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Definition: tonsillitis from Philip's Encyclopedia

Acute or chronic inflammation of the tonsils caused by bacterial or viral infection. It is signalled by fever, sore throat, and difficulty in swallowing. Chronic tonsillitis is often treated by surgical removal of the tonsils (tonsillectomy).


Summary Article: Tonsillitis from Black's Medical Dictionary, 42nd Edition

Inflammation of the TONSIL.

Acute tonsillitis

Symptoms of inflammation including soreness, pain, difficulty in swallowing and fever. The tonsils look red and may be covered in white spots of pus.

Causes

The disorder is most commonly part of a virus infection of the upper respiratory tract such as the COMMON COLD, INFLUENZA or infectious MONONUCLEOSIS, in which case the inflammation usually subsides as other symptoms develop. It may also be caused by a bacterium, most commonly caused by the β-haemolytic STREPTOCOCCUS. In the developing world it may be the presenting feature of DIPHTHERIA, a disease now virtually non-existent in the West since the introduction of IMMUNISATION.

Symptoms

The onset is usually fairly sudden with pain on swallowing, fever and malaise. On examination, the tonsils are engorged, red and may be covered with a whitish discharge (PUS). This may occur at scattered areas over the tonsillar crypts (follicular tonsillitis), or it may be more extensive. The glands under the jaw are enlarged and tender, and there may be pain in the ear on the affected side: although usually referred pain, this may indicate spread of the infection up the Eustachian tube to the ear, particularly in children. Occasionally an ABSCESS, or quinsy, develops around the affected tonsil. Even experienced doctors may find it difficult to distinguish between viral and bacterial tonsillitis.

Treatment

Most cases need no treatment beyond pain-killers and temperature reduction. Therefore, it is advisable to take a throat swab to assess whether there are bacteria present before prescribing antibiotics. PENICILLIN and ERYTHROMYCIN are the drugs of choice where beta-haemolytic streptococci are isolated, together with paracetamol or aspirin, and plenty of fluids. Removal of tonsils is indicated: when the tonsils and adenoids are permanently so enlarged as to interfere with breathing (in such cases the adenoids are removed as well as the tonsils); when the individual is subject to recurrent attacks of acute tonsillitis which are causing significant debility, absence from school or work on a regular basis (more than four times a year); and when there is evidence of a tumour of the tonsil. Recurrent sore throat is not an indication for removing tonsils.

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