Tonsillitis in children

Children with tonsillitis usually have a fever and a sore throat. Some children may complain of earache – this is because the sensory nerve that supplies the back of the throat also supplies the ear; so even though there is no infection in the ear, the ear may be sore. This is called referred pain. Other symptoms include painful swallowing, enlarged painful neck glands, voice change (a child may speak like he/she has a hot potato in his/her mouth), nausea, vomiting, fatigue, body aches and snoring.

By Dr Eve Samson

Healthy tonsils Inflammation of the tonsils

What you may see

swollen uvula

Children with tonsillitis look unwell, flushed, dehydrated, and may indicate that their throat is sore, and they are struggling to swallow. You may be able to feel the swollen glands in the neck and smell bad breath. The tonsils will look enlarged and may be red or may have a grey slough on them. If the child is drooling or is unable to swallow (or experiences very painful swallowing) and can only open their mouth a little bit, the infection may have progressed to an abscess that will need to be drained by an Ear Nose & Throat surgeon in hospital. Most tonsillitis is either bacterial or viral, although there are other causes for the tonsils to swell and become painful. Your doctor may do a throat swab to check for bacteria, such as Streptococcus, which could be causing the infection. Your doctor may also do a blood test to look for a viral cause, such as mononucleosis.

throat rednes gray furry tongue whitish spots

red swollen tonsils

Why did this happen?

How to prevent it

Regular hand sanitisation, good dental hygiene, and avoiding contact with other sick children who may be contagious can help to prevent contracting infections. Parents and relatives who smoke should consider quitting. Even though you may smoke outside, change your clothing, and use breath mints or only smoke on weekends, you are still a smoker and are putting your child at increased risk of more frequent upper respiratory tract infections, tonsillitis, and asthma.

What to do

Keep your child well hydrated by giving them plenty of water and oral rehydration solution to drink. Eating soothing ice lollies, ice-cream and jelly may also help.

Manage your child’s fever and pain by keeping him or her cool and giving them acetaminophen, ibuprofen or mefenamic acid. (Panado, or Nurofen, or Ponstan). Stronger pain killers may be necessary if the child has an abscess, and these will be prescribed by your doctor.

Gargling salt water (in older children) helps to decrease bacterial load in the mouth.

Make an appointment to see your child’s doctor for an early assessment before the infection develops into a complication.

When to visit casualty

• Your child is dehydrated. • Your child is drooling and cannot swallow, and you suspect an abscess. • Your child is making a snoring sound when breathing (called stertor).  Dr Eve Samson is an ENT at Vincent Pallotti hospital in Pinelands, Cape Town. She studied medicine and ENT at the University of Cape Town and is passionate about children’s health and wellness.

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