefore, the treatment of angina at home is dangerous for the baby’s life.

In case of follicular inflammation, small follicles filled with pus are visible through the bright red surface of the mucous membrane of the tonsils. ¹ .The painting resembles the star-studded night sky ¹ . The lymph nodes are enlarged and sharply painful.

Treatment of follicular sore throat necessarily involves the use of antibiotics ^1.2 – they are selected and prescribed by a doctor. In this case, after a few days, the follicles are opened, freed from pus, the small ulcers that form in their place quickly heal, leaving no trace behind ^1.2 .

Lacunar

More often the disease is more severe than follicular ¹ .The temperature is stable at numbers above 39 ⁰ C, weakness and headache are literally bedridden, you constantly want to sleep, but body aches do not allow you to rest. Used in the treatment of lacunar angina, non-steroidal anti-inflammatory drugs have an analgesic and antipyretic effect, which temporarily relieves the condition ^{4, 5} .

The disease is accompanied by the appearance of a pus taste and bad breath. Soreness when swallowing increases with suppuration and increased edema.

A yellowish-white purulent plaque appears on the reddened surface of the mucous glands in the mouths of the lacunae, which can be easily removed with a cotton swab ^1.2 . Gradually, it becomes so much that it covers most of the tonsils, but at the same time does not go beyond their boundaries.

On the 5-7th day, and in the treatment of purulent tonsillitis with antibiotics on the 2-4th day, when the lacunae are cleared of pus, the condition improves ^1.2 . The fever drops to 37.5-37.9 ⁰ C, the sore throat becomes less severe.After another 4-5 days, recovery occurs ^1.2 .

Important! The manifestations of the lacunar inflammatory process can be confused with the symptoms of diphtheria sore throat; without treatment in children, diphtheria quickly leads to swelling of the tissues of the oropharynx, pharynx and larynx and, as a result, to severe difficulty in breathing. A gray-white filmy plaque on the tonsils looks like pus, but it is tightly connected to the underlying tissues, passes to the soft palate, the lateral walls of the pharynx and the larynx. It is imperative to consult a doctor for tonsillitis in a child!

Up to contents

Treatment

To avoid contamination of others, you need to stay at home if the treatment of angina is carried out at home, or quickly go to the hospital if therapy involves a hospital stay.

The room should be ventilated as often as possible, if possible, ultraviolet irradiation and wet cleaning should be carried out. Dishes and towels must be strictly individual.

Tonsillitis therapy includes the creation of a gentle regimen, general and local therapy.

Gentle mode

• At the onset of the illness and the first couple of days after the temperature has returned to normal, it is better to stay in bed ¹ . Then, when the fever has passed, you need to follow the home regimen and avoid physical activity.
• Increased temperature promotes increased sweating. drinking plenty of water – fruit drinks and still mineral water will help reduce the symptoms of intoxication and avoid dehydration. Alternative treatment of angina with milk and honey is contraindicated. Sweet milk is an ideal breeding ground for bacteria, they multiply rapidly, and this aggravates the course of the disease ¹ .

• Food must be thermally processed, liquid or chopped, unsalted and unsweetened, without the addition of spices and herbs ¹ .It is better to choose dishes that are easily digestible vegetable and dairy with a low content of simple carbohydrates, boiled, stewed, steamed ¹ .

Systemic drug therapy

Regardless of the severity of the condition, streptococcal tonsillitis is an indication for antibiotic therapy in the form of tablets or injections ^1.2.4 . Therefore, with angina, you need to see a doctor.

Antibiotics are especially important in the treatment of angina in children and people with weakened immunity.They help prevent the development of complications ² .

The choice of antibiotic and its dosage is determined by the doctor. In particular, beta-hemolytic streptococcus is sensitive to the latest generation of penicillin drugs and macrolides ^1.2 . The duration of the course of treatment for angina with fever in both an adult and a child is on average 7 days ² . Severe condition – an indication for hospitalization in an infectious diseases hospital, injection or drip of antibiotics ² .

Antibiotics kill not only pathogenic bacteria, but also beneficial microflora of the oral cavity and digestive tract, which can provoke the development of candidiasis. For the purpose of its prevention, antifungal drugs are used ² . They are also used to treat fungal sore throat, which usually occurs in patients with severely weakened immunity, for example, against the background of AIDS or taking medications that suppress the immune system ^2.5 .

Non-steroidal anti-inflammatory drugs help to quickly stop inflammation and fever, reduce sore throat.

Desensitizing drugs are indicated for the prevention of allergies and autoimmune complications ² .

Local therapy

To speed up the cleansing of the tonsils, gargling with saline (sea salt, soda) solutions, antiseptic solutions ^2.3 helps. As them, traditional medicine suggests using infusions and decoctions of medicinal plants, for example, chamomile or calendula. Traditional medicine has more effective means – special preparations for rinsing the throat ^2.3 , such as HEXORAL ^® .In the treatment of mild forms of viral sore throat, they are used as the main means of preventing the development of a bacterial inflammatory process of the tonsils ³ , in other cases they become an addition to systemic antibiotic therapy.

The main active ingredient of the preparations HEXORAL ^® SOLUTION and HEXORAL ^® AEROSOL is an antiseptic hexetidine, which has antiseptic, antifungal, analgesic, hemostatic and deodorant effects ⁶ .

