Tonsillitis

I took my 6 year-old daughter to the doctor because of her sore throat. She said my daughter had tonsillitis, and swabbed her throat for the laboratory. My daughter has been given antibiotics to start immediately but I am to telephone for the laboratory result in 2 days’ time. Can you tell me about tonsillitis and why the throat swab was necessary?

Tonsillitis is a common infection of the tonsils in the throat. In about half of the cases the infection is due to a bacteria called Streptococcus, in the other half it is due to a viral infection. Your doctor can make the diagnosis of tonsillitis by seeing pus on the tonsils but cannot tell whether it is bacterial or viral. The laboratory will do that by culturing the swab.

Because there is a 50% chance that it will be the Streptococcus it is reasonable to start antibiotics. If it is due to the Streptococcus then a longer than usual course of antibiotic will be given.

In cases of tonsillitis it is important to tell the doctor if there is any family history of rheumatic fever because the Streptococcus can trigger this serious disease in those who are genetically predisposed. This aggressive approach demonstrated by your doctor has helped to make rheumatic fever uncommon in first-world countries.

Repeated tonsillitis will prompt your doctor to suggest having the tonsils removed. Otherwise tonsillitis is just an unpleasant infection except in those who are liable to develop rheumatic fever because there is a family history of it.