Patients with symptoms of tonsillitis should see their primary care provider or an ENT (ear, nose, and throat) specialist, or otolaryngologist. To determine whether a patient has a viral or bacterial infection, a doctor will typically swab the tonsils or pharynx (rapid strep testing). However, false negatives can occur with this test, so it is recommended that doctors obtain a throat culture in patients with negative rapid strep testing but who also show symptoms of streptococcal disease. Patients with a throat culture that is positive for GABHS, but without tonsillitis symptoms, are likely strep carriers.
Viral tonsillitis usually gets better without additional treatment. Hydration and pain control are important, and hospitalization may be required in severe cases, particularly when a patient becomes dehydrated or has an airway obstruction.
Bacterial tonsillitis is usually treated with antibiotics, which help GABHS tonsillitis get better faster, and prevent complications such as rheumatic fever. Common antibiotics used to treat tonsillitis include penicillins, cephalosporins, macrolides, and clindamycin.
In certain situations determined by your ENT specialist, surgery may be recommended to remove the tonsils. Typically, children who have seven episodes of tonsillitis in one year, or five episodes per year for two consecutive years, or three episodes per year for three consecutive years, are considered candidates for tonsillectomy. If a patient has a severe case of tonsillitis—peritonsillar abscess—surgery may be needed to drain the abscess around the tonsil.