Tonsillitis & Pharyngitis


Tonsillitis

Tonsillitis is inflammation (swelling) of the tonsils.

The tonsils are lymph nodes in the back of the mouth and top of the throat. They normally help to filter out bacteria and other microorganisms to prevent infection in the body.

They may become so overwhelmed by bacterial or viral infection that they swell and become inflamed, causing tonsillitis. The infection may also be present in the throat and surrounding areas, causing inflammation of the pharynx. The pharynx is in the back of the throat, between the tonsils and the voicebox (larynx).

Tonsillitis is extremely common, particularly in children.

Symptoms

  • Difficulty swallowing
  • Ear pain
  • Fever, chills
  • Headache
  • Sore throat - lasts longer than 48 hours and may be severe
  • Tenderness of the jaw and throat
  • Voice changes, loss of voice

Exams and Tests

The health care provider will look in the mouth and throat for swollen tonsils. The tonsils are usually reddened and may have white spots on them. The lymph nodes in the jaw and neck may be swollen and tender to the touch.

Tests that may be done include:

  • Rapid strep test
  • Throat swab culture

Treatment

If the cause of the tonsillitis is bacteria such as strep, antibiotics are given to cure the infection. The antibiotics may be given once as a shot, or taken for 10 days by mouth.

If antibiotic pills are used, they must be taken for the entire amount of time prescribed by the doctor. DO NOT stop taking them just because the discomfort stops, or the infection may not be cured.

Rest to allow the body to heal. Fluids, especially warm (not hot), bland fluids or very cold fluids may soothe the throat. Gargle with warm salt water or suck on lozenges (containing benzocaine or similar ingredients) to reduce pain.

Over-the-counter medications, such as acetaminophen (Tylenol) or ibuprofen may be used to reduce pain and fever. Do NOT give a child aspirin. Aspirin has been linked to Reye syndrome.

Some people who have repeated infections may need surgery to remove the tonsils (tonsillectomy).


Pharyngitis

Pharyngitis is inflammation of the pharynx, which is in the back of the throat, between the tonsils and the voicebox (larynx).

Causes

Many germs can cause pharyngitis.

Viruses are the most common cause of pharyngitis. Many different viruses can cause pharyngitis.
Bacteria that can cause pharyngitis include Group A streptococcus, which leads to strep throat in some cases. Other, less-common bacteria that cause sore throats include corynebacterium, arcanobacterium, Neisseria gonorrhoeae, and Chlamydia pneumoniae.

Most cases of pharyngitis occur during the colder months. The illness often spreads among family members.

Symptoms

The main symptom is a sore throat.

Other symptoms may include:

  • Fever
  • Headache
  • Joint pain and muscle aches
  • Skin rashes
  • Swollen lymph nodes in the neck

Exams and Tests

Your health care provider will perform a physical exam and look at your throat.

A rapid test or throat culture to rule out strep throat may be done. Additional laboratory tests may be done depending on the suspected cause.

Treatment

It is important to avoid antibiotics when a sore throat is due to infection with a virus. The antibiotics will not help. Using them to treat viral infections helps strengthen bacteria to become resistant to antibiotics.

Most sore throats are soon over. In the meantime, the following remedies may help:

  • Drink warm liquids. Honey or lemon tea is a time-tested remedy.
  • Gargle several times a day with warm salt water (1/2 tsp of salt in 1 cup water).
  • Drink cold liquids or suck on popsicles.
  • Suck on hard candies or throat lozenges to soothe your sore throat. This is often as effective as more expensive remedies. DO NOT use candies or lozenges in young children because of the choking risk.
  • Use a cool-mist vaporizer or humidifier to moisten and soothe a dry and painful throat.
  • Try over-the-counter pain medications, such as acetaminophen. DO NOT give aspirin to children.

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