Tonsillitis: Symptoms, Treatment and When to See a Doctor

Severe pain when swallowing, fever and coating on the tonsils — this is how tonsillitis begins. It is an acute infection, and it cannot be treated “hoping for the best”: without proper therapy it can lead to complications affecting the heart, joints and kidneys. Let’s look at how tonsillitis shows itself, why it is dangerous and how it is treated.

What Tonsillitis Is and How It Differs from an Ordinary Sore Throat

Tonsillitis (in Russian and Ukrainian usage, angina) is an acute inflammation of the palatine tonsils, or acute tonsillitis. Unlike an ordinary sore throat with ARVI, tonsillitis is more severe: the pain is sharp, the temperature is high, and you feel unwell. With a cold the throat is scratchy and there is a runny nose and cough, while with tonsillitis there is usually no cough.

It is important to understand the difference between bacterial and viral tonsillitis. The bacterial kind, as a rule, occurs without cough or runny nose, with coating and a high temperature. The viral kind is more often accompanied by cough, runny nose, hoarseness and conjunctivitis, and there may be no coating. Whether an antibiotic is needed depends on the type, so if a person has fallen ill and the throat hurts more and more, it is better not to guess but to see a doctor.

Pathogens, Types of Tonsillitis and Ways the Infection Spreads

Where does tonsillitis come from? It is caused by bacteria, most often group A beta-hemolytic streptococcus, as well as viruses and fungi. Infection occurs by airborne droplets when talking and coughing, and through shared dishes and household items. Is tonsillitis contagious? Yes, especially in the first days of the illness. The main types differ in severity and in the features of their course. A person remains contagious for about a day after starting antibiotics, and without treatment, much longer.

Symptoms of Tonsillitis in Adults and Children

Tonsillitis begins acutely: the temperature rises to 38–40 °C, and chills, weakness, headache and muscle and joint pain appear. The throat hurts more and more, and every swallow is difficult. The lymph nodes under the lower jaw enlarge and hurt. In small children, vomiting, abdominal pain and refusal to eat are added. Tonsillitis in an adult with a fever is a common picture, in which a consultation is needed within the first 24 hours.

What the Throat Looks Like with Tonsillitis

The tonsils are enlarged, bright red and swollen. White or yellow coating, purulent dots or films are visible on them. Sometimes the coating merges. The tongue is coated, and the palate and arches are red. Because of the coating, tonsillitis is often confused with ordinary pharyngitis, and sometimes with diphtheria, so you cannot make a diagnosis yourself.

Which Symptoms Require Urgent Medical Help

Call a doctor or an ambulance urgently if:

• breathing or swallowing is difficult, and you cannot swallow saliva;
• the sore throat has sharply intensified on one side and the mouth opens with difficulty;
• a temperature above 39 °C lasts more than 2–3 days;
• a rash, joint pain or heart pain has appeared;
• a child is lethargic, refuses to drink, and has dry lips and infrequent urination.

Diagnosis of Tonsillitis at the Helyos Medical Center

Diagnosis begins with an examination. An ENT doctor examines the throat, palpates the lymph nodes, and assesses the color and condition of the tonsils. To distinguish bacterial tonsillitis from viral, a rapid strep test and a throat swab for flora are done. A complete blood count and CRP show the severity of inflammation. If complications are suspected, an ECG and a urine test are ordered. A comprehensive ENT examination makes it possible to select the right treatment.

How Tonsillitis Is Treated: Home Measures and Medical Therapy

Treatment of tonsillitis depends on the pathogen. With the bacterial form, the doctor prescribes an antibiotic — more often from the penicillin group. The course usually lasts 7–10 days, and it must not be shortened even if you feel better: an inadequately treated infection is dangerous because of complications. With viral tonsillitis, antibiotics are not needed, and treatment is symptomatic.

What to do at home:

• stay in bed for the first 3–5 days;
• drink plenty of warm fluids: tea, fruit drink, compote, broth;
• eat soft, non-irritating food;
• gargle with antiseptic solutions;
• use paracetamol or ibuprofen for high temperature and pain;
• give the sick person separate dishes and a towel, and children should not attend kindergarten or school.

Hot compresses and warming the throat are contraindicated with tonsillitis: heat increases inflammation and may contribute to the development of an abscess. You should not mechanically remove the coating or smear the tonsils yourself.

Why Tonsillitis Is Dangerous and When You Need an ENT Doctor at Helyos

The danger of tonsillitis is that streptococcus can cause complications not only in the throat. If the illness is severe or recurs 5–7 times a year, a consultation with an otolaryngologist is needed. The doctor will assess the condition of the tonsils and decide which treatment is suitable — conservative or surgical. Tonsillitis in children is treated by pediatricians and ENT doctors: details are on the page about tonsillitis treatment in children in Dnipro. With chronic tonsillitis an operation is possible: ENT surgery in Dnipro includes removal of the tonsils as indicated.

Complications of Inadequately Treated Tonsillitis

• Peritonsillar abscess — a pocket of pus next to the tonsil.
• Rheumatic fever with damage to the heart and joints.
• Glomerulonephritis — inflammation of the kidneys.
• Ear infection, sinusitis, inflammation of the lymph nodes of the neck.
• Chronic tonsillitis with frequent flare-ups.

If tonsillitis recurs often — seven or more episodes in a year, five or more per year for two years in a row, or three or more per year for three years in a row — the doctor may discuss removal of the tonsils. The decision is made individually after a full examination.

To avoid complications, it is important to start treatment in time, complete it, and take follow-up tests 1–2 weeks after recovery on the doctor’s recommendation.