Tonsillitis is an inflammation of the palatine tonsils, ovoid-shaped structures located in the oropharynx, on either side of the uvula. When viruses or bacteria come into contact with these tissues, they can cause an inflammatory reaction that leads to swelling and sore throat. The inflammation can be acute or protracted, resulting in symptoms varying in intensity and duration.
During the winter season, the drop in temperatures and the stay indoors favor the circulation of viruses, making respiratory tract infections very common.
What are the symptoms and how is it treated? We discuss this with Dr. Michele Cerasuolo , an ENT specialist at Humanitas San Pio X and the Humanitas Medical Care medical centers.
What are tonsils and what are they for?
The tonsils are lymphatic organs strategically located at the level of the palate (palatine tonsils), the base of the tongue (lingual tonsils), and the nasopharynx (adenoids). They play a key role in the immune system, acting as the first line of defense against microorganisms entering the body through the nose and mouth.
They are particularly active in childhood, as they help “train” the immature immune system, while in adulthood they undergo a process of progressive atrophy and, consequently, their defensive function is reduced and episodes of tonsillitis become less frequent than in childhood.
What causes tonsillitis?
The origin of tonsillitis is mainly infectious :
- Viral Origin (most common): Caused by adenoviruses, rhinoviruses (responsible for the common cold), influenza viruses, or the Epstein-Barr virus (Mononucleosis).
- Bacterial origin: the main cause is group A beta-hemolytic streptococcus .
Symptoms of tonsillitis
Symptoms of tonsillitis mainly involve the throat and neck.
Signs vary depending on the severity, but the most common include:
- Severe sore throat : often worsened when swallowing.
- Redness and swelling: the tonsils appear swollen and hyperemic.
- Plaques : presence of whitish exudate on the tonsillar surface.
- Fever : often accompanied by chills and fatigue.
- Swollen lymph nodes : Swollen lymph nodes in the neck (lateral cervical).
- Reflex pain: Pain may radiate toward the ear (reflex otalgia) due to the sharing of some nerve endings.
- Bad breath : often linked to the accumulation of bacteria and inflammatory material.
Acute tonsillitis and recurrent tonsillitis: the differences
Depending on the progression of symptoms and their duration, tonsillitis is classified into acute and recurrent forms.
Acute tonsillitis appears suddenly and is characterized by severe pain in the throat, often accompanied by high fever and difficulty swallowing. If treated properly, it tends to resolve within a few days.
The recurrent form , however, can develop after repeated episodes of acute inflammation and more frequently affects children and young adults. In this case, the symptoms are more persistent and may alternate with flare-ups.
How to treat tonsillitis?
Treatment for tonsillitis varies depending on the source of the infection. When the cause is bacterial , the doctor may prescribe antibiotic therapy. If the inflammation is viral , symptomatic medications, such as antipyretics and analgesics, are used to manage fever and pain. It is essential to avoid self-medication , especially with antibiotics, to prevent the development of antibiotic resistance.
In cases of frequent relapses, therapy aimed at supporting the immune system may be considered to reduce the occurrence of relapses.
Removal of the tonsils ( tonsillectomy ) is considered only in specific cases, such as:
- Recurrent and close infections that require repeated courses of antibiotics.
- Presence of serious complications, such as peritonsillar abscess.
- Tonsillar hypertrophy causing sleep apnea or severe breathing difficulties.
