Tonsillitis in Children: Causes, Symptoms, and Diagnosis

Tonsils are lymph nodes which can be seen as small lumps at the back of the throat. Tonsils act as filters which trap germs, which could otherwise have entered the child’s airway causing infections. Tonsils also make antibodies to fight against infections. Tonsillitis is an infection of the tonsils and is quite common in children.

What are the symptoms of tonsillitis in children?
Tonsillitis is usually seen in young children between the age groups of 5 and 10 years of age. Although children less than 5 years in adolescence can also get a tonsil infection. The common symptoms of tonsillitis in children are fever, pain in the throat, sore throat and difficulty in swallowing. Children with tonsillitis appeared very ill. On examination of the throat we usually find tonsils big, red and swollen. Pus points might also be seen. In addition the lymph nodes on the neck might be enlarged as well.

What are the microorganisms causing tonsillitis in children?
Tonsillitis in children can be caused by various viruses and bacteria. Common viruses causing tonsillitis in children are Rhinovirus, Enterovirus, RSV and influenza virus. The most common bacteria causing tonsillitis is Group A beta hemolytic streptococci.

Do all children with tonsillitis require antibiotics?
Antibiotics are usually prescribed to all children having tonsillitis. Antibiotics should be given for the minimum duration of 7 to 10 days in proper doses to reduce the complications of tonsillitis. The most common antibiotics used are penicillin, a group of antibiotics like amoxicillin and cephalosporin like cephalexin or cefadroxil.

What are the complications of acute tonsillitis in children?
If tonsillitis is left untreated, it can lead to acute and long term complications. The most common acute complication of tonsillitis is a Peritonsillar Abscess. In this condition pus accumulates besides the tonsils and leads to a significant amount of swelling inside the throat. This condition is a surgical emergency and the child needs to be operated as quickly as possible.

The other complications of tonsillitis is that it can later lead to acute rheumatic fever and post streptococcal glomerulonephritis.

Large tonsils specially if associated with large adenoids can lead to obstruction in breathing of the child during sleep. This can lead to a significant amount of snoring and a condition called obstructive sleep apnea.

My child got repeated throat infections, should I go ahead with a Tonsillectomy?
Tonsillectomy is recommended in children if the number of tonsillar infections are more than 5 to 7 a year. It should be remembered that most children with repeated sore throat or throat infections actually have a viral infection and not tonsillitis.

It is important to understand that children with tonsillitis require proper care and supervised treatment under a pediatric pulmonologist. Antibiotics should not be used unless they have been prescribed.

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