Tonsillitis - ENT

Tonsillitis Treatment Abroad

Overview

onsils are two oval-shaped collection of lymphoid tissue located on each side of the back of the throat. These immunocompetent tonsils function as our immune system's first line of defense against ingested infectious agents. Recent research shows that our tonsils produce T lymphocytes or T-cells, a white blood cell type that plays a crucial role in preventing infections. Aside from serving as the body’s filters to trap pathogens, they also help in producing antibodies to easily help the body fight infections.

What is Tonsillitis?

Tonsillitis is initiated by a bacteria or virus that causes the tonsils to swell and be infected by pathogens inhaled or ingested thru our nose and mouth. Anybody can have tonsillitis. However, children ages 5 and up (preschool to mid-teenage years) are more susceptible.

Why do tonsils get infected?

Since the tonsils are the immune system's first line of defense against pathogens, this purpose may make the tonsils more susceptible to infection. Nevertheless, this function declines after puberty- that’s why tonsillitis rarely occurs in adults.

Causes

Most of the time, tonsillitis is caused by a common virus, but a bacteria may also cause tonsillitis such as the Streptococcus pyogenes, which is the most common bacterium. Other strains of streptococcus bacteria may also cause Strep throat.

Signs and Symptoms of Tonsillitis:

• Bad breath
• Difficult or painful swallowing
• Enlarged or tender and lymph nodes in the neck
• Fever
• Headache
• Red, swollen tonsils
• Scratchy or throaty voice
• Sore throat
• Stomachache (especially in younger children)
• Stiff neck
• Yellow coating or white or patches on the tonsils

When to call your family doctor or paediatrician

If your child is experiencing:

• Difficulty breathing
• Drooling
• Extreme weakness or fussiness
• Extreme difficulty or pain in swallowing
• A sore throat that doesn't go away within a day

Risk factors for tonsillitis include:

Younger age - Tonsillitis occurs more in children from preschool years to mid-teenage years.

Recurrent exposure to germs - School-age children are frequently exposed to bacteria and viruses and are in close contact with their peers that’s why they are prone to tonsillitis.

Complications

Frequent swelling of the tonsils can cause complications such as:

• Difficulty breathing
• Obstructive Sleep Apnea - disrupted breathing during one’s sleep
• Tonsillar Cellulitis - swelling that spreads into the throat’s surrounding tissue
• Tonsillar Abscess - inflammation that results in a pool of pus behind the tonsils

Streptococcal infection

If tonsillitis isn’t treated well or the prescribed antibiotic is incomplete you or child will be at risk for rare disorders such as:

Post-Streptococcal Glomerulonephritis - an inflammatory disorder that affects the kidneys which results in inefficient removal of excess fluids and waste products from the bloodstream. 

Rheumatic fever – a type of inflammatory disorder that affects the body’s other tissues, joints and heart

Finding an Ear, Nose and Throat Surgeon or Specialist

If you or child is experiencing tonsillitis, you may visit your family doctor or your child's pediatrician. Then if it may require other treatment procedures such as surgery, you may be referred to an ENT, a specialist in the ear, nose and throat disorders or what you call an otolaryngologist.

Tests to diagnose Tonsillitis

Your family doctor or paediatrician may start with a physical exam that will include:

• Thru a penlight, your doctor will take a look at your throat, the ears and nose to look to check if they are also infected, as these may also be considered sites of infection.
• Check for Scarlatina, a type of skin rash that is associated with cases of Strep throat.
• Gently palpate or feel the neck for swollen lymph nodes or glands. 
• Thru a stethoscope, your doctor will listen to your breathing.
• Check and feel for spleen enlargement to rule out mononucleosis, a disease that also causes swelling of tonsils.

Then, laboratory tests will be performed to confirm diagnosis of Tonsillitis.

Throat swab

Through a sterile swab, the doctor rubs the back of your throat to get a secretions sample. The sample will then be assessed in a lab for streptococcus bacteria. If the test result is positive, then you have a bacterial infection. However, if the result is negative, then what you have is a viral infection.

Complete blood cell count (CBC)

The medical technologist draws a small amount of your blood through a needle syringe. This is performed to check what blood profile is elevated, below normal or normal to know whether your infection is caused by a virus or bacteria. If the test result is negative, the CBC may aid in determining other causes of your tonsillitis.

Tonsillitis Treatments

Antibiotic Therapy

Through the lab tests, it will be determined if your tonsillitis is caused by a viral or bacterial infection. If it is caused by bacteria such as group A streptococcus, your family doctor will prescribe antibiotics like Penicillin- which is the most common antibiotic treatment. It may be taken through the mouth for 10 days. If you or your child is allergic to the prescribed penicillin, your doctor will prescribe another antibiotic.

You must make sure to take the prescribed full course of antibiotics even if you feel better or the symptoms have gone completely. Inform your doctor if you have missed an antibiotic dose. Not completing the antibiotic therapy can worsen the infection and increase you or your child's risk of complications such as kidney inflammation or rheumatic fever.

Surgery (Tonsillectomy)

For an effective treatment for tonsillitis, it’s a must to have an accurate diagnosis. When tonsillitis occurs frequently and a patient doesn’t respond to prescribed treatments, surgery or tonsil removal is recommended. 

Tonsillectomy is a surgical procedure performed to remove the tonsils. This surgery is performed when a patient has recurring tonsillitis or bacterial tonsillitis that doesn't respond anymore to antibiotic therapy. You may have frequent tonsillitis if you experience:

• More than 7 episodes of tonsillitis in a year
• More than 5 episodes of tonsillitis a year in each of the preceding 2 years
• More than 3 episodes of tonsillitis a year in each of the preceding 3 years

Tonsillectomy may also be performed if tonsillitis results in complications which include:

• Abscess that doesn't recover after antibiotic therapy
• Difficulty in breathing
• Difficulty in swallowing like chunky foods and meats
• Obstructive Sleep Apnea

Tonsillectomy is performed as a one-day surgery, unless the patient is very young. Usually, after a one-day surgery you or your child may be able to go home on the day of the surgery. Complete recovery from tonsillectomy takes 7 to 14 days.

How much does Tonsillectomy cost?

Tonsillectomy in Thailand may cost USD $2,012 while Tonsillectomy in the Philippines may cost USD $2,500. In the UK, tonsillectomy ranges from USD $2,467 to USD $4,365. The cost of tonsillectomy in Cuba and Mexico costs around USD $3,500 while in the US, it is cheaper with USD $2,850. 

For more information about tonsillitis rocedures and where you can find the best treatment option, do not hesitate to contact us!