HEXORAL ^® solution / aerosol:

• is active against gram-positive bacteria, which include beta-hemolytic streptococcus, and fungi of the genus Candida, which are activated by a decrease in immunity and the use of antibiotics ⁶ ;
• has a high safety profile, so it can be used not only for adults, but also for children from 3 years old ⁶ ;
• relieves painful sensations when swallowing ⁶ ;
• valid until 12 noon ⁶ .

HEXORAL ^® TABS and TABS CLASSIC contain antiseptics with a broad spectrum of antimicrobial action. HEXORAL ^® TABS also contains a local anesthetic to help relieve sore throat ⁷ . Various aromatic oils give the tablets a pleasant taste and aroma. “Mint” HEXORAL ^® TABS can be used in the treatment of children from 4 years of age and older ⁷ . HEXORAL ^® TABS CLASSIC is available in orange, lemon, honey lemon, blackcurrant flavors and is approved for use from the age of six ⁷ .

HEXORAL ^® TABS EXTRA based on amylmetacresol, dichlorobenzyl alcohol and lidocaine has an antiseptic effect and, being active against most gram-positive and gram-negative bacteria, fungi, reduces tissue edema and sore throat ⁸ . The drug is approved for use from the age of 12 ⁸ .

Indicators of recovery: normal body temperature within 5 days, disappearance of pain in the throat and palpation of lymph nodes, normalization of blood counts and absence of complications ¹ .

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Possible complications

Tonsillitis can cause local complications ^1.2 :

• the formation of a paratonsillar abscess, characterized by severe intoxication, one-sided sore throat, swelling of one gland, deviation of the tongue towards the side inability to fully open the mouth, forced tilt of the head towards the abscess;
• otitis media, or inflammation of the middle ear, accompanied by pain, congestion and a feeling of pressure in the ear, and in the absence of therapy – labyrinthitis (damage to the inner ear), manifested by tinnitus, nausea, vomiting, dizziness and disturbance of the sense of balance.

Without treatment, catarrhal, follicular or other tonsillitis in adults and children can lead to the development of diseases such as ^1.2 :

9036 Rheumatism

9036 Systemic volvulus

9036 connective tissue, manifested by the defeat of small blood vessels of various organs

Myocarditis	Inflammation of the muscular membrane of the heart
Systemic connective tissue disease associated with immune disorders, occurring with damage to the heart and joints
Rheumatoid and infectious polyarthritis	Joint inflammation 9064	Inflammation of the joints 9064
Glomerulonephritis and nephritis	Kidney inflammation
Sepsis	Rovi

Most often, such complications occur in people who have started the disease, who went to the doctor late or did not receive treatment at all ¹ .

Up to content

Prevention

Reducing the risk of illness will help ² :

• following the rules of personal hygiene, in particular regular hand washing ² ;
• hardening: air baths, rubdowns and showers with gradually decreasing water temperatures, gargling with cold water ² ;
• morning exercises and physical education ² ;
• rehabilitation of the oral cavity: carious teeth, diseased gums, chronic rhinitis, sinusitis, adenoids;
• sanitation of ENT foci of infection – therapy of rhinitis, sinusitis, solution of the problem of nasal congestion, which makes breathing through the mouth and reduces the protective functions of the mucous membrane of the oropharynx ² .

The information in this article is for guidance only and does not replace professional medical advice. Consult a qualified professional for diagnosis and treatment.

Literature

1. N.L. Kunelskaya, A.B. Turovsky. Angina: diagnosis and treatment // “RMZh”. – 2010. – No. 7, p. 438.
2. V.S. Dergachev. Angina. Clinic, diagnostics and treatment algorithm. The choice of local antibacterial therapy // “RMZh”.- 2007. – No. 18, p. 1350.
3. G.Z.Piskunov, I. B. Angotoeva. Acute tonsillopharyngitis // Attending physician. – 2007. – No. 2.
4. P.A. Kochetkov, V.M. Svistushkin. Acute streptococcal tonsillitis – modern principles of therapy // “RMZh”. – 2014. – No. 26, p. 1891.
5. Polyakova T.S., Polyakova E.P. Chronic tonsillitis: diagnosis, treatment, prevention // “breast cancer”. – 2004. – No. 2, p. 65.
6. Instructions for use of preparations HEXORAL ^® SOLUTION and HEXORAL ^® AEROSOL.
7. Instructions for use HEXORAL ^® TABS and TABS CLASSIC.
8. Instructions for use HEXORAL ^® TABS EXTRA.

Should a sore throat be treated with antibiotics?

Angina, chronic tonsillitis – thousands of people are familiar with these diagnoses. Is it possible to get rid of sore throat forever? How much antibiotics should you drink? Can this disease be prevented?

These and other questions of the readers of “Komsomolskaya Pravda” were answered on the direct line by assistant of the Department of Infectious Diseases of the Belarusian State Medical University, Candidate of Medical Sciences Nikita Solovey.

– I have chronic tonsillitis. For the last year, sore throats have passed without fever, but with stomatitis. Maybe you can carry out some kind of prevention?

– How does stomatitis manifest?

– Ulcers appear in the oral cavity are very painful.

– This problem may not be related to your chronic tonsillitis. Stomatitis can be caused by other causes, you need to be examined by a specialist who deals with oral mucous membranes, for example, dentists.

– And I also have constant traffic jams.

– If you do not have a fever and severe sore throat, topical medicines with anti-inflammatory and antimicrobial effects can be effective, for example, evidence of efficacy in studies has been obtained for nanocolloidal silver, extracts of certain algae and herbs. These funds can be useful for stomatitis as well.

