Tonsillitis In Children

What is tonsillitis?

Tonsillitis is an inflammation (swelling) or infection of the tonsils. The tonsils are tissues on both sides of the back of your child's pharynx (throat). Both the tonsils and the adenoids help your child fight infections in his airway. Your child's adenoids are above the tonsils and behind his nose. When your child's tonsils are infected, often his adenoids are also infected. Children with tonsillitis often get better within a week. Some children have recurrent (comes back more often than once a year) tonsillitis.

What causes tonsillitis?

• Viruses: Tonsillitis in children is usually caused by germs called viruses. Viruses that cause a cold or influenza (the flu) may cause viral tonsillitis in children. Tonsillitis is common in teenagers with an illness called infectious mononucleosis (mono). With mono, the symptoms of tonsillitis can last up to a few weeks.
  
  
• Bacteria: Tonsillitis also can be caused by germs called bacteria. Group A streptococci often cause bacterial tonsillitis (strep throat).

How is tonsillitis spread to other people?

Tonsillitis and sore throats 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 day care centers and between family members at home. Some germs that cause tonsillitis may be passed between adolescents who are sexually active.

What are the signs and symptoms of viral tonsillitis?

Signs and symptoms of acute viral tonsillitis come on fast and do not last long. Your child may have any of the following:

• Cough
  
  
• Hoarseness
  
  
• Runny or stuffy nose
  
  
• Sore, watery eyes
  
  
• Diarrhea (loose, watery bowel movements)
  
  
• Rash on his body or in his mouth

What are the signs and symptoms of bacterial tonsillitis?

Signs and symptoms of acute bacterial tonsillitis occur fast and do not last long. Your child may have any of the following:

• Sudden pain in his throat and pain with swallowing
  
  
• Fever and bad breath
  
  
• Red, swollen throat and snoring
  
  
• Sleep apnea (when your child's breathing stops for a short time during sleep)
  
  
• Whitish-yellow patches on the back of his throat
  
  
• Nausea (sick to his stomach), vomiting (throwing up), and stomach pain
  
  
• Painful, swollen lumps on the sides of his neck
  
  
• Rash that looks like sunburn with little bumps

Signs and symptoms of chronic bacterial tonsillitis occur slowly and last longer. Your child may have any of the following:

• Bad breath
  
  
• Long-lasting sore throat
  
  
• Red, swollen throat
  
  
• Painful, swollen lumps on the sides of his neck
  
  
• Open-mouth breathing
  
  
• Dark circles under his eyes
  
  
• Crooked teeth

How is tonsillitis diagnosed?

• History and physical exam: 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. The signs and symptoms that your child has can help caregivers learn if he has an infection.
  
  
• 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.

How is tonsillitis treated?

With treatment, your child may feel better faster. He may be able to return to school more quickly. Treating your child's tonsillitis may help prevent his spreading the infection to others. It also may decrease your child's risk of getting heart or kidney problems as a result of the infection. Your child may need any of the following:

• Medicines:
  
  
  • Ibuprofen or acetaminophen: These medicines are given to decrease your child's pain and fever. They can be bought without a doctor's order. Ask how much medicine is safe to give your child, and how often to give it.
    
    
  • Do not give aspirin to children under 18 years of age: Your child could develop Reye syndrome if he takes aspirin. Reye syndrome can cause life-threatening brain and liver damage. Check your child's medicine labels for aspirin, salicylates, or oil of wintergreen.
    
    
  • Antibiotics: Antibiotic (germ-killing) medicine may be needed if strep throat bacteria are the cause of your child's tonsillitis. Give your child this medicine as directed by his caregiver. Have your child take the antibiotics until they are gone, even if he feels better.
    
    
  • Steroids: Steroid medicine may be given to reduce swelling in your child's throat.
  
  
• Surgery: If your child has breathing changes when he sleeps, such as snoring, he may need to have his tonsils removed. This surgery is called a tonsillectomy. If he gets tonsillitis often, he also may need to have his tonsils removed. If his adenoids are swollen, they may be removed during a tonsillectomy. After a tonsillectomy, your child may not get sore throats as often.

What are the risks of tonsillitis?

• If your child takes antibiotics, he may have side effects, such as nausea or diarrhea. He also may have an allergic reaction to the medicine. Frequent antibiotic use may decrease how well the medicine can fight infection. 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.
  
  
• A bacterial infection that is not treated with antibiotics may spread to your child's ears or sinuses. Sinuses are spaces in the bones of your child's face. Your child may have problems breathing or swallowing. Without treatment, tonsillitis may lead to more serious illnesses, such as peritonsillar abscess or meningitis. Your child may get rheumatic fever, which can lead to problems with your child's heart or joints. The infection may spread to his neck veins and lungs. Ask your child's caregiver for more information about these risks.

How can I care for my child with tonsillitis at home?

• 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 very sore, he may not feel like eating or drinking. Make sure your child drinks liquids so that he does not lose too much body fluid. Ask your child's caregiver how much liquid your child needs to drink every day.
  
  
• Decrease throat pain: Your child may gargle with warm salt water to decrease his throat pain. Ask caregivers how to make a saltwater gargle for your child.
  
  
• 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 until he has finished his antibiotic medicine. Ask your child's caregiver when your child can return safely to school or day care without infecting others.

Where can I find more information about tonsillitis?

• Centers for Disease Control and Prevention (CDC)
  1600 Clifton Road
  Atlanta , GA 30333
  Phone: 1- 800 - 232-4636
  Web Address: http://www.cdc.gov/
  

When should I call my child's caregiver?

Call your child's caregiver if:

• You have questions or concerns about your child's treatment or care.
  
  
• Your child has throat pain, trouble swallowing, fever, or other symptoms that are not getting better or are getting worse.
  
  
• Your child has a bumpy, rough rash on his body; reddish cheeks; and a red, swollen tongue.
  
  
• Your child is snoring or has pauses in his breathing when he sleeps.

When should I seek immediate help?

Seek immediate care or call 911 if:

• 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 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.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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