Dear Doctor,

A month ago I suffered from tonsillitis and swallowed antibiotics which helped. However, my throat is sore again and I feel like I have a fever. I suspect the infection didn’t go away entirely. What can I do? Lucy

Dear Lucy,

Tonsils are two lymph nodes, located on each side at back of the throat. They serve as protective structures checking entry of dust, infectious germs, foreign particles, into the respiratory system. They also produce white blood cells that help combat infection. Tonsillitis is the condition where tonsils get infected and inflamed.

The infection could be due to viruses like that of common cold, Epstein barr virus, and bacteria like streptococci. The symptoms include sore throat, throat pain, fever, swollen and red tonsils. It can cause ear infections, bad breath, pneumonia and even infection of the brain. Untreated or recurrent streptococcal throat infection carries risk of causing kidney or heart problem later on.

Diagnosis is clearly made by physical examination and can be supported by a complete blood count. The causative microbes can be identified by cultures. Treatment is by suitable antibiotics, taken in correct dose for the prescribed duration of time. Fever and pain can be relieved by antipyretic and anti-inflammatory drugs.

Drinking plenty of water, drinking hot water, hot saline gargles, keeping room humidified, are measures that help to relieve symptoms. Herbs like ginger, basil, turmeric, are useful in treating symptoms of tonsillitis. Honey is also helpful. If symptoms are recurrent or persistent or very severe, surgical removal of tonsils remains the only option.

If you have had relapse of symptoms after treatment of tonsillitis once, there are two possibilities. Either the initial infection has not cleared or there is reinfection. Get a complete blood count done to know if infection is present, then a culture can help to identify the causative microbes and suitable antibiotic which could clear the infection.