Treating Tonsillitis: What You Need to Know

Tonsils are the two soft tissue masses in the back of your throat. (1) They’re part of your lymphatic system, and they’re the body’s first line of defense in fighting off infection because they’re designed to protect you from germs that try to enter your system. Tonsillitis is when there is either inflammation or an infection of the tonsils, and it’s usually (but not always) caused by a virus.

RELATED: What Causes Tonsillitis 

Most of the time tonsillitis will go away on its own in about five to seven days, explains James Clark, MBBCh, an assistant professor of otolaryngology at Johns Hopkins Medicine in Baltimore. Home remedies for managing tonsillitis symptoms include getting rest, staying hydrated, gargling with salt water, using a humidifier to eliminate dry air (which can further irritate a sore throat), and treating pain and fever with ibuprofen (Advil) or acetaminophen (Tylenol). (2)

If your sore throat seems to keep getting worse (or has not improved after about three days), you’re in a lot of pain when you eat or drink, or you have a fever of at least 101 degrees F, you’ll want to see your doctor to get it checked out, Dr. Clark says. Here’s what to expect.

Doctors Diagnose Tonsillitis by Physical Exam and Usually Perform a Throat Swab, Too

Tonsillitis is most often a clinical diagnosis, which means it is usually diagnosed based on signs and symptoms of tonsillitis, so your doctor will start by asking you about your symptoms and giving you a physical exam, says Nicholas Rowan, MD, an associate professor of otolaryngology at John Hopkins Medicine in Baltimore.

“I make sure to look in the back of their throat to see if the tonsils are red or inflamed, and have white patches or some [pus],” Dr. Rowan says. “I look to see if one side is more swollen than the other and feel their neck to check for swollen lymph nodes.”

Your doctor will also likely do a throat swab, which, like it sounds, is when the doctor uses a cotton swab to collect a sample of fluids from the back of the throat. (3) The doctor can perform a rapid strep test on the sample in the office  — looking for strep throat — and report the results to you within minutes. Your doctor may also send the sample to a lab for a more reliable and comprehensive throat culture (which can take one or two days, and can confirm or rule out strep and other infections).

Doctors want to rule out strep throat as an underlying cause when tonsillitis is suspected because strep throat does require treatment with antibiotics, since it is a bacterial infection. It’s important to make sure there aren’t any other underlying causes for throat pain that require other treatment, Clark says.

RELATED: Complications That Can Result From Tonsillitis 

Diagnosing tonsillitis might also include these actions: (2)

• Using a lighted instrument to look in the ears and nose for other signs of infection.
• In children, checking for a rash known as scarlatina, which can be a symptom associated with strep throat.
• Listening to breathing with a stethoscope.
• Ordering a complete blood cell count, a blood test that can reveal whether the different types of blood cells are at normal levels (as abnormal blood cell levels can indicate infection).

Treatment for Tonsillitis Depends on Whether a Virus or Bacterial Infection Is to Blame

The majority of patients who have viral tonsillitis or who test negative for strep can expect a full recovery within five to seven days without specific treatment, Clark says, adding that there is no indication for taking antibiotics in this situation. “If the person fails to recover during this period, then they should follow up with a healthcare provider for repeat evaluation,” he says.

RELATED: Do You Really Need That Antibiotic? 

If the tonsillitis tests positive for strep throat (a bacterial infection), then antibiotic treatment is usually recommended to reduce symptom severity and speed recovery, Clark explains. Without antibiotic therapy, strep throat symptoms will typically resolve on their own eventually, but the medication will help you feel better sooner and significantly reduces the risk of complications from the infection.

Once a person starts antibiotics for strep throat, they usually begin to feel better, often within 24 to 72 hours of starting the medicine, according to Clark. “Failure to improve within these time periods should raise suspicion for alternative diagnoses or complications,” he says, and the person should return to their healthcare provider.