– Why does chronic tonsillitis occur at all? Is this all due to reduced immunity?

– No, this is a feature of inflammation of the tonsils, which develops in response to exposure to certain microorganisms, often with not entirely correct treatment of recurrent episodes of angina.

– If sore throats occur two to three times a year, is this an indication for tonsil removal?

– Research to date shows that tonsil removal in adults often does not lead to a decrease in recurrent oropharyngeal inflammation. In fact, otolaryngologists make the final decision on the indications during long-term observation of the patient.

Antibiotics must be taken for at least 10 days

– The son is already in the 8th grade, and from the 5th grade he suffers from tonsillitis.Now they literally every two weeks, he practically does not go to school. Angina is manifested only by high, up to 38 degrees, temperature. He was already in the hospital. He constantly drinks antibiotics. The analysis showed that he had staphylococcus aureus. What should we do?

– Recurrent tonsillitis is a common situation. It is imperative to adequately treat each exacerbation with the correct course of antibiotics. It is not necessary to use injections, today most antibiotics are highly effective when taken by mouth.It is essential to carry out 10-day courses of antibiotic therapy. Otherwise, you get a clinical effect – the sore throat disappears, the temperature drops, but the pathogen remains on the tonsils.

– Is it possible to undergo any other examination besides the smear that revealed staphylococcus aureus?

– Unfortunately, most studies do not show the real picture, since we can only examine the microflora from the surface of the tonsils. And in patients with chronic tonsillitis, as studies show, deep in the tonsils there may be a completely different microflora.Therefore, it is more important to adequately treat each flare-up episode.

– I’m already desperate. Taking antibiotics so often is also harmful.

– Even the frequent use of antibiotics used in modern outpatient practice does not have any long-term consequences. It’s a delusion. They can certainly have side effects during treatment, just like any other medication. But those drugs that are allowed in our time do not have serious long-term consequences.

– I am 40 years old. The throat is constantly inflamed. Maybe I should have my tonsils removed? My doctor says that problems with the heart and joints may begin.

– At your age, removing tonsils will not be beneficial. Heart and joint problems can be caused by recurrent sore throat caused by streptococcus pyogenic. This pathogen is more typical for children and adolescents and is rarely found in older age. In the case of chronic pharyngitis during exacerbations, drugs with local antimicrobial and anti-inflammatory effects, for example, containing nanocolloidal silver or extracts of medicinal plants, can be used.

Virus can also cause angina

– Is it possible to do without antibiotics for angina?

– It all depends on what kind of sore throat the patient develops. There are sore throats, which are caused by bacterial pathogens, most often pyogenic streptococcus. But there are sore throats, which are caused by respiratory viruses, and then antibiotic therapy is not needed. There are symptoms that practically exclude the bacterial nature of angina: if, in addition to complaints of sore throat, raids on the tonsils, fever, there is also conjunctivitis, or cough, or diarrhea, or a rash.This most likely indicates the viral nature of the disease and requires the use of only agents with a local anti-inflammatory effect.

– My tonsils were removed as a child. And now, as I understand it, doctors are in no hurry to prescribe such an operation.

– First you always need to adequately treat a sore throat. If this is not done, an acute, often repetitive process can turn into a chronic one.

– I heard that the tonsils are not completely removed, but only trimmed.

– There is no scientific evidence for the effectiveness of this procedure. We must understand that by removing the tonsils, we prevent frequent relapses of tonsillitis, but open the way for infection to the upper respiratory tract. The tonsils are the barrier organ of the immune system. Recent studies show that the recurrence rate of acute respiratory viral infections in children who have had their tonsils removed is two and a half times higher than in those children who have not been operated on. Therefore, the tonsils should be removed when there is a real threat of the formation of acute rheumatic fever with consequences in the form of damage to the heart, joints, or when angina often recurs, and the ongoing antibiotic therapy becomes ineffective.In addition, not all patients have a predisposition to rheumatic complications. Therefore, if we generalize the world experience, there are no clear instructions under which the tonsils must be removed unambiguously. Everything is decided individually.

Charge and stay cool

– I am 46 years old and have chronic tonsillitis since childhood. Maybe you can recommend a drug that you need to take constantly?

– How does your tonsillitis manifest?

– There are seasonal exacerbations, when the throat is sore, corks appear.

– Is the temperature rising?

– Not now.

– If an exacerbation occurs with a high fever, severe sore throat, it is important to be treated with a 10-day course of oral antibiotics. It is impossible to shorten this course, even if the patient begins to feel good. Local antimicrobial agents can be used with the antibiotic. In the case of erased exacerbations, it is permissible to use only local remedies.

– Are there methods to prevent or prevent sore throat?

– Of the methods that have been proven effective for frequent tonsillitis, the only effective method is long-term use of antibiotics with prolonged action.These antibiotics are injected into the patient once a month for a long time. But such prevention is prescribed for very good reasons, when a person has more than six tonsillitis per year or there is a threat of rheumatic complications.

In other cases, you just need to carry out general preventive measures: observe a rational regime of work and rest, eat right, develop physically, take multivitamins.

– Does hypothermia affect the occurrence of sore throat?

– Of course.Hypothermia can lead to an acute or exacerbation of a chronic process. In our oral cavity, the causative agents of tonsillitis live like this, but often they cannot realize their pathogenic potential until some predisposing factor appears. And hypothermia is just that.

– Do herbal rinses help?

