Inflammation of the tonsils, two areas of tissue at the back of the throat that form part of the body’s defence system
The tonsils are two areas of lymphatic tissue at the back of the throat that form an important part of the body’s defences against infection. A condition known as tonsillitis develops if the tonsils become inflamed and painful. This usually occurs as a result of infection. Infections may be caused either by viruses, such as those that cause the common cold, or bacteria, such as streptococci.
In children under the age of 10, tonsillitis is common because the tonsils are exposed to many infections for the first time. Children who have tonsillitis may also have enlarged adenoids. Tonsils become smaller with age and therefore tonsillitis occurs far less frequently in adults (see Pharyngitis and tonsillitis).
The symptoms of tonsillitis usually develop over a period of about 24–36 hours. The symptoms of the condition may include:
Sore throat and discomfort when swallowing.
Enlarged and tender lymph nodes in the neck.
Babies and children who are too young to talk are unable to tell their parents they have a sore throat, but they may refuse to eat or drink because of the discomfort when swallowing. They may also be lethargic and irritable.
Sometimes, a painful abscess called quinsy (also known as peritonsillar abscess) forms next to a tonsil, causing difficulty in opening the mouth and swallowing. In young children, the rapid rise in temperature at the start of tonsillitis may cause a convulsion (see Febrile convulsions).
You may be able to make your child more comfortable by practising simple self-help measures at home. To bring down a fever, you can give your child liquid paracetamol or ibuprofen at the recommended dose, and you should encourage your child to drink small amounts of fluid at regular intervals, particularly if he or she has been vomiting (see Bringing down a fever). This will help to prevent dehydration, which can be serious. Cold, nonacidic drinks such as milk can help to relieve a sore throat, but older children may prefer ice cream or ice lollies. Older children may also find that sucking throat lozenges or gargling with warm salt water helps to relieve a sore throat.
You should consult the doctor if self-help measures do not bring down body temperature, if your child is taking very little fluid, or if symptoms do not improve in 24 hours.
The doctor will examine your child’s throat and may take a swab to test for bacterial infection. He or she may also look inside your child’s ears to check for an ear infection (see Otoscopy). If the doctor suspects a bacterial throat infection, a course of antibiotics will be prescribed.
Most children recover fully from tonsillitis within a few days. However, if your child is not drinking adequate amounts of fluid, he or she may become dehydrated and need to be admitted to hospital for treatment with intravenous fluids and antibiotics. If quinsy has developed, the abscess may need to be surgically drained.
Some children have frequent episodes of tonsillitis, but by the age of 10 these bouts are usually rare. If a child misses school regularly because of tonsillitis, the doctor may recommend surgical removal of the tonsils (see Tonsillectomy and adenoidectomy).
From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.