TONSILLITIS

inflammatory infection of the tonsils caused by invasion of the mucous membrane by microorganisms, usually hemolytic streptococci or viruses. The symptoms are sore throat, difficulty in swallowing, fever, malaise, and enlarged lymph nodes on both sides of the neck. The infection lasts about five days. The treatment includes bed rest until the fever has subsided, isolation to protect others from the infection, and warm throat irrigations or gargles with a mild antiseptic solution. Antibiotics or sulfonamides or both are prescribed in severe infections to prevent complications. The complications of acute streptococcal tonsillitis are proportional to the severity of the infection. The infection may extend upward into the nose, sinuses, and ears or downward into the larynx, trachea, and bronchi. Locally, virulent bacteria may spread from the infected tonsil to the adjoining tissues, resulting in a peritonsillar abscess (see quinsy). More serious are two distant complicationsacute nephritis (kidney inflammation) and acute rheumatic fever, with or without heart involvement. Repeated acute infections may cause chronic inflammation of the tonsils, evidenced by tonsillar enlargement, repeated or persistent sore throat, and swollen lymph nodes in the neck. The treatment in this case is surgical removal (tonsillectomy). Scarlet fever, diphtheria and trench mouth may also produce acute tonsillitis. In diphtheria the tonsils are covered with a thick, whitish, adherent membrane; in trench mouth, with a grayish membrane that wipes off readily.