– Perhaps only at the very initial stage and with viral tonsillitis. If a real bacterial sore throat has developed, antibiotics cannot be dispensed with.

Komsomolskaya Pravda , 24 November 2015

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90,000 Chronic tonsillitis

Your child is about to have surgery. We would like to give you and your child information about the need for this intervention. We make sure that you do not feel helpless in this situation. We would like to acquaint you with the essential points of the operation itself, the risk factors in the event of its failure.The written information offered to you serves this purpose. Read it carefully to discuss any confusion with your doctor.

Every healthy child has lymphoid tissue in the pharynx, which unites into the so-called lymphadenoid pharyngeal ring. It includes the palatine tonsils – “tonsils” – they can be seen when examining the mouth – they look like balls protruding on the sides of the tongue, the pharyngeal tonsil – it cannot be seen during a direct examination of the oral cavity, it is hidden in the nasopharynx, behind the palate, the lingual tonsil – is located at the root of the tongue, and many lymphoid follicles are scattered along the back of the pharynx, at the entrance to the larynx (see.rice. eighteen). These formations help the child defeat pathogenic bacteria that enter the throat during breathing and eating, and contribute to the formation of local immunity – protection against pathogens. By the way, in these organs there are no cells that affect the sexual development of the child, they do not produce sex hormones, so their diseases do not affect the sexual development of the child, and when they are removed if necessary (more on this later), sexual development is not disturbed.

In early childhood – usually from 2 to 5-7 years – the described organs work very hard, as the child expands the sphere of contacts with peers, attending kindergarten, and inevitably often becomes infected and develops respiratory diseases.At the same time, if the child’s immune forces are not strong enough due to congenital features, environmental factors and other reasons, the lymphoid organs increase in volume. This enlargement of the palatine tonsils is called “hypertrophy of the palatine tonsils”, they can become inflamed – inflammation of the tonsils is called tonsillitis. Tonsillitis can be acute or chronic. In children, chronic tonsillitis and adenoids – an enlarged pharyngeal tonsil – are often combined.

The tonsils of the pharynx have a significant impact on the state of health, the development of nearby organs.What is this influence? A perceived obstruction to the passage of the air stream through the nose leads to breathing through the mouth. The consequence is obvious – untreated air enters the respiratory tract – not purified, not warmed up and not humidified. A chronic inflammatory process, constantly smoldering in the tissue of the tonsils and adenoids, periodically exacerbating, contributes to protracted, recurrent diseases of the trachea and bronchi (bronchitis, obstructive bronchitis, tracheitis, pharyngitis), can independently or aggravate the course of allergies, in severe cases manifested in the form of bronchial asthma , allergic rhinopathy, atopic dermatitis.Adenoids and enlarged palatine tonsils, filling the pharynx, impair the functioning of the auditory tubes, which cannot sufficiently deliver air to the middle ear, as a result of which secretory otitis media develops, which can lead to hearing loss, and if an infection enters the ear, to its acute inflammation – acute purulent otitis media. Bad breathing through the nose contributes to the abnormal development of the maxillofacial region – the teeth bite is disturbed, the shape of the face changes (the so-called “adenoid face”).

The causative agents of infectious diseases of the respiratory tract (most often streptococci) after a sore throat remain in the palatine tonsils, their chronic inflammation develops – chronic tonsillitis. Under the confluence of unfavorable circumstances (hypothermia, stress, viral infection), the process in the tonsils is activated. It proceeds in the form of another sore throat with deposits on the tonsils or purulent plugs. What is very dangerous, each exacerbation of tonsillitis can cause complications in the form of diseases of other organs and systems of the child’s body, most often – rheumatic diseases of the heart and joints, kidney diseases (pyelitis, pyelonephritis, glomerulonephritis).In addition, exacerbation of tonsillitis or tonsillitis sometimes cause complications in the form of an abscess (abscess) in the pharynx. This complication is called paratonsillar abscess. A paratonsillar abscess indicates that the palatine tonsil does not cope with its function, it can recur at any time.

What factors contribute to the enlargement of the pharyngeal tonsils, the development of chronic tonsillitis?

• Heredity – at least if the parents suffered from adenoids, tonsillitis, the child, to one degree or another, will also face this problem.
• Inflammatory diseases of the nose, throat, pharynx – and respiratory viral infections, and measles, and whooping cough, and scarlet fever, and tonsillitis, etc.
• Eating disorders – especially overfeeding.
• Propensity to allergic reactions, congenital and acquired immunity deficiency.
• Violations of the optimal properties of the air that the child breathes – very warm, very dry, a lot of dust, an admixture of harmful substances (environmental situation, excess of household chemicals).
• Inadequate (incorrect) treatment of acute tonsillitis (tonsillitis). The most common mistakes are an incomplete course of antibiotic treatment, incorrect dosage, violation of the therapeutic and protective regime (early getting out of bed, walking on the street earlier than 7-10 days from the start of treatment).

Thus, the actions of parents aimed at preventing chronic tonsillitis are reduced to the correction, or even better, to the initial organization of the lifestyle that contributes to the normal functioning of the immune system – feeding according to appetite, physical activity, hardening, limiting contact with dust and household chemicals …

What is the difference between chronic tonsillitis and tonsil hypertrophy?

Hypertrophy of the tonsils is an increase in their size at the age of a child up to 9-10 years old. In chronic tonsillitis, the tonsils can be of any size, its distinctive feature is the development of a chronic inflammatory process in the tonsils.

