Acute tonsillitis is the inflammation of parietal tonsils caused by germs or viruses. It is a common children disease (between 5 and 10 years) and rarely occurs in older people (especially after 50). Tonsillitis is spread with saliva droplets, which is why children are often infected at school, where the disease can also become epidemic.
Acute tonsillitis is characterized by sudden onset of symptoms, high fever and poor general condition. Also, the patient reports neck pain, especially when swallowing, which can “hit” the ears. There may be a mouth stench, possibly accompanied with voice change and bubo (swollen lymph node).
The disease usually lasts for 4-5 days. Treatment basically requires staying in bed, topical antisepsis with gargles and painkillers. If the cause is microbial, the appropriate antibiotic should be administered. Dosage, route of administration (orally or through vein) and time of antibiotic treatment are evaluated on a case-by-case basis to ensure that complications are avoided and the full recovery of patient’s health.
The duration of administration of the medication should not be less than 10 days to avoid the emergence of resistant germs.
Frequent attacks or relapses in acute tonsillitis cause persistent inflammation of the parietal tonsils, which is characterized as chronic tonsillitis and is more common in adults.
Tonsils are either hypertrophic or atrophic.
Chronic tonsillitis is caused by the same pathogens that cause acute tonsillitis. Usually there is a bad smell due to the presence of plugs in the tonsils.
Symptoms are persistent slight pain in swallowing, feeling of choking or knot in the throat, tensile fever, joint pain, swollen lymph nodes.
The treatment is surgical. Tonsillectomy is always recommended when tonsillitis is due to streptococci to avoid complications, as chronically inflamed tonsils are considered to be a source of infection for the body.
Complications of tonsillitis are local, such as abscesses in the adjacent tonsils and systemic such as rheumatic fever (which affects the joints and the heart) and glomerulonephritis that affect the kidneys.
The indications for tonsillectomy can be distinguished in absolute cases when surgery is necessary and in relevant cases where surgery may be avoided. The strict indications are severe hypertrophy which causes difficulty in breathing and sleep apnea syndrome, peritonsilar abscess and all the complications of tonsillitis, chronic tonsillitis and mainly streptococcal and suspicion of tonsilar tumors.
There is no contradiction concerning the age of the patients. The operation can be done at any age as long as the indications suggest it.
However, children younger than 4 years old should only be operated if this is absolutely necessary.
The procedure usually takes less than an hour and often does not require an overnight stay in the clinic. Nowadays, a new method of tonsil removal imply ultrasound surgical head (Ultracision), which minimizes pain and bleeding.