What is Tonsilitis?
Tonsillitis is an acute infection of the tonsils, the two large, pink, round glands on either side of the front part of the pharynx, near the root of the tongue. If they are small, they are hardly visible. But if they are large, and this is frequently so in children, they may stand out prominently.
The tonsils are composed of lymphoid tissue, and are part of the body’s defence mechanism. Standing at the portals of entry to the gastric and respiratory systems, they theoretically act as guardians of the body. However, due to their anatomical structure, this feature is frequently overcome. So, instead of trapping and destroying micro-organisms in the multitude of crevices and crypts covering their entire surface, the reverse often occurs. Frequently masses of organisms enter the surface crypts then commence to multiply rapidly, so quickly that the tonsil’s ability to destroy them is overcome. Instead, the germs infect the tonsillar tissue, and an acute bout of tonsillitis may rapidly take place.
The tonsils become red and inflamed. Enlargement quickly occurs. The surrounding areas become red and inflamed, and very tender. After a few days, the excess of mucus that is formed both by the tonsils and the surrounding lining of the oral cavity and pharynx tends to form areas of pus. Small patches of creamy-white exudate appear as dots on the surface of the tonsils. After another day or two, this may accumulate so that the tonsils are covered with a thick layer of cheesy-looking material.
The breath becomes foul. The throat is parched, dry and very painful. Eating is difficult. General systemic symptoms set in, and the temperature rises, often with a rigor, and shivering bouts interspersing with the hot, sweaty turns.
The glands in the neck and under the jaw (particularly the tonsillar lymph gland in the neck just adjacent to the position of the tonsil) become very large and tender. This is part of the body’s reactive protective mechanism aimed at quelling the invaders by producing cells and antibodies to fight them off. Restlessness is common, with general aches and pains in the body. The joints and large muscle masses (limbs, back etc) become sore. Malaise and lassitude set in. Inability to sleep from the general constitutional illness is another common symptom.
Sometimes the infection may spread into the middle ear, for the Eustachian tube (a readily available pathway for infection) is close by. Then the added problem and discomfort of an acute ear infection may occur.
All stages of infection may occur, from the mild to the very severe, as described. It may affect the child (chiefly), but the adult is not immune.
Treatment is essentially aimed at killing the bacterial invasion, reducing the temperature and bringing symptomatic relief from the lever aches and pain and, of course, from the very sore throat. Severe attacks of tonsillitis (and whenever pus is present, or there is an elevated temperature) need the doctor’s attention. Usually, the use of antibiotics will cut short an attack, and will often prevent a mild attack from becoming worse and from developing complications (essentially infected ears or quinsy).
Penicillin (or the semi-synthetic drugs that have a very large range of bacterial activity) is often successful in bringing prompt relief in most cases. But other antibiotics may be favoured by the doctor. It will depend on his or her experience with any local epidemic currently in the district, and this can greatly modify the prescribing decision. Oral antibiotics, generally, are more readily absorbed when taken on an empty stomach. However, others may be required with milk, for some tend to nauseate, and milk seems to check this. Be guided by the doctor’s instructions.
But many general measures are essential as well. Bed rest for several days, and until the infection is overcome and the temperature becomes normal, is desirable. This naturally means no school or work for several days. The taking of analgesics for the relief of pain and for reducing the elevated temperature is a wise move. Gargling the throat with hot saline every half to two hours mechanically helps remove debris, and the heat is often soothing. It doesn’t cure, but it may afford considerable symptomatic relief from pain and discomfort.