【Common Diseases】Tonsillitis

A Complete Guide to Treating Tonsillitis (Hong Kong Edition)

Tonsillitis refers to inflammation of the palatine tonsils, located on either side of the throat. The tonsils are part of the lymphatic system and are responsible for defending against bacteria and viruses that enter the mouth and upper respiratory tract. However, when they become infected, they can become red, swollen, and painful, and can even affect swallowing and breathing.

In Hong Kong, tonsillitis can occur throughout the year, but is more common in autumn and winter and during the peak influenza season. The proportion of patients is higher among children and adolescents, but adults can also be affected.

The editor has referred to information from the Hong Kong Hospital Authority, the Department of Health and international otolaryngology, and has compiled the causes, treatments and local medical resources of tonsillitis in detail as follows.

1. Types and causes of tonsillitis

  1. Acute tonsillitis

    • Viral infections (most common): such as adenovirus, influenza virus, and Epstein-Barr virus
    • Bacterial infection (rare): Group A Streptococcus is the most common
    • Symptoms: Severe sore throat, difficulty swallowing, fever, hoarseness, swollen lymph nodes in the neck

  2. Chronic tonsillitis

    • Repeated tonsil infections lead to tissue fibrosis and surface depressions, making it easier for bacteria to harbour.
    • May cause bad breath and long-term throat discomfort

  3. Peritonsillar Abscess

    • Severe complications of acute tonsillitis
    • Severe pain on one side of the throat, difficulty opening the mouth, and slurred speech
    • ENT emergency

2. Causes and Risk Factors

  • Prolonged contact with infected people (eg, in schools or offices)
  • Low immunity
  • Chronic nasal congestion or rhinitis
  • Smoking or secondhand smoke
  • Poor oral hygiene

💡Editor ’s Tip :
There are many people in confined spaces such as the Hong Kong subway and buses. During the winter flu peak, the virus can easily spread through droplets, causing acute tonsillitis.

3. Treatment Principles

The goals of treatment are to relieve symptoms, eliminate the infection, and prevent complications . Treatment depends on the cause of the infection (viral or bacterial).

1. Viral tonsillitis (most common)

  • Treatment is primarily supportive :
    • Pain relievers and fever reducers (paracetamol, ibuprofen)
    • Gargling with salt water (to relieve sore throat)
    • Drink plenty of water and get enough rest
  • Usually heals on its own within 7-10 days
  • No need for antibiotics (overuse can lead to drug resistance)

2. Bacterial tonsillitis (such as Streptococcus pyogenes infection)

  • The doctor will prescribe antibiotics (usually penicillins, such as Amoxicillin, or Macrolides for those allergic to penicillin)
  • Completing the full course of treatment (usually 10 days) can avoid complications such as rheumatic fever and nephritis
  • Take painkillers and rinse mouth to relieve discomfort

3. Peritonsillar abscess

  • Need ENT specialist treatment
  • May require incision and drainage of pus
  • Concurrent use of antibiotics and painkillers
  • Severe cases require hospitalization

IV. Surgical treatment of chronic and recurrent tonsillitis

When tonsillitis occurs ≥7 times a year , ≥5 times a year for two years , or ≥3 times a year for three years , your doctor may recommend tonsillectomy .

Surgery Information (Hong Kong)

  • Public hospitals : Waiting time ranges from several months to a year, and the cost is low (approximately HK$100-$500)
  • Private hospitals : Short waiting time, cost around HK$20,000-HK$40,000 (including hospitalization and anesthesia fees)

💡Editor ’s Tip :
Although tonsillectomy removes this line of immune defense, it has little impact on most adults. Instead, it can reduce the risk of recurrent inflammation and serious complications.

5. Medical treatment options and costs in Hong Kong

  • Public hospital emergency rooms : for emergencies with high fever, difficulty swallowing, respiratory distress, or suspected abscesses
  • Public ENT specialist clinics : referral required, low cost, long waiting time
  • Private ENT clinic : Consultation fee is approximately HK$500-$1,200, medication is not included
  • General clinics : can treat minor illnesses and prescribe medication, and refer to specialists if necessary

6. Daily care and prevention

  • Wash your hands frequently and avoid sharing eating utensils
  • Wearing masks during peak infection periods
  • Keep your mouth clean
  • Quit smoking and avoid secondhand smoke
  • Enhance immunity (adequate sleep, balanced diet)

7. When is it necessary to seek medical attention immediately?

  • Sore throat that is too severe to swallow water or food
  • Persistent high fever
  • Difficulty breathing and slurred voice
  • Significant swelling on one side of the throat (suspicion of an abscess)
  • Neck stiffness and confusion (possibly a serious systemic infection)

💬Let me tell you :
Many people in Hong Kong buy antibiotics on their own when they have a sore throat. However, most cases of tonsillitis are caused by viruses, making antibiotics ineffective and potentially leading to drug resistance. The best approach is to consult a doctor to determine whether the infection is bacterial and then decide whether to use medication. Furthermore, if recurring tonsils affect your daily life, tonsillectomy, a mature and safe procedure in Hong Kong, is a long-term solution.

⚠️ Disclaimer <br>This article is for reference only and does not constitute any medical advice. It is sourced from major medical articles.

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