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Acute Tonsillitis

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Acute Tonsillitis

Tonsillitis is very common, and if left untreated can be dangerous.

Acute tonsillitis is a throat infection that primarily involves the tonsils. It usually happens quickly and symptoms can progress rapidly. The tonsils can become so large that they obstruct the airway and make it impossible to swallow.

Acute Tonsillitis Causes:

Acute tonsillitis can be caused by bacterial or viral infections, just like other throat infections. Common viral causes of tonsillitis include:

  • Adenoviruses
  • Influenza virus
  • Epstein-Barr virus
  • Parainfluenza viruses
  • Enteroviruses
  • Herpes simplex virus

Acute Tonsillitis Symptoms:

Symptoms of tonsillitis tend to be more severe that other causes of sore throats, and they progress quickly. They are often also associated with:

  • Enlarged tonsils
  • A change in the voice
  • Yellow or white coating on the tonsils (exudate)
  • Severe sore throat
  • Swollen lymph nodes in the neck
  • Neck pain
  • Fever
  • Bad breath
  • Pain or difficulty swallowing
  • Difficulty opening the mouth (trismus)
  • Dehydration

Acute Tonsillitis Treatment:

It is difficult to discern between a viral and bacterial tonsillar infection when symptoms first appear. Initial symptoms can be treated by oral antiinflammatories and fever reducers. Rapid strep testing has an accuracy of about 40%, making it an unreliable test. A regular throat culture is more accurate, but it takes 3-5 days to get the results – the same time it takes to see if your symptoms resolve on their own or progress.

If symptoms progress and an exudate appears on the tonsils, oral antibiotics are helpful. Oral or injectable steroids and antiinflammatories reduce tonsillar swelling so you can swallow and stay hydrated. In severe cases, intravenous fluid, antibiotics, and steroids are needed to treat dehydration and stop the infection from progressing.

If tonsillitis is caused by a bacteria such as strep, antibiotics are given. Over-the-counter medications, such as acetaminophen (Tylenol) or ibuprofen may be taken to reduce pain and fever. Repeated or chronic infections can be treated with surgery to remove the tonsils, known as a tonsillectomy.

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Linda D. Dahl, MD