Taking steroids to relieve the pain associated with an acute sore throat should be avoided, says Clark. “The use of glucocorticoids depends on the severity of the illness,” he says, adding that such treatment is usually restricted to an exceptional case in which the person has severe throat pain and can’t swallow.

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What Is a Sore Throat? Symptoms, Causes, Diagnosis, Treatment, and Prevention

A sore throat is a common symptom of several different diseases. It can be related to a cold, the flu, or other illnesses like mononucleosis or strep….

By Cathy CassataNovember 25, 2020

How long does strep throat last? Duration and treatment.

People with a group A Streptococcus bacterial infection — also known as strep throat — often start feeling ill 2–5 days after exposure. Most will start feeling better 1–2 days after starting antibiotics.

According to the Centers for Disease Control and Prevention (CDC), if a person is not feeling better after taking antibiotics for 48 hours, they should see a doctor.

This article discusses the most important information about strep throat, including how long it lasts and how long someone is contagious.

We also discuss treatments, symptoms, causes, diagnosis, ways to prevent it, and when to see a doctor.

Share on PinterestAfter 1–2 days of taking antibiotics, a person with strep throat should start to feel better.

The incubation period for strep throat is 2–5 days. In this time, a person could pass the bacteria on.

The CDC recommend that people with strep throat should stay home until they are fever-free for at least 24 hours and have been taking antibiotics for at least 1 day.

People who do not receive treatment can remain contagious until they are better. However, most people require antibiotics to recover.

People with strep throat require medical treatment to get better and reduce the risk of serious complications. However, the CDC state that those who do not test positive for strep throat do not need to take medication.

It typically takes a day or two for someone with strep throat to start feeling better after starting antibiotic treatment.

Call a doctor if symptoms do not begin to lessen 48 hours after starting antibiotics.

A doctor will typically prescribe antibiotics to treat strep throat, usually penicillin or amoxicillin.

The CDC state that in most cases taking antibiotics reduces:

• the length of time someone is sick
• symptom severity
• the chance of spreading it to others
• the chance of complications

Even though someone may start to feel better within a day or two of starting antibiotic treatment, always take antibiotics exactly as prescribed.

Do not stop taking antibiotics early, as doing so might lead to more severe infections or complications.

Several at-home remedies may also help soothe a sore throat, most of which focus on keeping the mouth or throat moist and avoiding irritants. According to the National Institutes of Health News In Health, remedies include:

• drinking plenty of clear fluids
• sucking on hard candies or throat lozenges
• eating a popsicle or other frozen treats or cold liquids
• over-the-counter (OTC) medicated throat sprays with numbing or cooling compounds
• OTC pain medications, such as ibuprofen or acetaminophen
• avoiding food or drinks that are too warm or spicy
• avoiding smoking or inhaling secondhand smoke

The CDC indicate that the most common symptoms of strep throat are a painful sore throat that can come on very quickly and red, swollen tonsils.

Other common signs of strep throat include:

• a fever
• tiny, red spots on the roof of the mouth, often with white patches or pus streaks
• pain during swallowing
• swollen lymph nodes, often in the front of the neck
• stomach pain
• nausea or vomiting
• a headache
• skin rashes associated with scarlet fever

Strep throat is a bacterial infection that occurs due to a bacteria called Streptococcus pyogenes (S. pyogenes).

S. pyogenes belongs to a group of bacteria that grow in chains of spherical cells called group A Streptococcus.

According to a 2020 article, strep throat causes approximately 5–15% of sore throats in adults and 20–30% of cases involving children.

The CDC state that group A strep bacteria typically live in the throat and nose and spread through tiny droplets of infected mucus or moisture.

Even people who are not experiencing symptoms can spread the bacteria.

Most people become exposed to infectious mucus droplets by:

• breathing them in
• touching things contaminated with them and then touching the nose or mouth
• touching skin sores caused by other group A bacteria
• drinking from the same glass or straw, eating from the same plate or sharing food, using the same utensils

To diagnose strep throat, a doctor will examine someone’s mouth, throat, neck, and nose and ask them about their symptoms.

