Ear, Nose & Throat

A Parents’ Guide to Tonsillitis in Children

written by Becki Andrus

When your child is complaining about a sore throat, it could be caused by a variety of health concerns: a head cold, strep throat, tonsillitis, and more.

Looking at the throat can provide additional clues to identify the underlying cause of a sore throat. For example, white spots might be an indication of strep throat, while swollen tonsils could be a sign of tonsillitis.

Why are the Tonsils Swollen?

Tonsils are located behind the nose in the back of the throat. They work to trap infection-causing germs and bacteria.

The tonsils work as part of the immune system, producing antibodies that help with fighting infections. If the child has either a bacterial or viral infection, then the immune system is actively working to combat the pathogens.

Part of this immune response causes the tonsils to become swollen and inflamed. The medical term when this swelling and inflammation occurs is called tonsillitis.

Other possible causes of tonsillitis include allergies, air pollution, being around cigarette smoke, postnasal drip, or fungal infection.

Symptoms and Signs of Tonsillitis

While a sore throat is often the first symptom of tonsillitis, there are other coinciding symptoms that parents should watch for when their child is sick. Here are a few signs that might indicate your child’s sore throat is something more:

  • Swallowing causes pain
  • Red coloring inside the throat
  • Fever
  • Visible pustules or blisters on the tonsils
  • Tonsils look swollen
  • Lymph nodes in the neck are tender or swollen
  • Earache
  • Runny nose or sinus congestion
  • Lethargy or fatigue

Watch for other potential symptoms in young infants, such as drooling, unusual fussiness, or refusal to eat.

If you notice any of these symptoms, the next step is to talk to an ear, nose, and throat doctor. Our medical team can complete a thorough examination to determine the underlying diagnosis causing the symptoms.

3 Types of Pediatric Tonsillitis

If a doctor diagnoses your child with tonsilitis, the medical history and symptoms will categorize their condition in one of three ways:

  • Acute Tonsillitis: A sudden onset of tonsillitis, such as swollen tonsils when the child is sick with the common cold. Usually, an acute infection will clear up in 7 – 10 days.
  • Recurrent Tonsillitis: Multiple instances of tonsil infections happening throughout the year. The swelling reduces between tonsillitis episodes.
  • Chronic Tonsillitis: Ongoing swelling and inflammation in the tonsils. Even after treatment for an infection, the tonsils are still swollen.

Potential Complications from Tonsillitis

Most of the time, tonsillitis is a minor health concern that will clear up within a week or so. But moderate or severe cases can lead to potential complications, such as:

  • Breathing problems because the swollen tonsils block the airway
  • A serious infection that can spread to other parts of the throat and body
  • Dehydration or malnutrition because the child is having a hard time eating
  • Coinciding health issues, such as a sinus or ear infection

If tonsillitis is caused by strep throat, it’s essential to seek treatment immediately. Untreated strep throat can lead to serious health issues, such as kidney or heart problems.

Treatment Options for Tonsillitis

The best way to determine a treatment plan is by first identifying the diagnosis. So, we begin with an exam to take a look at the throat. Sometimes, other diagnostics are needed, such as a throat culture to see if a bacterial infection is present.

When bacteria cause tonsillitis, it’s common to use antibiotics to clear the infection. Usually, the symptoms will subside within 3 days of antibiotics, but it’s important to continue with the treatment after symptoms improve.

Viral infections cause most cases of tonsillitis. If a virus causes tonsillitis, then antibiotics are not effective. Instead, you should use remedies to alleviate the pain while the child heals from the viral infection.

Common at-home suggestions for tonsillitis treatment include:

  • Over-the-counter pain relief medication, such as acetaminophen or ibuprofen
  • Sucking on throat lozenges
  • Saltwater gargling
  • Drinking plenty of water, broth, and juice
  • Sucking on popsicles or smoothies

For minor cases of tonsillitis, these at-home remedies are sufficient without a visit to the doctor.

Signs You Need to Talk to a Doctor

When a child is sick, it’s always a good idea to schedule a doctor’s appointment to identify the cause of their symptoms. Sometimes, minor symptoms will clear up without medical treatment.

But monitor your child for other symptoms that might indicate the need to talk to a doctor:

  • Snoring while sleeping
  • Breathing problems at night
  • Difficulty eating
  • Sore throat that doesn’t go away after a few days
  • Swelling on the outside of the neck
  • Stiff neck

When the tonsils are significantly enlarged, they can interfere with breathing and eating. If breathing problems are a concern, you might need to call 911 or visit an emergency room without delay.

Is a Tonsillectomy Necessary?

An occasional occurrence of tonsillitis isn’t usually a cause for concern. These symptoms often occur when a child has a common cold or flu.

But if there is a history of repeat infections, you might want to talk to an ENT about possible treatment options. The biggest concern is breathing problems while the child is sleeping, known as obstructive sleep apnea.

When swollen tonsils are blocking the airway, then a tonsillectomy can be a solution to open the airway. Often, a tonsillectomy is paired with an adenoidectomy – the removal of both the tonsils and adenoids at the same time.

This outpatient procedure is quite standard but isn’t necessary for every child. An ENT specialist can review the child’s medical history to determine if surgery is essential.

Tips for Preventing Tonsillitis

If your child has recurring tonsillitis, then you can be proactive about preventing future infections.

Since bacterial or viral infections usually cause tonsillitis, then the key to prevention is to focus on general health habits. Here are a few recommendations:

  • Teach your child to wash their hands regularly to prevent the spread of disease
  • Minimize contact with other people who are sick with upper respiratory infections
  • Keep the child away from secondhand smoke
  • Be proactive about a healthy diet to support immune functions

Talk to an ENT Doctor

Primary care physicians can be helpful when your child is sick, but there are times when it’s best to talk to a specialist. If your child is suffering from tonsillitis, then our medical team is just a phone call away.

We offer ENT services in the Collin County and Dallas areas. Collin County Ear, Nose, and Throat is a preferred provider because of our outstanding reputation in the community. Call us to schedule an examination in Frisco or Plano, TX. We have an online form you can use to request an appointment or call: (972) 596-4005.

Our clients' stories

We find our patients’ experiences the most rewarding part of the job. Without them, we wouldn’t be one of the longest standing ENT practices in the area!

“We consulted Dr Tseng based on our pediatrician's recommendation. He's so great a doctor who took time to explain us everything and genuinely guided us in the right direction. He's such a caring, genuine and knowledgeable doctor. Oh how I wish there were more like him! ”

Hetal U. user icon

“I have used Collin Co. ENT and Dr. Kenny Carter for over 3 years, primarily for ear problems. The staff has been consistently helpful and friendly to me. When I have had problems needing immediate attention and explained the need, have been able to get an appointment within a reasonable time to address the problem. I recommend Dr. Carter and his staff.”

Stan B. user icon

“Dr. Matheny performed 2 surgeries on my wife, both were successful with great results. He is not only a great surgeon, but a great person. It was a pleasure working with him. One of the best doctors we have ever seen in our lives.”

Mehrdad M. user icon
Make an appointment