Tonsillitis (medically known as tonsillitis or angina tonsillaris) is an inflammation of the palatine tonsils. This typically manifests as a sore throat and difficulty swallowing. Tonsillitis can often be treated with medication. However, if the tonsils become inflamed frequently, a tonsillectomy —the surgical removal of the tonsils —may be recommended to prevent recurrent infections. Read here about the different types of tonsillitis, when a tonsillectomy may be necessary, and when you should see a doctor! ICD codes are internationally recognized codes for medical diagnoses and can be found, for example, in doctors’ letters or on disability certificates.
What is tonsillitis
Tonsillitis is an inflammation of the palatine tonsils, which are located on the right and left sides of the throat. It is one of the most common reasons people visit a doctor. Children and adolescents are more likely to develop tonsillitis than adults.
Viruses are usually the causative agent of tonsillitis. Less commonly, bacteria trigger tonsillitis, usually streptococcal bacteria. The spots or yellowish-whitish deposits on the inflamed tonsils, typical of bacterial tonsillitis, consist of dead bacteria and dead immune system cells. Tonsillitis can occur on one or both sides of the tonsil.
Acute tonsillitis
Acute tonsillitis usually begins quickly. However, in the majority of patients, symptoms improve significantly after just three days. Tonsillitis usually heals on its own within one to two weeks. However, in bacterial tonsillitis, antibiotics may be necessary to support and accelerate the healing process. Doctors refer to chronic tonsillitis when the inflammation lasts for more than three months. The course can vary. Often, the inflammation in the tonsils smolders, and patients are asymptomatic or experience only mild tonsillitis symptoms. Occasionally, acute inflammation flares up.
Chronic tonsillitis
Current guidelines refrain from using the term “chronic tonsillitis.” Instead, experts refer to recurrent tonsillitis, a recurring infection.
You can find out more about this in the article Chronic Tonsillitis.
Tonsillitis: Surgery used to be quicker
You have a severe sore throat with painful difficulty swallowing. Pustules on the tonsils are usually only visible when bacteria are causing the inflammation. In a viral infection, the tonsils tend to be tense and slightly red but can also develop a greasy, gray-white coating, as in mononucleosis. However, laryngitis can also trigger a sore throat.
Who is susceptible to tonsillitis?
It’s a vicious circle: the more often you get tonsillitis, the more susceptible you are. This is because the tiny tubules of the tonsils become scarred when they become inflamed. Viral or bacterial infections develop behind these tubules particularly easily. For some patients, the constant inflammation impairs their quality of life so much that they have to have their tonsils removed.
There used to be more tonsillectomies. Why?
The guideline now states that tonsil surgery should only be performed if you have had six or more bouts of bacterial tonsillitis per year that require antibiotic treatment. A high bar! Perhaps too high. Each case must be carefully considered, and, if necessary, surgery performed if it alleviates the symptoms—even if the guidelines do not yet recommend surgery.
Specialist in otorhinolaryngology
Dr. Adeel runs a private practice in West Yorkshire specializing in ENT medicine.
Tonsillitis: Examinations and Diagnosis
Severe sore throat and difficulty swallowing, fatigue, and fever often lead those affected to a doctor. The doctor will first ask a few questions about their medical history ( anamnesis ). Possible questions include:
Physical examination
The doctor will then check for redness, swelling, or plaque on the throat and tonsils. They will also palpate the lymph nodes, particularly those in the neck and back of the head. These may be swollen in cases of tonsillitis.
A notice
The examination and the symptoms described are usually sufficient for the doctor to diagnose “tonsillitis.”
Throat swab
If tonsillitis is suspected to be caused by certain bacteria (group A beta-hemolytic streptococci, or GABHS for short), the doctor will take a throat swab. To do this, they will swab a special cotton swab along the back of the throat to collect a sample of the saliva present there. Any streptococci present in the swab can then be detected using a rapid test or in a laboratory. The rapid test results are available in just a few minutes, but the test does not detect every streptococcal infection. Analysis of the swab in a laboratory, using bacterial culture, is more reliable. However, this takes one to two days.
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Further investigations
In some cases, further tests may be necessary. For example, if an encapsulated pus pocket (abscess) is suspected, the doctor may perform an ultrasound. In some cases, blood tests may also be useful, for example, to rule out other diseases.
Tonsillitis: When to see a doctor?
If you suspect tonsillitis and have only mild symptoms, you can initially try to relieve the symptoms at home. However, if the symptoms do not improve within the first three days or worsen, you should seek medical advice from an ENT specialist in West Yorkshire.
In addition, prompt medical attention is required in the following situations:
- abnormal breathing sounds
- breathing difficulties
- very severe pain, especially when chewing, swallowing, or opening the mouth
- Acute rheumatic fever in the family
- severe general illnesses
- high fever, especially if it cannot be reduced with medication
Children, pregnant women, and people with weakened immune systems should be particularly vigilant and seek early medical advice. If you are in the area, consulting an ENT specialist West Yorkshire can ensure you receive a proper diagnosis and treatment tailored to your condition.
For further information on tonsillitis and related treatments, including tonsillectomy, speak to your local ENT professional.
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