Problem of the week – Do I have tonsillitis or strep throat

Tonsillitis is an infection of the tonsils and can be caused by bacteria or a virus.

Strep throat is the most common bacteria to cause tonsillitis is children and can only be definitely confirmed with a culture.

Tonsillitis Management – The management of tonsillitis is somewhat different in young children versus adolescents and adults.

   In children – Children often get sore throats being exposed so     frequently in school to colds and strep bacteria. Colds associated with sore throats do not require antibiotics which we don’t want to give unless necessary.  A rapid strep test and culture if the test is negative is the most common way to confirm you have Strep throat for which antibiotics are given.  In the case of a negative culture no antibiotics are given.  However, in the case of recurrent and chronic infections of the tonsils antibiotics may be given without a culture.

    In adolescents and adults – Adults often have chronic tonsil problems and a culture only reveals Strep some of the times.  In adults with large, red tonsils with white spots antibiotics are typically needed.  It’s also important to give an appropriate antibiotic to cover some of the more resistant bacteria that are around.  Zithromax is not a good choice of antibiotics for tonsillitis even in penicillin allergic people.

  Peritonsillar abscess – When a bacterial tonsil infection spreads outside the tonsil you may have an abscess.  If you have increased pain on one side associated with trouble swallowing and breathing along with trouble opening your mouth, there may be an abscess and evaluation with a physician is indicated.  Peritonsillar abscess typically do require surgical drainage by an ENT doctor.

Chronic tonsillitis – This can occur in children and adults when the tonsils continue to get recurrent infections despite proper management.  In the case the tonsils are no longer healthy and removal of the tonsils may be indicated.  This is very common in adolescents and young adults.

As always, feel free to call with any question in regard to your tonsils particularly if the problem is a recurrent one.

Dr B

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