• Tonsils and adenoids are composed of tissues similar to the lymph nodes or glands.
• Acute tonsillitis is an infection of the tonsils caused by one of several types of bacteria or viruses.
• Chronic tonsillitis is a persistent infection of the tonsils and can cause tonsil stone formation.
• Signs and symptoms of tonsil or adenoid infection include:
  • Sore throat
  • Fever
  • Bad breath
  • Difficulty swallowing
  • Swollen lymph glands in the front of the neck
• Peritonsillar abscess is a collection of pus behind the tonsils.
• Obstruction to breathing by enlarged tonsils and adenoids may cause snoring and disturbed sleep patterns.
• Bacterial infections of the tonsils and adenoids are treated with antibiotics, viral infections are not.
• Tonsillitis and adenoid infections are diagnosed with a history and physical exam. A throat culture and rapid strep test may be ordered in cases of tonsillitis suspected to be bacterial.
• Tonsillectomy and adenoidectomy (surgical removal of the tonsils) may be recommended: (1) for repeated or persistent infections; (2) when serious complications of infection occur; and (3) when enlargement of the tonsils and adenoids causes breathing, swallowing, or dental problems.

 

The tonsils and adenoids are composed of tissues similar to the lymph nodes or glands found in the neck or other parts of the body. Together, they are part of a ring of glandular tissue (Waldeyer’s ring) encircling the back of the throat.

The tonsils are the two masses of tissue on either side of the back of the throat. Normal tonsils are usually about the same size and have the same pink color as the surrounding area. On their surfaces are little depressions, called crypts, which may appear deep and contain pus pockets or tonsil stones.

The adenoids are located high in the throat behind the nose and soft palate (the roof of the mouth) and unlike the tonsils, are not easily visible through the mouth. A tonsillectomy and an adenoidectomy (commonly referred to as a T & A) are surgical procedures performed to remove the tonsils and adenoids.

 

The tonsils and adenoids are thought to assist the body in its defense against incoming bacteria and viruses by helping the body form antibodies. However, this function may only be important during the first year of life. There is no evidence to support a significant role of the tonsils and adenoids in immunity. Medical studies have shown that children who have their tonsils and adenoids removed suffer no loss in their future immunity to disease or ability to ward off infections.

The most prominent symptom of tonsillitis and adenoid infection is a sore throat. Other signs and symptoms of tonsillitis and adenoid infection include:

• Fever
• Bad breath
• Congestion and runny nose
• Swollen lymph nodes in front of the neck
• Red, swollen tonsils with patches of pus (white spots)
• Pain or difficulty swallowing
• Loss of voice or muffled voice
• Headache
• Abdominal pain
• Coughing up blood
• If the adenoids are enlarged, breathing through the nose may be difficult and symptoms may include:
  • Breathing through the mouth, especially in children
  • Noisy breathing in the day; snoring at night is often observed
  • Nasal-sounding voice

When there is a sore throat and cold symptoms such as congestion, runny nose, sneezing, and coughing, the cause is most likely a virus. Viral infection of the tonsils or adenoids usually resolves without treatment within two weeks.

Sore throat with a sudden mild fever, without symptoms of an upper respiratory tract infection, may point to a bacterial infection. If these symptoms are present, see a doctor for diagnosis because of the risk of strep throat. Although strep throat will usually go away even without treatment, an untreated strep infection can lead to complications including rheumatic fever, which can permanently damage the heart.