If a child has adenoids along with chronic tonsillitis or enlarged palatine tonsils?

The presence of adenoids, obstructed nasal breathing significantly affect the development of tonsil disease.In this case, otolaryngologists suggest removing the adenoids in the compensated form of tonsillitis, while preserving the palatine tonsils, and in the decompensated form, include in the scope of the operation to remove the palatine tonsils and adenotomy, which slightly lengthens the operation and is almost imperceptible to the patient, but strongly affects the result of the operation. If this is not done, the child has a high likelihood of progression of tonsillitis or adenoiditis, which will negate the results of tonsillectomy – difficulty in nasal breathing will remain, the child will again become sick often, snoring will not go away or worsened.

When is tonsillitis treated and when is surgery performed?

There are two forms of chronic tonsillitis: compensated and decompensated. With a decompensated form, no surgical treatment can be dispensed with – the tonsils must be removed. This diagnosis is made when tonsillitis is often exacerbated (2-3 sore throats per year), the process goes beyond the tonsils, if diseases of distant organs and systems develop, for example, nephritis, rheumatic diseases of the heart and joints.The tonsils must be removed if a paratonsillar abscess develops.

Is it possible and necessary to treat chronic tonsillitis?

Let us emphasize that it is not only possible to heal, but also necessary. Until the child develops the changes mentioned earlier, every six months should be carried out as a local treatment in the form of irrigation of the pharyngeal mucosa with aqueous solutions with anti-inflammatory, anti-allergic and antimicrobial properties, and general methods of treatment, including vitamin preparations, agents affecting immune system, locally acting vaccines, physiotherapy methods (magnetic, laser therapy, inhalation).Otolaryngologists consider it especially important in the treatment of tonsillitis to carry out a course of washing the lacunae of the palatine tonsils (7-10 procedures per course of treatment).

How urgent should the operation be?

The operation to remove the tonsils – tonsillectomy – is planned, that is, it is performed when the child is in full health or in remission of chronic diseases. It should not be performed during acute illness (ARI) and 3-4 weeks after recovery. Thus, it is always possible to perform this operation in a favorable period for the child, which will minimize the risk of postoperative complications.

Do the palatine tonsils grow again, are relapses possible?

No, completely removed palatine tonsils cannot grow back.

How are tonsils removed?

This operation is performed using local or general anesthesia (anesthesia). It lasts 25-30 minutes and with the correct psychological preparation of the child, it is tolerated satisfactorily. The simplicity of the operation is not evidence of its safety. Complications due to anesthesia, bleeding, and damage to the palate are also possible.But all this does not happen often.

Surgeons have long abandoned the removal of tonsils with ultrasound and laser due to the enormous risk of complications.

How long is the child in the hospital after surgery?

Due to the high risk of bleeding in the postoperative period, the child is in the hospital for 6 days after the operation.

What should be done after the child is discharged?

The child is discharged from the hospital under the supervision of an ENT doctor or pediatrician at the local polyclinic.Home treatment is usually recommended for 1-2 weeks. In this case, physical activity should be limited, however, it is not necessary to keep the child in bed. When eating the first days, you should not eat hot, spicy food, sour juices and fruits, carbonated drinks, ice cream. After 5-7 days, the diet becomes normal. On the 10-14th day after discharge, with a satisfactory general condition of the child, the absence of elevated body temperature, smooth healing of the wound in the throat, you can visit the children’s team, go outside.You can’t just go in for sports, go to the pool. The wound in the pharynx heals completely in 3-4 weeks. A month after the operation, there are no restrictions on lifestyle and diet.

How to remove tonsils at the Children’s City ENT Center?

To establish a diagnosis, in the absence of an ENT doctor in the clinic, you can make an appointment at the city consultative ENT office by calling 2-78-49-00 (reference).

Reception is carried out on weekdays, from 8.00. to 20.00.

If the diagnosis of chronic tonsillitis is established and you have made a decision to operate on the child, with a referral for surgical treatment issued at the polyclinic, you should go to the admission department of the 3rd Children’s Clinical Hospital at any time convenient for you. Your child will be recorded for hospitalization on the day you have chosen and will be given an examination plan (a list of tests required to perform the operation). Hospitalization is carried out on Tuesday and Thursday, from 13.00. until 15.00. and on Sunday from 16.00. to 18.00. The operation is carried out the next day.

Treatment of acute chronic tonsillitis in adults and children

Acute tonsillitis is one of the most common infectious ENT diseases. Most often we are talking about angina, a rapidly developing inflammation of the palatine tonsils (tonsils). Up to 90% of people have noted its symptoms at least once in their life, and the first episode of the disease often occurs in childhood.

A large number of acute tonsillitis is recorded in the Russian Federation every year, mainly in cold seasons.But the real incidence is several times higher, since many patients do not consider angina as a reason to see a doctor and prefer self-medication. But it is precisely this approach that is the main reason for the high prevalence of chronic and complicated tonsillitis.

In medicine, tonsillitis is an inflammation of one or more tonsils. These are key components of the Pirogov-Valdeyer protective lymphopharyngeal ring, which belongs to the organs of the immune system.

The surface of the tonsils is folded, covered with elongated depressions (crypts).This ensures long-term contact between microorganisms and cells of the immune system, improves the quality and specificity of the immune response. Even in absolutely healthy people, the tonsils are not sterile; in the depths of their crypts and on the surface of the epithelium, a large number of various microorganisms are preserved.

