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Tonsillitis in Children

Medically reviewed by Last updated on Oct 3, 2022.

What is tonsillitis?

Tonsillitis is an inflammation of the tonsils. Tonsils are the lumps of tissue on both sides of the back of your child's throat. Tonsils are part of the immune system. They help fight infection. Recurrent tonsillitis is when your child has tonsillitis many times in 1 year. Chronic tonsillitis is when your child has a sore throat that lasts 3 months or longer.

Mouth Anatomy

What causes tonsillitis?

Tonsillitis may be caused by a bacterial or a viral infection. 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.

What are the 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

How is tonsillitis diagnosed?

Your child's healthcare provider will look into your child's throat and feel the sides of his or her neck and jaw. Your child's provider will ask about your child's signs and symptoms. Your child may need any of the following:

  • A throat culture may show which germ is causing your child's illness. A cotton swab is rubbed against the back of your child's throat.
  • Blood tests may show if the infection is caused by bacteria or a virus.

How is tonsillitis treated?

Treatment may decrease your child's signs and symptoms. Treatment also may lower the number of times that he or she gets tonsillitis in a year. Your child may need any of the following:

  • Acetaminophen decreases pain and fever. It is available 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.
  • NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If your child takes blood thinner medicine, always ask if NSAIDs are safe for him or her. Always read the medicine label and follow directions. Do not give these medicines to children younger than 6 months without direction from a healthcare provider.
  • Antibiotics help treat a bacterial infection.
  • A tonsillectomy is surgery to remove your child's tonsils. Your child may need surgery if he or she has chronic or recurrent tonsillitis. Surgery may also be done if antibiotics are not working.

How can I care for my child?

  • Help your child rest. Have your child slowly start to do more each day. Return to his or her daily activities as directed.
  • Encourage your child to eat and drink. Your child may not want to eat or drink if his or her throat is sore. Offer ice cream, cold liquids, or popsicles. Help your child drink enough liquid to prevent dehydration. Ask how much liquid your child needs to drink each day and which liquids are best.
  • Have your child gargle with warm salt water. If your child is old enough to gargle, this may help decrease his or her throat pain. Mix 1 teaspoon of salt in 8 ounces of warm water. Ask how often your child should do this.
  • 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 or she feels better and his or her fever is gone for at least 24 hours.

Call 911 for any of the following:

  • Your child suddenly has trouble breathing or swallowing, or he or she is drooling.

When should I seek immediate care?

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

When should I contact my child's healthcare provider?

  • Your child has a fever.
  • Your child's symptoms do not get better, or they get worse.
  • Your child has a rash on his or her body, red cheeks, and a red, swollen tongue.
  • You have questions or concerns about your child's condition or care.

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 healthcare providers to decide what care you want for your child. 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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