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What are the symptom of tonsillitis?


The main symptom of tonsillitis is a sore throat. It may develop either suddenly or gradually. It may be either mild or severe.

Your child may:

• Find that it hurts to swallow. If the pain is intense, the child may stop swallowing saliva and start to drool.

• Complain of an earache

• Have a fever of 101 degrees Fahrenheit or higher.

• Complain of a headache.

• Complain of a stomachache (this is quite common).

• Complain of general aches and pains, loss of appetite and may vomit.

• Have bad smelling breath.

What does tonsil look like?

When tonsils are infected, they will look redder than usual and swollen.

• A grayish-white or yellowish coating may cover part or all of the tonsils.

• The surrounding area of the throat near the tonsils also may appear red and inflamed. There may be swelling at the sides of the neck as the lymph nodes grow larger while producing cells to fight the infection.

Is tonsillitis ever serious?

Tonsillitis can occasionally become serious. For example, infection may spread beyond the tonsil to form an abscess , which is a localized collection of pus.

• An abscess that forms around an inflamed tonsil is known as a peritonsillar abscess or quinsy. This almost always develops on one side only, and usually in adults rather than children.

• Another type of abscess, one that develops mainly in young children, is a retropharyngeal (behind the throat) abscess . This usually causes high fever and great difficulty in swallowing. If detected very early, peritonsillar or retropharyngeal abscesses can sometimes be treated successfully with antibiotics. In most cases, however, surgery is required to drain the abscess.

Other possible complication

• The most serious complication of tonsillitis is rheumatic fever, which often is accompanied by rheumatic heart disease. Rheumatic fever develops only if the tonsillitis is due to a type of bacterium known as group A beta hemolytic streptococcus. It also usually occurs only in children who have had repeated infections that have not been adequately treated with antibiotics.

• Another complication of streptococcal tonsillitis is a type of kidney disease known as acute glomerulonephritis. However, whether glomerulonephritis can be prevented by early antibiotic treatment of streptococcal tonsillitis is not clear.

• A common complication of tonsillitis is infection of the lymph nodes in the neck, known as cervical adenitis. This type of infection can usually be successfully treated with antibiotics. Occasionally the infection progresses, an abscess forms, and surgery is required to drain it.

• Other possible complications of tonsillitis include middle-ear infections (otitis media) and sinus infections. More often, however, these infections develop at the same time as, or independently of, tonsillitis.

How tonsillitis is treated?

Treatment of tonsillitis aims to relieve its symptoms. Surgery is very rarely required.

• It is not always necessary to identify the exact cause of tonsillitis before beginning treatment, but it generally is advisable to at least determine whether the infection is due to streptococcal bacteria, so that appropriate treatment can be started. A "rapid strep" test is now available. If the test is positive, it is almost certain that your child's tonsillitis is caused by streptococcus bacteria. If the test is negative, a traditional laboratory culture will be needed.

• Tonsillitis caused by streptococcus bacteria must be treated with penicillin or other suitable antibiotics in order to prevent the development of rheumatic fever. Penicillin is the best drug to use, unless your child has an allergy to it. It should be given by mouth for at least 10 days. Taking penicillin for shorter time periods may not completely clear up the infection.

Alternatively, a single intramuscular injection of long-acting penicillin can be given, but this is relatively painful. For children who are allergic to penicillin, other suitable antibiotics are available.

• Tonsillitis due to viruses, like other infections due to viruses, does not respond to any currently known antibiotics.

• Acetaminophen or ibuprofen may relieve sore throat and other symptoms of tonsillitis. Aspirin is best avoided in children of any age because of the risk of Reye's syndrome.

• Tonsillitis may sometimes be due to other types of bacteria that also may respond to antibiotic treatment. Judgments about such treatment should be left to your doctor.