Normally, this interaction does not provoke an inflammatory reaction and is asymptomatic. Pathogenic microbes are destroyed in a timely manner, the growth of opportunistic flora is effectively inhibited, and the tonsils remain in a calm, unchanged state.

In case of violation of this protective mechanism, microorganisms begin to multiply and penetrate deep into the amygdala, provoking its inflammation. This condition is called tonsillitis. It can be acute and chronic. Moreover, decompensation, recurrence of chronic tonsillitis in symptoms resembles an acute form of the disease, and this condition is also called angina.

Features of the acute stage of the disease

Acute tonsillitis or tonsillitis is a rapidly developing and short-term infectious inflammation of the palatine tonsils, followed by a complete regression of symptoms and the return of the lymphoid tissue of the pharynx to its original state.Often, the inflammatory process captures the adjacent palatine arches and the mucous membrane of the pharynx, which is called tonsillopharyngitis.

The characteristic manifestations of angina include:

• Rapid onset of the disease, development of the main symptoms within a few hours.
• Sore throat. It increases with swallowing, and its localization depends on the side of the lesion.
• Redness, swelling, enlargement of the tonsils and palatine arches. With the catarrhal form of the disease, there are no other changes.With follicular sore throat, whitish-yellow foci appear on the surface, as if translucent from the inside, and the lacunar form is characterized by the appearance of raids, purulent films.
• Increased body temperature, signs of general intoxication.
• Enlargement and tenderness of the submandibular, upper cervical lymph nodes.

If the disease is treated incorrectly, the tonsils may remain enlarged, inflamed even after the patient’s well-being has returned to normal.Purulent plugs persist in their crypts, and the protective function is impaired. The tonsils themselves become a focus of infection, which is able to periodically activate and spread.

How to treat acute tonsillitis

Angina in a preschool child becomes a reason to see a doctor, but an adult patient is often prone to self-medication. This approach predisposes to the transformation of acute tonsillitis into a chronic and complicated form.

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To treat this infectious disease in an adult should also be under the supervision of a competent specialist. This will allow not only to quickly cope with uncomfortable symptoms, but also serve as prevention of an unfavorable course of the disease.

Treatment of acute tonsillitis is usually complex and may include:

• Application of topical (local, local) agents with analgesic, anti-inflammatory, antimicrobial action. These can be lozenges, lozenges, sprays, pharmacy and homemade rinses.Treatment of acute tonsillitis at home in most cases is limited to the haphazard use of these drugs.
• Systemic antibiotic therapy, drugs are prescribed in the form of tablets, suspensions for swallowing or solutions for injection. Antibiotics are often required even in the case of angina with ARVI, to suppress the activated opportunistic bacterial flora.
• Physiotherapy.
• Inhalation.
• Immunomodulatory therapy.
• Symptoms (eg, antipyretics, pain relievers). They do not affect the course of the disease and do not change the prognosis, but they improve the patient’s well-being.
• Modern minimally invasive techniques (intratonsillar laser destruction).

Treatment of acute tonsillitis in adults and children in most cases is carried out conservatively. But the addition of purulent complications, the spread of the process to the periopharyngeal tissue may require surgical intervention (operation).

Conservative methods of treatment. Are they effective?

Treatment of acute tonsillitis in children of different ages and in adults is traditionally carried out conservatively. But this therapy has several disadvantages:

1. Antiseptic local remedies for sore throat act superficially and for a short time, moreover, they are quickly washed off with saliva. Therefore, when using them, it is impossible to achieve a complete cleansing of the crypts of the tonsils, to cope with deeply located foci of inflammation.
2. Local treatment of acute tonsillitis in children is often associated with certain difficulties. Parents are faced with the insufficient effectiveness of rinsing, the child’s negative attitude to the use of sprays and inhalations.
3. The use of antibiotics is associated with the suppression of the own microflora of the oral cavity, intestines, genitals. The developing dysbiosis (dysbiosis) negatively affects the well-being and digestion, disrupts the functioning of the immune system.Therefore, many parents prefer to cure a child’s disease without using antibiotics, increasing the risk of complications.
4. Antimicrobial agents should be selected taking into account the sensitivity of the microflora isolated from the glands, and the bacteriological analysis required for this is carried out for several days and is not always available.
5. Patients often complete treatment immediately after the sore throat disappears, without adhering to the recommended antibiotic therapy times. This is fraught with the preservation of a dormant infectious focus, creates conditions for the recurrence of the disease and the development of microflora resistance.
6. In most cases, it is not possible to restrict the use of only one drug, and complex therapy requires time and adherence to a specific treatment regimen.

To fully cure acute tonsillitis means not only to save the patient from intoxication and sore throat. A competent doctor tries to achieve a complete sanitation (cleansing) of the tonsils and eliminate the inflammatory reaction, but conservative therapy cannot always provide an adequate solution to this problem.

Intratonsillar laser destruction – we treat angina quickly and effectively

In the 90s of the XX century, Professor Sergei Viktorovich Korenchenko patented and introduced into clinical practice an innovative method of treating tonsillitis: intratonsillar laser destruction. It allows you to simultaneously eliminate infectious-inflammatory and purulent foci in the tonsils, while maintaining the anatomical and functional integrity of the amygdala.

During laser destruction, altered, inflamed tissues and bacterial-lymphocytic accumulations in the depths of the crypts are almost instantly destroyed.They seem to evaporate, which is not accompanied by burns and destruction of the surrounding healthy areas of the tonsils.

