Acute Pharyngitis and Tonsillitis

The pharynx and tonsils have lymphoid tissue (white blood cells) that form part of the defense mechanism against viruses and bacteria that enter the body through the nose or mouth.

Pharyngitis and tonsillitis are caused mainly by viruses. Less often, it may be the result of bacterial infection and antibiotic treatment will be required.

Most cases of sore throat are the result of acute pharyngitis. Tonsillitis occurs when the infection gets more serious, and the tonsils become painful and inflamed.

Tonsillitis caused by Viruses

The majority of tonsillitis are caused by viruses (like Adenovirus, Influenzae viruses, Parainfluenzae virus, Respiratory Syncytial Virus etc) that can affect the upper respiratory tract, including the virus that causes infectious mononucleosis (the Epstein- Barr virus). Tonsillitis can also be caused by bacterial infections (like Streptococcus species, Staphylococcus species).

Acute tonsillitis caused by the Epstein - Barr virus can cause infectious mononucleosis. It is also called ‘kissing disease’ because of its spread via saliva and it commonly affects adolescents and young adults. It is characterised by :

• Sore throat
• Fever
• Enlarged cervical lymph nodes
• Enlarged tonsils and fatigue
• Other clinical manifestations are splenomegaly (enlarged spleen), hepatomegaly and hepatitis (enlarged liver and inflammation of the liver) and low platelet and white blood count.

Tonsilities caused by Bacteria

Acute tonsillitis due to a specific type of bacteria (Group A Streptococci) is called strept throat.

Symptoms caused by strep throat include :

• A sudden onset of pain and pain on swallowing
• Tender lymph glands in the neck
• High spiking fever
• A lack of upper respiratory tract symptoms (like running nose, nasal blockage).

As most cases of tonsillitis are caused by viruses, symptomatic treatment with painkillers, fever medications and hydration is enough. However, if the infection is caused by strep throat or another bacterial infection, treatment with antibiotics is needed.

School-going children are prone to viruses and bacteria that cause upper respiratory tract infection and tonsillitis. These tend to get passed on in childcare centres and schools where children are in close proximity.