Tonsillitis in Children

Tonsillitis is the infection of tonsils. Tonsils are pads of lymph tissue in the upper part of throat. Tonsillitis is caused by bacteria and viruses. It produces throat pain, difficulty in swallowing, fever, weakness and cough. The treatment consists of appropriate antibiotics (in the case of bacterial tonsillitis), pain killers and supportive measures. Because tonsillitis can lead to severe complications one should get diagnosed promptly. Lastly, tonsillectomy surgery is done in those who suffer from recurrent tonsillitis or show complications.

Tonsillitis is very common in school going children. Frequent episodes cause absence from school, thereby affecting performance. Enlargement of tonsils and adenoids causes snoring in children affecting their growth and development.

Video on Tonsil/Adenoid problems and their consequences in children.

what are tonsils? what do they do?

Tonsils are part of lymph tissue in the body. Lymph is a type of body fluid which circulates in the body and is important for immunity. Tonsils are lymph nodes inside the throat. They defend and protect against infections. They have protective function till 12 to 13 years of age after which they reduce in size. However, tonsils themselves may get infected and produce tonsillitis.

Having tonsils inside the throat is absolutely normal. But, enlarged or infected tonsils cause a lot of problems. We shall discuss these problems below. Lastly, we shall list some home remedies that you can follow during an attack.


Infection of the tonsils produces a variety of symptoms. The most common ones are

  1. Throat pain or sore throat
  2. Pain while swallowing
  3. Cough
  4. Difficulty in breathing
  5. Earache
  6. Bad breath
  7. Voice change
  8. Headache
  9. Difficulty while swallowing

Kids show irritability and refuse feeds. In addition to that, they look dull and feverish during tonsillitis. Normally, the above symptoms last for a few days and subside. But in some cases, they lead to complications, as we shall see below.

Tonsillitis and fever
Mum keeping her hand over son’s forehead


Acute, chronic and recurrent tonsillitis are the three types. Each is managed in a different fashion. Acute tonsillitis refers to an acute episode of tonsil infection that lasts for a few days or a week. It subsides after that. Whereas, chronic tonsillitis lasts really long. In addition to sore throat, it will produce neck swellings and bad breath. Recurrent tonsillitis refers to one of the following conditions-

  1. 7 or more episodes in a single year
  2. 5 or more episodes in 2 consecutive years
  3. 3 or more episodes in 3 consecutive years

Your ENT specialist may advice surgery to remove tonsils when it is recurrent or chronic. Acute tonsillitis is controlled by medicines. But, an antibiotic may be added if the infection is bacterial.

what causes this infection? is tonsillitis contagious?

Tonsil infection is caused by bacteria or viruses. Bacterial infections present more severely. They need antibiotics for cure. However, viral infections don’t need any antibiotic unless there is super added bacterial infection. The common bacteria involved are Steptococci and Corynebacterium. Epstein Barr virus, HIV, Hepatitis virus and rhinoviruses are the viral causes.

The viruses and bacteria which cause the infection can spread from one individual to another. Hence the infection is contagious. The spread is through body fluids, phlegm, saliva, sneezes and coughs. School going children are in contact with many persons. So, they develop tonsillitis frequently. Once you start an antibiotic course, you stop being infective in a few days.

can tonsillitis cause complications?

If left untreated tonsillitis can complicate. The infection may spread from the throat to ears, nose, neck and chest. Firstly, a spread to the ear will mean earache, and in worst cases, ear discharge. Secondly, nasal spread causes nasal discharge, blockage, sneezing and headache. Thirdly, the infection may pass through the tonsils further deep inside causing an abscess (pus collection). In this condition pain is so bad that one cannot swallow his own saliva. Lastly, a spread downwards into the chest produces cough and breathing difficulty.

When should i get a consult?

If your child suffers from any of the below, then you should get a consult.

