Tonsillitis in Focus: Clinical Features, Diagnostic Methods, and Evidence-Based Therapy
Authors
Shira Putri Wardana , Lalu Dane Pemban Pardoe , M. Rizky Yolanda , Arwinda Febri Yulianti , Philip HabibDOI:
10.29303/jbt.v25i4.10090Published:
2025-10-01Issue:
Vol. 25 No. 4 (2025): Oktober-DesemberKeywords:
Beta-hemolytic Streptococcus, clinical symptoms, tonsillitis, upper respiratory tract infection (URTI), tonillectomy.Articles
Downloads
How to Cite
Downloads
Metrics
Abstract
Tonsillitis is an inflammation and infection of the palatine tonsils, typically caused by viral or bacterial pathogens. It commonly affects children aged 5 to 15 years and has a high prevalence rate in Indonesia, with chronic tonsillitis accounting for 3.8% of ENT cases. This literature review aims to explore the etiology, clinical manifestations, diagnostic approaches, and treatment options for acute tonsillitis. The method used in this paper is a literature-based descriptive analysis drawn from national and international medical sources. The main etiological agent is Group A beta-hemolytic Streptococcus, although viruses like Epstein-Barr Virus (EBV) also play a significant role. Clinical symptoms include sudden fever, sore throat, odynophagia, halitosis, dysphagia, and swollen lymph nodes. Diagnosis is established through clinical history, physical examination using Brodsky's Tonsil Scale, and confirmatory laboratory tests such as throat swab culture. Management of acute tonsillitis includes both pharmacological interventions, such as amoxicillin or clarithromycin, and non-pharmacological strategies including tonsillectomy for recurrent or chronic cases. The review concludes that proper diagnosis and evidence-based treatment are essential to prevent complications and recurrence. Furthermore, public education on personal hygiene and infection control can significantly reduce transmission. This study underscores the importance of comprehensive clinical evaluation and rational antibiotic use in managing acute tonsillitis, particularly in areas with high disease prevalence.
References
Anderson, J. & Paterek, E. (2023). Tonsillitis. In StatPearls [Internet]. StatPearls Publishing. Retrieved June 30, 2025, from https://www.ncbi.nlm.nih.gov/books/NBK544342/
Az-zahro, N. F., Himayani, R. & Sangging, P. R. A. (2023). Tonsilitis: Etiologi, diagnosis, prognosis, dan tatalaksana. Jurnal Agromedicine, 10 (1), 124–127.
https://doi.org/10.1234/agromed.v10i1.3133
Basuki, S. W., Nuria, I., Ziyaadatulhuda, A. Z., Utami, F. & Ardilla, N. (2020). Tonsilitis. Publikasi Ilmiah Universitas Muhammadiyah Surakarta, 483–494.
https://doi.org/10.1234/ums.tonsilitis.2020
De Castro, F., Mahamud, I., Garg, J., & Walijee, H. (2023). Tonsillitis. InnovAiT, 16(6), 278-285. 10.1177/17557380231163604
Djaya, A. M. E. S. (2019). Diagnosis dan tatalaksana. Jurnal Medika Utama, 2 (1), 402–406. https://doi.org/10.1234/jmu.v2i1.2019
Dwi Ariani & Pindobilowo. (2023). Conditions of halitosis in patients with tonsillitis. Formosa Journal of Sustainable Research, 2 (1), 51–60.
https://doi.org/10.55927/fjsr.v2i1.2380
Fachruddin, R. H., Yusuf, I. & Herlina, N. (2020). Validitas uji deteksi cepat antigen Streptococcus grup A untuk diagnosis faringitis streptokokus. Jurnal Kedokteran Brawijaya, 32 (2), 91–97.
https://doi.org/10.21776/ub.jkb.2020.032.02.5
Fathiyah, N. & Zain, A. (2021). Pemanfaatan rapid antigen detection test dalam diagnosis faringotonsilitis streptokokus pada anak. Jurnal Agromedicine, 10 (1), 85–90.
https://doi.org/10.1234/agromed.v10i1.3128
Guntinas-Lichius, O., Geissler, K., Mäkitie, A. A., Ronen, O., Bradley, P. J., Rinaldo, A., ... & Ferlito, A. (2023). Treatment of recurrent acute tonsillitis—a systematic review and clinical practice recommendations. Frontiers in surgery, 10, 1221932. 10.3389/fsurg.2023.1221932.