A doctor will probably ask if someone has come into contact with others with strep throat.

But the only way to definitively diagnose strep throat is to run a rapid strep test. This test involves a doctor running a swab along someone’s throat and then testing the sample using methods that detect strep bacteria within minutes.

In some cases, a doctor may also perform a throat culture, which involves culturing throat samples from a swab for a day or two.

According to the CDC, strep throat is more common in children, typically aged 5–15 years old.

Although it is more common in children, adults who may be more likely to contract the bacteria are parents of children who go to school or are in contact with children.

The best way to reduce the risk of getting strep throat is to avoid exposure to infected droplets.

According to the CDC, common prevention methods include:

• washing the hands frequently for at least 20 seconds or use an alcohol-based sanitizer
• avoiding touching the nose, mouth, or face
• avoiding contact with people who have contagious infections
• washing glasses, plates, utensils, and other items after someone with strep throat has used them or come into contact with them

People with strep throat can also reduce the risk of spreading it to others by:

• taking antibiotics
• washing their hands frequently, especially after coughing or sneezing or before preparing or eating food
• coughing or sneezing into a tissue of the upper elbow or shirt sleeve, not the hands
• placing used tissues into the trash can or garbage
• staying home when symptomatic
• avoiding sharing food and drinks, plates, utensils, or glasses with others

Complications are uncommon. However, if the bacteria spread to other parts of the body, a person can develop:

• abscesses
• swollen lymph nodes
• ear infections
• sinus infections
• rheumatic fever, which is a heart disease
• post-streptococcal glomerulonephritis, which is a kidney disease

If a person develops symptoms or they know that they have come into contact with the bacteria, they should talk to a doctor as soon as possible.

Also, talk to a doctor about severe sore throats, or those that do not get better after a few days.

People should also talk to a doctor when swollen lymph nodes or a high fever accompany a sore throat.

The CDC state that most people with a sore throat have a viral infection, although strep throat accounts for 5–15% of sore throats in adults and 20–30% of sore throats in children.

Most people with strep infections start to feel better a few days after starting antibiotics. And many people with strep throat are contagious as long as they are sick, though taking antibiotics typically lowers this risk significantly within 24–48 hours.

People who think they have strep throat should talk with a doctor as soon as possible to get proper treatment and prevent complications.

Antibiotics for angina: which antibiotic is best for angina or tonsillitis

Angina is caused by a viral or bacterial infection. Antibiotics are given when a sore throat is thought to be caused by the latter type of infection, as they can relieve symptoms and prevent complications. Questions such as: a certain type of antibiotic, its dosage, timing and time of use – the doctor, as a rule, selects for each patient purely individually, taking into account all the characteristics of his body. In this article, we will give you general information about angina, what kind of disease it is, and what antibiotics to drink for angina.

Angina is an infectious disease characterized by acute inflammation of the palatine tonsils and mucous membranes caused by infection or irritants such as viruses, fungi or bacteria.

With such a trouble as tonsillitis, antibiotic treatment should be correctly selected and carried out even at the very first symptoms. In addition to viral and bacterial, there are several more types of angina:

• Lacunar angina
• Catarrhal angina
• Follicular (purulent) tonsillitis

Viral and bacterial angina

Contrary to popular belief, this disease is most often caused by viruses, only about 10 – 15% of angina in adults have a bacterial etiology (even less often fungal) and require antibiotic treatment.

A sore throat of bacterial etiology (most often caused by streptococci) is characterized by a rapid onset of symptoms. Both the pharynx and the palatine tonsils are susceptible to inflammation, on which characteristic white or greenish-yellow plaques appear. This results in a very severe sore throat that often makes it difficult to swallow solid foods. Unlike viral pharyngitis, with bacterial angina, there is almost always a fever (temperature over 38 ° C), which sometimes even reaches 40 ° C and chills. Cough and runny nose are usually absent. Very often there is also an increase in the submandibular and cervical lymph nodes.

