Duration

The duration of acute tonsillitis varies.Initially, there is the incubation period, the time from infection to inflammation, which is about 2-4 days. Afterwards symptoms become apparent and the diagnosis of acute tonsillitis is made. The duration of the disease is about one to two weeks in total, depending on the type and fitness of the patient.

This statement applies to tonsillitis under antibiotic treatment. The duration of the disease is often perceived as shorter. This is because the symptoms sometimes subside after a few days, although this does not mean that one is healthy.

It is therefore important to keep to the prescribed duration of medication. If the antibiotics are discontinued early, the remaining pathogens multiply and the acute tonsillitis breaks out again. There is also the possibility of chronification.

After a duration of 3 months or more, or if symptoms occur several times in a short time, tonsillitis is classified as chronic. In this case, a consultation about removal of the tonsils (tonsillectomy) is advisable. The conservative general treatment of the symptoms is independent of the cause (bacterial or viral infection) and the course and usually includes the same treatment options.

For example, at the beginning of every tonsillitis, an attempt can be made to relieve the symptoms independently. However, if the sore throat becomes very severe, lasts excessively long, or if other symptoms (such as pus formation on the tonsils) are added, a doctor should be consulted at the latest (a consultation with the family doctor is sufficient at first, there is no need to see an ENT specialist immediately). So what helps at first are throat rinses and solutions for gargling, which have analgesic and/or disinfectant ingredients and can thus combat sore throats and support the bacteria defence.

Likewise, the tonsils can also be brushed locally with an antiseptic (pyctanin solution). Cold neck wraps also help to relieve sore throats. A fever-reducing painkiller such as ibuprofen or paracetamol can be taken to combat any accompanying fever, which also helps to combat sore throats.

With regard to diet, softer and cooler food should be used in the acute stage of tonsillitis, and foods containing strong spices or acids should be avoided in order not to additionally irritate the mouth and throat area. An ample fluid intake, especially in the form of pain-relieving teas (sage, chamomile), can maintain the fluid balance in existing fevers and additionally help against sore throats. Whether antibiotic therapy is necessary, however, depends largely on the pathogen causing tonsillitis.

Since it concerns in most cases bacteria and viruses are the release in rare cases, the treating physician usually prescribes an antibiotic. In the case of an acute tonsillitis without complications, this is a 7-10-day intake of penicillin (in case of intolerance or ineffectiveness, the administration of a 1st or 2nd generation cephalosporin or macrolide is also possible). In the case of recurring complaints or chronic tonsillitis, an extended antibiotic therapy will be attempted first (amoxicillin & clavulanic acid), in some cases surgical removal of the tonsils (tonsillectomy) can also be used as a last resort.

If the tonsillitis is viral, there is no causal treatment option. Care must be taken to ensure a sufficient fluid intake in the form of water or tea. It is important not to carry off a sufficient physical protection around the tonsillitis and thus unnecessarily the risk of a rheumatic fever to increase!

With pronounced difficulty in swallowing one should do without hard solid food first and change to porridge as well as soups. Strongly acidic juices and foods can additionally irritate the almonds and should be avoided temporarily. Mouth and throat rinses with sage or chamomile tea also have a calming and disinfecting effect.

Antipyretic drugs such as paracetamol can be used to reduce fever. Also household remedies such as calf compresses can be very helpful. Ibuprofen relieves pain and at the same time has an anti-inflammatory effect.

In case of severe or persistent pain, purulent plaques, high fever or even breathing difficulties, it is essential to consult a doctor. In case of a bacterial cause – recognizable by the purulent coatings – antibiotics are prescribed. The best known is penicillin.Alternatively, cephalosporins or, in case of allergy to these two, macrolides, can be considered.

It is important to always take the antibiotic through to the end of the prescription – even if the symptoms subside much faster – because bacteria still remain in the depths of the tonsils and can quickly lead to an acute inflammation again. In the case of a single acute tonsillitis, surgery is not an option. However, if a patient suffers from chronic purulent tonsillitis that occurs more than three times a year, a tonsillectomy is performed.

This is the surgical removal of the palatine tonsils by the ear, nose and throat specialist. If the tonsillitis is of bacterial origin, it is assumed that the pathogen belongs to the group A streptococci. Streptococci are spherical bacteria that occur mainly in the nasopharyngeal area and can cause tonsillitis, among other things.

