Amigdalite

Amigdalite, or tonsillitis, is an inflammation of the palatine tonsils usually caused by infection. Viral infections are the most common cause, but bacteria such as group A Streptococcus can also be responsible. Other pathogens include Epstein-Barr virus, adenovirus, influenza, and Haemophilus influenzae.

Typical symptoms include sudden onset sore throat, fever, painful swallowing, enlarged red tonsils, and sometimes white or yellow exudates. Tender swollen lymph nodes in the neck, bad breath, and a muffled voice may occur. Children may present with stomach discomfort or vomiting. A clinician may use assessment tools like the Centor criteria to estimate the likelihood of a streptococcal infection, with confirmation by rapid antigen detection testing or throat culture when appropriate.

Complications are possible and can be serious. These include peritonsillar abscess, otitis media, sinusitis, and, though less common in modern practice, rheumatic fever or post-streptococcal glomerulonephritis after untreated GAS infection. Distinguishing bacterial from viral etiologies is important to guide treatment.

Treatment depends on the cause. Viral tonsillitis is managed with supportive care such as analgesics, fever reducers, hydration, and rest. If a streptococcal infection is confirmed or strongly suspected, antibiotics like penicillin V or amoxicillin are typically used for 7–10 days; alternatives exist for penicillin allergy. Recurrent or chronic tonsillitis may lead to consideration of tonsillectomy after evaluation by an ear, nose, and throat specialist. Prevention focuses on good hygiene and reducing transmission, as vaccines are not available for most common causes. Most cases resolve within a week or so with appropriate care.