Tonsillitis Overview

Tonsillitis is an inflammation of the glands of the throat, which results in a sore throat. Tonsillitis can be caused by either viruses or bacteria. Most cases of tonsillitis resolve in a few days without antibiotic medication.

Tonsillitis Causes

Whether viral or bacterial, tonsillitis is transmitted most commonly from one person to another by social contact such as droplets in the air from sneezing. Most of the time, tonsillitis is caused by a viral infection.

Bacterial tonsillitis can be caused by Streptococcus pyogenes,the organism that causes strep throat. If left untreated, strep throat may lead to a more serious condition called rheumatic fever, which can affect the heart several years later.

• Only about 30% of tonsillitis in children is caused by strep throat.
• Only 10% of tonsillitis in adults is caused by strep throat.

Tonsillitis Symptoms

Symptoms of tonsillitis include:

• Sore throat
• Difficulty feeding (in babies)
• Pain with swallowing
• Fever
• Headache
• Abdominal pain
• Nausea and vomiting
• Cough
• Hoarseness
• Runny nose
• Redness of the tonsils and throat
• Tenderness in the glands of the neck (swollen lymph glands)
• White patches on the tonsils
• Redness of the eyes
• Rash
• Ear pain (caused by nerves that go to the back of the throat also go to the ear

Is Tonsillitis Contagious?

Tonsillitis is contagious. Tonsillitis is spread mainly by droplets from direct contact (kissing) or airborne droplets (cough).

Viral caused tonsillitis is often contagious for about 7–10 days while untreated bacterial caused disease may be contagious for about 2 weeks.

However, bacterial caused tonsillitis can be treated with antibiotics and the patient usually is not contagious 24–48 hours after starting antibiotics.

When to Seek Medical Care

The majority of people that develop tonsillitis recover without medical care. Call a doctor for advice if you a person has some of the following symptoms:

• Fever
• Pain with swallowing
• Social contact with a person with strep throat
• Tender glands in the neck
• Rash
• Pain is not relieved with home care
• Pain worsens
• Unable to control secretions; unable to eat, drink, or take medicines
• Change in voice, such as muffled speech or "hot potato" voice (speaking as if a hot object is being held in the mouth)
• Difficulty breathing

Tonsillitis can develop into more serious medical conditions in some people. Anyone with tonsillitis who is drooling, unable to eat or drink, or has any breathing difficulty needs to go to a hospital's Emergency Department immediately for evaluation.

Sometimes the tonsils may swell or form aperitonsillar abscess resulting in intermittent blockage of the feeding and breathing pathways. If the affected person may have difficulty breathing or eating, they should seek medical care.

Tonsillitis Diagnosis

The doctor will conduct a physical examination. Sore throats caused by viruses may look exactly like those caused by bacteria.

The doctor looks for these conditions:

• Signs of infection (redness, discharge, swollen lymph glands)
• Abscess (a shift in one tonsil toward the center and a shift of the uvula away from the infected side)
• Airway compromise (muffled speech, drooling, and inability to swallow)
• The doctor may order diagnostic tests that will look for strep infection. In some cases, the doctor may start antibiotic treatment without tests.
• If the doctor performs a rapid diagnostic test with a swab specimen from the back of the throat, positive results for strep throat may be available during the office visit. However, it typically takes 24-48 hours to confirm rapid test results of a bacterial infection.
• Rarely, other conditions such as diphtheria,a foreign body, or cancer may start with a sore throat. If an abscess or a more worrisome condition (cancer, diphtheria) appears to be present, the doctor may consult an ear, nose, and throat specialist.

Tonsillitis Self-Care at Home

• Throat pain and fever may be improved with over-the-counter pain relievers such asibuprofen (Advil, for example) oracetaminophen (Tylenol).
• Ease sore throat pain by gargling frequently with warm salt water (8 ounces of warm water mixed with 1 teaspoon salt).
• Drink plenty of clear liquids to avoiddehydration.

Tonsillitis Medical and Surgical Treatment

Because most sore throats are caused by viruses, antibiotics are not routinely needed. However, penicillin is the most commonly prescribed class of antibiotics.

