Tonsilitis

Tonsillitis is inflammation of the tonsils, typically of rapid onset.^[1] It is a type of pharyngitis.^[7] Symptoms may include sore throat, fever, enlargement of the tonsils, trouble swallowing, and large lymph nodesaround the neck.^[1] Complications include peritonsillar abscess.^[2]

Tonsillitis is most commonly caused by a viral infection, with about 5% to 40% of cases caused by a bacterial infection.^[4][5] When caused by the bacterium group A streptococcus, it is referred to as strep throat.^[8] Rarely bacteria such as Neisseria gonorrhoeae, Corynebacterium diphtheriae, or Haemophilus influenzae may be the cause.^[4] Typically the infection is spread between people through the air.^[5] A scoring system, such as the Centor score, may help separate possible causes.^[4] Confirmation may be by a throat swab or rapid strep test.^[4]

Treatment efforts involve improving symptoms and decreasing complications.^[4] Paracetamol (acetaminophen) and ibuprofen may be used to help with pain.^[4] If strep throat is present the antibiotic penicillinby mouth is generally recommended.^[4] In those who are allergic to penicillin, cephalosporins or macrolides may be used.^[4] In children with frequent episodes of tonsillitis, tonsillectomy modestly decreases the risk of future episodes.^[9]

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.^[6] It is most common in school aged children and typically occurs in the fall and winter months.^[4][5] The majority of people recover with or without medication.^[4]In 40% of people, symptoms resolve within three days, and in 80% symptoms resolve within one week, regardless of if streptococcus is present.^[3] Antibiotics decrease symptom duration by approximately 16 hours.^[3]