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Chapters

0:00 Introduction
1:08 Causes of Tonsillitis
2:02 Symptoms of Tonsillitis
2:43 Diagnosis of Tonsillitis
3:29 Treatment of Tonsillitis



Tonsillitis is inflammation of the tonsils in the upper part of the throat.[1][2] Tonsillitis is a type of pharyngitis that typically comes on fast (rapid onset).[1][8] Symptoms may include sore throat, fever, enlargement of the tonsils, trouble swallowing, and large lymph nodes around the neck.[1][2] Complications include peritonsillar abscess.[1][3]

Tonsillitis is most commonly caused by a viral infection and about 5% to 40% of cases are caused by a bacterial infection.[1][5][6] When caused by the bacterium group A streptococcus, it is referred to as strep throat.[9] Rarely bacteria such as Neisseria gonorrhoeae, Corynebacterium diphtheriae, or Haemophilus influenzae may be the cause.[5] Typically the infection is spread between people through the air.[6] A scoring system, such as the Centor score, may help separate possible causes.[1][5] Confirmation may be by a throat swab or rapid strep test.[1][5]

Treatment efforts involve improving symptoms and decreasing complications.[5] Paracetamol (acetaminophen) and ibuprofen may be used to help with pain.[1][5] If strep throat is present the antibiotic penicillin by mouth is generally recommended.[1][5] In those who are allergic to penicillin, cephalosporins or macrolides may be used.[1][5] In children with frequent episodes of tonsillitis, tonsillectomy modestly decreases the risk of future episodes.[10]

About 7.5% of people have a sore throat in any three-month period and 2% of people visit a doctor for tonsillitis each year.[7] It is most common in school-aged children and typically occurs in the colder months of fall and winter.[5][6] The majority of people recover with or without medication.[1][5] In 40% of people, symptoms resolve within three days, and in 80% symptoms resolve within one week, regardless of whether streptococcus is present.[4] Antibiotics decrease symptom duration by approximately 16 hours.[4]