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Tonsillitis: Causes, Symptoms, Risk Factors, Diagnosis, Treatment and Complications

Nov 14, 2023

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Causes Of Tonsilitis

Symptoms Of Tonsilitis

Risk Factors Of Tonsilitis

Diagnosis Of Tonsilitis

Oral swab

The whole count of cells (CBC)

Treatment Of Tonsilitis

Treat pain and fever.

Antibiotic-containing medication


Complications Of Tonsilitis

Tonsillitis Causes, Symptoms, Risk Factors, Diagnosis, Treatment and Complications

Tonsillitis is a term given to the inflammation of the tonsils, which are two oval-shaped tissue pads located in the back of the throat, one on each side. Tonsillitis is characterized by swollen tonsils, aching throats, difficulty swallowing, and tender lymph nodes on the sides of the neck.

Tonsillitis can also be caused by bacterial infections, however, most cases are caused by common viral illnesses.

The most effective therapy for tonsillitis depends on the underlying cause, so it's important to get an accurate and quick diagnosis. Tonsillitis removal surgery was once a common method of treating the condition. Still, it is now usually reserved for situations where the infection is severe, doesn't improve with medicine, or results in serious consequences.

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Causes Of Tonsilitis

Although bacterial infections can sometimes be the cause, viruses are the most common cause of tonsillitis.

The most common cause of tonsillitis is Streptococcus pyogenes, also referred to as group A streptococcus, and the cause behind strep throat. Tonsillitis can also be brought on by a variety of bacterial strains and other strep types.

The tonsils serve as the immune system's first line of defense against oral bacteria and viruses. This function may make the tonsils more prone to inflammation and infection. However, the tonsils' immune system starts to weaken beyond puberty, which may be the cause of the very frequent occurrence of tonsillitis in adults.

Also Read: Laryngeal Cancer: Causes, Symptoms, Risk Factors, Diagnosis, Treatment and Prevention

Symptoms Of Tonsilitis

Most kids who have tonsillitis are in preschool or mid-adolescence. Typical signs and symptoms of tonsillitis include:

  • Red and swollen tonsils
  • There are dots on the tonsils or a layer of yellow or white material.
  • Uncomfortable or difficult swallowing
  • Painful throat
  • High temperature
  • Larger, sensitive lymph nodes (glands) in the neck
  • A raspy, muffled, or throaty voice
  • Foul-smelling breath
  • Stomach pain
  • A sore or stiff neck
  • Head Pain

Among the signs of tonsillitis in young children who are unable to express their emotions are:

  • Drooling due to difficulty or discomfort
  • Refusal of food
  • Unusual fussiness

Also Read: Earwax Blockage: Causes, Symptoms, Risk Factors, Diagnosis and Treatment

Risk Factors Of Tonsilitis

The following are some risk factors for tonsillitis:

  • Young age: The age group between 5 and 15 years old is most susceptible to bacterial tonsillitis, which primarily affects children.
  • Frequent exposure to infections: School-age children frequently come into contact with their peers as well as bacteria or viruses that could cause tonsillitis.

Diagnosis Of Tonsilitis

The doctor will start the physical examination of your child by:

  • Using a light instrument to examine your child's throat, ears, and nose—all of which may be infection sites
  • Looking for the scarlatina rash, which has occasionally been connected to strep throat
  • Using a stethoscope, gently palpate your child's neck to check for enlarged lymph nodes or glands while keeping an eye on their breathing.
  • Checking for splenic enlargement (to rule out tonsil irritation from mononucleosis)

Oral swab

The doctor performs a brief examination to get a sample of secretions from your child's throat using a sterile swab. In a lab or clinic, the sample will be tested for streptococcal germs.

Many clinics are equipped with a lab that can provide test results in just a few minutes. However, a second, more reliable test is normally sent to a lab that can usually deliver the results within a few days or even hours.

If the quick in-clinic test results are positive, your child most certainly has a bacterial infection. If the test comes back negative, even though extremely highly unlikely, your child most certainly has a viral disease. However, your doctor will wait until the more reliable out-of-clinic laboratory test to determine the cause of the infection.

The whole count of cells (CBC)

Your physician could ask for a small amount of your child's blood to do a complete blood cell count (CBC). This test counts the different types of blood cells and is commonly done in a clinic. Determining whether a bacterial or viral agent is more likely to be the source of infection can be done with the help of the profile of high, normal, and below-normal readings. A complete blood count is rarely necessary to diagnose strep throat. If the results of the lab test for strep throat are negative, a complete blood count (CBC) may be necessary to determine the cause of tonsillitis.

