Is Tonsillitis Ever Serious?

Tonsillitis can occasionally become serious. For example, infection may spread beyond the tonsil to form an abscess , which is a localized collection of pus.

• An abscess that forms around an inflamed tonsil is known as a peritonsillar abscess or quinsy. This almost always develops on one side only, and usually in adults rather than children.

• Another type of abscess, one that develops mainly in young children, is a retropharyngeal (behind the throat) abscess . This usually causes high fever and great difficulty in swallowing. If detected very early, peritonsillar or retropharyngeal abscesses can sometimes be treated successfully with antibiotics. In most cases, however, surgery is required to drain the abscess.

Other Possible Complications

• The most serious complication of tonsillitis is rheumatic fever, which often is accompanied by rheumatic heart disease. Rheumatic fever develops only if the tonsillitis is due to a type of bacterium known as group A beta hemolytic streptococcus. It also usually occurs only in children who have had repeated infections that have not been adequately treated with antibiotics.

• Another complication of streptococcal tonsillitis is a type of kidney disease known as acute glomerulonephritis. However, whether glomerulonephritis can be prevented by early antibiotic treatment of streptococcal tonsillitis is not clear.

• A common complication of tonsillitis is infection of the lymph nodes in the neck, known as cervical adenitis. This type of infection can usually be successfully treated with antibiotics. Occasionally the infection progresses, an abscess forms, and surgery is required to drain it.

• Other possible complications of tonsillitis include middle-ear infections (otitis media) and sinus infections. More often, however, these infections develop at the same time as, or independently of, tonsillitis.