Tonsillitis Treatment in Corpus Christi, TX
Tonsillitis is inflammation of the palatine tonsils—the two oval-shaped lymphoid tissue masses located at the back of the throat, one on each side. The tonsils serve as part of the immune system’s first line of defense against inhaled or ingested pathogens. However, the tonsils themselves are susceptible to infection, and in patients who experience recurrent episodes, the tonsils may become a source of chronic infection, obstruction, and impaired quality of life rather than a protective organ. At Corpus Christi ENT Sinus & Allergy, Dr. Todd M. Weiss evaluates and treats tonsillitis in patients of all ages, from initial acute episodes through surgical management when indicated.
Types of Tonsillitis
Acute Tonsillitis
Acute tonsillitis is a sudden-onset infection of the tonsils, most commonly caused by Group A beta-hemolytic Streptococcus (strep throat) or viral pathogens including adenovirus, Epstein-Barr virus (infectious mononucleosis), influenza, and rhinovirus. It is characterized by severe sore throat, difficulty swallowing, fever, and tonsillar enlargement with or without exudate.
Recurrent Acute Tonsillitis
Recurrent acute tonsillitis is defined as seven or more episodes in one year, five or more episodes per year for two consecutive years, or three or more episodes per year for three consecutive years. This pattern significantly impairs quality of life and productivity and is a well-established indication for tonsillectomy.
Chronic Tonsillitis
Chronic tonsillitis refers to persistent low-grade tonsillar inflammation characterized by chronic sore throat, malodorous breath, tonsillar crypts filled with debris (tonsil stones or tonsilloliths), and tender cervical lymph nodes. Unlike acute tonsillitis, fever is not typically present.
Peritonsillar Abscess
A peritonsillar abscess is a collection of pus between the tonsillar capsule and the surrounding pharyngeal wall. It represents the most common deep space infection of the head and neck and requires prompt drainage and antibiotic therapy. Recurrent peritonsillar abscess is a strong indication for interval tonsillectomy.
Symptoms of Tonsillitis
- Severe sore throat, often described as the worst the patient has experienced
- Enlarged, erythematous tonsils with or without white or yellow exudate
- Swollen, tender lymph nodes along the jaw and neck (anterior cervical lymphadenopathy)
- Muffled or “hot potato” voice characteristic of peritonsillar abscess
- Referred ear pain (otalgia) from shared innervation of the tonsil and ear via the glossopharyngeal nerve
- Trismus (difficulty opening the mouth) suggests peritonsillar abscess
- Odynophagia (painful swallowing)
- Fever, often high-grade in bacterial tonsillitis
- Fatigue, malaise, and loss of appetite
Diagnosis
Diagnosis of acute bacterial tonsillitis is confirmed by throat culture or rapid streptococcal antigen testing. Examination includes assessment of tonsillar size, the presence of exudate, lymphadenopathy, and signs of peritonsillar abscess. In patients with suspected infectious mononucleosis (Epstein-Barr virus), a heterophile antibody test (Monospot) is performed. Severely enlarged tonsils in adolescents and young adults should raise suspicion for mononucleosis, as splenomegaly in this condition contraindicates vigorous physical activity due to risk of splenic rupture.
Treatment
Antibiotic Therapy
Confirmed Group A streptococcal tonsillitis is treated with a 10-day course of penicillin or amoxicillin. Amoxicillin-clavulanate or cephalosporins are used in patients with penicillin allergy or prior treatment failure. Erythromycin or clindamycin are alternatives for patients with penicillin allergy. Azithromycin (five-day Z-pack) is used for uncomplicated streptococcal pharyngitis but has slightly lower eradication rates. It is critical to complete the full antibiotic course to prevent rheumatic fever.
Supportive Care
Pain management with acetaminophen or ibuprofen, adequate hydration, and throat lozenges provide symptomatic relief during the acute phase. Corticosteroids may be prescribed for severe odynophagia or significant tonsillar swelling impairing the airway.
Tonsillectomy
Tonsillectomy, the surgical removal of the palatine tonsils, is indicated for recurrent acute tonsillitis meeting established clinical criteria (Paradise criteria), chronic tonsillitis refractory to antibiotic therapy, peritonsillar abscess (especially recurrent), tonsillar hypertrophy causing obstructive sleep apnea or dysphagia, and concern for tonsillar malignancy. Tonsillectomy is performed under general anesthesia and is typically an outpatient procedure. Dr. Weiss will discuss indications, surgical technique, recovery, and expected outcomes during your consultation.
Tonsil Stones (Tonsilloliths)
Tonsil stones are calcified deposits that form within the crypts of the palatine tonsils when debris, including food particles, bacteria, and dead cells, becomes trapped and mineralizes over time. They may cause chronic bad breath (halitosis), a sensation of something stuck in the throat, and mild throat discomfort. Conservative management includes gargling with salt water and manually dislodging visible stones. Recurrent, symptomatic tonsil stones that do not respond to conservative measures may warrant tonsillectomy.
Schedule an Appointment Today
If you or your child has frequent or severe sore throats, treatment can bring lasting relief. Call us at (361) 320-6130 or connect with us online to schedule an appointment.