Tonsillitis and strep throat are often viewed as similar illnesses because both infect the inside of your throat. While both these terms are used synonymously, the conditions can be widely differentiated on the basis of their cause and certain symptoms.
Tonsillitis (तोंसिल्लितिस in Hindi) can be caused by several types of viruses and bacterial infections, including the bacteria that cause strep throat. Strep throat (स्ट्रेप थ्रोट in Hindi) is only caused by group A Streptococcus bacteria and never by any other virus or bacteria.
While you can have tonsillitis with or without strep throat, strep throat can never be called tonsillitis.
Read on to understand the causes of tonsillitis and strep throat, similarities, and differences in their symptoms, what is the recommended diagnosis and treatment for each.
Tonsillitis and Its Causes
Tonsils are a pair of round, red balls at the back of your throat, on each side, whose primary responsibility is to act as the body's first line of defense.
Tonsils trap bacteria, viruses, etc., that enter through the oral cavity and initiate an immune response (a biological reaction that the body generates to recognize and defends itself from foreign substances that appear harmful) after recognizing them.
Tonsillitis is the painful inflammation or infection of your tonsils. Tonsillitis can be caused by viruses or bacteria.
a) Viral tonsillitis is caused by a virus and is the most common type of tonsillitis. The same viruses that cause cold (rhinovirus) or the flu (influenza virus) are also responsible for causing tonsillitis. Viral tonsillitis is less serious and in most cases, the symptoms go away on their own.
Some other viruses that cause tonsillitis are Hepatitis A virus, HIV (human immunodeficiency virus), Herpes simplex virus (HSV), Epstein-Barr virus (EBV), Coronavirus, and Adenovirus.
b) Bacterial tonsillitis is caused by bacteria; the most common one being group A Streptococcus bacteria. While this is less common (accounts for about 15 to 30% of tonsillitis cases), bacterial tonsillitis produces more serious symptoms.
Causes of Strep Throat
Strep throat infection is caused only by group A Streptococcus bacteria and is often more serious than a tonsillitis infection. Strep throat is an infection of the throat, but it can infect your tonsils as well.
Strep throat infection is contagious and can spread through droplets when you cough or sneeze, or through contaminated food and drinks.
Symptoms of Tonsillitis and Strep Throat: Similarities and Differences
The two infections are often confused because of the common symptoms that strep throat and tonsillitis share. Some of these include:
A sore throat
Difficulty and pain when swallowing
Enlarged painful lymph nodes (immune cells that fight infections) around your neck area
Headaches
Fever (it is generally high in case of strep throat infection)
Unique Symptoms of Tonsillitis
Swollen and reddish tonsils
Stiffness in your neck
Stomach pain
White or yellow discolouration around or on the tonsils
Runny or congested nose
Bad breath and cough
Unique Symptoms of Strep Throat
Swollen, red tonsils, often occurring with pus (thick, protein-rich liquid at the site of infection)
Nausea
Vomiting
Due to a lot of similarities in the symptoms of strep throat and tonsillitis, it is always advisable to visit your ENT (ear, nose and throat) specialist for the right diagnosis and to identify the cause of your strep throat or tonsillitis symptoms.
Risk Factors and When To See A Doctor
Whether it is tonsillitis or strep throat, check with your doctor immediately in case of the following:
If your symptoms do not get better for more than 4 days
If you have a fever higher than 102.6°F
If you have extreme pain while swallowing fluids or foods
If you have extreme fatigue or weakness
Diagnosis of Tonsillitis and Strep Throat
Your ENT specialist will examine your throat and check for swelling, redness, or white spots on your tonsils. Your lymph nodes, ears, and nose will also be closely examined for signs of an infection.
If your doctor suspects tonsillitis, then a throat culture is taken by gently swabbing the back of your throat. The culture will be sent to a lab to identify if your tonsillitis is caused by a bacteria or virus.
A rapid viral nasopharyngeal (upper part of the throat that is behind your nose) swab test can also be used to check for certain other viruses.
To identify strep throat, your doctor will recommend a rapid strep test. This test involves swabbing the throat and running a test on the swab, to quickly show if group A strep is causing the strep throat.
Rapid strep test results take about 10 to 15 minutes. If the test is positive, your doctor can treat your strep throat accordingly. If the test is negative, and your doctor still suspects strep throat, then a throat culture test (a sample from your throat is taken and studied in the lab) is done.
Treatment and Management
While managing symptoms of sore throat and tonsillitis at home are very similar, the prescription medicines for treating tonsillitis and strep throat are quite different.
Tonsillitis
Tonsillitis is less serious and the symptoms are usually self-limiting. Treatment for tonsillitis is similar to that of a common cold.
You might be prescribed medicines for tonsilitis to relieve pain, manage fever and reduce inflammation. Your doctor might also give you vitamins to boost your immune system to fight off the infection quickly.
Home remedies to treat tonsillitis symptoms are:
Drink plenty of fluids to soothe a sore throat.
Take lots of rest to reduce inflammation and swelling.
Gargle with warm salt water to reduce any discomfort in your throat.
Suck on lozenges.
Use a humidifier to moisten the air in your home.
Avoid smoking.
Strep Throat
If you are diagnosed with strep throat, your treatment should ideally start immediately.
Strep throat is usually treated with antibiotics. Antibiotics are medicines that fight bacterial infections. You should start to feel better in just a day or two after starting antibiotics.
If you test positive for strep throat but have no symptoms (called a “carrier”), then you will usually not need antibiotics. You are less likely to spread the bacteria to others and very unlikely to get complications.
You can get rid of strep throat symptoms at home by gargling with warm salt water and having warm soups or vegetable broths. Taking a lot of rest is the best way to get rid of your sore throat and other symptoms.
Remember that you can get strep throat again if you have already had it earlier. It is important to follow these basic hygiene practices to protect yourself from getting strep throat repeatedly:
Wash your hands with soap and water regularly. Use an alcohol-based hand rub if soap and water are not available.
Cover your mouth and nose with a tissue when you cough or sneeze. Discard the used tissue in the bin immediately.
The best way to avoid falling sick with strep throat or tonsillitis is to maintain distance from people who are infected or are down with a cold.
Sore throat and tonsillitis are most commonly seen in children aged between 5 and 15 years. The weather also affects your risk of being infected with germs that cause sore throat or tonsillitis; especially during the beginning of spring.
Practice hand and respiratory hygiene at all times to protect yourself and others around you. Consult your ENT specialist if you have recurrent episodes of tonsillitis or strep throat.
References:
1. Centers for Disease Control and Prevention. 2021. Is your sore throat strep?. [online] Available at: <https://www.cdc.gov/groupastrep/diseases-public/strep-throat.html> [Accessed 15 February 2021].
2. Ndhealth.gov. 2021. [online] Available at: <https://www.ndhealth.gov/Disease/Documents/faqs/Strep%20Throat.pdf> [Accessed 15 February 2021].
3. Usi.edu. 2021. [online] Available at: <https://www.usi.edu/media/925441/tonsillitis.pdf> [Accessed 15 February 2021].
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