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Follicular tonsillitis is an infection of the tonsils that can cause sore throat, fever, and difficulty swallowing. It can be caused by viruses or bacteria, and bacterial infections can be treated with antibiotics. Chronic recurring tonsillitis may require a tonsillectomy. Complications can include dehydration, blocked airways, abscess, or Lemierre syndrome. Comfort measures such as warm tea and pain relievers can help, and complications are rare if treated appropriately.
Follicular tonsillitis is an infection of the two bean-sized pieces of lymph tissue known as the tonsils. As part of the immune system, the tonsils are located in the back of the throat on either side of the tongue and filter out incoming viruses and bacteria. If they become infected, a person will experience typical cold symptoms such as sore throat, chills, and fever. Viral tonsillitis usually goes away on its own in 4 to 10 days, but bacterial follicular tonsillitis can be treated with antibiotics. Chronic recurring tonsillitis may require a tonsillectomy. Complications of this type of tonsillitis can include dehydration and kidney failure resulting from the inability to swallow, blocked airways due to swelling, abscess, or Lemierre syndrome.
The tonsils are the part of the immune system responsible for filtering viruses and bacteria that enter the body through the nose and mouth. Some of the viruses may include adenovirus, rhinovirus or influenza. Group A beta-hemolytic strep, or strep throat, is likely the culprit for a bacterial infection of the tonsils. Staphylococcus aureaus, diphtheria, syphilis, and streptococcus pneumoniae are other bacteria that can cause tonsillitis.
White blood cells, also part of the immune system, begin to defend the body by attacking viruses or bacteria. During the attack, the body may develop fever and sore throat, stiff or swollen neck, headache, chills, body aches, and/or cough. The tonsils can become red and swollen and often have small white or yellow spots or patches. It may be difficult for the patient to swallow or breathe due to throat pain and sinus congestion.
Most of the time, viral tonsillitis clears up on its own within 10 days of symptom onset. Antibiotics don’t kill viruses, so they are rarely prescribed for viral tonsillitis. If you have bacterial follicular tonsillitis, antibiotics may be prescribed. Sometimes a person will have repeated episodes of tonsillitis and may need to have their tonsils surgically removed. Untreated tonsillitis can lead to a pediatric autoimmune neuropsychiatric disorder related to strep.
A doctor may suggest comfort measures if follicular tonsillitis is viral or until antibiotics start to take effect. Drinking warm tea and gargling with warm salt water may be recommended to ease a sore throat. Over-the-counter pain relievers, such as acetaminophen or a nonsteroidal anti-inflammatory, can also help. Aspirin should not be taken by anyone under 20 because Reye’s syndrome could develop. Additional rest may be encouraged.
Complications of follicular tonsillitis can occur on rare occasions. If swallowing is too difficult, dehydration can occur. An inflamed airway can make breathing difficult. A few days after the onset of this tonsillitis, a peritonsillar abscess may form near one or both tonsils. The internal jugular vein can also become infected, which can lead to a pocket of pus forming near the tonsils, causing septicemia or Lemierre syndrome. These complications rarely occur if tonsillitis is treated appropriately.
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