Why is it better to be treated in the clinic using intratonsillar laser reduction?

• Reducing the time of cure, simplifying the treatment regimen for angina.
• Improving the prognosis of the disease, effective prevention of purulent complications.
• Minimizing the risk of the disease becoming chronic, preventing the development of rheumatism and other systemic complications.

Intratonsillar laser destruction is a bloodless, fast and painless treatment procedure that does not leave scars in the throat and does not require long-term rehabilitation. In the Clinic of Dr. Korenchenko, it is used to treat acute and decompensated chronic tonsillitis in children and adults.

90,000 6 diseases that can be treated without antibiotics

In many cases it is better to give up antibiotics in favor of natural remedies
Photo: pixabaycom

For some conditions, antibiotics are unnecessary and may even be harmful.

Antibiotics work against bacteria, but are powerless against viruses, therefore, these drugs should be taken when it makes sense. According to experts, in almost 80% of cases, doctors prescribe antibiotic treatment for the sake of safety, and also because patients themselves ask for it.

6 diseases that are best treated without antibiotics

1. Cough. Antibiotics are not helpful for coughs from a cold. It is best to use home remedies such as thyme tea, thyme tea, or steam inhalation to relieve symptoms.

2. Tonsillitis. If sore throat or tonsillitis is caused by streptococci, then yes, an antibiotic may help.There is little benefit from antibiotics for all other pathogens, and symptoms go away a little faster.

3. Pharyngitis. For sore throat, symptom relief without antibiotics makes more sense. For example, using sage or pain relievers.

4. Inflammation of the sinuses (sinusitis). Studies have shown that no matter if you drink an antibiotic or not, sinus infections go away in about ten days.The body can fight on its own and it makes sense to treat the symptoms with, for example, steam inhalation, pain relievers, and nasal sprays.

5. Otitis media. Otitis media has been proven to heal only one day faster with antibiotics. If fluid comes out of the ear, see a doctor!

6. Uncomplicated cystitis. In order not to form resistance to antibiotics, experts advise against using them for uncomplicated cystitis.Instead, the symptoms should be treated by drinking plenty of fluids and taking pain relievers.

90,000 tablets, lozenges, lozenges, sprays

Liquid dosage forms are simple and convenient to use, provide delivery of active substances directly to the site of inflammation. Features of the design of the bottles allow you to spray the substance even into hard-to-reach places of the pharynx.

The effectiveness of sprays depends on the correctness of their use – spraying directly on the back wall of the pharynx and ENT organs with a given multiplicity.

TOP-5 popular drugs

• Jox, spray. An anti-inflammatory drug, effective against bacteria, viruses, fungi and protozoa. Includes povidone-iodine, highly active for tonsillitis (including streptococcal, together with an antibiotic), tonsillitis, tonsillopharyngitis.With hyperthyroidism, heart failure, bearing a fetus, lactation, in children under 6 years of age and with intolerance, it is not prescribed.

• Cameton. Combined aerosol with a local anti-inflammatory, distracting effect for the treatment of diseases of the ENT organs: pharyngitis, rhinitis. Includes camphor, chlorobutanol hemihydrate, levomenthol and eucalyptus oil. Cannot be used by children under 5 years of age and with allergies to ingredients.

• Ingalipt. Combined antifungal, bacteriostatic, antiphlogistic and anesthetic drug.In the composition – sulfanilamide, sodium sulfathiazole, thymol, eucalyptus and mint oils. Indicated for the treatment of tonsillitis, pharyngitis, laryngitis. It is not used in case of hypersensitivity to active substances.

• Hexoral. Antimicrobial, analgesic, enveloping, antiviral aerosol, active against most microorganisms. Contains Hexethydine, which adheres to tissues. Helps with tonsillitis, pharyngitis. Contraindicated in children under 3 years of age and in hypersensitivity reactions.

• Teraflu lar. Local anesthetic, antimicrobial spray with benzoxonium chloride, lidocaine, helping with pharyngitis, laryngitis, non-purulent and chronic tonsillitis. Forbidden during pregnancy and lactation, up to 4 years and with hypersensitivity.

90,000 Antibiotics for chronic tonsillitis

Chronic tonsillitis is an infectious inflammation of the tonsils, which is constant in nature and from time to time manifested by an acute attack of tonsillitis. Most often, the chronic form of tonsillitis affects the palatine tonsils, which, due to their location, are easily exposed to bacteria and the development of inflammation.

The development of acute tonsillitis is facilitated by many factors, including a violation of nasal breathing (children often suffer), curvature of the nasal septum, polyps and others. Also, the disease can become chronic due to frequent outbreaks of acute tonsillitis. Regular fight against inflammation and taking antibiotics weaken the immune system, and the disease becomes permanent.

About chronic tonsillitis and its symptoms

Chronic inflammatory process of the tonsils is a frequent companion of people with weakened immunity.When the protective functions of the body decrease, the bacteria living in the mucous membranes of the throat begin their active reproduction.

Since angina is transmitted by airborne droplets, it is quite easy to become infected with the disease, especially during an exacerbation of colds and flu.

Tonsillitis is divided into the following main types:

• catarrhal;
• lacunar;
• follicular;
• necrotic.

The disease manifests itself with the following symptoms:

• enlarged lymph nodes;

90,021 sore throat, especially when swallowing;

90,021 redness of the tonsils and throat;

• increased body temperature;
• purulent formations;
• raid.