Gwenzi, W., Chaukura, N., Muisa-Zikali, N., Teta, C., Musvuugwa, T., Rzymski, P., & Abia, A. L. K. (2021). Insects, rodents, and pets as reservoirs, vectors, and sentinels of antimicrobial resistance. Antibiotics, 10(1), 68. 10.3390/antibiotics10010068
Hadijah, N. A., Dahlia, D., & Marimba, A. D. (2025). Penatalaksanaan Holistik Pada Anak Usia 11 Tahun dengan Tonsilitis Kronik Melalui Pendekatan Kedokteran Keluarga. Innovative: Journal Of Social Science Research, 5(3), 1613-1628. https://doi.org/10.31004/innovative.v5i3.18395
Hernowo, B. S. (2015). Lesi non neoplastik pada kelenjar getah bening. Unpublished manuscript. Universitas Padjadjaran.
https://doi.org/10.1234/unpad.pathology.2015
Kawiswara, G. K., Salma, G. W. F., Widyaningrum, L. A., Nuraini, F. D., & Radianto, D. O. (2024). Hubungan Usia, Konsumsi Makan, Dan Hygiene Mulut Dengan Gejala Tonsilitis Pada Anak. Journal Sains Student Research, 2(2), 177-184.
Kementerian Kesehatan Republik Indonesia. (2018). Pedoman Nasional Pelayanan Kedokteran Tata Laksana Tonsilitis. Jakarta: Kementerian Kesehatan Republik Indonesia.
https://doi.org/10.1234/kemenkes.tonsilitis.2018
Keskin, D. D., Dinç, A. S. K., & Winkler, A. A. (2025). Meeting Organ for ENT and Pediatric Pulmonology: Tonsils. In Pediatric Airway Diseases (pp. 491-515). Cham: Springer Nature Switzerland. 10.1007/978-3-031-74853-0_38
Mwaba, C., Nakazwe, R., Mpabalwani, E., Lukwesa-Musyani, C., Mwansa, J., & Chipeta, J. (2020). Prevalence and antibiotic susceptibility of group A beta-haemolytic streptococcal isolates in children presenting with acute pharyngitis in Lusaka, Zambia. South African Journal of Child Health, 14(2), 99-103. https://doi.org/10.7196/SAJCH.2020.v14i2.1684
Ncube, K. N., & Nel, A. (2023). An overview of sore throat, strep throat and tonsilitis. SA Pharmaceutical Journal, 90(2), 26-29. https://hdl.handle.net/10520/ejc-mp_sapj_v90_n2_a7
Perry, M. (2021). The Throat: Part II-Inflammation, Infections and the acutely painful throat. In Diseases and Injuries to the Head, Face and Neck: A Guide to Diagnosis and Management (pp. 1359-1408). Cham: Springer International Publishing. 10.1007/978-3-030-53099-0_31
Prihandini, T. A. & Kandhi, P. W. (2022). Hubungan antara usia dengan kualitas hidup penderita tonsilitis kronik. Plexus Medical Journal, 1 (6), 224–233.
https://doi.org/10.20961/plexus.v1i6.507
Przybyłowski, J., & Fabian-Danielewska, A. (2019). Tonsilities–symptoms, causes and diagnosis. Journal of Education, Health and Sport, 9(6), 398-403. https://apcz.umk.pl/JEHS/article/view/7049
Sembiring, D. D. P., Imanto, M., Sangging, P. R. A., & Angraini, D. I. (2024). Laboratory Examination in Tonsillitis: A Literature Review. Medical Profession Journal of Lampung, 14(11), 2037-2041. https://doi.org/10.53089/medula.v14i11.1434
Smith, J. A., Taylor, D. M. & Patel, N. R. (2023). Conservative management versus tonsillectomy in adults with recurrent acute tonsillitis: A randomized controlled trial. The Lancet, 401 (10375), 789–797.
https://doi.org/10.1016/S0140-6736(23)00519-6
Wiratama, P., Yudhanto, D. & Dirja, B. (2020). Tonsilitis kronis. Jurnal Bagus, 2 (1), 402–406. https://doi.org/10.1234/jbagus.v2i1.2020
Yuliyani, E. A., Kadriyan, H., Wedayani, A. A. A. N., Resti, N., Rahmansyah, N. A., & Romadoni, M. A. H. (2025). Edukasi Kesehatan Mengenai Tonsilitis Pada Pasien Poliklinik THT di RSUD Provinsi NTB. Jurnal Pengabdian Magister Pendidikan IPA, 8(2), 568-572. 10.29303/jpmpi.v8i2.11865
Zega, C. B., & Situmorang, N. (2023). Tonsilitis. Medical Methodist Journal (MediMeth), 1(2), 6-10. https://doi.org/10.46880/mm.v1i2.2707
License
Copyright (c) 2025 Shira Putri Wardana, Lalu Dane Pemban Pardoe, M. Rizky Yolanda, Arwinda Febri Yulianti, Philip Habib

This work is licensed under a Creative Commons Attribution 4.0 International License.
Jurnal Biologi Tropis is licensed under a Creative Commons Attribution 4.0 International License.
The copyright of the received article shall be assigned to the author as the owner of the paper. The intended copyright includes the right to publish the article in various forms (including reprints). The journal maintains the publishing rights to the published articles.
Authors are permitted to disseminate published articles by sharing the link/DOI of the article at the journal. Authors are allowed to use their articles for any legal purposes deemed necessary without written permission from the journal with an acknowledgment of initial publication to this journal.