Basics
Tonsillitis is a sudden inflammation of the tonsils that most commonly occurs in early childhood. Tonsillitis occurs when either viruses or bacteria infect the tonsils, two groups of fleshy tissue at the back of the throat. Figure 01 A doctor must identify whether the cause is bacterial or viral in order to determine the best treatment approach. A child who has frequent or persistent episodes of tonsillitis may have chronic tonsillitis. In such cases, the doctor may recommend that the tonsils be removed surgically. However, tonsillectomies are performed less often today than in the past because research has shown that this procedure may not always help lower the risk of tonsillitis.
Figure 01. Normal Tonsils
Causes
Bacteria or viruses entering through the nose or mouth can cause tonsillitis. Because the tonsils are positioned at the back of the throat, they come into contact with bacteria and viruses that enter through the nose and mouth. Normally the tonsils trap these organisms and produce antibodies to help fight infection. However, the tonsils occasionally become infected, inflamed, and swollen, making them unable to fight off germs trying to enter the body.
A variety of bacteria or viruses can cause tonsillitis. The bacteria most commonly responsible for tonsillitis is group A beta-hemolytic streptococcus (also known as “strep”). Adenoviruses, parainfluenza viruses, influenza viruses, the Epstein-Barr virus (the virus that causes mononucleosis), enteroviruses (usually found in the intestinal tract), or the herpes simplex virus can all cause viral tonsillitis.
It is important to learn the cause of tonsillitis because treatment approaches are different. Antibiotics, for example, commonly prescribed for bacterial tonsillitis, are not effective against viral tonsillitis.
Tonsillitis may be caused by a fungus in patients with HIV infections. Immunocompromised patients such as those infected with HIV are susceptible to infection with the Candida fungus. Candida may infect the tonsils in addition to other parts of the mouth and throat in these patients.
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I'm Beth Isaac, PharmD. Welcome to PDR Health!
