Tonsillitis and Adenoid Infection

  • Medical Author:
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Treating a Sore Throat

Can someone catch tonsillitis from another person?

Tonsillitis may or may not be contagious, depending on the cause. If the cause is viral, it is usually contagious, but this depends upon whether or not a person has been exposed to that particular virus before. Mononucleosis, a viral cause of sore throat, is contagious the first time a person is exposed to the virus, usually in childhood or adolescence.

If the cause of the tonsillitis is bacterial, it is also contagious. For example, strep throat is highly contagious.

If the tonsillitis and enlarged adenoids are chronic or caused by a chronic condition, such as sinusitis or hay fever (chronic rhinitis), it is not likely contagious.

What are common problems affecting the tonsils and adenoids?

The most common problems occurring with the tonsils and adenoids are acute, 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. Symptoms of acute tonsillitis can either come on suddenly, or be of a gradual onset of a sore throat usually accompanied by a fever.

Other signs and symptoms of acute tonsillitis include:

  • Difficulty swallowing saliva
  • Drooling
  • Ear pain with swallowing
  • 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

Strep throat 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 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 symptoms include:

Some orthodontists believe 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 ears, leading to chronic ear infections.

Medically Reviewed by a Doctor on 2/25/2016

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