Tonsillitis

Symptoms

Tonsillitis is a common problem in children, and occurs when viral or bacterial throat infections are localised to the tonsils.  In this case typically the tonsils are enlarged and red, and often have pus spots on the surface.  Children usually have a temperature above 38°C, and a sore throat making it difficult to eat and drink normally.

Tonsillitis differs from the usual coughs and colds that many people suffer (called upper respiratory tract infections).  In these cases the throat  is generally red, but without localised swelling or pus on the tonsils.  Your GP or other medical professionals can be very helpful in distinguishing between these two problems.

Other common symptoms of tonsillitis include a cough, earache (as the nerve to the tonsil also supplies the ear), and swollen glands in the neck.

Treatment

Non-surgical:   For the majority of children, managing mild tonsillitis with pain medication (paracetamol or ibuprofen), and encouraging fluid intake is enough, with subsequent recovery in a few days.  Antibiotics may be required in more severe cases, but if infections are infrequent this may be all that is required.   

Longer term preventative antibiotics, such as azithromycin, can occasionally have a role in reducing recurrent episodes of tonsillitis.  However, antibiotics do not prevent viral tonsillitis, and the infections often recur once the antibiotics are stopped.  Parents frequently seek a solution to the recurrent tonsillitis in order to avoid the regular use of antibiotics.

Surgical

Tonsillectomy (removal of the tonsils) is a very effective treatment for recurrent episodes of moderate and severe tonsillitis.  Based on the national SIGN guidelines (Scottish Intercollegiate Guideline Network), tonsillectomy is usually appropriate if a child has:

Severe infections which are impacting on their normal life, such as school or nursery, and

7 or more infections in one year, or

5 or more infections per year for two years, or

3 or more infections per year for three years