How is bacterial tonsillitis treated?

In case of symptoms characteristic of a bacterial infection, it is necessary to consult a general practitioner who, after examination, will most likely prescribe an antibiotic for purulent sore throat. Taking antibiotics to treat this particular disease is only possible with a doctor’s prescription, we strongly advise against buying antibiotics for sore throat without a prescription. You can get an electronic prescription for an antibiotic from a doctor in a few clicks using the Doc.ua service. A poorly chosen antibiotic or an inadequate dose will not work and may cause side effects. In addition to antibiotics, you should also take probiotics, pain and fever medications (ibuprofen or paracetamol), and sore throats (just like you would treat viral pharyngitis). Cold compresses on the forehead and neck can help fight fever, as well as proper hydration by drinking water, raspberry juice, or lemon tea.

Which antibiotic to drink for angina

Antibiotics for angina are quite serious drugs that are best taken after being prescribed by a doctor on an individual basis.

Practice has long shown that with what antibiotics to treat a sore throat, it will pass in such terms. Often patients make the mistake of stopping their medications immediately after all acute symptoms have disappeared. However, even regardless of what antibiotics you were prescribed for angina, strong or weak, the entire antibiotic course must be completed.

Also, tonsillitis should be treated with antibiotics as soon as the first symptoms appear. In no case should you start such a disease and put off its treatment indefinitely.

Do I need to take antibiotics for angina

Do I need to treat angina with antibiotics? Yes, bacterial or purulent sore throats need to be treated with antibiotics, but some people try to avoid these drugs because of their fear of them. People who are somehow afraid of antibiotics can be roughly divided into two large groups:

• Those who are afraid of their negative impact on the body.
• Those who had an unpleasant experience when they independently decided which antibiotics to take for angina, or when the doctor, for the sake of his own reinsurance, prescribed strong drugs, in the case when it was completely possible to do without them.

However, every adult should also be aware of the fact that antibiotics for angina for adults are necessary drugs in the treatment, so you need to know which antibiotics to treat angina for an adult, and which antibiotics treat angina for a child.

How long do antibiotics help with sore throat

How quickly does an antibiotic help with sore throat? Once a person with bacterial angina starts taking antibiotics, they are expected to have a significant improvement in their symptoms within the first 24 to 72 hours. What day do antibiotics help with angina? On average, with antibiotic treatment, recovery can take three to five days. And if symptoms are still present at the end of this period, the patient will be asked to return for a reassessment.

Antibiotic for angina in children

Angina in children is a very common disease that requires a special approach to treatment. Most often, for treatment, the doctor also prescribes an antibiotic for purulent tonsillitis in children. However, not all antibiotics can be taken by children, only a doctor can determine how an antibiotic can be taken for angina in children.

If the suspected cause of tonsillitis is a virus, the doctor will not prescribe antibiotics, then the strategies we list below are the only treatment for sore throat in children. Your child will likely get better within seven to ten days.

Home care strategies to use during treatment for sore throat in children include the following:

• Encourage rest. Encourage your child to sleep a lot.
• Provide sufficient fluid. Give your child plenty of water to keep their throat moist and prevent dehydration.
• Salt water rinse. Gargling with salt water will help soothe a sore throat. Have your child gargle with the solution and then spit it out.
• Give your child lozenges for a sore throat.
• Humidify the air. Use a cold air humidifier to remove dry air that can further irritate a sore throat.

What antibiotics to take for angina?

