Tonsillitis

Tonsillitis is an inflammation of the tonsils, two oval lymphoid masses located at the back of the throat. It commonly affects children but can occur at any age. Most cases are caused by viral infections, though bacteria, particularly group A Streptococcus (Streptococcus pyogenes), can also be responsible. Acute tonsillitis may be isolated or part of a broader infection such as a cold or sore throat.

Symptoms typically include a sore throat, fever, painful swallowing, and enlarged, tender tonsils sometimes with white or yellow coating. Other signs can include swollen lymph nodes in the neck, bad breath, earache, difficulty swallowing, and fatigue. In children, abdominal pain or reduced appetite may occur. Symptoms usually last a few days to about a week, depending on the cause.

Diagnosis is usually clinical, based on history and examination. A rapid antigen detection test or throat culture may be used to test for streptococcal infection, particularly in children and adolescents, to distinguish bacterial from viral causes and guide treatment.

Treatment focuses on relieving symptoms and addressing the underlying cause. Viral tonsillitis is managed with rest, fluids, analgesics such as acetaminophen or ibuprofen, and throat soothing measures. Bacterial tonsillitis is treated with antibiotics, typically penicillin or amoxicillin, for about 7–10 days; alternatives are used for penicillin allergy. Antibiotics shorten symptoms and reduce contagion if the infection is bacterial.

Complications can include peritonsillar abscess, recurrent episodes affecting quality of life, and, rarely, spread to surrounding areas. Persistent or recurrent tonsillitis may lead to consideration of tonsillectomy in selected cases. Preventive measures emphasize good hand hygiene and avoiding close contact with infected individuals.