Tonsillitis is an infection of the tonsils and that infection can be viral and it can be bacterial. Ones that we are more concerned about are recurrent bacterial infections and it is usually strep that we are most concerned about. Those strep infections can get down within the tonsil tissues itself within the crisp or enfolds of the tonsils and that is where the bacteria can actually live. They live in colonies that we call biofilms.
Symptoms associated with tonsillitis are pain, fever is very frequent, sore throat, and inability to swallow because it hurts so much. The issue about treating it is when is it appropriate to use antibiotics and certainly viruses can cause tonsillitis and we don’t give antibiotics for that. That is why we culture. Bacterial infections, particularly strep, warrant treatment with antibiotics. There are now good studies that show that if a child is having recurrent infections of 7 infections for 1 year, 5 infections for 2 years, or 3 infections for 3 years, then that warrants removal of the tonsils.
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