Tonsillitis and Adenoid Infection 

Introduction
Tonsillitis is a very common condition among children, but may also occur in adults.  The tonsils are lymph nodes and the adenoids are glands located in the throat.  Although they work to filter germs, they are vulnerable to infection as well.  Most cases of tonsillitis can be treated with rest or medications however, the tonsils and adenoids may need to be surgically removed in people with recurrent infections or severe symptoms.

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Anatomy
You have two tonsils located in the back of your throat and two adenoids positioned in your upper throat behind your nose.  The tonsils and adenoids are glands that filter germs that enter through your nose and mouth to help keep you healthy.

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Causes
The tonsils and adenoids can swell and become infected by bacterial or viral infections.  The specific virus that causes mononucleosis “mono” (Epstein-Barr virus) and strep throat (Streptococcus pyogenes) can lead to tonsillitis.

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Symptoms
Tonsillitis causes a sore throat that lasts longer than two days and may be very painful.  When you open your mouth and look at the back of your throat, your tonsils may look red, swollen, and have white patches on them.  It may be painful or difficult to swallow.  The lymph nodes in your jaw and neck may feel swollen and tender, and your ears may ache.  You may have a headache, fever, or chills.  You may lose your voice or it may sound different.  You may notice bad breath. 
 
Infected adenoids cause swelling and enlargement that can make it hard to breathe through your nose.  You may mouth breathe instead and snore at night.  The airway blockage caused by enlarged adenoids can contribute to sleep apnea, a sleep disorder that causes a person to stop breathing momentarily during sleep.  Additionally, infected adenoids are associated with recurrent ear infections.

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Diagnosis
Your doctor can diagnose tonsil or adenoid infections by carefully examining your ears, nose, and throat.  The lymph nodes in your neck will also be examined.  A swab may be used to obtain cells from your throat to check for specific infections, such as strep throat.  Blood tests may be used to check for mononucleosis.  X-rays may be used to check the size of the adenoids.

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Treatment

Infections that are caused by bacteria are treated with prescription antibiotics.  Antibiotics do not work on viral infections.  Plenty of rest, drinking warm liquids, throat lozenges, and gargling with salt water may help.  Over-the-counter pain medication may help ease symptoms, but aspirin should NOT be taken by children with viral infections.

People with recurrent infections or severe symptoms may need to have their tonsils and/or adenoids surgically removed.  A tonsillectomy and an adenoidectomy can be performed at the same time.  The procedures are usually performed as outpatient surgeries.  In some cases, an overnight hospital stay may be necessary. 

Tonsillectomy and adenoidectomy use general anesthesia, meaning that you will not be awake for the procedure.  The tonsils and adenoids are accessed through the mouth.  They are either surgically removed or destroyed with heat (cauterization).  Bleeding is controlled with cautery and packing.  No stitches are necessary.

Recovery from the surgery takes about a week.  You should eat soft foods, and cool drinks may help make your throat feel better.  You may have some nasal drainage or a stuffy nose while you heal.  Most people can breathe more easily through their nose and experience a decrease in throat and ear infections following surgery.

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Prevention
You can help prevent spreading and contracting the infections that cause tonsillitis with frequent hand washing.  Avoid touching your eyes or nose when you are around people that have colds.  Disinfect shared surfaces, such as telephones, keyboards, counter tops, doorknobs, faucet handles, and toys.  Use disposable paper towels instead of shared fabric hand towels.  When on public transportation during the winter, wear gloves.  Cough and sneeze into a tissue. 

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Am I at Risk

You may be at risk for tonsillitis and adenoid infections if you are in environments with groups of people, such as daycare centers, schools, places of employment, sporting events, or concerts.

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Complications
Chronic tonsil and adenoid infections may lead to chronic ear infections and hearing loss. 

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Advancements
Intracapsular tonsillectomy is an alternative to traditional tonsil and adenoid surgery.  In contrast to traditional tonsillectomy, intracapsular tonsillectomy removes about 90% of the tonsil, but not the capsule.  This technique is associated with less pain and bleeding than traditional tonsillectomy.

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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on April 13th, 2016. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.