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Tonsils are two masses of tissue in the back of the throat which act as filters to trap germs that could potentially enter your airways and cause an infection. They also produce antibodies to help fight infection, however the tonsils themselves can become infected. “This condition is known as tonsilitis, which is the inflammation of the tonsils and is caused by bacteria, viruses, blood disorders and fungi,” says ENT (Ear, Nose, Throat) specialist Dr Ken Esterhuizen. “Tonsilitis can be contagious and recurrent in individuals and although it is much more common in the young, it does occur in adults and seldom in the elderly.”

What are its symptoms?

The main symptoms of tonsillitis are inflammation and swelling of the tonsils. Other symptoms include:

  • Sore throat or tenderness
  • Redness of the tonsils or a yellow/white coating on the tonsils
  • Blisters/ulcers on the throat
  • Headaches
  • Loss of appetite
  • Ear pain
  • Difficulty swallowing or breathing
  • Swollen glands in the neck or jaw area
  • Fevers/ chills
  • Bad breath

According to Dr Esterhuizen: “Occasionally the infection may spread to involve heart valves (rheumatic fever) or kidney tissue (glomerulonephritis); skin or joints. If it is part of a viral infection then the brain may be involved.”

How is it diagnosed?

“Tonsillitis is diagnosed by the history of the patient and examination, and if necessary special investigations,” says Dr Ken Esterhuizen.

Physical exam

  • Using a lighted instrument to examine the throat, ears and nose 
  • Checking for a rash known as scarlatina
  • Gently feeling (palpating) your neck to check for swelling
  • Listening to your breathing with a stethoscope.

Throat swab

In infective tonsillitis there may be a history of specific symptoms like sore throat, difficulty in swallowing or difficulty in breathing if they are large or non specific symptoms such as fever, muscle / joint pain, abdominal pain or headache. Examination of the patient may show an inflamed tonsil(s) with or without white pustules (follicles) and possibly swollen neck glands. A simple throat swab can be done by rubbing a sterile swab over the back of the throat to get a sample of the secretions to check for streptococcal bacteria.

Complete blood cell count (CBC)

“Special investigations may include a full blood count, swab of the tonsils and more specific tests for antibodies against the common pathogens,” says Dr Esterhuizen. The test results produces a count of the different types of blood cells and will indicate a profile for what’s elevated, what's normal or what's below normal. This will then determine whether the infection is caused by bacteria or a viral agent.

What are your treatment options?

“For bacterial causes, it is treated with antibiotics, and for viruses and fungi it’s antivirals and fungicides respectively. Adjunctive medication such as pain killers or steroids may be necessary. The pain killers may be oral, or topical (mouth sprays and gargles). Surgical treatment is indicated if the condition is recurrent or as part of the management of recurrent ear infections or upper airway obstruction.”

At-home care

At-home care tips to use during recovery include:

  • Get plenty of sleep and rest.
  • Drink warm fluids such as broth, tea or warm water with honey.
  • Gargle warm salt water to sooth your throat.
  • Humidify the air to eliminate dryness that may further irritate a sore throat.
  • Lozenges can also help to relieve a sore throat.
  • Avoid irritants such as cigarette smoke and cleaning products that can irritate your throat.
  • Treat pain and fever with the proper medication prescribed by your doctor.

Can it be prevented?

The germs that cause viral and bacterial tonsillitis are contagious, which is why it is important to practise good hygeine.

  • Wash your hands thoroughly and frequently.
  • Avoid sharing food, drinking glasses, water bottles or utensils.
  • Replace your toothbrush after being diagnosed with tonsillitis.

To prevent spreading the bacterial or viral infection to others:

  • Stay at home when you are ill
  • Speak to your doctor to find out when it is safe for you to go back to work/school.
  • Get into the habbit of coughing or sneezing into your elbow.
  • Wash your hands after sneezing or coughing.

Find out more

For more information, speak to a Clicks pharmacist on the prevention and treatment of tonsillitis. You can find the contact details to your nearest Clicks Pharmacy or call 0860 245 257.

The accuracy of this information was checked and approved by ENT Specialist Dr Ken Esterhuizen, in August 2017