Infected tonsils: Should your child have surgery?

A close of friend is currently on treatment for septic tonsillitis.

She is having such difficulty speaking and eating that she is only communicating using text messages and surviving on almost liquid food.

Most of us are familiar with tonsillitis, what we often call “tonsils”.

WHAT IS TONSILLITIS?

It refers to inflammation of the tonsils. Tonsils are the two masses of tissue on each end at the back of your throat whose role is to trap germs and limit the spread of infection to the airways.

However, they sometimes get overwhelmed and get infected and inflamed, hence tonsillitis.

CAUSES

Inflammation of the tonsils is usually caused by viruses or bacteria.

Although anyone can get them, it is most common in children. Almost all children will have at least one episode of tonsillitis in their childhood.

However, it can recur, with some getting several infections in a year.

SIGNS AND SYMPTOMS
If you have tonsillitis, you may experience some or all of the following: Swollen, painful tonsils, pain during swallowing, sore throat, hoarse voice, painful lymph nodes on the side of the neck, bad breath, fever, chills, headache, muscle aches, and joint pain.

Children may experience nausea, vomiting, and abdominal pain.

If someone looks into your throat, they may see reddening of the tonsils, or in septic cases, there may be pus.

DIAGNOSIS

The diagnosis of tonsillitis is usually clinical, mostly from the signs and symptoms and by having a look at the throat — the swelling, redness, and/or pus clinches the diagnosis.

However, since treatment is dependent on the cause (whether viral or bacterial), the doctor may do some blood tests to find out the cause.

When pus is present, however, it is usually bacterial in origin.

In cases of persistent tonsillitis that will not clear on treatment, the doctor may carry out a throat swab to check for the specific causative organism.

TREATMENT
You will need to rest, take medicines such as ibuprofen (Brufen) or paracetamol (Panadol) for pain and fever and give your voice a rest.

Take lots of fluids. If the cause is bacterial, the doctor will prescribe an antibiotic, which you should take as prescribed until you complete the dose.

Additionally, you may gurgle warm salty water twice a day or use a gargle solution bought from a pharmacy.

Surgery may also be done, though this is usually only reserved for patients with frequently recurring severe episodes of tonsillitis.

In this case, surgery involves removal of the tonsils. Your doctor will advise you on when this is necessary.

COMPLICATIONS

It is important that all bacterial throat infections are effectively treated since failing to do so may result in spread of the infection to other parts of the body, including the lungs and ears, or cause a generalised body infection.

Additionally, you might develop rheumatic heart disease, a condition that affects the functioning of the heart.

Most episodes of tonsillitis will clear within a few days. Most, if managed well, will clear without complications.

PREVENTION

Since many infections are spread through inhalation, it is difficult to prevent infection. Cough etiquette, including coughing into a tissue, as well as frequent hand-washing, may help reduce infection.

Teach these to your child. If he is ill, keep him/her away from school to avoid infecting others.

Additionally, vaccination to cover some of the organisms causing tonsillitis and other infections exist such as pneumococcal vaccines, influenza vaccine (both available to children for free), and flu vaccines, among others.

The writer is a doctor and public health specialist. Send your questions to [email protected]