  1. Child doesn’t eat or drink (EMERGENCY)
  2. Child is weak and feverish
  3. Sore throat lasting for more than 2 days
  4. Difficulty in breathing (EMERGENCY)
  5. Drooling of saliva (EMERGENCY)
  6. Neck stiffness
  7. Cough and sputum
  8. Ear discharge
  9. High fever

In the above cases, supportive treatment alone may not suffice. You need professional help to avoid complications. Moreover, a few of these symptoms may indicate an impending complication. Do you need more support? Talk to one of our experts immediately.


ENT Specialists treat the bulk of children suffering from throat pain. However, general practitioners and pediatricians also treat tonsillitis. Frequently, the latter ask for a cross consult with ENT specialists to rule out complications and to seek expert opinion. Above all, cases of chronic and recurrent tonsillitis get referred to ENT specialists for surgical or permanent solution.

When you bring your child to us, we check the throat and the tonsils. The glands may show redness or pus points. The neck glands may be swollen and painful. The child may also run a temperature. ENT specialists check the ears and insides of the nose. Frequently, we ask for blood tests and neck x-ray. Blood tests help us differentiate between a viral and bacterial infection. The neck x-ray, however, helps rule out adenoid enlargement at the back of nose. We auscultate the chest to see if the breathing is normal. Last, we may take a swab from the throat to see if there is Strep infection.


Even if tonsils are not infected, their enlargement makes breathing difficult in the night. Because tonsils and adenoids belong to lymphoid tissue, children with big tonsils often have adenoid enlargement in the back of nose. This produces severe snoring. Snoring in kids is not normal because it reduces oxygen supply to brain. Consequently, it affects mental and physical development of the child. Such kids suffer from mouth breathing, protruding teeth, irritability, stunted growth, and a dull looking elongated face. The face is referred to as Adenoid facies. We shall discuss about snoring in kids in a different post.

what is strep throat?

Strep throat is an infection caused by Streptococci bacteria. Prompt use of an appropriate antibiotic is needed. Above all, inadequate or incomplete treatment of a Strep infection can lead to serious problems like Rheumatic fever and Glomerulonephritis. Rheumatic fever is the infection of heart valves and joints. Glomerulonephritis is an infection of kidneys which results in reduced filtration of blood. Are you worried if your sore throat is a Streptococcal infection? Call us at World ENT Care and let us guide you.

treatment of tonisllitis

For viral tonsillitis, supportive treatment is enough. Firstly, take adequate rest. Keep yourself warm and hydrated. Avoid citrus fruits and drink plenty of warm fluids like soup. Nextly, take medicines for fever or sore throat. Additionally if you suffer from nose block or cough ask your doctor for appropriate medicines. Your symptoms will resolve in a few days time. If not revert back to your doctor. We start antibiotics when we suspect a bacterial infection. Recurrent and chronic tonsillitis need a more permanent solution.

what is TONSILLECTOMY? is it harmful?

Tonsillectomy is a permanent solution to recurrent tonsillitis or enlarged tonsils. We have clear criteria on who needs the surgery. Certainly, it is a very safe surgery. In our set up we offer it as a day care procedure. We use coblation, laser and radiofrequency methods for tonsillectomy. We discuss the relative benefits of each technique with the parents and decide which to use. Tonsillectomy is a scientific solution to recurrent and chronic tonsillitis, which if left untreated leads to complications. But the procedure has very clear indications. Talk to one of our experts if your doctor has advised tonsillectomy and you need a second opinion.

will tonsil removal cause any side effects?

Tonsils cease to function beneficially after a certain age. So, their removal does not cause any adverse effect. The defense mechanism of the upper airway remains intact even without the tonsils. But talk to your doctor if the removal of tonsils is really indicated in your kid.

are there home remedies for tonsillitis?

There are quite a few methods to keep your kid comfortable during an attack of tonsillitis. I have listed a few below.

  1. Take adequate rest
  2. Humidify the room
  3. Drink plenty of fluids preferably warm
  4. Mix a pinch of salt in half glass warm water and gargle few times daily
  5. Avoid exposure to dust, smoke and pollution
  6. Take medicines for pain and fever
  7. Use throat lozenges

Although tonsillitis is a very common problem in children, get professional help so that you treat it completely and adequately. Incomplete treatment can cause complications.

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