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Wednesday, June 16, 2021

Sore throat: when is it a symptom of tonsillitis and when of Covid-19

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A sore throat, difficulty swallowing, and swollen lymph nodes in the neck are the most common symptoms of tonsillitis. 

Tonsillitis is the inflammation of the palatine tonsils that are part of the first line of defense of our immune system.

It usually affects preschool-age children to young adults, although it can also occur in other age groups.

The origin of most tonsillitis is viral, although it can also be caused by bacteria.

The bacteria that most commonly causes tonsillitis is Streptococcus pyogenes and it is more common to affect children between 5 and 15 years old because these populations are often more exposed to contact with other people at school.

The most common symptoms are:

  • Redness and enlargement of tonsils
  • Difficulty or pain when swallowing
  • Fever
  • Whitish patches on the tonsils
  • Swelling and tenderness in glands in the neck

In young children:

  • Difficulty to swallow.
  • Salivation in excess.
  • Decay.

It is important to know that the sore throat associated with an active Covid-19 infection is not usually as intense as tonsillitis (mainly bacterial, also associated with difficulty swallowing).

Covid-19 infection is usually accompanied by other symptoms such as fever, altered sense of smell, decay, headaches, muscle pain, and/or shortness of breath.

Treatment of tonsillitis

Treatment will depend on the cause (viral or bacterial) and will be determined by the specialist doctor in charge.

Complications that can result from a misdiagnosed or treated tonsillitis can be:

  • Snoring and sleep apnea due to excessive enlargement of the tonsils.
  • Infection around the tonsil or around the neck (peritonsillar abscess).
  • Bacterial tonsillitis caused by Group A streptococcus Pyogenes can cause distant (rare) complications such as rheumatic fever or inflammation of the kidneys.

When is it necessary to remove the tonsils?

In the current approach to tonsillitis, tonsillectomy (removal of the tonsils) is avoided except in very severe cases. The main criteria that influence the decision are:

● When the patient suffered more than six episodes of tonsillitis during a year (recurrent tonsillitis).

● When there is considerable hypertrophy in the tonsils that causes apneas (interruptions in breathing) or difficulty swallowing.

Prevention is one of the fundamental measures to avoid these conditions, mainly in children. Improving hygiene habits such as correct handwashing, avoiding sharing utensils and correct respiratory hygiene are essential to prevent this pathology.

Image Credit: iStock

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