• The medication may be given as a single-dose injection (a shot) or may be provided as a prescription for oral antibiotics (pills taken by mouth).
• People who are allergic to penicillin may be treated with erythromycin. Treatment with oral antibiotics may be provided for 10-14 days.
• It is important to complete all the pills prescribed, even if symptoms go away and you feel better. Completion of the full course of antibiotics prevents the serious complication of rheumatic fever that may result in a form of heart disease.

Throat pain and fever may be improved with medications such as ibuprofen or acetaminophen.

It is also important to drink plenty of fluids to avoid becoming dehydrated.

Gargling with warm salt water (8 ounces of warm water mixed with 1 teaspoon salt) will ease sore throat pain. Gargle several times a day.

Occasionally, abscesses may develop that require needle aspiration or incision and drainage to help the infection heal and to reduce throat blockage or obstruction. If patients experience six or more infections in one year, some clinicians recommend surgical removal of the tonsils (tonsillectomy). An ENT specialist is frequently consulted for treatment of the patients.

Tonsillitis Follow-up

• Make sure the patient follows up on all the tests the doctor performs and take all the medications the doctor prescribes.
• Patients should finish the entire course of antibiotics prescribed by the doctor, even if the person is feeling fine and symptoms go away.
• Children and adults are not contagious 24 hours after starting antibiotic treatment for strep throat caused by bacteria. The child or adult can return to school (day care) or work after this period of time while the person is taking antibiotics.
• If symptoms remain or get worse, the patient should contact their doctor.
• If social contacts develop symptoms tonsillitis, they may need to be evaluated.

Tonsillitis Prevention

• Wash hands frequently to prevent the spread of the virus or bacteria that cause tonsillitis.
• Avoid prolonged contact with people with strep throat caused by bacteria until 24 hours after antibiotics are started.
• emedicinehealth.com(source)

Most Children With Sore Throats Don't Need Tonsillectomies, but Bed-wetters Might
By Brenda Goodman
WebMD Health News
Reviewed by Louise Chang, MD
Jan. 3, 2011 -- Most children who get repeated throat infections probably don't need surgery to remove their tonsils and would improve in time with careful monitoring, according to new clinical guidelines on tonsillectomies in children.
The new guidelines also suggest, however, that removal of the tonsils, or tonsillectomy, may improve problems tied to poor sleep, including bed-wetting, slow growth, hyperactive behavior, and poor school performance.
In fact, sleep-disordered breathing -- a set or problems that range from snoring to obstructive sleep apnea -- is now the most common reason for tonsil removal in kids younger than 15.
"We used to think that only if you were an air traffic controller did it matter if you slept well or not, and now we know that's not the case," says Amelia F. Drake, MD, chief of the division of pediatric otolaryngology at the University of North Carolina School of Medicine in Chapel Hill.
More than half a million tonsillectomies are performed each year on children in the U.S., making it the second most common surgery in this age group, just behind procedures to place tubes in the ears to relieve recurrent ear infections.
Despite the fact that it is a mainstay of American medicine, experts have long disagreed about how useful or appropriate tonsillectomies may be.
The new guidelines, published Monday by the American Academy of Otolaryngology - Head and Neck Surgery, are the first set of official recommendations on tonsillectomy published in the U.S. The guidelines aim to give doctors and parents more information about when tonsillectomy may be warranted and to help minimize the risks and pain of this procedure in young patients.
"I thought they were very comprehensive," says Drake, who reviewed the new recommendations but was not involved in drafting them. "This is an area where improvements and refinements can have a huge impact. This is medicine at its core."

