Tonsillitis in Children
Tonsillitis is most prevalent in children between the ages of 5 and 15. This is because children are frequently in close contact with peers at school and easily transmit viruses and bacteria that can cause tonsillitis. The tonsils also tend to be more active in childhood as they are an important part of the developing immune system. Tonsillitis can cause discomfort and interfere with eating and drinking. Parents should monitor symptoms and contact the child’s pediatrician if they persist beyond 3-4 days. With rest and supportive care, most cases in otherwise healthy children resolve without issue.
What Causes Tonsillitis?
In most cases, tonsillitis is caused by a viral or bacterial infection. Viruses are the most common cause, especially in children. The viruses that commonly cause tonsillitis include influenza, parainfluenza, rhinovirus, coronavirus, adenovirus, respiratory syncytial virus, and Epstein-Barr virus.
Bacterial tonsillitis occurs less often and is typically caused by Group A streptococcus bacteria, also known as strep throat. Other bacteria like staphylococcus, pneumococcus, and haemophilus influenza can also sometimes cause bacterial tonsillitis.
Symptoms of Tonsillitis
The most common symptoms of tonsillitis include:
- Sore throat
- Pain or difficulty swallowing
- Fever
- Headache
- Fatigue
- Swollen, red tonsils sometimes with white patches
- Swollen lymph nodes in neck
- Bad breath
- Loss of appetite
Symptoms usually start suddenly and tend to be worse in children and teenagers. Most cases of tonsillitis resolve within 3-4 days with proper rest and symptom management. However, bacterial tonsillitis may last longer without antibiotic treatment.
Complications of Tonsillitis
In most cases, tonsillitis is mild and self-limiting. However, some potential complications to watch for include:
- Dehydration from difficulty swallowing and drinking
- Chronic tonsillitis with frequent repeat infections
- Peritonsillar abscess (collection of pus near tonsils)
- Spread of infection to other parts of the body
- Breathing difficulty (rare)
Contact your doctor promptly if experiencing signs of dehydration, intense throat pain, stiff neck, changes in voice, or difficulty breathing. Timely treatment can prevent more serious complications.
Who is at Risk for Tonsillitis?
Tonsillitis is most common in school-aged children between 5-15 years old. This is due to increased exposure to viruses and bacteria in school environments. Adults can also develop tonsillitis but it becomes less frequent with age as the tonsils shrink. Those with weakened immune systems are at higher risk for tonsillitis as well.
Diagnosing Tonsillitis
If symptoms of tonsillitis last longer than 3-4 days, it’s recommended to see a general practitioner (GP). The GP will ask about symptoms and do an examination of the throat. They may use a tongue depressor to visually inspect the tonsils for swelling, redness, and white patches.
The GP may also take a throat swab and send it for laboratory testing. This can identify whether the cause is viral or bacterial. A blood test can also sometimes be done to check for glandular fever (infectious mononucleosis).
Imaging scans are not normally needed but may be done if there are concerns about peritonsillar abscess or complications.
Home Remedies for Tonsillitis
In addition to prescription medication, some home remedies can provide symptom relief:
- Drink warm liquids like herbal tea, broth, and warm water
- Eat cold, soft foods like ice cream, smoothies, and chilled soups
- Gargle with warm salt water
- Use throat lozenges or hard candies
- Use a humidifier or steamy shower to moisten airways
- Rest your voice and avoid talking/whispering
- Get ample rest and sleep
These methods can help reduce throat pain and discomfort associated with tonsillitis. They are most helpful for mild viral cases alongside OTC medication.
When to See a Doctor
You should contact your general practitioner if:
- Tonsillitis symptoms last longer than 4 days
- Symptoms are severe or get worse
- You have signs of dehydration or difficulty swallowing
- You have a high fever above 38°C
- Tonsils are swollen with white/yellow spots
- Neck glands are tender and swollen
- You have repeated bouts of tonsillitis
Seeking prompt medical care can help identify if antibiotics are needed for bacterial tonsillitis. It also allows for assessment of potential complications. Self-care is appropriate for mild cases, but do not hesitate to see a doctor if symptoms concern you.
Treatment Options
Rest and Symptom Relief
In mild viral cases, the main treatment is rest along with over-the-counter pain relievers like paracetamol or ibuprofen. This can help relieve sore throat, fever, and headache. Staying hydrated and gargling warm salt water can also help soothe throat pain.
Antibiotics
For bacterial tonsillitis, antibiotics may be prescribed. Penicillins like amoxicillin are most commonly used. A 10-day course is typical but make sure to finish the entire course even if feeling better sooner.
Surgery
For chronic, recurrent tonsillitis, surgery to remove the tonsils (tonsillectomy) may be recommended. This is usually only done when tonsillitis occurs frequently and severely impacts normal functioning.
Tonsillectomy Recovery
Tonsillectomy is done under general anaesthesia as an outpatient procedure or with an overnight hospital stay. Recovery involves resting at home for 1-2 weeks. Pain and discomfort are common during recovery so medication, soft foods, and proper hydration are important. Most people can return to normal activity in 2 weeks.
Preventing Tonsillitis
While tonsillitis cannot be completely prevented, good hygiene helps reduce the spread of infections that cause it. Thorough hand washing, covering coughs/sneezes, avoiding shared utensils, and disinfecting surfaces can help stop transmission. Getting adequate rest, eating healthy, and managing stress can also strengthen the immune system to fight infection.
In summary, tonsillitis is a common throat infection treatable with self-care and sometimes antibiotics. Severe, chronic cases may require tonsil removal but this is rare. See a doctor if symptoms persist longer than 3-4 days or severely impact normal functioning. With proper treatment and precautions, most cases of tonsillitis resolve without complications.
Photo “Tonsillitis” by Anthony Cunningham for Zoom Health
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