The best antibiotics for angina:

Macrolides

• Azithromycin
• Sumamed (there are children’s forms)
• Azitro Sandoz (child uniforms available)
• Azitrox
• Clarithromycin (Clabel, Fromilid, Aziklar)
• Fromilid (children’s forms available)

Penicillins

• Amoxil
• Flemoxin
• Ospamox (children’s forms available)

Combined (penicillin + clavulanic acid)

(combined drugs are more effective because they provide a faster effect on the bacteria that cause angina)

• Amoxiclav (there are children’s forms)
• Augmentin (there are children’s forms)
• Medoclav
• Abiclav

Ceftriaxone (Emsef, Rota) cef, Medakson, Promocef)

• Cefma
• Cefix (there are children’s forms)
• Cefodox (children’s forms available)
• Zinnat (there are children’s uniforms)

Tetracyclines

(less effective antibiotics, rarely prescribed, but very expensive compared to other groups)

• Tetracycline
• Doxycycline

Help Doc. ua: you can make an appointment with an otolaryngologist and order the necessary drugs on the website.

symptoms, treatment in adults, lacunar tonsillitis in children

The surface of the palatine tonsils is riddled with depressions called lacunae. They have wide ramifications in the body of the lymphoid tissue. Lacunar tonsillitis or lacunar tonsillitis is an acute inflammatory process that develops in lacunae.

This disease is more common in children and adolescents, while in adults it usually develops as an exacerbation of a smoldering infection. After 50 years, the likelihood of developing lacunar tonsillitis decreases. This disease is diagnosed all year round, but the maximum number of cases falls on the period from October to January. Symptoms and treatment of lacunar tonsillitis in adults and children may have some differences.

Causes of lacunar tonsillitis

Infection can occur through food, inhalation of air and as a result of household contact. Primary angina is caused by staphylococci, streptococci, fungi, viruses. Secondary lacunar tonsillitis in adults and children can develop as a result of tuberculosis, scarlet fever or other infection, if its consequence is pathological processes covering the region of the palatine tonsils along with the tissue surrounding them. Among the factors favoring the development of the disease, it should be noted:

• periodontitis and caries;
• inflammatory processes in the oropharynx and nasopharynx;
• hypothermia;
• adverse environmental conditions;
• constant fatigue.

Causes of lacunar tonsillitis of a chronic nature are constant irritation of the mucous membranes with tobacco smoke, frequent use of alcohol, and mouth breathing (this phenomenon develops, for example, with sinusitis). In children, the disease becomes chronic with ineffective treatment of an acute process.

Symptoms of lacunar tonsillitis

The pathogenesis of this disease is characterized by rapid development. In full, the signs of pathology appear within a day. In this case, the temperature can rise to a febrile value, that is, up to 38-39 degrees, or to a pyretic level (39-41 degrees). Lacunar tonsillitis without temperature is a rather rare occurrence.

With a disease such as lacunar tonsillitis, symptoms may be non-specific, including weakness, headaches, insomnia, lack of appetite, fatigue. Pain is possible not only in the throat when swallowed, but also in the joints of the jaw, as well as in the muscles.

Against the background of a rather pronounced pallor of the nasolabial triangle, hyperemia of the cheeks is noted. Lymphadenitis is possible, that is, inflammation of the lymph nodes in the jaw and neck, as well as tachycardia (heart rate that exceeds the norm).

Diagnosis of lacunar tonsillitis

An otolaryngologist examines the oral cavity to identify the disease. Lacunar tonsillitis will be diagnosed if, during pharyngoscopy, the doctor notes inflammation of the tonsils, purulent plaque, hyperthermia of the soft palate, and accumulation of pus in the lacunae.

Bacteriological tests reveal the presence of various microorganisms. Usually it is Staphylococcus aureus, hemolytic staphylococcus aureus and group A beta hemolytic streptococcus. As for viruses, adenoviruses, cytomegaloviruses and herpes virus are most often detected with lacunar angina.

Differences between lacunar and follicular angina

If angina is follicular, then whitish-yellow plaque or festering vesicles are present on the surface of the tonsils. When the follicle is opened into the peritonsillar tissue, there is a risk of developing a paratonsillar abscess.

