At the back of the throat, the tonsils serve as the body's first line of defense, trapping germs entering the airways and producing antibodies to fight infection.
However, tonsils can become infected themselves by bacteria or viruses, leading to swelling and inflammation known as angina blanche, or white angina. This common condition, especially in children, features white patches on the inflamed tonsils.
Angina blanche is a tonsil infection affecting the two pads of tissue at the back of the throat. It can occur at any age but is most prevalent in children from preschool through mid-teens. While often viral, it can be bacterial, with Streptococcus pyogenes (group A strep)—the cause of strep throat—being the most common culprit. Other streptococci and bacteria may also contribute.
As the tonsils act as immune sentinels against oral pathogens, they are prone to infection. Their immune activity wanes after puberty, explaining rarer cases in adults.
Key symptoms include red, swollen tonsils with white coating or patches; sore, scratchy throat; painful swallowing; fever; bad breath; headache; and stomachache, particularly in young children. Infants may drool or refuse food due to swallowing pain.
Diagnosis is straightforward via throat exam. Most cases resolve fully within 7-10 days, with or without treatment.
Highly contagious, angina blanche spreads easily. Minimize risk by avoiding infected individuals, frequent handwashing, and isolating while symptomatic.
Seek immediate care if throat swelling impedes breathing. Consult a doctor for fever over 39°C, muscle weakness, stiff neck, or persistent sore throat beyond two days. While many cases self-resolve, some require intervention.
Diagnosis involves throat inspection for swollen tonsils with white patches, external checks for lymph nodes or rash, and swab testing to distinguish viral from bacterial causes.
Chronic cases may lead to obstructive sleep apnea from airway swelling. Infections can spread, causing cellulitis or peritonsillar abscesses requiring drainage or surgery. Incomplete antibiotic courses risk rheumatic fever or post-streptococcal glomerulonephritis.
Home care forms the foundation, especially for viral infections where antibiotics are ineffective.
Prioritize rest to aid recovery, stay hydrated with caffeine-free hot drinks to soothe the throat, and gargle saltwater for relief. Use humidifiers to combat dry air, and avoid irritants like smoke.
For bacterial cases, doctors prescribe antibiotics like penicillin—complete the full course, even if symptoms improve, to prevent complications.
Tonsillectomy, once common, is now reserved for recurrent or chronic angina causing sleep apnea, breathing/swallowing issues, or refractory abscesses. Modern techniques include laser, radiofrequency, ultrasound, coblation, or electrocautery.
