Tonsillitis
Tonsillitis is a bacterial infection of the tonsils usually caused by the Streptococcus bacteria
Classically tonsillitis presents with a progressive sore throat, fever, enlarged neck nodes and feeling unwell. The tonsils appear red and swollen and often have a white exudate.
Some patients can be so unwell that they are unable to eat and drink
In adolescents and young adults the first episode of tonsillitis often occurs in association with glandular fever.
How to treat tonsillitis?
Whilst some patients improve with simple pain relief, most patients will need antibiotic treatment and respond fairly quickly to this
The recommended antibiotic in the UK in Penicillin. However the absorption through the gut is not always so good and it may be necessary to switch to Co-amoxiclav which has better absorption. Some patients may require admission to hospital for intravenous antibiotics and fluids if the infection is particularly severe and does not respond to oral antibiotics and patients remain in pain and are unable to eat and drink
Regular pain killers in the form of Paracetamol and Ibuprofen are helpful.
When should you have your tonsils removed?
It can be difficult to decide when it would be best to have tonsils removed. There is no hard and fast rule and the recommendations in the NHS are quite extreme with 7 infections in one year, or 4 per year over 2 consecutive years. Essentially the decision to remove tonsils is a balance between undergoing surgery with a painful 2 week recovery period with time out of school and a small risk of bleeding compared with having repeated infections and this will vary depending on the patients circumstances.
Complications of tonsillitis?
Sometimes oral antibiotics are insufficient to treat the infection and it may be necessary to be admitted to hospital for intravenous antibiotics steroids, pain killers and fluids. This is usually effective and patients respond quickly and are discharged within a couple of days.
Peritonsillar and deep neck abscess
Sometimes the infection in the tonsils can spread to a space behind the tonsil. This pushes the tonsil towards the midline.
This can be very painful and patients may have trouble even drinking and opening their mouths. Hospital admission with intravenous antibiotics is necessary and sometimes the abscess needs to be drained.