Each type of tonsillitis can become chronic and remain in the tonsil mucosa for quite a long time.

Another reason for the appearance of chronic tonsillitis is delayed treatment and not fully completed therapy. Very often, after the symptoms disappear, people quit therapy, thinking that the disease is no longer there.

Treat chronic tonsillitis with surgery and medication. The tonsils are removed when the disease is running, when the accumulations of pus are too extensive, and antibiotics do not help.Fortunately, this does not happen very often.

Antibiotics for chronic tonsillitis

Antibiotics for acute angina are prescribed strictly by a doctor, since self-medication with inappropriate drugs can only muffle the infection and the disease will take on a chronic form.

Preparations are selected taking into account the physiological characteristics and individual sensitivity of the patient, for example, children and pregnant women should be treated with extreme caution with antibiotics.

Penicillin medications are most often prescribed for chronic tonsillitis. These drugs are quickly absorbed into the tissues, inhibit the development of infection and are well excreted by the body.

The penicillin group, in comparison with other antibiotics, is less toxic, therefore it is excellent for the treatment of pregnant women and children.

Penicillin preparations:

1. Amoxicillin.
2. Benzylpenicillin.
3. Phenoxymethylpenicillin.

If the patient has contraindications to taking penicillins, other groups are used as an alternative.

Macrolides:

1. Azithromycin.
2. Clarithromycin.
3. Roxithromycin.
4. Erythromycin.

Lincosamides:

1. Lincomycin.
2. Clindamycin.
3. Doxycycline.
4. Tetracycline.

What antibiotics to use for the treatment of tonsillitis depends on which pathogen played a role in its development. If, according to the test results, the presence of staphylococcus is detected, then drugs of the aminoglycoside group are used:

1. Levofloxacin.
2. Amikacin.
3. Ciprofloxacin.

Which antibiotics to choose

Among the many microorganisms that live in the mucous membrane of the nasopharynx, staphylococcus bacteria most often affect the appearance of inflammation of the tonsils. The development of this type of bacteria can only be stopped with antibiotics.

If the infection caused by staphylococci is not completely treated, then the ailment will cause complications on the heart and muscles, and for a long time the absence of treatment will result in an increased body temperature (up to 40 ° C).

Penicillin antibiotics are most effective for treating staphylococcal tonsillitis. But if the treatment does not bring results for a long time, then the doctor prescribes antibiotics of other groups.

The doctor selects the appropriate drugs based on general health indicators, the individuality of the organism, the type of the causative agent of tonsillitis and the neglect of the disease.

Additional medications may be prescribed if certain symptoms are present.

Medicines are used strictly according to the instructions, sometimes the dosage is adjusted by the doctor, then all additional recommendations should be followed.

Preparations of the penicillin group are drunk for at least 7 days, but not more than 10. In no case should they be reduced or prolonged on their own.

Medicines of other groups have a higher dosage and toxicity, so they should be drunk no more than 5 days.

Antibiotics for children

Chronic tonsillitis is aggravated, accompanied by high fever, which is very dangerous for the child’s body. The child may not withstand very high temperatures, which can be fatal.Therefore, angina in children is often treated with antibiotics.

The easiest way for children to tolerate treatment with drugs of the penicillin series. Among them, Sumamed is considered to be more effective and convenient to use today. This drug needs to be taken only once a day, and it is available in different dosages and forms. Since babies often agree to drink syrup, and not a pill, Sumamed is also made in liquid form.

Also, a child from tonsillitis can be treated with the following drugs:

1. Amoxicillin.
2. Solutab.
3. Augmentin.
4. Hemomycin

Remember, no matter how gentle the drugs are, they still have a destructive effect on the intestinal microflora. Therefore, antibiotic therapy should be combined with drugs that protect and restore microflora.

Antibiotics during pregnancy

Antibiotic treatment during pregnancy is highly undesirable, especially in the first trimester. But the lack of therapy for chronic tonsillitis is extremely dangerous.Any transferred infection during the period of embryonic development of a child can lead to pathological processes.

For the treatment of chronic tonsillitis, there are drugs that can be used during the period of bearing a baby. The safest among them is Flemoxin. The peculiarity of the drug is that it is easily absorbed into the walls of the stomach and quickly excreted. The fact that Flemoxin does not remain in the body for a long time and is safe for the development of the fetus.

Pregnant women can also take:

1. Amoxon.
2. Medoclav.
3. Clavunath.
4. Amoxicar.
5. Danemox.

This kind of medication is taken for at least 2 weeks, otherwise the treatment of the infection will not bring the desired results. And remember, pregnant women after treatment should certainly be re-tested.

Together with antibiotics

Treatment of chronic or acute tonsillitis with antibiotics alone can be significantly delayed. To speed up the healing process and relieve some of the symptoms, you should make your therapy comprehensive.

In the fight against chronic tonsillitis, you must adhere to all the rules of treatment. Along with taking the antibiotic prescribed for you, you should definitely use gargling, warming up, inhalation and follow a diet. Which recipes for traditional medicine to use for this depends entirely on you.

Antibiotic treatment will work if:

• to drink drugs for as many days as prescribed by the doctor;
• adhere to bed rest;
• regularly ventilate the room;

90,021 drink more fluids;

• use warming herbal decoctions;
• gargle with antimicrobial solution;
• avoid hypothermia;
• Strengthen the immune system with vitamins and minerals.