Help! My Child Has Tonsillitis!

Your tonsils are two masses of lymphatic tissue, found one on each side of the back of your throat. They’re part of your immune system, helping to prevent infections in your body. When the tonsils themselves become infected, the condition is called tonsillitis.

Tonsillitis can happen at any age, but it’s most common in children from 5-15 years old. It’s so common in children that almost every child will get the infection at least once in their lifetime.

At Oasis Ear, Nose, and Throat in Surprise, Arizona, our board-certified otolaryngologists and facial plastic surgeons, Dr. James Osborne and Dr. Bryan Smedley, see many patients with tonsillitis, and they know how concerning it can be for parents to see their children sidelined with this illness. That’s why they’ve put together this guide to get you familiar with the facts about tonsillitis and how we can successfully treat it.

Tonsillitis 101

The tonsils are your immune system's first line of defense against pathogens that enter your body through your mouth, which makes them particularly vulnerable themselves to infection. However, their immune system function declines after puberty, leading to the relatively rare cases of tonsillitis in adults.

Viruses are the most common cause of the infection, especially the viruses that cause the common cold. Around 15 to 30% of tonsillitis cases are caused by bacteria. The most common bacterium responsible is Streptococcus pyogenes (group A streptococcus), which also causes strep throat.

You can develop tonsillitis if someone who’s infected coughs or sneezes near you, and you breathe in the aerosolized droplets, or if you touch a contaminated surface, and then touch your nose or mouth. In addition, being in direct contact with a lot of people increases your risk of infection. That’s why kids in daycare or school often get sick.

Tonsillitis symptoms

Tonsillitis causes a wide range of symptoms, including:

Very sore throat
Difficulty or pain when swallowing
A scratchy voice
Fever and chills
Earache
Stomachache
Headache
Stiff neck
Bad breath
Swollen lymph nodes on jaw and neck
Red, swollen tonsils
Tonsils with white or yellow spots

Very young children may also experience increased irritability, poor appetite, and/or excessive drooling.

Contact your doctor if your child experiences:

A sore throat with a fever
A sore throat that lingers for more than 24-48 hours
Painful or difficult swallowing
Extreme weakness, fussiness, or fatigue

Diagnosing tonsillitis

Your child's doctor will take several steps to diagnose the cause of the infection. The physical exam includes:

Using a light to look at your child's throat, ears, and nose, all of which may be sites of infection
Checking for a scarlatina rash, associated with some cases of strep throat
Gently palpating the neck to check for swollen lymph nodes
Using a stethoscope to listen to their breathing
Checking for enlargement of the spleen to rule out mononucleosis

The doctor will also take a throat culture using a sterile swab. The sample will be checked for presence of streptococcal bacteria.

In addition, he may take a sample of your child’s blood for a complete blood count, which can show if the infection is viral or bacterial. This may affect treatment options.

Treating tonsillitis

If your child’s tonsillitis is caused by a bacterial infection, the doctor will probably prescribe a course of antibiotics, usually penicillin, which needs to be taken for 10 days. He can prescribe an alternative if your child is allergic to penicillin. They must take all of the medicine, as stopping early can lead to complications, including a worsening infection.

If the tonsillitis is viral in origin, antibiotics won’t work; palliative care provides the best option, and your child should recover in 7-10 days. Here are some good at-home strategies:

Rest as much as possible
Stay hydrated to keep the throat moist and prevent dehydration
Provide warm liquids and cold treats (ice cream, fruit pops) to soothe the throat
Use a saltwater gargle
Humidify the air; dry air can further irritate a sore throat
Use lozenges for children over four
Treat pain and fever; ask your doctor about child-friendly medications

Tonsillectomies, surgery that removes the tonsils, was once the go-to strategy for tonsillitis, but a 2018 study found that adults who’d had their tonsils removed as children had long-term increased risks of respiratory and infectious diseases. Now the procedure is used only to treat frequently recurring tonsillitis or bacterial tonsillitis that doesn't respond to antibiotic treatment.

If your child is struggling with a sore throat and swollen glands, it could be tonsillitis, and you need to get medical help. The doctors at Oasis ENT can diagnose the problem and get your child the treatment they need. Give the office a call at 623-234-4640, or contact us online as soon as possible.