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Bacterial tonsillitis: Symptoms, diagnosis and treatment

What is bacterial tonsillitis?

If you're feeling fine one moment, and then suddenly your throat is extremely painful, you've got a fever, and all your energy has vanished in a haze of illness, you could well have bacterial tonsillitis, sometimes called strep throat.

Strep is short for Streptococcus pyogenes, a common strain of bacteria that can live in your throat and nose for months without causing any harm. Tests show that about 15% of healthy people have the strep “bug” living in their mouths or throats, without causing any symptoms. Often people who are carriers of strep have no symptoms, but they can pass an infection on to others.

Once in a while, though, these bugs can turn on you. Maybe you've been under too much stress, or your immune system has been overtaxed from fighting a virus such as a common cold or the flu. Or perhaps you've picked up a bug from an infected person. Whatever the reason, the normally dormant strep organisms can suddenly start releasing toxins and inflammatory substances to bring on a sore throat and other symptoms.

Although bacterial tonsillitis feels awful, it often goes away within a few days without specific treatment. Over the counter painkillers help relieve the symptoms whilst the body battles the infection.

What are the symptoms of bacterial tonsillitis?

Although, by definition, strep throat is caused by the Streptococcus pyogenes bacteria, other bacteria can occasionally invade the throat and cause similar symptoms. Other possible bacterial invaders include staphylococcus, neisseria and Haemophilus influenzae.

Stress, overwork, exhaustion and fighting off viral infections can weaken the body's defences and allow strep throat to attack. And like other throat infections, strep throat also tends to occur during the colder months.

What is the treatment for bacterial tonsillitis?

Even if bacterial tonsillitis is confirmed antibiotics may not be needed since these usually don’t speed up recovery time and may cause side effects. In addition, taking antibiotics when they’re not needed can increase the likelihood of antibiotic resistance developing in the future.

However, if symptoms are severe, are not improving, or a person has a weakened immune system then antibiotics may be recommended.

A standard dose of penicillin, taken for 10 days, usually treats a strep infection without any problems. For people allergic to penicillin, the alternative is usually erythromycin or other types of antibiotics. Relief from the sore throat should come within 24 to 36 hours after you start taking antibiotics.

Frequently, people on antibiotics notice improvement quickly and stop taking their medications before the full course of treatment is taken. This can have dangerous consequences. Prematurely halting your dosage may lead to developing post-infection heart (rheumatic disease) or kidney disease. So even though you may feel better right away, it's important to finish the entire course.

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