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Medical Author:

John P. Cunha, DO, FACOEP

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.

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Medical Editor:

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.

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In this Article

• Tonsillitis and adenoids infection facts
• What are the tonsils and adenoids?
• What is the purpose of the tonsils and adenoids?
• What are the symptoms of tonsillitis or an adenoid infection?
• Is tonsillitis contagious?
• What are common problems affecting the tonsils and adenoids?
• How are tonsillitis and adenoid infection diagnosed?
• How is tonsillitis and adenoid infection treated?
• When should the tonsils and/or adenoids be removed?
• Patient Comments: Tonsillitis - Symptoms
• Find a local Ear, Nose, & Throat Doctor in your town
• Adenoids and Tonsils Index

Diagnosis of tonsillitis and adenoid infection is based on a medical history and a physical exam.

If symptoms suggest strep throat, the doctor may want to do a throat culture or rapid strep test. These tests are done by swabbing the back of the throat and checking for the Streptococcus bacteria. This can be performed in the doctor's office. If the Epstein-Barr virus, which can cause mononucleosis, is suspected as a cause for the tonsillitis, a test for mononucleosis may be done.

Strep throat is more likely if at least 3 of the following signs or symptoms are present:

• Fever
• White or yellow spots or coating on the throat and/or tonsils (tonsillar exudates)
• Red spots on the roof of the mouth (upper palette)
• Swollen or tender lymph nodes on the neck
• Absence of coughing or sneezing

Antibiotic treatment may be needed if the infection is caused by bacteria. In more severe, recurrent or chronic cases, surgery (tonsillectomy or adenoidectomy) may be needed.

Bacterial infections of the tonsils and adenoids are treated with various antibiotics. Tonsillitis caused by the Streptococcus bacteria can lead to serious complications. Once treatment begins, it is important to take the full course of antibiotics as prescribed because premature discontinuance of therapy can lead to adverse consequences and regrowth of the bacteria. Surgical removal is considered in situations resistant to medical therapy or in frequently recurrent infections.

Viral causes of tonsillitis or enlarged adenoids are often treated with only supportive care (hydration and control of fever). Antibiotics are not effective for viral infection of the tonsils.

A peritonsillar abscess should be drained either by removal of fluid with a needle and syringe (needle aspiration), cutting open with a scalpel (incision), or tonsillectomy. Chronic stones in the tonsil can be removed with a clean finger or with a blunt probe. Massive enlargement of the tonsils and adenoids causing airway obstruction may be treated with a long course of antibiotics, or even a brief course of steroids to reduce inflammation (cortisone-related medications, such as prednisone and prednisolone).