Tonsillitis in Children- Causes, Symptoms & Treatment

Tonsillitis in Children

Medically Reviewed By
Dr. Arti Sharma (Paediatrician)
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When learning the parts of the body, most of us remember having heard about tonsils. But very few people know what function the tonsils serve. The only time they do arise in a conversation is when they get infected, causing tonsillitis. At times, tonsillitis in children under five years of age may make us wonder how that came to be. So if your child has tonsillitis, does it also mean he has to undergo surgery? Read everything you need to know about tonsillitis in this article before you consult a paediatrician.

What Is Tonsillitis?

When the tonsils in the back of the mouth swell and get inflamed, such a condition is termed as tonsillitis. Tonsils usually sit at the back of the throat, hanging down, and doing their best to filter out any germs that might find their way into the body.

There are two types of tonsillitis –

  1. Chronic Tonsillitis: In such a case, the condition of tonsil swelling continues to stay unabated for up to a period of 12 weeks or even more.
  2. Recurrent Tonsillitis: When tonsillitis stays for a shorter time, but keeps occurring multiple times within a single year, the condition could be termed as recurrent tonsillitis.

Causes of Tonsillitis in Kids

Here are some causes of tonsillitis in kids:

  • Most tonsillitis is caused by common bacteria that inadvertently end up infecting the throat and the tonsils. The primary ones in this category are the Group A streptococcus bacteria. These have the tendency to cause strep throat as well, which is why many people end up spreading the bacteria to others before they can even realise that they have an infection. In extreme cases, Group A streptococcus bacteria have been known to be responsible for causing rheumatic fever.
  • At times, viruses do end up inside the body and in the process result in tonsillitis. These are generally the ones that are also known to cause influenza or even the common cold. When they end up infecting the tonsils, the symptoms or effects might be slightly less than that of a bacterial infection. However, it is extremely rare to be able to tell apart the actual microbe that has caused tonsillitis.

In severe cases, certain viruses such as the Epstein-Barr virus is known to cause glandular fever or mononucleosis in children, which is also accompanied by marked signs of tonsil infection in the child.

Signs and Symptoms of Tonsillitis in a Child

Signs and Symptoms of Tonsillitis in a Child

A bacteria or virus can infect the tonsils and tonsillitis can set in causing issues in the throat and swelling all around. Common symptoms for that are:

  • Immense difficulty and pain while swallowing food
  • Your child refusing to eat since swallowing is painful
  • Constant pulling of the ear since the throat and ear are connected
  • A sore throat that shows no signs of reducing or going away
  • Pain in the neck or the jaw
  • Extremely bad breath that is uncomfortable
  • Breathing through the mouth when sleeping or even occasional snoring
  • Fever of high temperature and trembling sensations
  • Enlargement of the glands present in the neck
  • Having trouble while speaking and losing voice
  • An intense headache
  • Constant drooling at the mouth

How Is Tonsillitis Diagnosed?

The quickest way a doctor can diagnose tonsillitis is by taking a look inside the mouth of the child and observing the appearance of the outer layer of the tonsils. Redness with visible inflammation and pus blobs or a white layer over the tonsils are strong signs of tonsillitis.

This will be followed by the doctor checking for swelling present in the surrounding areas. He might check the area below the jaw and around the neck, trying to ascertain if the lymph nodes have swollen, too. Since the pus and lymph nodes are a part of the combative measure taken by the body’s immunity system, their presence or swelling indicates the presence of an infection.

Based on these observations, your doctor will opt for taking a throat swab and look for bacteria in it. The primary aim is to check if strep bacteria are present that cause strep throat to happen.

For reddened, inflamed tonsils, or tonsils with white patches or pus, the doctor will go ahead and prescribe a dosage of antibiotics. Most doctors get that done anyway if they suspect strep to be present. A complete uninterrupted course of antibiotics that stretches beyond a week is absolutely necessary to completely remove the infected bacteria. Improvement might be visible in the initial days itself, but that does not mean that the bacteria have been eliminated. In case antibiotics bring no relief, then the infection is termed to be viral.

Throughout this period, it is important for your child to get as much rest as possible and stay at home for his own benefit and to avoid spreading the infection to others.

Tonsillitis Treatment for Kids

There are several approaches to treat tonsillitis in kids. Some of them include,

1. Antibiotics

Antibiotics for tonsillitis in a child is recommended only when the doctor is absolutely sure that the reason behind the infection is bacterial. Many times, temporary medication might be administered until any lab reports or test results are acquired that can help confirm a bacterial diagnosis. If there are strong signs of a high fever, there are pus type entities on the tonsil, an absence of cough, and the lymph nodes have swollen and become sensitive, a primary dosage of antibiotics might be prescribed right away.

