How to Spot the Signs of Tonsillitis

Your tonsils are part of your immune system, which fights infections in your body. These two masses of lymphatic tissue are located at the back of your throat, one on each side. When they become infected, the condition is called tonsillitis.

Anyone can get tonsillitis, but it’s most commonly found in children 5-15 years old. It’s such a common infection that almost every child will get it at least once in their lives.

At Oasis Ear, Nose, and Throat, our board-certified otolaryngologists, Dr. James Osborne and Dr. Bryan Smedley, see many patients with tonsillitis in our Surprise, Arizona office. They know how distressing it can be for parents to see their kids suffering from this illness. That’s why they’ve put together this guide to get you familiar with how you can spot the signs of tonsillitis, so you’ll know when to seek medical help.

More about tonsillitis and its causes

When pathogens (e.g., viruses, bacteria, fungi) enter through your mouth, the tonsils are your immune system's first line of defense. That makes them particularly vulnerable to infection. However, their role in the immune system declines after puberty, which is why it’s relatively rare to find cases in adults.

The most common cause of infected tonsils are viruses, especially those that cause the common cold. Only around 15 to 30% of cases are caused by bacteria. The most common bacterium responsible is Streptococcus pyogenes (group A streptococcus), the same culprit behind strep throat.

You can develop tonsillitis if an infected person coughs or sneezes near you and you breathe in the aerosolized droplets. You can also get it if you touch a contaminated surface then touch your nose or mouth. Because it’s so easily transmitted, being in direct contact with a lot of people increases your infection risk. That’s why kids in daycare or even grade school often get sick.

How to spot the signs of tonsillitis

Common signs and symptoms of tonsillitis include:

• Red, swollen tonsils
• White or yellow patches on the tonsils
• Severe sore throat
• Difficult or painful swallowing
• Neck pain or stiff neck
• A scratchy or throaty voice
• Fever
• Enlarged lymph nodes in the neck
• Bad breath
• Stomachache
• Headache

If you have a newborn or infant who’s unable to describe how they feel, signs of tonsillitis include:

• Drooling because of painful swallowing
• Refusing to eat
• Unusual fussiness

If your child experiences a sore throat with fever, soreness that lasts more than 48 hours, or extreme weakness or lethargy, contact your doctor as soon as possible.

Diagnosing tonsillitis

When you bring your child into Oasis ENT with possible tonsillitis symptoms, the doctor takes several steps to diagnose the cause of the problem. First he conducts a physical exam, looking in the ears, nose, and throat for signs of infection, and at the lymph nodes.

Second, he uses a sterile swab to take a throat culture, which is checked for the presence of streptococcal bacteria.

Third, he may take a blood sample to run a complete blood count, which can show if your child has a viral or bacterial infection. The result affects treatment options.

Treating tonsillitis

If your child does have tonsillitis and it’s caused by a bacterium, the doctor usually prescribes a course of antibiotics, most often penicillin, which they need to take for 10 days. If your child’s allergic to penicillin (many people are), he can prescribe an alternative. Your child must take all the medicine; stopping early, even if they feel better, can lead to complications, including a worsening infection.

If the tonsillitis is caused by a viral infection, antibiotics won’t work. In that case, palliative care provides the best option, and your child should recover fully in 7-10 days. Here are some good at-home strategies:

• Rest as much as you can
• Stay hydrated: keeps throat moist and prevents dehydration
• Suck on warm liquids and cold treats (e.g., ice cream, fruit pops): soothes the throat
• Use a saltwater gargle 2-3 times per day
• Humidify the air: dry air irritates a sore throat
• Use lozenges for children over four
• Treat pain and fever using child-friendly medications

It used to be that tonsillectomies, surgery that removes the tonsils, was the go-to strategy for tonsillitis, and many times doctors would remove tonsils proactively to prevent infection. However, a 2018 study found adults who’d had their tonsils removed as children had increased long-term risks of respiratory and infectious diseases, probably because of the tonsils’ role in the immune system. Now the procedure is used only to treat recurring tonsillitis or bacterial infections that don’t respond to antibiotic treatment.

If you notice any of the signs of tonsillitis in your child, it’s time to call the experts at Oasis Ear, Nose, and Throat for an accurate diagnosis and appropriate treatment. Give our office a call at 623-234-4640, or book your appointment online with us today.