Diagnosis
The diagnosis of tonsillitis is usually divided into several steps.A first indication of the presence of tonsillitis can in most cases be found during the doctor-patient consultation (anamnesis). During the physical examination, the attending physician pays particular attention to painful enlargement of the lymph nodes in the area of the neck. Within the oral cavity, an inspection of the palate and throat should be performed.
During the examination, severe redness in the back of the throat and an increase in the size of the palatine tonsils are noticeable. Depending on the form of tonsillitis, purulent spots and/or plaques may also be found. Whitish deposits may even appear on the surface of the tongue in a number of cases.
In these cases, which are typical for the presence of tonsillitis, a blood analysis should also be performed. For the further course of the disease and the choice of a suitable therapy, it is essential to clarify whether tonsillitis is caused by bacteria or a virus. Although the presence of purulent deposits in the throat is in principle more likely to indicate a bacterially induced form of the disease, a blood test should not be omitted under any circumstances.
Especially if there is a strong increase in white blood cells, a bacterial infection can be assumed. Tonsillitis caused by group A streptococci (beta-hemolytic streptococci) can be detected within a few minutes by a throat swab. Since some symptoms of acute tonsillitis are similar to those of a more serious disease (Pfeiffer’s glandular fever), palpation of the liver and spleen should also be performed during the physical examination.
Symptoms
The symptoms of tonsillitis depend on the causative pathogen. Patients suffering from tonsillitis usually experience very early onset of sore throats. Due to the sometimes severe swelling of the palatine tonsils, tonsillitis causes pronounced swallowing difficulties for those affected.
Many patients describe the pain they feel as stabbing. Pronounced clinical pictures cause pain that radiates into the ears. The reason for this phenomenon is the fact that there is an access to the ears in the area of the throat.
Due to the sometimes severe swelling of the palatal tonsils, this access can be blocked and the ventilation of the ears can be restricted. Characteristically, the discomfort around the ears increases especially during the swallowing process. In addition, especially the acute forms of the disease can lead to a pain-related restriction of the mouth opening.
Due to additional swelling of the lymph nodes of the neck, even the slightest movement can be perceived as painful. Since tonsillitis is a disease caused by bacterial and/or viral pathogens, it can also lead to general symptoms parallel to the inflammation of the palatal tonsils. Inflammatory processes in the area of the middle ear can often be observed, especially in children. In addition, the affected patients often suffer from severe coughs and rhinitis. If tonsillitis is caused by a viral pathogen, the simultaneous occurrence of fever is not uncommon.