Tonsillitis

Common symptoms of tonsillitis include:

• Red, swollen tonsils.
• White or yellow coating or patches on the tonsils.
• Sore throat.
• Trouble swallowing or painful swallowing.
• Fever.
• Enlarged, tender glands called lymph nodes in the neck.
• A scratchy, muffled or throaty voice.
• Bad breath.
• Stomachache.
• Neck pain or stiff neck.
• Headache.

In young children who can't tell how they feel, symptoms of tonsillitis may include:

• Drooling due to trouble swallowing or painful swallowing.
• Not eating.
• Being fussier than usual.

It's important to get a diagnosis if your child has symptoms that may mean tonsillitis.

Call your healthcare professional if your child has:

• A sore throat with fever.
• A sore throat that doesn't go away within 24 to 48 hours.
• Painful swallowing or trouble swallowing.
• Extreme weakness, tiredness or fussiness.

Get care right away if your child has any of these symptoms:

• Trouble breathing.
• Extreme trouble swallowing.
• A lot of drooling.

Common viruses most often cause tonsillitis. But bacterial infections also can be the cause.

The most common bacterium causing tonsillitis is Streptococcus pyogenes, also called group A streptococcus. This bacterium causes strep throat. Other strains of strep and other bacteria also may cause tonsillitis.

Why do tonsils get infected?

The tonsils are the immune system's first line of defense against germs and viruses that enter the mouth. This work puts the tonsils at high risk of infection. But the tonsil's immune system work slows after puberty. This might explain why adults rarely have tonsilitis.

Risk factors for tonsillitis include:

• Young age. Tonsillitis most often affects children. Tonsillitis caused by bacteria is most common in children ages 5 to 15.
• Being around germs. School-age children are in close contact with other children. So they often have contact with viruses or bacteria that can cause tonsillitis.

Irritation or swelling, called inflammation, of the tonsils from getting tonsillitis often can cause complications. Complications of chronic tonsillitis include:

• Disturbed breathing during sleep, called obstructive sleep apnea.
• Infection that spreads deep into nearby tissue, called tonsillar cellulitis.
• Infection that causes a buildup of pus behind a tonsil, called peritonsillar abscess.

Strep infection

Tonsillitis caused by group A streptococcus or another strain of streptococcal bacteria must be treated with antibiotics. If it isn't treated or if treatment isn't finished, your child has a higher risk of rare disorders such as:

• A serious condition that can affect the heart, joints, nervous system and skin, called rheumatic fever.
• Complications of scarlet fever, a streptococcal infection that has a rash as a main symptom.
• Swelling and irritation, called inflammation, of the kidney. This is called poststreptococcal glomerulonephritis.
• Swelling and irritation, called inflammation, of the joints. This is called poststreptococcal reactive arthritis.

Other people can catch the germs that cause viral and bacterial tonsillitis. So the best way to prevent tonsillitis is to teach children to:

• Wash hands often and well. This is very important after using the toilet and before eating.
• Not share food, drinking glasses, water bottles or utensils.
• Use a new toothbrush after being diagnosed with tonsillitis.

To help children not spread infection to others:

• Keep children at home when they're ill.
• Ask a healthcare professional when it's OK for a child to go back to school.
• Teach children to cough or sneeze into a tissue or into their elbows.
• Teach children to wash their hands after sneezing or coughing.