Introduction
Tonsillitis refers to infection of the palatine tonsils which are on each side of the mouth. The tonsils can become infected and cause significant pain and lethargy. Dr Robinson had recurrent tonsillitis as a child and can sympathise with patients who suffer from this condition.
Causes
Tonsillitis is either bacterial or viral. There are rarer causes of tonsillitis, but the vast majority of episodes of tonsillitis in the developed world fall into these two categories. The bacterial causes of tonsillitis include:
- Strep Pneumonia
- Hemophylus Influenza
- Moraxella Caterhallis
The viral causes include:
- Adenovirus
- Epstein Barr Virus (Glandular fever)
- Parainfluenza
Symptoms
Pain, this is the main symptom of tonsillitis. Dr Robinson can vouch for the fact that this condition is painful. The pain is usually on both sides of the throat and can be associated with the following:
- Pus on tonsils
- Otalgia (Painful ears)
- Halitosis (Bad breath)
- Fevers
- Lethargy
- New onset of snoring
These symptoms typically last for 5 – 10 days and can progress to a quinsy which is a collection of pus beside the tonsil on one side.
Diagnosis
The diagnosis of tonsillitis is a clinical one. If you have inflamed red tonsils with pus on them then you have tonsillitis. If this is the case, then you should start treatment for your tonsillitis.
Investigations
Tonsillitis itself doesn’t necessarily require any investigations. Throat swabs have been done historically but are not usually that helpful in the treatment of the condition. Blood tests can be done but again do not change management of the condition.
Medical Management of tonsillitis
The management of tonsillitis is based around pain relief and hydration. If you have tonsillitis, ensure that you drink at least 4 litres of water per day and take regular panadol and nurofen. If your GP suspects that you have bacterial tonsillitis, then you should also have a course of penicillin antibiotics. It is rare that people need to go to hospital for their tonsillitis, however if you feel that you are not coping at home or are getting significantly worse, then it is recommended that you go to hospital for treatment.
Surgical Management of tonsillitis
Dr Dan Robinson recommends performing a tonsillectomy (taking out your tonsils) if you have had one of the following:
- 7 episodes of tonsillitis in a year
- 5 episodes of tonsillitis per year for 2 years
- 3 episodes of tonsillitis per year for 3 years
- 2 episodes of a quinsy
- Obstructive sleep apnoea / sleep disordered breathing
Having a tonsillectomy involves a general anaesthetic. The operation takes approximately 20 minutes and can be done as a day stay procedure. The operation is very safe when performed in Australia. Dr Robinson recommends that everyone has one week off work or school after they have had their tonsils removed.
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