How Do You Know If Your Throat Is Infected?

In less than one-third of people, throat infections are caused by a bacterial infection. Group A streptococcus (strep throat) is the most common bacterial cause and usually occurs in children between the ages of 5 and age 15.

Strep throat is less common in children under age 3 and in older adults. Untreated strep throat sometimes causes complications. Complications can include?tonsillar cellulitis or abscess,?rheumatic fever, and?kidney inflammation?(glomerulonephritis). Rarely, bacterial infections such as gonorrhea and diphtheria cause throat infections.

Below are some facts about throat infections:

• Throat infections are usually caused by a virus but may be caused by bacteria such as streptococcal bacteria.
• Symptoms include severe pain with swallowing and swollen, red tonsils.
• The diagnosis is based on an examination of the throat.
• If untreated, tonsillopharyngitis which is caused by bacteria may become a tonsillar abscess.
• Pain is relieved with analgesics, and a streptococcal infection is treated with antibiotics.
• Sometimes the tonsils have to be surgically removed.

The tonsils contain?lymphoid tissue?that is part of the body's immune defense system. Thus, the tonsils and nearby throat tissue frequently become infected by organisms that enter the nose and throat.

Symptoms of Throat Infection

People with a throat infection have severe pain with swallowing and usually speaking. The pain is sometimes also felt in the ears. Some people have a fever, headache, and an upset stomach. The tonsils are red and swollen and sometimes have white patches on them. Lymph nodes in the neck may become swollen and tender.

In people who have frequent tonsil infections, the normal small pits in the tonsils sometimes become filled with white, hardened secretions that resemble tiny stones. These stones can trap odor-causing bacteria, causing chronic bad breath, and can predispose people to subsequent bouts of tonsillitis.

Tonsillitis

People with a?cold virus infection?often have a runny, congested nose and a cough. People with?mononucleosis?often feel extremely tired and have many swollen lymph nodes, and their increasing tonsillar swelling may begin to block air when a person breathes, causing noisy breathing. People who have had their tonsils removed can still get throat infections.

Treatment of Throat Infection

• Pain relievers (analgesics)
• For strep throat, antibiotics
• Sometimes surgical removal of the tonsils

Analgesics given by mouth, such as?acetaminophen?or nonsteroidal anti-inflammatory drugs (NSAIDs), often help reduce pain in people with a throat infection. Gargling with warm salt water has often been recommended but has not been shown to help. Some doctors also give a single dose of a corticosteroid,?dexamethasone, particularly if symptoms are severe;?dexamethasone?may shorten the duration of symptoms. It may also help lessen airway blockage caused by mononucleosis.

Tonsillectomy

People who have repeated streptococcal infections of their tonsils may need to have their tonsils removed (tonsillectomy), according to suggested guidelines. Typically, it is?children?who need a tonsillectomy, including children who have had more than 6 infections in 1 year, more than 4 infections in each of 2 years, or more than 3 infections per year for 3 years. Doctors consider tonsillectomy if the child has an acute infection that is severe and persistent despite being treated with antibiotics, if the child has significant obstruction (including obstructive sleep disorder) or a recurrent peritonsillar abscess, or if they suspect cancer.

For?adults,?doctors do not use these specific criteria for when to do a tonsillectomy. However, doctors may do tonsillectomy in adults who have severe bad breath due to tonsillar stones.

For both?children and adults,?doctors do allow for individual differences when deciding whether to recommend a tonsillectomy.

There are numerous effective techniques for tonsillectomy. Doctors can use a scalpel or an electrocautery device, or they can destroy the tonsils using radio waves.

Fewer than 2% of people, adults more than children, have bleeding complications resulting from a tonsillectomy. Bleeding typically occurs within 24 hours of surgery or after about 7 days. People who have bleeding after a tonsillectomy should go to a hospital.

Partial tonsillectomy?is sometimes done in patients with tonsillitis that cause some blockage in the throat. Part of the enlarged tonsil can be removed by shaving the tonsil using special scissors, or using other devices such as laser, radiofrequency, or electrocautery. It works as well as total tonsillectomy to relieve airway obstruction that is causing snoring and interruption of sleep. Tonsils do not usually grow back.

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