2. Acetaminophen

Taking enough rest and drinking lots of fluids is the way to go when recovering from tonsillitis. Supplementary medication that accompanies it is usually ibuprofen or acetaminophen. They help in controlling the fever and bring relief to your child.
Also, ensure that your child does not consume ASA or acetylsalicylic acid when the infection is viral. It has been noted that consumption of ASA could result in the child developing the Reye’s syndrome, which was known to cause damage to multiple internal organs, including the liver and even the brain.

3. Tonsillectomy 

Antibiotics and ibuprofen work together in combating the infection of tonsillitis and keeping the fever down. But if tonsillitis keeps occurring repeatedly, doctors might suggest getting a family checkup done to look for signs of Group A streptococcus carriers. If so, then antibiotics might be administered to those family members as well. This will ensure that your child doesn’t fall prey to yet another tonsillitis attack.

At times, even after all precautions, a child may keep getting tonsillitis rather frequently. Or a particular tonsillitis infection might be quite severe, causing an intensive quinsy condition to form on it. In these scenarios, and when medication fails to treat the condition, doctors might recommend removing the tonsils, termed as tonsillectomy.

How Long Does It Take to Recover After Tonsillectomy?

Both processes take place under general anaesthesia. Tonsillectomy recovery time is usually very low, and most people return back home the same day itself.

How Can You Care for Your Child After Surgery?

In tonsillectomy, a throat undergoes quite a substantial surgery. This usually results in pain in the throat, as well as the ears, since the entire system is interconnected. Your child might be cranky, crying constantly, and in pain.

Doctors will definitely prescribe painkillers in the right dosage to reduce the pain. Even if slight fever might onset post the surgery, most doctors avoid giving ibuprofen since there is a good chance that the area of surgery might start bleeding. Aspirin, as always, is a strict no-no.

Since your child will have difficulty swallowing and the area will be sensitive, resort to feeding him with some warm broth that can soothe the area and is easy to swallow as well. At the same time, ice cream is a great choice, too, that will keep the area cold and make your child happy. Soft foods or apple juice are good choices to give your child after the surgery. Keep chips away, though, since their sharp texture could harm the surgery area. Similarly, raw food items or carbonated drinks should be avoided.

Throughout the recovery, let your child stay at home for at least a week, and avoid any kind of intensive physical games for a couple more weeks. Even if he starts feeling better in a few days, the entire medication cycle and rest is necessary to recover fully and prevent imminent infection again.

Risks and Complications of Tonsillitis in Children

A little bleeding, once the surgery is done, is normal. However, if bleeding continues and in substantial amounts, you should contact your doctor immediately. At times, vomiting might also occur. But if it continues with a high frequency, that is a risk to be mitigated soon.

If this is further followed by intensive dehydration, a high fever crossing 102 degrees for many days, severe pain in the ear and breathing difficulties, rush your child to the emergency room as soon as possible.

Home Remedies for Tonsillitis

The natural remedies mentioned below can be tried out to reduce the infection or get some relief from the pain before opting for a doctor’s visit or choosing to carry out tonsillectomy.

1. Using Turmeric With Some Milk

This remedy is the ultimate recipe of every household to counter any illness. In the case of tonsillitis, this is even more effective. Boil a cup of milk, add 1 to 2 pinch of turmeric powder to it when it is still hot. Then, add a pinch of pepper powder and give it a good mix. Let your child sip on it before going to bed. This remedy is quite potent in healing the inflamed tissues and can provide some relief pain, too.

2. Using the Flowers of Banapsha Tree

The flowers of banapsha, or neelpushpa, as they are also called can provide relief from the tonsillitis pain. Add a few flowers to some milk and boil it. This remedy is a natural way to bring relief from the pain.

3. Using the Juice of Carrots

Apart from the health and nutritive benefits that carrots provide, the juice of carrots also contains anti-toxin elements that help fight the infection causing tonsillitis in the first place. Also, it contains carminative properties, and therefore, relieves constipation.

4. Using Alum With Water

This is yet another age-old remedy that has been passed down from earlier generations, and with good reason. Take a block of alum and powder it down. Mixing it with some warm water, and using the same for gargling, has shown good results in bringing down the inflammation of the tonsils and reducing the pain from the infection as well.

How to Prevent Your Child from Getting Tonsillitis?

Make sure the usual hygiene steps are followed where the child washes hands regularly before eating anything. A balanced diet in keeping a strong immunity plays a good role in preventing tonsillitis.

Tonsillitis cannot be prevented easily, and most kids do get it once in their lifetime. But taking the right treatment can prevent the chances of having to undertake a tonsillectomy. By keeping the immunity intact and keeping a balanced diet, a healthy future is not difficult to attain.

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