Tonsillitis is an acute inflammation of the tonsils. Tonsils are masses of lymphatic tissue at the back of the throat. They have a protective function, which is to act as a filter to prevent infections occurring in our mouth, throat and sinuses which can spread to other parts of the body. They also produce antibodies to fight infections in the throat and nose. Tonsillitis occurs when the tonsils become inflamed as a result of bacterial or viral infection.
Tonsillitis affects mostly children between the ages of 3-7 years old because this is when their tonsils are in their most active stage, fighting infections. When the child grows older, the tonsils will shrink and infections will become less common. Severe forms of tonsillitis are seen in infants or children who have not developed any protective immunity against infections and also in adults who have some form of immunodeficiency e.g HIV patients, uncontrolled diabetes, or taking antibiotics which destroys the normal flora of organisms in the mouth.
Tonsillitis is usually not a serious condition. Sometimes following an attack of tonsillitis, an abscess develops on the tonsils. If this happens, the tonsils can swell such that it can lead to breathing difficulties, due to narrowing of the airway passage in the throat. Other secondary complications due to tonsillitis are chronic tonsillitis (recurrent episodes of acute tonsillitis), peritonsillar abscess (due to spread to surrounding tissues), pneumonia, glomerulonephritis, osteomyelitis, otitis media (ear infections), adenoid problems, and rheumatic fever.
What causes the condition?
The most common cause of tonsillitis is of bacterial origin. The most common is the group A beta-hemolytic streptococcus strain, i.e. Streptococcus pyogenes. The streptococcus bug can sometimes be found in the throat and nose for months without causing any symptoms. However, at times especially if an individual is run down or has some reason for their immunity to be suppressed, eg. if fighting a virus such as the common cold, the bacteria tend to invade the cells of the tonsils. This can lead to inflammation of the tonsils with release of toxic substances, leading to tonsillitis.
Other bacteria which can cause tonsillitis are streptococcus pneumonia, haemophilus influenzae, and staphylococcus aureus which are often found in patients who have recurrent tonsillitis. Research has shown that H. influenzae has been most resistant to therapy and frequently causes recurrent infections. It has been found that these strains of bacteria carries the gene for fibronectin-binding protein, which gives them the ability to enter the epithelial cells and persist in the throat even after therapy.
Viruses can also cause tonsillitis. The more common viral infections are from multitudinous rhinoviruses, echoviruses and adenoviruses.
The common symptoms of tonsillitis are severe sore throat. This tends to be accompanied by swollen glands on sides of the neck, fever, headache, malaise (weakness) Sometimes, the swelling can be so great that it blocks the eustachian tube (ear canal) usually in a child who may develop an otalgia (earache) as well as difficulty in hearing. The patient may also have loss of appetite, and in very young children, vomiting, abdominal pain and diarrhoea are common symptoms.
If the patient develops a tonsillar abscess, the tonsils will be inflamed and he/she will also feel severe pain and tenderness around the roof of the mouth (soft palate). The child will also have difficulty in swallowing, and muffled speech because of the abscess.
Tonsillitis is usually diagnosed in a patient with a sore throat, by examination and visualisation of the tonsils at the back of the throat. Findings by the Doctor include redness of the tonsils with associated swelling