Tonsillitis is a very common event, especially during childhood. A tour of its typology, symptoms and possible treatments.
The palatine tonsils, also called tonsils, are two accumulations of lymphoid tissuelocated at the bottom of the oral cavity, on both sides of the pharynx. These physiological structures have a defensive function, as they protect the respiratory and digestive mucosa from external aggressions by pathogenic microbes.
The lymphoid tissue that composes them collects the information of the entry of foreign elements into the mouth of the individual and their cells are responsible for fighting infections in the first line of front, since they are mostly macrophages, T lymphocytes and B lymphocytes. In addition, the latter are capable of producing antibodies (especially IgA) that inhibit the adhesion of bacteria to the mucosa of the mouth. This antigenic situation can be transmitted to other organs, which receive the warning that something is not right in the body.
As you can see, masses of tissue that at first seem practically anecdotal perform an essential function when it comes to combating certain pathological processes and, therefore, their inflammation is one of the first signs that you are fighting against something. In the following lines we tell you everything you need to know about tonsillitis.
- We recommend you read: “The 13 differences between a cold and a flu”
What is tonsillitis?
According to the U.S. National Library of Medicine, tonsillitis is defined as an inflammation of the tonsils. This term is also known as tonsillitis or angina, both interchangeable as they refer to the same clinical sign. As you can imagine, tonsillitis is an extremely common event in society, especially in children’s groups and in people at risk of further infections.
At this point it is necessary to emphasize that there are two types of tonsillitis according to their severity and duration:
- Acute tonsillitis: very common in young children and adolescents, benign and self-limiting.
- Chronic tonsillitis: in this case the tonsils suffer almost permanent viral or bacterial infections. Symptoms occur for more than 6 months.
From this point we are going to look mostly at acute tonsillitis, since this is the one that reports more medical interest and is more common in society. Even so, we will dedicate a few final lines to its chronic variant.
Causes of acute tonsillitis
You may be surprised to learn that, according to epidemiological studies, acute tonsillitis accounts for 1.3 out of every 100 consultations in general practitioners and 20% of sick leave in adults. In raw figures, this translates into 40 million consultations per year in the United States alone. It is necessary to distinguish tonsillitis of viral or bacterial origin, and we dissect both events in the following lines.
1. Viral tonsillitis
The most common is that the pathogen, regardless of the age of the affected, is of viral origin, since these microorganismsare the cause of more than 50% of cases of tonsillitis globally. Here is a list of the main suspects and their epidemiological statistics:
- Herpes Simplex virus: very common in society. It is the cause of 12.9% of tonsillitis cases.
- Influenza virus: The flu of a lifetime causes 5.2% of cases. Up to 20% of the world’s population has the flu at any given time.
- Coxsackie virus: from flu-like symptoms in normal cases, this microorganism attributes 3.9% of tonsillitis cases.
- Parainfluenza and adenovirus: separately they do not explain more than 4% of tonsillitis cases.
- 7.1% of cases do not have a specific identifiable viral agent.
With this list we wanted to show you that multiple causative agents can give rise to this event and, in addition, in many cases a specific cause cannot be found. We recall again that viral infections are prevalent in cases of tonsillitis of young children and adults.
2. Bacterial tonsillitis
Within this group, the causative bacterial agents are 3: group A beta-hemolytic streptococcus, non-A beta-hemolytic streptococcus and other non-streptococcal bacteria. The first of the groups is the most important, as it is estimated that it causes 20-40% of cases in adults and 5-15% in children. It should also be noted thatbacterial tonsillitis is more prevalent than viral tonsillitis in a specific age group: between 3 and 15 years of age.
Symptoms
The most common form of tonsillitis is erythematous, accounting for about 90% of cases. In the primary care consultation, the patient describes pharyngeal pain and difficulty swallowing, among other things. We can include the symptoms of this pathology in the following:
- Sore throat and difficulty swallowing, as well as tender, dilated glands in the neck. This means that the lymph nodes are also swollen by the infectious process (adenopathy).
- Red and swollen tonsils and appearance of white or yellow patches on them.
- Fever, as an immune response to the infectious process.
- Bad breath (transient halitosis).
- Stomach pain, especially in young children.
- Stiffness in the neck, headache and even scratchy voice.
In general, if a person comes with this symptomatology to the medical center, tonsillitis is immediately suspected. The professional usually performs a streptococcal test, that is, obtain a sample of the patient’s pharyngeal mucosa to check if there is bacterial growth on it in a matter of minutes. If the test comes back negative, a laboratory analysis may be required to try to discover what the causative agent of the disease is.
Treatment
It is very important to differentiate viral tonsillitis from bacterial tonsillitis, as treatment in both cases varies drastically. Viral tonsillitis is (in the vast majority of cases) self-limiting, that is, no specific treatment is required to fight the infection. Certain drugs can be prescribed to the patient, but all of them are aimed at reducing the symptoms.
On the other hand, bacterial infections in the tonsils do require specific treatment. In these cases, antibiotics are prescribed, usually penicillin for 10 days if the causative agent is a group A strep (most common event). It is very important to follow the doctor’s recommendations regarding dosage and prescription of the drug, because if treatment is interrupted early, the infection can be reactivated with a worse prognosis.
Prevention
Tonsillitis is not contagious, but the etiological agents that cause it are. Talking about prevention in the world of infants is quite complex, because controlling what they do or do not do in a school environment (a real breeding ground for diseases) is a very complex task.
Even so, as adults you can follow several guidelines to avoid getting infected by certain viruses and bacteria. Do not leave home during the illness to avoid spreading the pathogen, carefully clean all materials used by patients and maintain maximum sanitation patterns are the most effective measures to avoid tonsillitis. Anyway, we must be clear about one thing: we all get sick at some time of the year and this is quite inevitable, but not every infection translates into tonsillitis.
Chronic tonsillitis
As we promised you at the beginning, we dedicate these last lines to chronic tonsillitis, a variant of the much less common pathology that usually requires surgery. In general, it is considered chronic to arecurrent tonsillitis that appears more than 7 times a yearor with certain patterns of periodicity for several years.
In these cases or when tonsillitis brings with it severe complications (difficulty breathing, inability to swallow or abscesses that do not disappear), tonsillectomy is used, that is, the total removal of the tonsils. This surgical process requires hospitalization and healing takes 7-14 days.
Summary
As you may have seen, tonsillitis is a pathology that unequivocally indicates that an infection is occurring, either of viral origin or bacterial cause. Most events are caused by certain viruses, although type A streptococci are also causative agents that must be taken into account.
Before an episode of tonsillitis, go to the doctor in all cases. You don’t know if the cause is a virus or bacteria, so waiting at home for it to resolve itself is not a good option. In the event that the etiological agent is a bacterial strain, treatment is necessary.
To the classic question “what do you do?” I always answer “basically I am a psychologist”. In fact, my academic training has revolved around the psychology of development, education and community, a field of study influenced my volunteer activities, as well as my first work experiences in personal services.
