Tonsillitis: Causes, Symptoms, and Treatment

Tonsillitis is an inflammation of the tonsils, which are part of the body's immune system located at the back of the mouth. It can be caused by bacterial or viral infections, with viruses being the primary cause due to the introduction of antibiotics. Tonsillitis is often acute, but it can also be chronic, leading to the formation of tonsil stones and biofilms. The condition is most common in children, but adults can also be affected.

Symptoms

Tonsillitis symptoms include a sore throat, swollen tonsils, white spots (pus) on the tonsils, coughing or sneezing, high temperature (fever), nausea, fatigue, pain when swallowing, and swollen lymph nodes in the neck. Symptoms typically worsen over 2-3 days and then gradually improve within a week.

Causes

Tonsillitis is most commonly caused by viral infections, such as colds and flu. However, bacterial infections, such as group A streptococcus, can also cause tonsillitis. In some cases, tonsillitis can be part of a broader infection known as glandular fever, which is caused by the Epstein-Barr virus.

Treatment

For acute tonsillitis, supportive management is often sufficient. This includes analgesia and adequate hydration. Antibiotics are not typically required unless the infection is severe, not easing after a few days, or if the immune system is not functioning properly. Common treatments include over-the-counter pain relievers like paracetamol or ibuprofen, gargling with salt water, and drinking plenty of fluids.

Complications

Complications of tonsillitis can include peritonsillar abscess, a collection of pus behind the tonsil, and parapharyngeal abscess, an infection in the space behind the tonsils. These complications may require surgical intervention, such as a tonsillectomy, which involves the removal of the tonsils.

Chronic Tonsillitis and Biofilms

Chronic tonsillitis is a persistent infection of the tonsils that can result in the formation of tonsil stones. Biofilms, which are communities of microorganisms embedded in a matrix of extracellular polymeric substances, play a role in chronic tonsillitis. These biofilms can be up to 500-1,000 times more resistant to antimicrobial compounds than their planktonic counterparts, leading to the recalcitrance of biofilm bacteria toward antibiotics.

In conclusion, tonsillitis is a common condition affecting both children and adults. It can be acute or chronic and can lead to complications if not properly managed. Treatment typically involves supportive care, and antibiotics are usually not necessary unless the infection is severe or not responding to other treatments.