Tonsillitis in Children

Tonsillitis is an inflammation of the tonsils. Tonsils are 2 large lumps of tissue in the back of your child's throat. They help fight infection. Tonsillitis may be caused by a bacterial or a viral infection. Viruses that cause a cold or the flu may cause viral tonsillitis in children. A virus that causes mononucleosis (mono) may also lead to tonsillitis. Group A streptococcus is the most common bacteria that causes tonsillitis. It also causes strep throat. Tonsillitis can spread from an infected person to others through coughing, sneezing, or touching. The germs can spread through kissing or sharing food and drinks. Germs spread easily in schools and daycare centers and between family members at home. 

Signs and symptoms of tonsillitis

• Fever and sore throat
• Nausea, vomiting, or abdominal pain
• Cough or hoarseness
• Runny or stuffy nose
• Yellow or white patches on the back of the throat
• Bad breath
• Rash on the body or in the mouth

Tonsillitis diagnosed

Your child's caregiver will look into your child's throat and feel the sides of his neck and jaw. He will ask your child about his signs and symptoms. Your child may need the following tests:

Throat culture: This is a test that may help caregivers learn which type of germ is causing your child's illness. A throat culture is done by rubbing a cotton swab against the back of your child's throat.

Blood tests: These may be done to see if your child has an infection caused by bacteria or a virus.

How is tonsillitis treated?

Ibuprofen: This medicine decreases pain, swelling, and fever. You can buy ibuprofen without a doctor's order. Ask how much to give your child and how often to give it. Follow directions. Ibuprofen can cause stomach bleeding and kidney damage if not taken correctly.

Acetaminophen: This medicine decreases pain and fever. You can buy acetaminophen without a doctor's order. Ask how much to give your child and how often to give it. Follow directions. Acetaminophen can cause liver damage if not taken correctly.

Antibiotics: This medicine is given to fight or prevent an infection caused by bacteria. Give it to your child as directed.

Tonsillectomy: This is surgery to remove your child's tonsils. Your child may need surgery if he has chronic or recurrent tonsillitis. Surgery is also done if antibiotics are not getting rid of his tonsillitis.

What are the risks of tonsillitis?

A bacterial infection that is not treated with antibiotics may spread to your child's ears or sinuses. Your child may have problems breathing or swallowing. Without treatment, tonsillitis may lead to more serious illnesses, such as peritonsillar abscess or meningitis. The infection may spread to other parts of his body. Your child may get rheumatic fever, which can lead to problems with his heart or joints.

If your child has a tonsillectomy, he may have pain, nausea, or vomiting. Your child may have trouble swallowing or opening his mouth. Surgery also may cause bleeding or infection, tooth damage, earache, or voice changes. Your child may still get infections in his throat after surgery.

How can I care for my child?

Have your child rest: Your child may get better more quickly if he rests as much as possible.

Make sure your child eats and drinks: If your child's throat is sore, he may not want to eat or drink. Make sure your child drinks liquids so that he does not get dehydrated. Ask how much liquid your child needs to drink every day.

Have your child gargle with warm salt water: If your child is old enough to gargle, this may help decrease his throat pain. Mix 1 teaspoon of salt in 8 ounces of warm water.

Prevent the spread of germs: Wash your hands and your child's hands often. Do not let your child share food or drinks with anyone. Your child may return to school or daycare when he feels better and his fever is gone for at least 24 hours.

When should I seek immediate care?

Seek immediate care or call 911 if:

• Your child is unable to eat or drink because of the pain.
• Your child suddenly has trouble breathing or swallowing, or he is drooling.
• Your child has voice changes, or it is hard to understand his speech.
• Your child has increased swelling or pain in his jaw area, or he has trouble opening his mouth.
• Your child has a stiff neck.
• Your child has not urinated in 12 hours or is very weak or tired.

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