Tonsillitis and Adenoid Infection
Medical Author: John P. Cunha, DO
Medical Editor: William C. Shiel, Jr., MD, FACP, FACR
What are the tonsils and adenoids?
The tonsils and adenoids are composed of tissues that are similar to the lymph nodes or glands found in the neck or other parts of the body. Together, they are part of a ring of glandular tissue (Waldeyer's ring) encircling the back of the throat.
The tonsils are the two masses of tissue on either side of the back of the throat. Normal tonsils are usually about the same size and have the same pink color as the surrounding area. On their surfaces are little depressions, called crypts, which may appear deep and contain pus pockets or stones.
The adenoids are located high in the throat behind the nose and soft palate (the roof of the mouth) and unlike the tonsils, are not easily visible through the mouth.
A tonsillectomy and an
adenoidectomy (commonly referred to as a T & A) are surgical procedures performed to remove the tonsils and adenoids.
What is the purpose of the tonsils and adenoids?
The tonsils and adenoids are thought to assist the body in its defense against incoming bacteria and viruses by helping the body form antibodies. However, this function may only be important during the first year of life. There is no evidence to support a significant role of the tonsils and adenoids in immunity. Medical studies have shown that children who have their tonsils and adenoids removed suffer no loss whatsoever in their future immunity to disease or ability to ward off infections.
What are common problems affecting the tonsils and adenoids?
The most common problems occurring with the tonsils and adenoids are
recurrent or chronic infections and significant enlargement (hypertrophy).
Acute Tonsillitis
Acute tonsillitis is an infection of the tonsils caused by one of several possible types of bacteria or viruses. Acute tonsillitis is characterized by either the sudden or gradual onset of a sore throat which is usually associated with fever. The patient may stop swallowing saliva, start to drool, complain of ear pain with swallowing, and have bad breath. The surface of the tonsil may be bright red or have a grayish-white coating (exudate). The lymph nodes in the neck may be swollen. Fever can be present.
Strep throat (tonsillitis) is a specific type of infection caused by the
streptococcus bacteria. Strep tonsillitis can cause secondary damage to
the heart valves (rheumatic fever) and kidneys (glomerulonephritis). It
can also lead to a skin rash (scarlet fever), sinusitis, pneumonia, and
ear infections.
Acute mononucleosis is caused by the
Epstein-Barr virus,
and can lead to a very severe throat infection which is characterized by
the rapid enlargement of the tonsils, adenoids, and lymph nodes of the
neck. It also causes extreme malaise and tiredness. The sore throat and gland swelling can last for one week to a month and does not respond to the usually prescribed antibiotics.
Chronic Tonsillitis
Chronic tonsillitis is a persistent infection of the tonsils. Repeated infections may cause the formation of small pockets (crypts) in the tonsils which harbor bacteria. Frequently, small, foul smelling stones are found within these crypts. These stones (tonsilloliths) may contain high quantities of sulfa. When crushed, they give off the characteristic rotten egg smell which causes bad breath. They may also give a patient the sense of something being caught in the back of the throat.
Peritonsillar Abscess
A peritonsillar abscess is a collection
of pus behind the tonsils that pushes one of the tonsils toward the uvula
(the prominent soft tissue dangling from the back of the upper throat. It
is generally very painful and is associated with decreased ability to
open the mouth. If left untreated, the infection can spread deep in the
neck causing life-threatening complications and airway obstruction.
Enlargement of (Hypertrophic) Tonsils and Adenoids
Obstruction to breathing by enlarged tonsils and adenoids
may cause snoring and disturbed sleep patterns that may lead to sleep pauses or sleep apnea.
Other features include frequent awakening from sleep, restless sleep,
nightmares, bedwetting, mood changes, excessive sleepiness, and even heart problems. Some orthodontists believe that chronic
mouth breathing from large tonsils and adenoids causes improper alignment
of the teeth (malocclusion). Chronic enlargement and infection of the
adenoids may lead to infection of the air passages around the nose
(sinusitis) or nasal drainage/obstruction, and/or may affect the
eustachian tube of the ear, leading to
chronic ear infections.
Next: How is tonsillitis and adenoid infection treated? »
- cefdinir, Omnicef - Explains the medication cefdinir (Omnicef), a drug used to treat infections such as middle ear, tonsillitis, strep throat, bronchitis, pneumonia, and skin and soft tissue.
- Tonsillectomy - Learn about the tonsillectomy or adenoidectomy surgery. Information on what to expect prior to surgery, during surgery, and recovery time from surgery.
- Sore Throat (Pharyngitis) - Learn more about sore throats, including causes, at-home treatments, differences from strep throat, reasons to seek medical care, and what it means to have multiple episodes of strep throat.
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