New Criteria for Removing Tonsils

The guidelines update a set of clinical indicators for tonsillectomies published in 2000 by the American Academy of Otolaryngology, which suggested that doctors could consider taking out the tonsils if a child had at least three cases of swollen and infected tonsils in a year.
The new guideline, however, says that kids should have at least seven episodes of throat infection, such as tonsillitis or strep throat in a year, or at least five episodes each year for two years, or three episodes annually for three years, before they become candidates for surgery, and that those infections should be documented by a doctor, rather than just reported by parents.
The idea, experts said, was to reserve surgery only for the most severely affected, because the surgery can rarely have serious complications including infections and serious bleeding.
"Children who have fewer episodes really aren't going to see a lot of benefit," says Jack L. Paradise, MD, professor emeritus of pediatrics at the University of Pittsburgh School of Medicine.
"There aren't many kids, overall, who meet those stringent criteria," Paradise says.
What's more, Paradise and other experts stress that even children who satisfy the guidelines shouldn't get an automatic green light for surgery.
"I'm not sure, if I had a child that met all the criteria, that I'd automatically subject the child to the consequences of that," Paradise says, "Post-operatively, it's a very painful procedure."

Changing Attitutes to Tonsillectomies

The tonsils are cone-shaped lumps of tissue embedded in the throat, and they are believed to play a role in how the body responds to infections, though experts aren't exactly sure how.
But in the early part of the 20th century, the tonsils were blamed as the "focus of infection" in the body, and doctors began taking them out as a way to promote good health.
The operation became so routine, for example, that entire classrooms of youngsters would get their tonsils taken out at school.
But by the 1970s, many experts were questioning how effective and appropriate it was to subject kids to a painful operation that could have rare but serious complications -- all for what new research suggested had begun to suggest were minimal improvements in the risk of sore throats.
At the same time, however, doctors were starting to become more aware of the myriad problems tied to sleep disordered breathing in children, a spectrum of problems that can range from snoring to obstructive sleep apnea.
And more tonsils began to be taken out as a way to open up the airway and improve sleep.
As sleep improves, research suggests behavior, growth, school performance, and even bed-wetting does, too.
"I've seen kids like this," says Drake. "Kids are so tired that their brains can't hear the signal from their bladders that it's time to go, and you take the tonsils out and the problem resolves."
That benefit, Drake acknowledges, is still controversial.
In fact, a study published in December in the Journal of Urology which followed a group of more than 300 children -- 257 who were undergoing tonsillectomies and 69 who were having surgeries for other reasons -- found no difference in the rates of bed-wetting before or after surgery in either group.
Still, doctors say the idea isn't all that far-fetched.
"Not wetting the bed requires a level of neurological control that's upset by a lot of different things," Paradise says. "I'm quite willing to believe that anything that upsets a child's equilibrium could have an effect on that, including poor sleep."

Improvement in Care for Kids Having Surgery

Several of the guidelines suggest ways doctors and parents can improve the care of kids having tonsillectomies.
One of the strongest recommendations is against the use of antibiotics just before or just after surgery.
"They are commonly given, and there's no evidence that antibiotics offer any benefit," says study researcher Reginald F. Baugh, MD, professor and chief of otolaryngology at the University of Toledo Medical Center in Ohio. "You run the risk of allergic reactions and there are the harms of overprescribing."
In drafting the statement that advises doctors to counsel parents about the importance of pain management in kids after surgery, Baugh says the panel that reviewed the evidence behind the guidelines was alarmed to learn that many parents don't give medications to control pain after the procedure.
source:medicinenet.com

Tonsillitis

What Are Tonsils?

The tonsils are situated at the back of your throat - one on the right and one on the left. These two balls of tissue are part of your body's infection fighting system - to help you prevent from getting sick. Usually, tonsils do their job well. But sometimes bacteria or viruses get into the tonsils. As a result, tonsils become so overwhelmed by bacterial or viral infection that they swell and become inflamed, causing tonsillitis.

Who gets Tonsillitis?

Person of any sex and age may fall a victim to bacteria infection leading to tonsillitis. But, tonsillitis is most common in children, however, the condition rarely occurs in children younger than two years. A peritonsillar abscess is usually found in young adults but can occur occasionally in children. The patient's history often helps identify the type of tonsillitis (i.e., acute, recurrent, chronic) that is present.

What is Tonsillitis ?

Tonsillitis is nothing but the inflammation of the tonsils. This may due to a bacteria infection, or germ, which in some instances responds to treatment with antibiotics. Signs of strep throat and tonsillitis are often alike. When tonsils have been surgically removed the operated person (especially a child) is more susceptible to infections.

What are the Symptoms of Tonsillitis ?