If tonsillitis is suspected, a doctor should be consulted to confirm the disease and initiate therapy. The attending physician will try to find out the exact reason for the occurrence of tonsillitis. The most important thing is whether a bacterial or viral pathogen is behind the individual illness.

If a viral background has been excluded, an antibacterial therapy with antibiotics will be initiated. The most common antibiotic for tonsillitis is penicillin V. It is taken orally and is usually prescribed for a period of 10 to 14 days. The reason for choosing this antibiotic is that streptococci, which in most cases of bacterial meningitis are the cause of the disease, are almost always sensitive to this drug, so they can be eradicated.

Penicillin V is generally well tolerated, but some people may have allergies to the drug. Within the population about 3% suffer from such an allergy, which is noticeable by the sudden appearance of red blisters on the skin. If a penicillin allergy is present, alternative antibiotics can be prescribed, such as Clarithromycin, which belongs to the group of macrolide antibiotics.

It is important to strictly adhere to the duration of the therapy prescribed by the doctor. Although the risk of infection is greatly reduced after just 24 hours and the symptoms of tonsillitis become better, antibiotic therapy should always be completed. In this way it can be prevented that a new tonsillitis breaks out within a few days or weeks and a new therapy is necessary.

If the antibacterial therapy is not sufficient, severe complications can also occur if the tonsillitis was caused by the bacterium streptococcus. Without sufficient destruction of this bacterium, rheumatic fever and bacterial endocarditis may occur. Since permanent damage, such as damaged heart valves, can remain, therapy with antibiotics is essential in the case of tonsillitis.

A special form of bacterial therapy for tonsillitis is chronic tonsillitis. This form of tonsillitis is also caused by bacteria, which can be treated with antibiotics. However, the elimination of the bacteria with antibiotics is much less successful than in acute tonsillitis.

The causing bacteria in this case are usually Haemophilus influenzae or Staphylococcus aureus. If a therapy with antibiotics is not successful, removal of the tonsils can help. Most home remedies for the treatment of tonsillitis are intended to alleviate the associated symptoms.

Depending on the severity of the infection, tried and tested home remedies can make the disease much more pleasant. However, it is important to remember that if you have an infection caused by streptococci, you should consult a doctor and take antibiotics. A Streptokokken infection could cause serious complications such as rheumatic fever or Glomerulonephritis without the use of antibiotics, which can be prevented with antibiotic therapy.

Also with other pathogens, if the complaints do not improve in the first two days after symptom beginning, a physician should be visited. In general, the body should be spared and bed rest should be observed as far as possible. Symptoms such as difficulty swallowing can be alleviated by lozenges, which stimulate the flow of saliva.So-called neck compresses are often used to relieve the sore throat that is often associated with tonsillitis.

These promote blood circulation and thus help the inflammation to heal. Scarves and shawls that can be worn around the neck serve the same purpose. Against the pain, but also against the inflammation, gargle solutions from certain teas can help.

Sage tea is said to have a disinfecting effect and chamomile tea an anti-inflammatory effect. Calf compresses can be very effective against fever, especially in children. These cold cloths help to lower the body temperature in a natural way.

Other more or less effective household remedies to combat tonsillitis are saltwater solutions for gargling, honey and onion extract. The most important factor in making a diagnosis is the clinical symptoms of the patient. The doctor will first ask about them in an anamnesis.

This is followed by a physical examination. The family doctor will palpate the cervical lymph nodes, measure fever, shine a light into the ears with an ear mirror and look at the throat. He will do this with the help of a wooden spatula, possibly also with a lamp and a mirror.

During the examination, he can detect fever and identify enlarged, overheated cervical lymph nodes. In addition, he will be able to recognize a whitish coating on the tongue and determine whether the palatal tonsils are enlarged, reddened or purulent. If rare pathogens are suspected or if tonsillitis does not heal despite antibiotic therapy, a smear is taken from the tonsils with a cotton swab and examined so that a very specific antibiotic therapy can be initiated.

However, this is only necessary in the rarest cases. A blood test for antibodies is not necessary in the case of simple tonsillitis, but is important if rheumatic fever is suspected.

Chronic tonsillitis: see topic chronic tonsillitis. If acute tonsillitis is protracted, e.g. due to premature discontinuation of antibiotic therapy, chronic tonsillitis can occur. This is defined as a purulent tonsillitis that lasts for at least three months.