Differences Between Viral And Bacterial Tonsillitis
Viral and bacterial tonsillitis do not differ much in their symptoms. It is a disease that presents with fever, throaty voice, difficulty swallowing (dysphagia) and local pain. According to the American Academy of Otolaryngology, this pathology is defined by an inflammation of the palatine tonsils or the pharyngeal mucosa.
It has different meanings, as it is also known as adenotonsillitis , tonsillitis or pharyngotonsillitis . Beyond its name, it is a disorder of great clinical interest due to its frequency. Do you know what types exist? Here we explain them to you.
About the distribution of tonsillitis
Before discovering the differences between viral and bacterial tonsillitis, we are going to contextualize the situation of this pathology a bit, according to its incidence in the general population. Various studies show us repetitive patterns that are sustained over time. Here are some examples:
- Acute tonsillitis occurs in 1 out of 100 patients who see a doctor. It accounts for an estimated 20% of sick leave among adults.
- In the United States, it causes 40 million consultations a year.
- 400,000 of these cases require surgical procedures, for example removal of the tonsils.
- This pathology follows a seasonal pattern, depending on the prevalence of the viruses and bacteria that cause it during the year.
As we can see, this disease of infectious origin is commonly present in medical consultations. Therefore, knowing how to identify it, both in origin and in severity, is essential. Here are the differences between viral and bacterial variants.
Differences between viral and bacterial tonsillitis
The main difference between both pathologies is their causal agent. Literature review studies analyze the most common forms of the disease:
- It is estimated that between 50 and 90% of tonsillitis are of viral origin. The most common particles involved are the Epstein-Barr virus, influenza, herpes simplex, and various adenoviruses.
- The remaining 10 to 50% are of bacterial origin. The main pathogen that generates it is group A hemolytic streptococcus ( Streptococcus pyogenes ).
Interestingly, the causative type depends, in part, on the age of the patient. Other studies emphasize that in children under three years of age the most prevalent form is the viral one, while between 5 and 10 years of age, bacterial variants are the most common.
Bacterial tonsillitis
The same investigations already cited above delve further into the pathogenic bacteria that cause bacterial tonsillitis. Through cultures of pharyngeal samples from children between 3 and 10 years of age with recurrent pathology, the following microorganisms were isolated:
- Streptococcus pyogenes in 30.2% of cases (it is estimated that it can reach 40%).
- Haemophilus influenzae in 20.3%.
- Staphylococcus aureus in 19.2%.
- Staphylococcus pneumoniae in 5%.
All these percentages, initially anecdotal in nature, show us the great variety of bacteria that can cause a picture of bacterial tonsillitis in infants. This form is considered more severe than the viral variant, as it develops with a high fever, severe sore throat, and the appearance of pus plaques and bad breath.
It can heal spontaneously in 3 or 4 days, after its appearance under normal conditions. However, there is a dreaded complication which is acute joint rheumatism (RAA), an autoimmune disease that appears two weeks after infection.
Other bibliographical sources cite the importance of applying antibiotics, as they provide various benefits. Some of these are as follows:
- Faster clinical improvement occurs after 24-48 hours.
- They prevent local suppurative complications. Professional appointments estimate that they occur in 1 to 2% of cases, such as the appearance of phlegmons.
- They reduce the contagion time.
- Side effects are minimized.
- They prevent the appearance of non-suppurative complications, such as RAA.
Viral tonsillitis
Viral tonsillitis, although more common, usually presents with a less severe condition. The incubation period is short, two to three days, after which a general malaise with low-grade fever begins to appear.
The bibliographic sources reveal that this pathology does not have a great medical relevance, since it heals in a few days and does not present complications. Being of viral origin, once the immune system fights the infection, the symptoms disappear without major problem.
What to remember about tonsillitis?
We have immersed ourselves in the world of viral and bacterial tonsillitis, explaining their essential differences. Let’s remember the most relevant of both ways:
- The viral variant is much more common than the bacterial one and has a seasonal pattern (when viruses predominate in autumn and winter, it manifests more).
- Viruses are more common in infants under three years of age, and from here on, bacterial tonsillitis becomes more and more common.
- Bacterial tonsillitis has a more severe picture and possible adverse effects to take into account. The virus resolves on its own.
- In the case of the bacterial variant, the use of antibiotics is necessary. In the virus, this treatment is useless.
It must be borne in mind, however, that both forms are contagious due to their nature. That is why, when suspecting tonsillitis, both viral and bacterial, it is best to go quickly to a trusted doctor or pediatrician.