Tonsillitis is mainly characterized by swelling within the tonsils, which become red and inflamed and may even show a surface coating of white spots.

Some of the main signs and symptoms of tonsillitis are:

• Pain while swallowing.
• Sensation of chill and presence of fever.
• Tonsils are engorged, enlarged and inflamed like Small balls.
• Enlarged, tender glands (lymph nodes) in the jaw and neck.
• In Acute state, they also discharge purulent fluid.
• Tone and rhythm of respiration is affected.
• Headache.
• Nasal congestion and runny nose.
• Severe sore throat.

How is the Infection Spread ?

Whatever the cause may be - whether it is a bacteria or a virus, tonsillitis is generally spread very easily from one person to other through airborne droplets, hand contact or kissing.

What are the Causes of the Tonsillitis ?

The most common cause of tonsillities is bacterial or viral infection. The herpes simplex virus like: Streptococcus pyogenes (GABHS) and Epstein-Barr virus (EBV), cytomegalovirus, adenovirus, and the measles virus cause most cases of acute pharyngitis and acute tonsillitis. Bacteria cause 15-30 percent of pharyngotonsillitis cases and GABHS are responsible for most of the bacterial tonsillitis.

Some other causes of Tonsillitis are given below:

• Repeated throat infections.

• Excessive use of spices, condiments, acrid, pungent and astringent food items.

• Constant dry, hawking, dog-like cough.

• Forcible and constant use of voice - often at a high pitch.

• Chronic Congestion, blockade of nose, when nose is blocked by viscid and tenacious mucus.

• Excessive eating of toffees, sweets, tamarind, tartaric acid, chewing gum etc.

Ayurvedic Medicines for the Treatment of Tonsillitis

Ayurvedic Medicine I

Ingriedients

• Dacha.
• Vast.
• Honey.
• Karajan.

Directions:

Use linctuses made out of all the above ingridients. You may take this 3 or 4 times in a day.

Ayurvedic Medicine II

Ingriedients

• Flowers of Banaphsha

Directions:
Boil flowers of Banaphsha and mix them in about 50 ml of water and when contents are reduced to one-third - mix it with 200 ml of milk and drink hot.

Ayurvedic Medicines III

Ingriedients:

• Chamolin Tea.
• Honey.
• Lemon.

Directions:

A chamomile tea may be given to the patient with lemon and honey added. This will help him give relief.

Ayurvedic Medicine IV

Ingriedients:

• Alum

Directions:

Gargle with purified alum, it will give you relief. You may even apply dry powder of alum over the swollen tonsils.

Herbal and Home Remedies for Tonsillitis

Fenugreek Seeds - Gargle made from fenugreek seeds is very effective for tonsillitis.
Vegetable Juices - Raw vegetable juices of carrot, beet, and cucumber in the ratio of 3:1:1 combination are also very beneficial for the treatment of tonsillitis.
Stay Hydrated - Drink lots and lots of liquids. Especially, frozen liquids help numb the throat. You may also try hot teas with honey, and clear soups. For some people, warm beverages help relieve the pain of tonsillitis better than cold ones do.
Salt Water - You may gargle with luke warm salt water many times in a day. ( one forth teaspoon of salt would be enough in half a cup of water) several times a day.
Lemon, Blackpepper and Salt - Take a lemon and cut it into two pieces. On one piece, put some salt and black pepper. Now press it with a knife s o that salt-pepper penetrate into the lime. Put the lemon on heat to make it warm. Slowly lick this lemon squeezing it until no juice remains. You may do this daily two or three times.
Hygiene - If you are suffering from a disease like tonsillitis, you should keep good hygiene.
Avoid Acidic Drinks, Spicy Food and Soar Substances - Don't drink acid drinks and try to avoid spicy food as it may irritate your throat. Sour substances like curds, buttermilk, and fried foods should also be avoided.
Rest - Give plenty of rest to your throat and try not to talk.
See a Doctor, if condition is serious - If you are have difficulty in swallowing, breathing or talking, or have any other concerns you should see a doctor immediately, or the condition may turn more serious.
Source:Ayurvedic-medicines.org