Lacunar tonsillitis is characterized by a light yellow coating at the mouths of the lacunae. It consists of leukocytes and torn particles of the epithelium. Often a confluent plaque is formed that covers the tonsils, but does not go beyond their surface. It is removed easily, as a result of this, there is no bleeding surface.

With these differences, lacunar and follicular angina are characterized by very similar symptoms. Also, their duration in most cases is the same. On average, follicular angina lasts as long as lacunar – from 5 to 7 days.

Treatment of lacunar angina

The need for hospitalization is determined based on the severity of the pathogenesis. When treating at home, you need to observe bed rest, limit contacts, drink plenty of fluids and eat warm, pureed food. In the absence of the effect of conservative treatment and difficulty in breathing, surgical removal of the tonsils may be necessary.

With a disease such as lacunar tonsillitis, it is necessary not only to treat the symptoms, but also to pay attention to adequate nutrition. Fresh milk should be excluded from the diet of a sick person. Otherwise, lactic bacteria, lingering on the mucous membrane, contribute to the reproduction of pathogenic organisms. In extreme cases, after drinking milk, you need to rinse your throat several times. From drinking it is best to use warm mineral water that does not contain gas, weakly brewed tea, possibly with the addition of honey.

In case of microbial etiology of the disease, antibiotic therapy is indicated. With a disease such as lacunar tonsillitis, treatment in adults is more often carried out with the help of antibiotics, sulfa drugs are less often prescribed. Proper selection of drugs will ensure:

• destruction of the pathogen;
• prevention of side effects in comorbidities;
• maintaining a balance between drug efficacy and safety.

Penicillin antibiotics are the first choice for ENT infections. Cephalosporins, macrolides, fluoroquinolones are also often prescribed.

Treat lacunar tonsillitis with high fever with antipyretics such as paracetamol or nurofen. Of the antihistamines that help reduce swelling of the tonsils, cetrin or suprastin are usually prescribed.

Local treatment consists of rinsing, lubricating the throat with Lugol’s solution, using inhalers and lozenges. When the temperature returns to normal, you can use vodka compresses in the neck area.

In a disease such as lacunar tonsillitis, a specialist should evaluate the symptoms and prescribe the appropriate treatment. Taking any medications without consulting a specialist is unacceptable.

After a doctor prescribes the appropriate therapy, the availability of medicines in pharmacies in Kyiv can be checked on our portal, and you can also order them online.

Surgery

The disease can be cured by sucking out the pus. This is done using the Tonsillor apparatus.

If there is no effect, a lacunotomy may be indicated. In this case, the resection of the tissues surrounding the tonsils is performed by the abdominal method or by a laser. As a result, the purulent contents come out, and the tissues, growing together, do not allow pus to accumulate in the gaps again.

Tonsillectomy is a surgical procedure that removes the tonsils. This is an extreme measure, which is taken when it is not possible to help the patient in other ways.

Lacunar tonsillitis in children

If treatment is delayed or inadequate, lacunar tonsillitis in children can cause abdominal pain, nausea, pain during swallowing radiating to the ear, indigestion, choking, convulsions, conjunctivitis. This state can last for about three days.

Lacunar tonsillitis for children is dangerous because it can provoke the appearance of a false croup. The cause of the phenomenon is swelling in the tonsils, due to which the airways overlap. At the same time, the child suffocates, his skin turns blue.

Improper antibiotic treatment of lacunar tonsillitis in children can lead to disability or death. Any medicine is prescribed taking into account the age and weight of the child.

Complications of lacunar tonsillitis

In severe cases, lacunar tonsillitis in children and adults can provoke various complications. The most common early complications are:

• laryngitis;
• sepsis or meningitis when the infection enters the blood;
• involvement of the mediastinal organs in the inflammatory process.

Possible late complications include myocarditis, pericarditis, pancarditis, acute rheumatic fever, pyelonephritis, hemorrhagic vasculitis.