Tonsillitis and Bronchitis

Overview

Tonsillitis is inflammation of the tonsils in the back of the mouth. Bronchitis is inflammation of the bronchial tubes, which carries air to the lungs. Both conditions can arise from a variety of afflictions, most often a viral or bacterial infection, but also from inhaled chemicals or irritants. A common bacterial infection that causes tonsillitis is Strep Throat.

Causes

In bronchitis, inflammation irritates the tiny, stroking hairs called cilia that line the bronchial tubes and cause them to stop functioning. This causes a growing buildup in the tubes and, in response, mucus is released to coat the tubes, which causes the cough associated with bronchitis.

Tonsillitis occurs when a viral or bacterial infection overwhelms the tonsils’ drainage function, and they become swollen and tender.

Bronchitis

• Adenovirus, Epstein-Barr, influenza, parainfluenza, and rhinovirus

• Inhaled chemicals, dust, smoking, pollutants, and other inhalant exposure

Tonsillitis

• Adenovirus, Epstein-Barr, influenza, parainfluenza, enterovirus, and herpes simplex I

• Group A streptococci (most often from strep throat)

Symptoms: As their names imply, the symptoms for tonsillitis and bronchitis are associated with inflammation of the tonsils and bronchial tubes.

Bronchitis

• Persistent cough with mucus (defining symptom)

• Cold-like symptoms

• Chest pain

• Difficult or labored breathing

Tonsillitis

• Sore throat and pain swallowing

• Fever

• Chills

• Aches

• Loss of appetite and nausea

Diagnosis: Tonsillitis is generally diagnosed with a physical exam consisting of inspection of the inflamed tonsils and a throat swab to perform a rapid strep test. This will determine if the tonsillitis is a result of strep throat or a viral infection, which will not respond to antibiotics. Bronchitis is a bit more difficult to diagnose and usually requires a few different tests.

Approximately one-third of recurrent acute Bronchitis cases is misdiagnosed and is actually asthma.

Bronchitis:

• Listen to breathing with a stethoscope

• Chest x-ray

• Sputum culture for bacteria

• Pulmonary function test to rule out asthma or emphysema

Complications: Both illnesses can have long-term health effects if not treated.

Chronic Bronchitis:

• Increased risk of lung cancer

• Trigger asthma attacks

• Increased susceptibility to infection and pneumonia

Tonsillitis:

• Abscess of tonsils and possible spreading

• Mouth and airway blockage

o For tonsillitis caused by strep throat, if it is left untreated by antibiotics, the bacteria spread into other areas of the body and can cause chronic kidney, liver, heart, skin and joint inflammation.

Treatment: Both bronchitis and tonsillitis are often caused by viral agents, so treatments are usually limited and should not involve antibiotics.

Bronchitis:

1. Supportive treatments to assure proper breathing in acute cases
2. Over-the-counter drugs such as Ibuprofin or Acetominophen
3. Application of macrolide antibiotics if sputum test suggests involvement of mycoplama or chlamydia bacteria
   

Tonsillitis:

1. Penicillin class antibiotics in the case of a positive strep tests
2. Removal of the tonsils through surgery is a last option for tonsillitis that recurs seven or more times in a year or 10 times over a few years, or for severe tonsillitis that obstructs the throat.

Looking Ahead

Greater knowledge of the viruses involved in bronchitis and tonsillitis are necessary for developing proper treatments. As neither affliction is fatal or damaging in the long term, there is not a great impetus for research in these areas. Also, a general depression in anti-microbial research lowers the chances for panaceas to these common diseases. Recent outbreaks of similar viruses such as SARS do show the necessity of understanding the mechanisms and finding possible treatments for these illnesses.