Also Read: Nasopharyngeal Carcinoma: Causes, Symptoms, Risk Factors, Diagnosis, Treatment, Prevention and Complications

Treatment Of Tonsilitis

Whether your child's tonsillitis is caused by a virus or bacteria, at-home care methods can make them feel better and help them recover faster.

If a virus is most likely the cause of your tonsillitis, these are the only treatments available. Your doctor does not prescribe antibiotics. Your child will probably feel better in seven to 10 days.

The following are some at-home care strategies to use during the recovery phase:

  • Recommend rest: Encourage your child to sleep well.
  • Drink plenty of liquids: To keep your child's throat moist and avoid dehydration, give them lots of water.
  • Serve nourishing food and drinks: Warm beverages like broth, tea without caffeine, or warm water with honey, as well as cold foods like ice pops, can soothe a sore throat.
  • Prepare a saltwater gargle: If your child can gargle, you can help ease their sore throat by making a solution of 1/2 teaspoon (2.5 milliliters) table salt and 8 ounces (237 milliliters) warm water. Have your child spit up the solution after gargling it.
  • Make the air more humid: Use a cool-air humidifier or spend some time in a steamy bathroom with your child to prevent aggravating their sore throat.
  • Give lozenges: Children over 4 can use lozenges to soothe sore throats.
  • Avoid the irritants: Keep cigarette smoke and throat-irritating cleaning materials out of your home.

Treat pain and fever.

Ask your doctor about using acetaminophen (Tylenol) or ibuprofen (Advil, Children's Motrin, and other brands) to treat a fever and lessen throat pain. For painless low fevers, there is no need for treatment.

Aspirin shouldn't be given to kids or teenagers unless a doctor specifically prescribes it to address a medical condition. Reye's syndrome is a rare but potentially fatal illness linked to children taking aspirin to treat symptoms of cold or flu-like illnesses.

Antibiotic-containing medication

If a bacterial infection is the source of your tonsillitis, your doctor will advise an antibiotic course of treatment. When group A streptococcus causes tonsillitis, penicillin is the most often prescribed antibiotic. It is taken orally for 10 days. Your physician will advise an alternate medication if your child has a penicillin allergy.

Your child must take the antibiotics exactly as prescribed for the full prescribed duration, even if their symptoms completely go away. The illness could worsen or spread to other parts of the body if the medication is not taken as directed. For example, your child may experience rheumatic fever and severe kidney irritation if they miss doses of their medicines.

Speak with your doctor or pharmacy if you frequently need to remember to give your child their dose.


A tonsillectomy is a treatment option for bacterial tonsillitis, chronic tonsillitis, and tonsillitis that does not improve following antibiotic therapy. Frequent tonsillitis is often defined as:

  • Seven or more times in the previous year
  • At least five episodes per year for the preceding two years
  • At least three episodes a year for the preceding three years

In cases where tonsillitis results in uncontrollable repercussions, like the ones listed below, a tonsillectomy could also be required:

  • Breathing issues in obstructive sleepers with apnea
  • Difficulty swallowing, especially when consuming meats and other heavy foods
  • An abscess that does not improve after antimicrobial treatment

A tonsillectomy is usually done as an outpatient procedure unless your child is very young, has a complex medical condition, or if problems arise after surgery. This means that your child should be able to go home on the day of the surgery. A complete recovery usually takes seven to fourteen days.

Also Read: Empty Nose Syndrome Symptoms, Treatment, Causes, & Diagnosis

Complications Of Tonsilitis

Recurrent or persistent (chronic) tonsillitis can cause the following complications: tonsil inflammation or enlargement

  • Breathing problems during sleep (also known as obstructive sleep apnea)
  • An infection that penetrates deeply and infects surrounding tissue (tonsillar cellulitis)
  • Disease that results in a pus collection behind the tonsils, or peritonsillar abscess
  • A strep throat

If the tonsillitis caused by group A streptococcus or another strain of streptococcal bacteria is left untreated or if antibiotic treatment isn't delivered in full, your child is more prone to have uncommon complications like the following:

  • Rheumatic fever is a serious inflammatory illness affecting the heart, nerves, joints, skin, and heart.
  • Consequences of streptococcal infection scarlet fever, which is characterized by a noticeable rash
  • Kidney inflammation (post-streptococcal glomerulonephritis).
  • The disease called post-streptococcal reactive arthritis, which causes inflammation in the joints

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